One of the main problems facing IVF patients over 40 years of age is the decline in ovarian reserves. Every woman is born with a finite number of ovarian follicles and while a very small number of these follicles succeed in becoming a mature egg, majority of the rest of the follicles never reach ovulation and are disposed with every menstrual cycle. Around the age of 37, the decline in ovarian reserves becomes very sharp.
As a woman gets older, declining ovarian reserves is not the only problem faced in fertility. As age gets older, so do the follicles in the ovaries. Therefore, another problem called "oocyte aging" becomes more pronounced. This is in fact one of the main reasons why women above the age of 40 are more likely to experience a miscarriage- An aging oocyte will be associated with a number of genetic problems, causing the baby to have genetic mutations, thus leading to a miscarriage.
At North Cyprus IVF Center, we offer a comprehensive treatment approach for 40+ patients, which combines a number of important considerations in terms of ovarian reserves and oocyte aging. Patients who still ovulate, and who still have a minimal level of ovarian activity are ideal candidates for our 40+ treatment program. It is important that the female patient still has at least 1/2 pre-antral follicles to be recruited via controlled ovarian hyperstimulation so that we can offer a chance of success with own eggs. For patients with no ovarian function, then using an Egg Donor becomes the only option.
#1- Cytoplasmic IVF Treatment: Patients who still have a few oocytes, but cannot get pregnancy with those oocytes due to oocyte aging can possibly benefit from our cytoplasmic IVF treatment. The principle here is, we use the genetic material from the patient, but we provide the non-genetic parts of the egg from an egg donor so that the patient's own eggs have a friendlier host for optimal growth. It is a known fact that the mitochondria found in the cell's cytoplasm is responsible for cellular energy production and cell growth. By providing the patient's eggs with donor mitochondria, we allow the eggs to grow more optimally and become more viable.
#2- PGS for Genetic Screening: While Cytoplasmic IVF Treatment will allow your eggs to be more viable with higher fertilization potential, it will not be able to eliminate potential genetic risks associated with the age of the patient. Therefore, pre-implantation genetic screening is a good idea to make sure only the genetically correct embryos are transferred into the uterus. Keep in mind that we are not aiming for just any pregnancy. We are aiming for a healthy and viable pregnancy.
#3- Embryo Batching: Given that IVF treatment after a certain age will only allow us to have just a few eggs, any method that will allow us to get more eggs will increase our chances of success. Therefore, while we will be providing your eggs with a better host for optimal growth via cytoplasmic transfer, we still need a certain number of eggs so that we can make sure in the end we have at least one well-grown, genetically correct embryo to transfer. Embryo batching is the key component of success in this age bracket. Combining two rounds of IVF cycles into one allows us to get double the number of eggs- Essentially, what we do is, we prepare you for one round of IVF cycle where we collect the eggs, infuse them with donor cytoplasm, fertilize into embryos and freeze. Once you are ready for the second round, we collect another set of eggs, repeat the same procedures and make a new batch of embryos. With the two sets of embryos at hand, we proceed with pre-implantation genetic screening (PGS) and select a chromosomally normal embryo for transfer, thus giving you the maximum chance of success possible using your own eggs.
We give your eggs the maximum chance of survival through cytoplasmic transfer - we collect two rounds of eggs to increase your likelihood of success by creating multiple embryos - We make sure the embryos to be transferred are chromosomally euploid through PGS testing. This is how we are able to offer you the maximum chance of success possible with your own eggs.
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Improvements in IVF technologies enable us to incorporate the use of additional techniques and procedures into our daily IVF practice. One such innovation in fertility treatments is Cytoplasmic IVF Treatment, sometimes referred to as the "Three parent Family". While the "Three parent family" has an interesting ring to it, it is more of a catchy phrase rather than being a fully correct statement.
Cytoplasmic IVF Treatment at North Cyprus IVF Centre has been offered since 2012. While it has been almost three years since we have brought this concept into practice, it is important to mention that this treatment is still in its infancy years and the number of cases performed are still far from creating accurate and statistically significant numbers. However, data so far suggests that cytoplasmic transfer is able to increase success rates by 4 to 5 percent compared to standard IVF/ICSI treatments.
What is Cytoplasmic IVF Treatment?
Cytoplasmic IVF Treatment is the treatment option suited for two types of patients:
- Patients with known mitochondria defects
- Patients in older age brackets with likely mitochondria defects due to oocyte aging.
As women age, so do their eggs. Just like any cell, the egg cells is consisted of a nucleus, which contains the genetic material as well as a cytoplasm, which surrounds the nucleus. Within the cytoplasm, there are many other organelles. One of the most important organelles in the the cell is mitochondrion (plural, mitochondria). Mitochondria are responsible for providing the cell with its energy, which facilitates cellular growth and development. As the oocyte (egg cell) ages, so do the mitochondria found within the egg cell. As the mitochondria age, they fail to provide sufficient amount of energy for growth and development, therefore, the egg cells start to lose their viability. This is precisely where cytoplasmic IVF treatment gets in the picture.
With cytoplasmic IVF treatment, a young, healthy and pregnancy proven egg donor is used, very much like an egg donation program. However, it is not the eggs, or the genetic material inside her eggs that we are interested in. Rather, we are interested in the cyoplasm of the donor's eggs. In cytoplasmic IVF treatment, we extract the cytoplasm of the donor's eggs and inject it into the eggs of the recipient. That way, we can provide a healthier cytoplasm (therefore mitochondria) for the growth and development of the recipient's eggs. In a way, we make the recipient's eggs' host environment more friendly for growth. This provides us with a higher chance of IVF success when the own eggs of a patient is used in more advanced age brackets.
However, it should be known that this treatment also has its limits. This is a treatment option which provides a healthier host for the growth and development of your own genetic material. This is not a method that can correct and genetic problems with your eggs that may come with age. If the main reason why you are not able to fall pregnant or experience miscarriages is due to genetic problems associated with oocyte aging, then cytoplasmic IVF treatment is not likely to generate desired results and in such cases, IVF with egg donation should be considered.
IVF with cytoplasmic transfer is mostly recommended for patients with known mitochondrial DNA defects, or patients in more advanced age brackets who still have some ovarian activity, but standard IVF treatments fail to succeed even though the patient has viable oocytes during treatment.
Please check out our "Cytoplasmic IVF Treatment" page for more information.
Dr. Savas Ozyigit
Egg donation in Cyprus, Gender selection in Cyprus and IVF treatments in North Cyprus in general: you will find information on new advances in IVF technology and latest IVF practices. All the blogs are personally written by Dr. Savas Ozyigit and his expert medical team.