IN VITRO ACTIVATION PROGRAMME AT NEAR EAST UNIVERSITY

We offer a reliable IVF treatment with your own eggs before egg donation…

Infertility patients with Diminished Ovarian Reserve (DOR: Low number of Oocytes) and Premature Ovarian Failure (POF: Premature Menopause with No Oocytes) constitute the most difficult group to successfully treat with In Vitro Fertilization (IVF). Pregnancy rates for this group of patients are usually less than 5%, and they are generally offered to do IVF using Donated Oocytes. Recently, In Vitro Activation (IVA) of dormant follicles by Ovarian Fragmentation (Hippo Signaling Disruption) and AKT Stimulation (IVA Drug Treatment: PTEN Inhibition and PI3K Stimulation) in patients with DOR and POF resulted in pregnancies and live births. IVA gives the patients hope of getting pregnant with own eggs, and may be tried before IVF with Egg Donation.

Reproductive Medicine Department at Near East University Hospital designed this IVA programme for patients with DOR and POF.

1. Transvaginal Ovarian Biopsy (TVOB)

Transvaginal Ovarian Biopsy (TVOB) will be performed using a 1 cm TruCat Biopsy Device under Transvaginal Ultrasound guidance and general sedation, in order to confirm the existance of follicles.

2. Laparoscopic Ovarian Fragmenting

(LOF)Laparoscopic Ovarian Fragmenting (a linear midline incision plus multiple 1-2 mm perpendicular cuts) will be performed on one ovary, and a 0.5×1 cm piece of the operated (LOF) ovary will be removed, fragmented In Vitro, and transplanted under the non-operated (control) ovary during the same laparoscopy session.

3. IVF Cycle
IVF Cycle will be started with the menstruation. Follicle development will be followed and oocytes will be retrieved from the Control, LOF and Transplanted ovaries. After ICSI, embryos will be transferred.

SUCCESS OF DRUG-FREE IVA

Drug-Free IVA, in other words, IVA with Ovarian Fragmentation and Transplantation, was successfully done and reported by mainly 2 groups:
Saint Mother Hospital, Kitakyushu, Japan/ Tanaka et al, Fert Stert, October, 2018.
Copenhagen University, Denmark/ Lunding et al, Fert Stert, December, 2018.
Tanaka et al reported 18.4% pregnancy rate in patients with DOR

SUCCESS OF IVA WITH FOLLICLE ACTIVATION DRUG TREATMENT

Kazuhiro Kawamura of Saint Marianne University/Japan was the first to show In Vitro Activation (IVA) of dormant follicles by Ovarian Fragmentation (Hippo Signaling Disruption) and AKT Stimulation (IVA Drug Treatment: PTEN Inhibition and PI3K Stimulation) in patients with DOR and POF may result in pregnancies and live births. Kawamura et al reported pregnancies either with vitrified-thawed or freshly (together with a Chinese team at Zhengzhou University) transplanted ovarian tissue. In patients with histologically proven existence of follicles, pregnacy rates were up to 18.4%.

IVA PROGRAMME AT NEAR EAST UNIVERSITY

Transvaginal Ovarian Biopsy (TVOB) and IVF will be performed in IVF Center, and Laparoscopic Ovarian Fragmenting will be done Operating Theater at Near East University Hospital.

IVA Programme will be performed by:

Professor Namik Kemal Duru, MD, OB&GYN
Assistant ProfessorAli Cenk Ozay, MD, OB&GYN
Assistant ProfessorOzlen Emekci Ozay, MD, OB&GYN
Assistant Professor Hanife Ozkayalar, MD, Pathologist
Associate Professor Suha Akpınar, MD, Radiologist
Yasemin Turkcan Cavdarlı, Embryologist