IUI ve ICSI’de laboratuvar süreci

Yardımla üreme tedavilerinde (YÜT) kullanılan sperm hazırlama yöntemleri, temelde in vivo koşulları taklit ederek in vitro koşullarda kaliteli spermin seçimini ve düşük kaliteli spermleri elemeyi amaçlamaktadır. Buna rağmen klasik ya da geliştirilen yeni yöntemlerde başarı hala istenilen düzeyde bulunmamaktadır. YÜT’ün başarısını arttırmak için in vivodaki seçim mekanizmalarının daha iyi anlaşılması ve seçilen spermlerin özelliklerinin belirlenmesi, spermin uygun olarak hazırlanması ve canlı doğum oranlarının arttırılmasına ihtiyaç duyulmaktadır. Doğru spermin seçimi tek başına başarı açısından oldukça önemlidir. Özellikle ICSI işlemi sırasında, spermin motilite, morfoloji ve vitalite (canlılık) durumu değerlendirilerek fertilizasyon ve iyi embriyonun geliştirilmesi sağlanmaktadır. Kullanılan geleneksel hazırlık yöntemlerinde spermler sedimantasyon yada migrasyon eğilimlerine göre ayrılarak, morfoloji ve motilite kriterlerine göre seçimleri gerçekleştirilmektedir. Spermin apoptoz ve benzeri belirtileri, DNA bütünlüğü, membran maturasyonu, foksiyonel mitokondri durumu ve ultra yapısı gibi spermin diğer karakteristik özellikleri tespit edilememektedir. Bu özelliklerin anlaşılmasını sağlayan yeni yöntemler kullanılmakta ve oldukça olumlu sonuçlar alınmaktadır. Fakat en iyi metodu seçmek için daha fazla randomize kontrollü çalışmaya ihtiyaç duyulmaktadır.

Laboratory procedure of IUI and ICSI

Basically, the sperm preparation methods which are used in assisted reproductive treatments (ART), aim to eliminate low quality sperm and select the quality sperm in vitro conditions by simulating in vivo conditions. Nevertheless, success rate is still under the desired goal in the classical or new developed methods. A better understanding of the selection mechanisms in vivo, determination of the characteristics of selected sperm, appropriately preparation of sperm, and increasing live birth rates are needed to increase the success of ART. Choosing the good quality sperm is very important for ART success. Especially during the ICSI procedure, sperm motility, morphology and vitality status are evaluated before choosing and fertilization and good embryo development are provided. In the traditional preparation methods, sperms are separated in respect of their tendency of sedimentation or migration and they selected according to their morphology and motility criteria. Apoptosis and similar symptoms of sperm, DNA integrity, membrane maturation, functional mitochondria status, ultrastructure and other characteristics of sperm cannot be determined. Besides, new methods are used which ensure understanding of these features and correspondingly promising results are obtained. But, to select the best method, there must be more randomized controlled study.

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