PGT-A : PGT for Aneuploidy Screening 1

PGT-A refers to screening chromosomal constitution of embryos to identify and select euploid embryos for transfer. The aim of this application is to : 1. Ensure higher implantation rate 2. Decrease spontaneous abortion rate 3. Prevent the birth of a syndromic child 4. Decrease time to achieve pregnancy.

PGT-A : PGT for Aneuploidy Screening 2

Since the PGT-A procedure does not require patient-specific test preparation like other PGT techniques, it can be planned upon patient’s decision during the IVF treatment. NGS technology is the most commonly used gold standard technology for aneuploidy screening and mosaicism detection.

PGT-M PGT for Monogenic / Single Gene Defects and Aneuploidy 1

Eventhough single gene disease patients are relatively young and fertile couples, pregnancy rates obtained following PGT-M application is not satisfying for the family and physicians, who are trying to manage such a difficult process. Chromosomal disorders such as Down Syndrome are frequently observed in embryos found suitable for transfer after PGT-M. Therefore, aneuploidy screening has a significant importance in single gene disease cases.

PGT-M PGT for Monogenic / Single Gene Defects and Aneuploidy 2

With the spread of trophectoderm biopsy and vitrifcation methods together with the development of whole genome amplifcation technologies, both single gene disease testing in embryos and euploid embryo selection with 24 chromosome screening became possible.When embryos are included in 24 chromosome aneuploidy test in addition to single gene disease screening, it was reported that pregnancy rate increases from 45% to 68% and spontaneous abortion rate decreases from 15% to 5%.

PGT-SR PGT for Chromosomal Structural Rearrangements 1

Embryos of couples carrying chromosomal structural rearrangements (resiprocal translocation, Robertsonian translocation or inversion) might be abnormal and infertility/subfertility problems might be observed in some cases. In these cases, selection of balanced/normal embryos is possible with PGT-SR using FISH or NGS technology depending on the karyotype of the couple.

PGT-SR PGT for Chromosomal Structural Rearrangements 2

In preimplantation genetic test of segmental aneuploidies, NGS technology can theoritically detect 10 mb partial deletions and duplications. Using patient tailored bioinformatic algorithms, enriched amplification and deep reading we can detect translocations as small as 2 mb. “ We provide solutions for chromosomal abnormalities; even as small as 2 mb.“

Combined PGT PGT for Monogenic / Single Gene Defects and Aneuploidy 1

Eventhough single gene disease patients are relatively young and fertile couples, pregnancy rates obtained following PGT-M application is not satisfying for the family and physicians, who are trying to manage such a difficult process. Chromosomal disorders such as Down Syndrome are frequently observed in embryos found suitable for transfer after PGT-M. Therefore, aneuploidy screening has a significant importance in single gene disease cases.

Combined PGT PGT for Monogenic / Single Gene Defects and Aneuploidy 2

With the spread of trophectoderm biopsy and vitrifcation methods together with the development of whole genome amplifcation technologies, both single gene disease testing in embryos and euploid embryo selection with 24 chromosome screening became possible.When embryos are included in 24 chromosome aneuploidy test in addition to single gene disease screening, it was reported that pregnancy rate increases from 45% to 68% and spontaneous abortion rate decreases from 15% to 5%.

PGT Preimplantation Genetic Testing 1

Mikrogen Preimplantation Genetic Testing Services: * Mikrogen Preimplantation Genetic Testing for Aneuploidy (PGT-A) * Mikrogen Preimplantation Genetic Testing for Monogenic/Single Gene Defects (PGT-M) : Single Gene Disorders / Late Onset Inherited Diseases / Inherited Cancers / HLA-Genotyping * Mikrogen Preimplantation Genetic Testing for Chromosomal Structural Rearrangements (PGT-SR)

PGT Preimplantation Genetic Testing 2

Planning the Genetic Test: Why Mikrogen? ◆ Concurrent access to current technologies and developments. ◆ Secure services under ISO 15189 accreditation. ◆ Personalized treatment plans for all medical applications. ◆ First laboratory in Turkey to perform embryo screening with NGS. ◆ Large test panel (over 2000) to provide all the tests you need. ◆ More than 20 years of experience in reproductive genetics.

ER Map Endometrial Receptivity Map 1

What is endometrialreceptivity? The endometrium is the inner layer of the uterus where embryo implantation takes place. It undergoes periodic changes throughout the enstrual cycle and it reaches a receptive status, when it is ready for embryonic implantation, around day 19-21 of the cycle. This period of time is known as the “window of implantation” (WOI) and it occurs 7 days after the peak of endogenous LH (LH+7).

ER Map Endometrial Receptivity Map 2

Personalised et Scheduling RECEPTIVE: The WOI matches the day on which the biopsy was taken / ET and BT stage should be scheduled on the same day and type of cycle on which the biopsy was taken. NON-RECEPTIVE: Pre or post receptive / The WOI is displaced / A new endometrial biopsy needs to be obtained to confirm this displacement. / Once the WOI is identified, a personalised embryo transfer is scheduled.

Andrology Genetics 1

High Sperm DNA fragmentation (SDF) is negatively associated with semen quality, the fertilisation process, embryo quality, and pregnancy outcome. Intra/inter-laboratory variation of currently used SDF techniques limits their accuracy. Flow Cytometric SDF (FC-SDF) assay has gained clinical importance compared to commonly used techniques due to it’s sensitivity (due to analysis of large number of sperm cells) which enables quantitative and subjective test results.

Andrology Genetics 2

Flow Cytometric Sperm Precursor Cell Analysis It is important to understand that in classical analysis method only the mature sperm cellscan be detected in the microscopic examination . This examination is subjecitve, depends highly on user experinece and has Intra/inter-laboratory variation that limits its accuracy. For this reason, it is highly probable that any cell entity belonging to the spermatogenic line is skipped in the TESE or semen specimens. This test enables

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