Short Curriculum Vitae
Dr. Kemal Ozgur completed his primary and secondary education at TED Ankara College. Dr. Ozgur graduated from Hacettepe University Faculty of Medicine in 1987, and then underwent an internship education in Obstetrics and Gynecology in Israel at the Telaviv University Faculty of Medicine. Afterwhich he continued his specialist training in Obstetrics and Gynecology at the Akdeniz University Faculty of Medicine. As a qualified specialist he held the position of associate professor in the Obstetrics and Gynecology department. During this time he established an Assisted Reproduction Technology (ART) unit at the university and served as its first Director. To continue his education and training in Fertility he then worked as a researcher in the Department of Reproductive Endocrinology, University of Stellenbosch Faculty of Medicine, in Tygerberg, South Africa, for 6 months and then as a research fellow at the Jones Institute, Norfolk, Virginia, USA for 2 years. On his return to Antalya, Turkey he established Antalya IVF in 2000, a private ART center providing all fertility related services. As Clinic Director he has seen the clinic grow from 200 IVF cycles to the current 1700 IVF cycles a year. Dr. Ozgur has also published numerous scientific studies in peer-reviewed IVF journals and has also presented numerous scientific studies both nationally and internationally at IVF congresses.
Session - 1
09:00 AM - 09:20 AM
Current evidence on freeze all. [Dr. Kemal Ozgur]
Purpose In segmented ART treatment or so-called ‘freeze-all’ strategy fresh embryo transfer is deferred, embryos cryopreserved, and the embryo transferred in a subsequent frozen embryo transfer (FET) cycle. The purpose of this cohort study was to compare a GnRHa depot with an oral contraceptive pill (OCP) programming protocol for the scheduling of an artificial cycle FET (AC-FET) after oocyte pick-up (OPU).
Methods This retrospective cohort study was conducted on prospectively performed segmented ART cycles performed between September 2014 and April 2015. The pregnancy, treatment duration, and cycle cancellation outcomes of 170 OCP programmed AC-FET cycles were compared with 241 GnRHa depot programmed AC-FET cycles.
Results No significant difference was observed in the per transfer pregnancy and clinical pregnancy rates between the OCP and GnRHa groups, 72.0 versus 77.2 %, and 57.8 versus 64.3 %, respectively. Furthermore, the early pregnancy loss rate was non-significantly different between the OCP and GnRH protocol groups, 19.8 versus 16.7 %, respectively.
However, nine (5.29 %) cycles were cancelled due to high progesterone in the OCP protocol group, while no cycles were cancelled in the GnRHa protocol group and the time taken
Session - 3
13:30 PM – 13:50 PM
Current evidence on IVF augmented with PGS. [Dr. Kemal Ozgur]
Parallel innovations in laboratory technologies and procedures over the last decade has seen the reproductive outcomes of IVF improve significantly. In vitro culture technology innovations have led to increased blastulation rates and as a result blastocyst transfers, with a concomittant increase in reported implantation rates. Cryopreservation technology innovations have led to the reporting of survival rates consistently >90%, with the use of vitrification. Comprehensive chromosome screening (CCS) innovations have led to clinically recognizable error rates of <0.5%, with single embryo transfers (SET) of screened embryos resulting in live birth rates equivalent to multi-embryo embryo transfers (ET) of unscreened embryos. Importantly, the increased survival rates of developmentally competent vitrified-warmed blastocysts have resulted in the increased use of frozen embryo transfers (FET), with implantation and live birth rates reported to be at least equivalent to those of fresh blastocyst transfers. With the reproductive outcomes of FET no longer inferior to those of fresh ET, clinicians have the opportunity to investigate how to exploit the benefits (i.e. endometrial receptivity) of FET and the optimal scheduling of procedures for transferring all embryos into physiologically normal intrauterine conditions of FET. The freeze-all strategy known as segmented-IVF has been purported to be a viable alternative to conventional IVF, especially if any conditions resulting from controlled ovarian stimulations (COS) have the potential to adversely affect the reproductive outcomes of fresh ET. Moreover, by combining blastocyst culture, blastocyst CCS, blastocyst vitrification, and blastocyst FET may achieve the best possible live birth outcomes in IVF.
Session - 5
16:30 PM – 16:50 PM
Does duostim delivery on its promises: routine ART practice. [Dr. Kemal Ozgur]
Study objective: To investigate the efficacy of DuoStim (dual phase ovarian stimulation) in infertile patients with a poor ovarian response (POR) after follicular phase ovarian stimulation (FPOS).
Background: Studies have shown that it might be possible to increase the number of oocytes retrieved in poor ovarian response patients by performing DuoStim, thereby, increasing the effectivity of a single IVF treatment.
Materials and methods: All patient-couples included in this retrospective observational study underwent autologous ICSI with the intention of blastocyst freeze-all and FET between May 2017 and August 2018. Patients underwent conventional ovarian stimulation (OS) in both the FP and luteal phase (LP), with FPOS starting on day 2 of the cycle and LPOS starting on the day of FPOS oocyte retrieval. All patients underwent a transvaginal ultrasound (TVS) clinical examination on day 2 of their cycle, to assess ovarian reserve (OR), with DOR patients counselled on the possibility of DuoStim. POR patients underwent Duostim on clinical assessment at FPOS oocyte retrieval; ≤5 oocytes were retrieved after FPOS and at least 4 antral follicles of ≥5mm were present. In Duostim patients, follicles ≤10-12mm were not aspirated at FPOS oocyte retrieval.
Results: In total 60 patients underwent DuoStim during the study period. The median age of the patients who underwent Duostim was 36.1 (32.6-38.8) years and their median antral follicle count (AFC) was 6.0 (3.0-9.0). The LPOS duration was significantly shorter than FPOS. The median oocyte number, mature oocyte rate, and blastocyst rate were not significantly different for FPOS and LPOS. More FPOS resulted in the development of blastocysts for cryopreservation (26 vs 20). There was also no significant difference in the per transfer pregnancy rates of FPOS and LPOS (70.5% vs 66.7%)
Conclusion: DuoStim increases the efficacy of IVF in POR patients, with the chance of freeze-all increasing from 43.3% to 58.3%.