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Rosi Technique

What is the New Generation of ROSI? What is Not?

’’ In February 2019, the Centrum Clinic IVF Team announced its first ROSI pregnancy. This situation was actually only the visible part of the iceberg. Because Prof. Dr. Recai Pabuçcu and his team had gone to Dr. Tanaka and his team from Japan where the foundations of the ROSI technique were laid and which had the largest ROSI series in the world. The team arrived in Turkey at the end of this education process and has achieved the first pregnancy in Turkey with their modern ROSI technique. In summary, the ROSI technique in the modern sense will be the glimmer of hope for thousands of families.

What we call azoospermia is having semen in man but there is no live sperm cells in the semen. One percent of men have azoospermia in population and thirty percent of men consulting for infertility have azoospermia, too.

What is ROSI technique? What is the difference from a classic test tube baby?

Before we talk about the ROSI technique, we must understand the stages of sperm production. Sperm production is a complex process that takes about 90 days. In this process;

-Spermatogonium (most precursor cell)

-Spermatocytes (precursor cells)

-Spermatid (premise)

-Spermatozoa (mature) cells enter the maturation process respectively.

Among these cells which we mentioned above, mature cell is the best fertilization capacity. However, since these cells are not present in azoospermia men, mature sperm cells are examined in the tissues taken from the testis. Testicular biopsy is called TESE. In the TESE procedure, up to 30-40% of men have mature sperm, but for men that cannot be found, the process can be a bit problematic. In this case, if there are no mature cells, the precursors are investigated and especially the spermatid precursors have a round or elonge sperm cell. Under normal conditions, these precursor cells are not capable of fertilizing the egg. However with the generation ROSI technique, this premise makes it possible for round and long sperm cells to fertilize the egg. Special technologies and techniques are used for this process.

In classical IVF technique, mature sperm cells are collected from the ejected semen sample, the best is selected and given into the egg. In the ROSI method, since there are no mature sperm cells in the semen, the procedure cannot be performed. The round cells extracted from the tissue obtained by TESE are introduced into the oocyte.

What are the chances of finding a round-precursor cell in a new ROSI cycle in people who have not previously had cells in TESE?

In the ROSI cycle, a new TESE procedure is performed and there may be a pre-treatment process. TESE, which is done to people who will be applied ROSI technique can have approximately 30% precursor-round cells.

Who can benefit from the ROSI technique?

People with a diagnosis of azoospermia that have not previously found mature sperm cells in the semen can benefit from this technique. However, mature sperm cells can be obtained in approximately half of these people after TESE. In this situation, the use of mature sperm cells is already a great advantage. However, people who have undergone a TESE procedure without any mature sperm cells may benefit from the ROSI technique.

Is the embryo healthy obtained with the ROSI technique?

Yeah. Up to now, we know that embryos obtained with the ROSI Technique do not pose a serious problem both in fertilization and genetics. However, we are still in an early process to reach a clear conclusion on the issue.

What are used in ROSI technique? Can Every Test Tube Center Do ROSI?

ROSI Technique is a technique that requires both mastery and equipment. This means that all centers cannot be fully implement the ROSI technique. Especially, the steps of extracting the precursor round cells and inserting them into the eggs are steps which require very fine workmanship. In addition, for ROSI operation you need to have a special machine. In other words, ROSI must be applied in experienced centers.

What is the chance of pregnancy with the ROSI technique? Is it better or worse than normal IVF?

Approximately percentage of 10-20 pregnancy success and percentage of 10 live birth success are predicted for per application with ROSI Technique. So, there is less chance of pregnancy than standard IVF treatment. In addition, the low rate with the ROSI technique is slightly higher so there is a possibility of pregnancy loss of about percentage of 30-40.

What options are there for couples who did not have a Sperm Cell in TESE before but also did not want ROSI?

The head of these is stem cell methods but today's technology has not yet been able to obtain a healthy birth from stem cells. So there is some time to stem cell. Another option is sperm donation but the legal legislation in our country does not give permission to this situation. Finally, the adoption option is also available.

Are children born with the ROSI technique healthy?

Up to now, more than 90 live births have occurred. Maybe this number can be expressed today with 300s. The data is based on the large ROSI series published in 2017.So far, 90 children were born healthy only 3 of them were unhealthy. In addition, consciousness and mind development are compatible with their peers.

Is ROSI performed at Centrum Clinic?

We have been implementing this process since February 2019.Equipment is being used from Japan. So far, more than 100 ROSI techniques have been applied in vitro fertilization and we achieved a total of 12 pregnancies.

The New Generation of ROSI-Summary in 7 steps:

1) Assessment of the situation of man and woman.

2) Asking hormone analysis to man and treatment with 6-8 weeks according to situation.

3) When the treatment is over for man, start of egg augmentation on the 2nd or 3rd day of menstruation for spouse.

4) Collection of mature eggs and the searching of sperm cells by biopsy from the testes called TESE at the same time

5) If there are mature sperm cells with mature cells or premature fertilization of the egg with round or long sperm cells.

6) Stimulation of the eggs to be fertilized by special electrical activation.

7) Transfer of obtained embryos.