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YARDIMCI ÜREME TEKNİKLERİ VE HEMŞİRELİK YAKLAŞIMI

Year 2020, Volume: 3 Issue: 1, 55 - 75, 19.12.2020

Abstract

Küresel bir sorun olan infertilite, fertil çağdaki eşlerin %8 ve %12’lik kısmını etkilemekte ve kişisel, toplumsal ilişkilerde sorunlar meydana getirmektedir. Bireylere hastalığın nedenleri incelenerek çeşitli tedavi yöntemleri uygulanmaktadır. Yardımcı üreme teknolojisi son zamanlarda birçok infertil çiftin çocuk sahibi olmalarını sağlamaktadır. Son yıllarda çoğu gelişmiş ülkedeki doğumların %1-2’sini oluşturmak için yardımcı üreme teknolojisi doğum sıklığı hızla artmakta ve buna bağlı bireylerde komplikasyonlar ve psikolojik sorunlar ortaya çıkmaktadır. Hemşireler, infertil çiftlerin tedavi sürecinde büyük sorunların krize dönüşmemesi ve çözümlenmesi adına uygulamalara katkıda bulunmaktadırlar. Yardımcı üreme teknikleri etkili tedavi ve bakımın sağlanması adına kalite ve etkinliği optimize etmek için hemşirelerin mesleki gelişimlerine ihtiyaç duymaktadır.

References

  • 1. Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clinical Biochemistry. 2018; 62: 2-10. 2. Kızılkaya Beji N. İnfertilite. Hotun Şahin N, Bilgiç D. (Ed.), Kadın Sağlığı ve Hastalıkları. Genişletilmiş İkinci Baskı, İstanbul, Nobel Tıp Kitapevleri; 2016. s. 141-145. 3. Remião, MH, Segatto NV, Pohlmann A, Guterres SS, Seixas FK, Collares T. The Potential of Nanotechnology in Medically Assisted Reproduction. Frontiers in Pharmacology. 2018; 8:1-9. 4. Shahraki Z, Tanha FD, Ghajarzadeh M. Depression, sexual dysfunction and sexual quality of life in women with infertility. BMC Women’s Health. 2018; 18: 92. 5. Ying L, Wu LH, Loke AY. Gender differences in emotional reactions to in vitro fertilization treatment: a systematic review. Journal Assisted Reproduction Technologies. 2016; 33(6), 689-701. 6. Çağlar M, Yeşiltepe Oskay Ü. İnfertilite ve cinsel yaşam üzerine etkileri. Jaren. 2020; 6(1): 157-62. 7. Meran Partovi HE, Kızılkaya Beji N. İnfertilite hemşireliğinin tarihçesi. Androloji Bülteni. 2016; 18: 60–4. 8. Williams M, Green L, Roberts K. Exploring the needs and expectations of women presenting for hysterosalpingogram examination following a period of subfertility: A qualitative study. International Journal of Clinical Practice. 2010; 64(12): 1653–1660. 9. Çetin C, Çetin MT. Dünden bugüne yardımla üreme teknikleri. Arşiv Kaynak Tarama Dergisi, 2014; 23(1): 148-155. 10. Yüksel UDY. (2019). Sperm Hazırlama Teknikleri. Her Yönüyle İn Vitro Fertilizasyon, 76. 11. Miyaoka R. Esteves SC. Sperm Retrieval Techniques. In Male Springer, Cham. Infertility. 2020; 621-635. 12. Coward RM, Mills JN. Obstrüktif azospermi için ofis bazlı sperm alımı için adım adım kılavuz. Öteleme Androlojisi ve Ürolojisi. 2017; 6(4): 730-744. 13. Arıcı A. Yardımcı üreme teknikleri. Türkiye Aile Planlaması Vakfi Görünüm Dergisi. 2012; 2-15. 14. Taşkın L. Doğum ve Kadın Sağlığı Hemşireliği. 16. Baskı, Ankara, Özyurt Matbaacılık; 2019. s. 569-575. 15. Kamath MS, Bhave P, Aleyamma TK, Nair R, Chandy A, Mangalaraj AM, Muthukumar K, George K. Predictive factors for pregnancy after intrauterine insemination: A prospective study of factors affecting outcome. Journal Human Reproductive Science. 2010; 3: 129-134. 16. Boomsma CM, Heineman MJ, Cohlen BJ, Farquhar C. Semen preparation techniques for intrauterine insemination. Cochrane Database Syst Rev. 2007; (4):CD004507. 17. Dikencik BK. Yardımcı üreme teknikleri. İn: Beji NK, ed. İnfertilite Sorunu, Yardımcı Üreme Teknikleri ve Hemşirelik Yaklaşımı. İstanbul, Emek Matbaacılık, 2001. s. 25-55. 18. Speroff L, Fritz MA. Klinik jinekolojik endokrinoloji ve infertilite. İn: Erk A, Günalp S, editors. 7. Baskı, İstanbul, Güneş Tıp Kitap Evleri; 2007. 19. Dancet EAF, VanEmpel IWH, Rober P, Nelen WLDM, Kremer JAM, D’Hooghe T.MPatent-centred infertility care: a qualitative study to listen to the patient's voice. Human Reproduction. 2011; 26: 827–833. 20. Huang LH, Kuo CP, Lu YC, Lee MS. Lee SH. Association of emotional distress and quality of sleep among women receiving in-vitro fertilization treatment. Taiwanese Journal of Obstetrics and Gynecology. 2019; 58(1): 168–172. 21. Sazonova A., Källen K., Thurin-Kjellberg A., Wennerholm U.B., Bergh C. Neonatal and maternal outcomes comparing women undergoing two in vitro fertilization (IVF) singleton pregnancies and women undergoing one IVF twin pregnancy. Fertil. Steril. 2013; 99(3): 731–737. 22. Practice Committee of American Society for Reproductive Medicine; Practice Committee of Society for Assisted Reproductive Technology. Criteria for number of embryos to transfer: a committee opinion. Fertility and Sterility. 2013; 99: 44–6. 23. SB. Üremeye Yardımcı Tedavi Uygulamaları ve Üremeye Yardımcı Tedavi Merkezleri Hakkındaki Yönetmelik. Sağlık Bakanlığı (SB) Resmi Gazete; 2010. 24. Haydardedeoğlu B, Kılıçdağ EB. A novel approach using a minimal number of injections during the IVF/ICSI cycle: Luteal half-dose depot GnRH agonist following corifollitropin alfa versus the corifollitropin alfa with a GnRH-antagonist cycle. Journal of the Turkish German Gynecological Association. 2016;17(3):155–158. 25. Siristatidis C, Sergentanis TN, Kanavidis P, Trivella M, Sotiraki M, Mavromatis I., ... Petridou ET. Controlled ovarian hyperstimulation for IVF: impact on ovarian, endometrial and cervical cancer—a systematic review and meta-analysis. Human reproduction update. 2013; 19(2): 105-123. 26. Albuquerque LET, Tso, LO, Saconato H, Albuquerque MCR, Macedo CR. Depot versus daily administration of gonadotrophin‐releasing hormone agonist protocols for pituitary down regulation in assisted reproduction cycles. Cochrane Database of Systematic Reviews. 2013; 1: CD002808. 27. Howie R, Kay V. Controlled ovarian stimulation for in-vitro fertilization. British Journal of Hospital Medicine. 2018; 79(4): 194–199. 28. D'Angelo A, Panayotidis C, Amso N, Marci R, Matorras R, Onofriescu M, Turp A.B, Vandekerckhove F, Veleva Z, Vermeulen N, Vlaisavljevic V, Recommendations for good practice in ultrasound: oocyte pick up†. Human Reproduction Open. 2019; (4): hoz025. 29. Weiss A, Neril R, Geslevich J, Lavee M, Beck-Fruchter R, Golan J, Shalev E. Lag time from ovulation trigger to oocyte aspiration and oocyte maturity in assisted reproductive technology cycles: a retrospective study. Fertility and Sterility. 2014; 102: 419–423. 30. Ubaldi F, Vaiarelli A, D’Anna R, Rienzi L. Management of poor responders in IVF: is there anything new? Biomed Research International. 2014; 2014:352098. 31. Doan HT, Quan LH, Nguyen TT. The effectiveness of transdermal testosterone gel 1% (androgel) for poor responders undergoing in vitro fertilization. Gynecol Endocrinol. 2017; 33(12): 977-9. 32. Bahçe M. Preimplantasyon Genetik Tanı Uygulamalarında Güncel Yaklaşımlar. Türkiye Klinikleri Tıbbi Genetik. 2018; 3(1): 91-6. 33. Chen HF, Chen SU, Ma GC, Hsieh ST, Tsai HD, Yang YS. Chen M. Preimplantation genetic diagnosis and screening: Current status and future challenges. Journal of the Formosan Medical Association. 2018; 117 (2), 94-100. 34. Simpson JL, Kuliev A, Rechitsky S. Improving assisted reproductive technology pregnancy rates: excluding aneuploid and interrogating euploid embryos. Fertility and Sterility. 2015; 104(3): 557-558. DOI: 10.1016/j.fertnstert.2015.06.017. 35. Schmutzler AG, Strowitzki T. "Global state of preimplantation genetic diagnosis. Frequency of application and indications." Gynakologische Endokrinologie. 2014; 3(1): 571-576. 36. Kahraman S, Beyazyurek C, Yesilipek MA, Ozturk G, Ertem M, Anak S, et al. Successful haematopoietic stem cell transplantation in 44 children from healthy siblings conceived after preimplantation HLA matching. Reproductive biomedicine online. 2014; 29(3): 340- 51. 37. Giarelli E, Reiff M. Genomic literacy and competent practice: call for research on genetics in nursing education. Nursing Clinics. 2012; 47(4): 529-545. 38. Maheshwari A, Bhattacharya S, Bowler U, Brison D, Child T, Cole C., Troup S. Study protocol: E-freeze- freezing of embryos in assisted conception: a randomised controlled trial evaluating the clinical and cost effectiveness of a policy of freezing embryos followed by thawed frozen embryo transfer compared with a policy of fresh embryo transfer, in women undergoing in vitro fertilisation. Reproductive Health. 2019; 16(1): 2-11. 39. Berntsen S, Pinborg A. Large for gestational age and macrosomia in singletons born after frozen/thawed embryo transfer (FET) in assisted reproductive technology (ART). Birth Defects Research. 2018; 110(8): 630–643. 40. Coates A, Kung A., Mounts E, Hesla J, Bankowski B, Barbieri E, Munné S. Optimal euploid embryo transfer strategy, fresh versus frozen, after preimplantation genetic screening with next generation sequencing: a randomized controlled trial. Fertility and sterility. 2017; 107(3): 723-730. 41. Westlander G. Utility of micro-TESE in the most severe cases of non-obstructive azoospermia. Upsala Journal of Medical Sciences. 2020; 1–5. 42. Rosenwaks Z, Pereira N. The pioneering of intracytoplasmic sperm injection: historical perspectives. Reproduction. 2017; 154(6): F71–F77. 43. Palermo GD, O’Neill CL, Chow S, Cheung S, Parrella A, Pereira N, Rosenwaks Z. Intracytoplasmic sperm injection: state of the art in humans. Reproduction. 2017; 154(6): F93–F110. 44. Aykan S, Gönültaş S, Yılmaz M, Dinçer MM. Gecikmiş orgazm ve anorgazmi. Androloji Bülteni. 2017; 19(4): 131-137. 45. Lotti F, Maggi M. Ultrasound of the male genital tract in relation to male reproductive health. Human Reproduction Update. 2014; 21(1): 56–83. 46. Turek PJ. Non-Microsurgical Testis Sperm Extraction. Encyclopedia of Reproduction, 2018; 385–391. 47. Hibi H, Sumitomo M, Fukunaga N, Sonohara M, Asada Y. Superior clinical pregnancy rates after microsurgical epididymal sperm aspiration. Reproductive Medicine and Biology, 2018; 17: 59–63. 48. Jensen CF, Ohl DA, Hiner MR, Fode M, Shah T, Smith GD, Sonksen J. Multiple needle-pass percutaneous testicular sperm aspiration as first-line treatment in azoospermic men. Andrology. 2016; 4(2): 257-62. 49. Pelit ES, Çiftçi H. Non-obstrüktif azospermik hastalarda mikrocerrahi testiküler sperm ekstraksiyonu ilk sonuçlmız: Journal of Harran University Medical Faculty. 2019; 16(1): 134-138. 50. Esteves S, Miyaoka R, Orosz J, Agarwal A. An update on sperm retrieval techniques for azoospermic males. Clinics. 2013; 68(S1): 99–110. 51. Mancuso AC, Boulet SL, Duran E, Munch E, Kissin DM, Van Voorhis BJ. 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ASSISTED REPRODUCTIVE TECHNIQUES AND NURSING APPROACH

Year 2020, Volume: 3 Issue: 1, 55 - 75, 19.12.2020

Abstract

Infertility, which is a global problem, affects %8 and %12 of couples in fertilite age creates problems in personel and social relations. The causes of the disease are examined and various treatment methods are applied to the couples. Assisted reproductive technology has recently enabled many infertility couples to have children. In recent years, the frequency of births due to assisted reproductive technology, which constitutes %1-2 of births in most developed countries, has been increasing rapidly and complications and psychological problems occur in couples. Nurses contribute to the practices in the treatment process of infertile couples in order to prevent major from turning into crises and to resolve them. Assisted reproductive techniques need professional development of nurses to optimize quality and efficiency in order to provide effective treatment and care.

References

  • 1. Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clinical Biochemistry. 2018; 62: 2-10. 2. Kızılkaya Beji N. İnfertilite. Hotun Şahin N, Bilgiç D. (Ed.), Kadın Sağlığı ve Hastalıkları. Genişletilmiş İkinci Baskı, İstanbul, Nobel Tıp Kitapevleri; 2016. s. 141-145. 3. Remião, MH, Segatto NV, Pohlmann A, Guterres SS, Seixas FK, Collares T. The Potential of Nanotechnology in Medically Assisted Reproduction. Frontiers in Pharmacology. 2018; 8:1-9. 4. Shahraki Z, Tanha FD, Ghajarzadeh M. Depression, sexual dysfunction and sexual quality of life in women with infertility. BMC Women’s Health. 2018; 18: 92. 5. Ying L, Wu LH, Loke AY. Gender differences in emotional reactions to in vitro fertilization treatment: a systematic review. Journal Assisted Reproduction Technologies. 2016; 33(6), 689-701. 6. Çağlar M, Yeşiltepe Oskay Ü. İnfertilite ve cinsel yaşam üzerine etkileri. Jaren. 2020; 6(1): 157-62. 7. Meran Partovi HE, Kızılkaya Beji N. İnfertilite hemşireliğinin tarihçesi. Androloji Bülteni. 2016; 18: 60–4. 8. Williams M, Green L, Roberts K. Exploring the needs and expectations of women presenting for hysterosalpingogram examination following a period of subfertility: A qualitative study. International Journal of Clinical Practice. 2010; 64(12): 1653–1660. 9. Çetin C, Çetin MT. Dünden bugüne yardımla üreme teknikleri. Arşiv Kaynak Tarama Dergisi, 2014; 23(1): 148-155. 10. Yüksel UDY. (2019). Sperm Hazırlama Teknikleri. Her Yönüyle İn Vitro Fertilizasyon, 76. 11. Miyaoka R. Esteves SC. Sperm Retrieval Techniques. In Male Springer, Cham. Infertility. 2020; 621-635. 12. Coward RM, Mills JN. Obstrüktif azospermi için ofis bazlı sperm alımı için adım adım kılavuz. Öteleme Androlojisi ve Ürolojisi. 2017; 6(4): 730-744. 13. Arıcı A. Yardımcı üreme teknikleri. Türkiye Aile Planlaması Vakfi Görünüm Dergisi. 2012; 2-15. 14. Taşkın L. Doğum ve Kadın Sağlığı Hemşireliği. 16. Baskı, Ankara, Özyurt Matbaacılık; 2019. s. 569-575. 15. Kamath MS, Bhave P, Aleyamma TK, Nair R, Chandy A, Mangalaraj AM, Muthukumar K, George K. Predictive factors for pregnancy after intrauterine insemination: A prospective study of factors affecting outcome. Journal Human Reproductive Science. 2010; 3: 129-134. 16. Boomsma CM, Heineman MJ, Cohlen BJ, Farquhar C. Semen preparation techniques for intrauterine insemination. Cochrane Database Syst Rev. 2007; (4):CD004507. 17. Dikencik BK. Yardımcı üreme teknikleri. İn: Beji NK, ed. İnfertilite Sorunu, Yardımcı Üreme Teknikleri ve Hemşirelik Yaklaşımı. İstanbul, Emek Matbaacılık, 2001. s. 25-55. 18. Speroff L, Fritz MA. Klinik jinekolojik endokrinoloji ve infertilite. İn: Erk A, Günalp S, editors. 7. Baskı, İstanbul, Güneş Tıp Kitap Evleri; 2007. 19. Dancet EAF, VanEmpel IWH, Rober P, Nelen WLDM, Kremer JAM, D’Hooghe T.MPatent-centred infertility care: a qualitative study to listen to the patient's voice. Human Reproduction. 2011; 26: 827–833. 20. Huang LH, Kuo CP, Lu YC, Lee MS. Lee SH. Association of emotional distress and quality of sleep among women receiving in-vitro fertilization treatment. Taiwanese Journal of Obstetrics and Gynecology. 2019; 58(1): 168–172. 21. Sazonova A., Källen K., Thurin-Kjellberg A., Wennerholm U.B., Bergh C. Neonatal and maternal outcomes comparing women undergoing two in vitro fertilization (IVF) singleton pregnancies and women undergoing one IVF twin pregnancy. Fertil. Steril. 2013; 99(3): 731–737. 22. Practice Committee of American Society for Reproductive Medicine; Practice Committee of Society for Assisted Reproductive Technology. Criteria for number of embryos to transfer: a committee opinion. Fertility and Sterility. 2013; 99: 44–6. 23. SB. Üremeye Yardımcı Tedavi Uygulamaları ve Üremeye Yardımcı Tedavi Merkezleri Hakkındaki Yönetmelik. Sağlık Bakanlığı (SB) Resmi Gazete; 2010. 24. Haydardedeoğlu B, Kılıçdağ EB. A novel approach using a minimal number of injections during the IVF/ICSI cycle: Luteal half-dose depot GnRH agonist following corifollitropin alfa versus the corifollitropin alfa with a GnRH-antagonist cycle. Journal of the Turkish German Gynecological Association. 2016;17(3):155–158. 25. Siristatidis C, Sergentanis TN, Kanavidis P, Trivella M, Sotiraki M, Mavromatis I., ... Petridou ET. Controlled ovarian hyperstimulation for IVF: impact on ovarian, endometrial and cervical cancer—a systematic review and meta-analysis. Human reproduction update. 2013; 19(2): 105-123. 26. Albuquerque LET, Tso, LO, Saconato H, Albuquerque MCR, Macedo CR. Depot versus daily administration of gonadotrophin‐releasing hormone agonist protocols for pituitary down regulation in assisted reproduction cycles. Cochrane Database of Systematic Reviews. 2013; 1: CD002808. 27. Howie R, Kay V. Controlled ovarian stimulation for in-vitro fertilization. British Journal of Hospital Medicine. 2018; 79(4): 194–199. 28. D'Angelo A, Panayotidis C, Amso N, Marci R, Matorras R, Onofriescu M, Turp A.B, Vandekerckhove F, Veleva Z, Vermeulen N, Vlaisavljevic V, Recommendations for good practice in ultrasound: oocyte pick up†. Human Reproduction Open. 2019; (4): hoz025. 29. Weiss A, Neril R, Geslevich J, Lavee M, Beck-Fruchter R, Golan J, Shalev E. Lag time from ovulation trigger to oocyte aspiration and oocyte maturity in assisted reproductive technology cycles: a retrospective study. Fertility and Sterility. 2014; 102: 419–423. 30. Ubaldi F, Vaiarelli A, D’Anna R, Rienzi L. Management of poor responders in IVF: is there anything new? Biomed Research International. 2014; 2014:352098. 31. Doan HT, Quan LH, Nguyen TT. The effectiveness of transdermal testosterone gel 1% (androgel) for poor responders undergoing in vitro fertilization. Gynecol Endocrinol. 2017; 33(12): 977-9. 32. Bahçe M. Preimplantasyon Genetik Tanı Uygulamalarında Güncel Yaklaşımlar. Türkiye Klinikleri Tıbbi Genetik. 2018; 3(1): 91-6. 33. Chen HF, Chen SU, Ma GC, Hsieh ST, Tsai HD, Yang YS. Chen M. Preimplantation genetic diagnosis and screening: Current status and future challenges. Journal of the Formosan Medical Association. 2018; 117 (2), 94-100. 34. Simpson JL, Kuliev A, Rechitsky S. Improving assisted reproductive technology pregnancy rates: excluding aneuploid and interrogating euploid embryos. Fertility and Sterility. 2015; 104(3): 557-558. DOI: 10.1016/j.fertnstert.2015.06.017. 35. Schmutzler AG, Strowitzki T. "Global state of preimplantation genetic diagnosis. Frequency of application and indications." Gynakologische Endokrinologie. 2014; 3(1): 571-576. 36. Kahraman S, Beyazyurek C, Yesilipek MA, Ozturk G, Ertem M, Anak S, et al. Successful haematopoietic stem cell transplantation in 44 children from healthy siblings conceived after preimplantation HLA matching. Reproductive biomedicine online. 2014; 29(3): 340- 51. 37. Giarelli E, Reiff M. Genomic literacy and competent practice: call for research on genetics in nursing education. Nursing Clinics. 2012; 47(4): 529-545. 38. Maheshwari A, Bhattacharya S, Bowler U, Brison D, Child T, Cole C., Troup S. Study protocol: E-freeze- freezing of embryos in assisted conception: a randomised controlled trial evaluating the clinical and cost effectiveness of a policy of freezing embryos followed by thawed frozen embryo transfer compared with a policy of fresh embryo transfer, in women undergoing in vitro fertilisation. Reproductive Health. 2019; 16(1): 2-11. 39. Berntsen S, Pinborg A. Large for gestational age and macrosomia in singletons born after frozen/thawed embryo transfer (FET) in assisted reproductive technology (ART). Birth Defects Research. 2018; 110(8): 630–643. 40. Coates A, Kung A., Mounts E, Hesla J, Bankowski B, Barbieri E, Munné S. Optimal euploid embryo transfer strategy, fresh versus frozen, after preimplantation genetic screening with next generation sequencing: a randomized controlled trial. Fertility and sterility. 2017; 107(3): 723-730. 41. Westlander G. Utility of micro-TESE in the most severe cases of non-obstructive azoospermia. Upsala Journal of Medical Sciences. 2020; 1–5. 42. Rosenwaks Z, Pereira N. The pioneering of intracytoplasmic sperm injection: historical perspectives. Reproduction. 2017; 154(6): F71–F77. 43. Palermo GD, O’Neill CL, Chow S, Cheung S, Parrella A, Pereira N, Rosenwaks Z. Intracytoplasmic sperm injection: state of the art in humans. Reproduction. 2017; 154(6): F93–F110. 44. Aykan S, Gönültaş S, Yılmaz M, Dinçer MM. Gecikmiş orgazm ve anorgazmi. Androloji Bülteni. 2017; 19(4): 131-137. 45. Lotti F, Maggi M. Ultrasound of the male genital tract in relation to male reproductive health. Human Reproduction Update. 2014; 21(1): 56–83. 46. Turek PJ. Non-Microsurgical Testis Sperm Extraction. Encyclopedia of Reproduction, 2018; 385–391. 47. Hibi H, Sumitomo M, Fukunaga N, Sonohara M, Asada Y. Superior clinical pregnancy rates after microsurgical epididymal sperm aspiration. Reproductive Medicine and Biology, 2018; 17: 59–63. 48. Jensen CF, Ohl DA, Hiner MR, Fode M, Shah T, Smith GD, Sonksen J. Multiple needle-pass percutaneous testicular sperm aspiration as first-line treatment in azoospermic men. Andrology. 2016; 4(2): 257-62. 49. Pelit ES, Çiftçi H. Non-obstrüktif azospermik hastalarda mikrocerrahi testiküler sperm ekstraksiyonu ilk sonuçlmız: Journal of Harran University Medical Faculty. 2019; 16(1): 134-138. 50. Esteves S, Miyaoka R, Orosz J, Agarwal A. An update on sperm retrieval techniques for azoospermic males. Clinics. 2013; 68(S1): 99–110. 51. Mancuso AC, Boulet SL, Duran E, Munch E, Kissin DM, Van Voorhis BJ. 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Details

Primary Language Turkish
Subjects Nursing
Journal Section Review Article
Authors

Özlem Akın 0000-0001-7210-8756

Ebru Şahin 0000-0001-7798-0690

Publication Date December 19, 2020
Submission Date July 16, 2020
Published in Issue Year 2020 Volume: 3 Issue: 1

Cite

APA Akın, Ö., & Şahin, E. (2020). YARDIMCI ÜREME TEKNİKLERİ VE HEMŞİRELİK YAKLAŞIMI. Sakarya Üniversitesi Holistik Sağlık Dergisi, 3(1), 55-75.