How should couples who have unsuccessful in vitro fertilization attempts follow? It is a process in which expectations are high but there are deep disappointments when negative results are received. In this process, the most important duties of in vitro fertilization centers should be to make the correct diagnosis, understand the couples, review the process, evaluate what can be done specifically for individuals, and recommend the most effective treatment option, considering the cost.
First of all, it is very important to analyze the treatment process that resulted negatively. Why was in vitro fertilization done? How many times was IVF treatment performed in total? Were there any comorbidities? Have initial examinations been performed? When did it start? How many eggs were taken? Has fertilization occurred? What is the quality of developing embryos? Was the transfer easy? It is very important to get answers to these questions...
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Especially in couples who have had more than 2 unsuccessful in vitro fertilization attempts, what special tests may be requested before the new treatment?
First of all, it is useful to review the initial tests and look at basic tests such as fasting sugar and thyroid. It is necessary to reveal the egg reserve and repeat the semen analysis. After these;
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Genetic analysis to be examined from husband and wife blood
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Sperm DNA damage test
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Office hysteroscopy procedure to evaluate the inside of the uterus
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If not examined, uterine film for the condition of the tubes
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What additional treatments can be recommended for couples with repeated in vitro fertilization failure?
The treatment method in the previous attempt can guide us. Treatment protocols may be changed. Among the treatments that can be applied:
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Needle-free in vitro fertilization applications - natural in vitro fertilization
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Co-culture process
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Punching a hole in the embryo with a laser
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Scratching the uterine tissue
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Pre-implantation genetic screening (genetic in vitro fertilization) process
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Some treatments effective on the immune system
If a BAD QUALITY embryo was given in the previous unsuccessful attempt, it would be correct to turn to procedures that increase the quality of the embryo. In this case, a large number of eggs develop It would be correct to raise them, apply a special hatching program, make good sperm selection, ensure fertilization in the best way and choose the best embryo.
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For sperm selection: IMSI technique, PICSI technique, chip technique can be used.
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The technique of combining embryos with blood taken from the expectant mother, called co-culture, is also among the recommended methods.
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Punching a hole in the embryo membrane with a laser is also one of the procedures that can help with adherence.
More If at least 2 GOOD QUALITY embryos were given in previous attempts, then a uterine film or office hysteroscopy may be recommended to first determine whether there is a problem in the uterus. If there is no problem in the uterus, the process of sorting the embryos by looking at their genetics before transfer and transferring only the embryos with healthy genetics from the unhealthy ones, that is, the process of pre-implantation genetic screening, may be recommended. Genetic screening stages are as follows:
Egg enlargement with daily injections
Collection of eggs
Fertilization of collected eggs with sperm selected in the laboratory
Obtaining embryos from fertilized eggs
Extracting cells, especially from day 5 embryos, with a special biopsy and sending them for genetic testing (Next generation sequencing-high resolution NGS technique)
Freezing all embryos
Following the receipt of genetic results, healthy embryos Thawing the embryos and transferring them into the uterus prepared with hormones
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