The concept of egg reserve has come to the fore regarding women's ovulation abilities and capacities. Egg reserve may be low depending on the person, or it may decrease due to certain exposures such as previous ovarian surgery and cancer chemotherapy. The presence of weak egg reserve constitutes a significant portion of patients who consult a doctor due to infertility. The egg reserve, called the follicle pool within the ovaries, is a concept that varies for each individual and decreases in direct proportion to age. Especially after the age of 36-37, the decrease in this capacity becomes more evident. For this reason, especially after the age of 40, both spontaneous pregnancies and pregnancies with in vitro fertilization are quite rare due to the presence of a small number of eggs of poor quality.
There are some cases who apply to a doctor for infertility treatment and especially those with limited egg reserves special methods have come to the fore. One of these is the special in vitro fertilization method called embryo pooling. In this method, after the in vitro fertilization treatment plan is made, injections that stimulate egg development, which we call gonadotropin, are administered. Once a sufficient number and maturity of eggs are obtained, these eggs are collected. However, as mentioned, since the reserve is low, the chance of obtaining a sufficient number of eggs is quite low. In many attempts, either no eggs hatch or 1 or 2 mature eggs are collected. Therefore, the eggs collected at the end of an in vitro fertilization cycle are fertilized and the resulting embryos are frozen. The same procedures are repeated after several in vitro fertilization attempts. Thus, after a few attempts, a sufficient number of embryos are obtained in the pool. Finally, among the embryos obtained and thrown into the pool, the highest quality ones and even those with normal chromosome numbers after genetic processing are transferred at a time. As a result, the number of pregnancies achieved increases.
With this method, the chance of pregnancy increases due to the selection of the best embryo and the increase in the number of embryos transferred. At the same time, the PGT (PGD) process, which cannot be applied in the older patient group due to the limited number of embryos, can be applied to the large number of embryos obtained in this way, and the healthiest embryo can be selected and still be used. The chance of pregnancy is increased.
From another perspective, freezing all embryos in an in vitro fertilization trial and transferring them to a later unstimulated cycle may also improve the outcome.
In in vitro fertilization, freezing all embryos (total freezing) may also improve the outcome. interest is increasing. Transferring embryos to a later natural cycle after freezing also neutralizes the negative effects of ovarian stimulation on the endometrium's capacity to hold the embryo (endometrial receptivity). Ovarian stimulation has been shown to have an adverse effect on endometrial receptivity and increases the risk of OHSS (ovarian hyperstimulation syndrome).
Freezing all embryos for later transfer increases implantation, while also increasing the pregnancy rate and providing safer in vitro fertilization treatment. For this reason, when the embryos obtained as a result of stimulation are frozen and thawed and transferred to the rested endometrium in the natural cycle, it increases the pregnancy rate.
Again, in cases where few embryos are obtained, all embryos are frozen without transfer and when they reach a sufficient number and quality, an increased pregnancy rate is achieved when thawed and transferred. is being done.
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