1) What should be done after unsuccessful IVF trials?
Firstly, it is very important to detect the problem correctly. For this reason, before trying another IVF treatment, the previous treatment processes and protocols should be examined and it should be determined whether age and ovary reserve of the patient are convenient or not. However, the main 3 reasons causing failures in pairs should be researched.
a) Genetic reasons; specific genetic tests should be made and genetic consultation should be provided as a result of chromosome analysis in the blood and genetic history of the pairs.
b) Implantation problems; the uterus and tubes of the patient should be monitored firstly (HSG) and it should be determined whether there are any structural disorders in tubes and uterus which may prevent implantation of embryo (myoma, intrauterine adhesion, double uterus, intrauterine curtain, polyps, adenomiosis) and liquid accumulation in the tubes (hydrosalpinx). As a result of this operation, it is required to cure these problems with laparoscopic and hysteroscopic surgery and to normalize the uterus.
c) Thrombopholia blood tests affecting intrauterine blood circulation should be performed. If any anomaly is found in these tests, the patient can be applied blood thinning medications and folic acid during pregnancy.
Furthermore, if the patient has experienced at least two unsuccessful trials, endometrial co-culture (artificial uterus) and PGD-PGS (genetic sorting at embryo level) techniques can be applied.
Also, better quality embryos can be obtained by selecting genetically good sperms with IMSI technique. With HLAG-5 technique, it can be detected which embryo has more chance for implantation.
2) I underwent several abortions. Has my chance for pregnancy decreased?
Abortion is very common in our country as birth control methods are not used healthily. The women who don’t have any child should be recommended to use contraceptives or condoms as a birth control method. In the patients having undergone abortions previously, there occur intrauterine adhesions due to abortion and rarely obstructions in the tubes due to infection. For this reason, uterus and tube film (HSG) should be monitored if pregnancy has not been achieved as a result of trial for 6 months or in order to determine whether there is actually a problem affecting fertility or not.
Another important problem is blood incompatibility and as a measure, rhogam should be applied if blood group of woman is Rh negative within the first 72 hours after abortions.
3) I was diagnosed with azoospermia, testis biopsy was performed and no sperm was found, do I have another chance to try?
The applied biopsy technique is important; however, if the biopsy wasn’t performed under microscope by competent people (microtese), it may be useful to try biopsy with this technique again. However, genetic tests (cariotype and Y microdeletion), hormone tests should be performed firstly and then microtese operation should be decided.
4) I experienced repeating abortions. Although it is said that there is not problem in the baby, my pregnancy comes to end with abortion. What should I do?
Firstly, it should be determined whether the abortions occur in early or late stage. If the abortion occurs in late stage, it should be detected whether there is cervical deficiency or not. In case of cervical deficiency, cerclage (strengthening the cervix) should be applied in 12-14thweek of pregnancy. If the cervix isn’t long enough as a result of anatomic anomalies or several previous cervix operations (conisation, etc), this operation can be performed to a higher level and more effectively with laparoscopic method before pregnancy.
This operation (laparoscopic abdominal cerclage) is being performed in our country by Prof. Dr. Yucel Karaman successfully.
If abortions occur at early stages, it may be require to apply genetic test (cariotype), HSG film and thrombophilia tests to the pairs and administer hysteroscopic surgery, PGD (genetic sorting on embryos), IMSI and blood thinning drugs to the patients according to the results.
5) I was diagnosed with endometriosis and I suffer from severe menstrual pains, can I become pregnant?
Endometriosis can be diagnosed with laparoscopy during last stage and with tests such as ultrasonography, pelvic MR, CA-125 during the early stage. There are two basic problems in endometriosis: pain and inability to have baby. The treatment can vary according to the problem. However, as a conclusion, endometriosis decreases the chance of having baby but gives the chance of becoming pregnant naturally at the rate between 40-60% according to the stage of disease if it is treated with laparoscopic surgery. The remaining people can be applied IVF treatment. For more information, please see chapter “Endometriosis” on our site.
Sağlam Fikir Sokak No:4 Esentepe Şişli