1) TREATMENTS BELONGING TO THE COUPLE
It is important to lose weight, quit smoking and fix general health problems in order to increase the quality of the egg and sperm cell to be used in the procedure. It might be useful to prescribe DHEA, Testosterone for a few months to the patients with prominently-decreased egg reserve in order to increase the egg quality and count. The insulin-sensitizing medicines (myoinositol, metformin) make the egg efficiency and intra uterine membrane structure improve. Hormonal treatments, antioxidant treatment applied to suitable patients in the couple with man factor may increase the sperm quality.
Oxidation of the fat molecules in the cell membrane causes free radicals to be formed. These free radicals harm the cells (cell death, cancer etc.). ANTIOXIDANTS decrease this formation. Amino-acids such as Vitamin A, C, E, selenium, I-carnitine, gingkobiloba, maca plant extracts, green tea, locust, royal jelly can be counted among powerful antioxidants found in the nature. The use of these substances especially in male infertile patients and in women with decreased egg reserve may increase the pregnancy rate by decreasing the cell injuries and it is suggested to use them in a controlled manner before the in vitro fertilization treatment.
2) THE APPLICATIONS CONDUCTED BEFORE THE TREATMENT
It is seen that 30% of the patients who were determined healthy in their previous follow-ups has uterine cavity problems. Therefore, a study in the uterine cavity with a slim optic device (hysteroscopy) may increase the pregnancy rate with the interventions carried out in this place (endometrial scratching). A uterine roentgen might be necessary before the treatment in the patients with suspicious tube problem in their ultrasonographic examinations. Cutting the connection of the blocked tube with the uterus through laparoscopy in the cases with blocked tube or blocking the tube with hysteroscopy increases the pregnancy rate.
There might be genetic problems in 7-10% of the couples whose trying has been unsuccessful (this rate is 35 in fertile couples). PGD can be conducted on the suitable patients after genetic examination.
Rarely, there might be coagulation problems restraining the embryo to hold on in some women. The success can be increased with a convenient treatment to for the suitable patients by studying the coagulation factors in patients who cannot get pregnant despite 2 times of good quality embryo transfer previously.
3) THE APPLICATIONS CONDUCTED IN THE TREATMENT PERIOD
The GROWTH HORMONE used additionally to the treatment in the patients with bad egg reserve increases the egg maturation and quality.
Change in the protocol in the patients who could not get pregnant with the previous protocol, natural follow-up in the patients who could not get response despite medicines and medicine application in small quantities or antiestrogen medicine applications can increase the chance to obtain egg and embryo.
PGD (preimplantation genetic diagnosis) procedure must be conducted to the embryos obtained in the patients with genetic problem (translocation, disease carrier, recurrent pregnancy losses). The obtained embryos are subjected to biopsy procedure in the 3.-5. day of their progress. The cells are genetically examined. Normal ones are transferred after the examination.
Embryo follow-up by video is method eliminating the subjectivity of the morphologically-made evaluation and it offers opportunity to choose the embryo of the best quality with tendency to grow and divide normally.
Adding some natural molecules increasing the chance of embryo to hold on the uterus, in its own natural environment and washing the uterine cavity with medicines stimulating the immunity system (NEUPOGEN) in patients with a thin membrane (thinner than 6 mm) inside the uterus during the treatment period may increase the pregnancy rate. (PREGNANCY VACCINATION)
Repression of the disease for 2 months by DEPOT GNRH ANALOG in the patients with sufficient ovary reserve who have endometrium (chocolate cyst) or prescription of contraceptive pills for 6-8 weeks increase the success at the transfer.
Choosing the best embryo in the 3.day in the patients with previous unsuccessful trying and making additional transfer from the ones who could stand until 5. day among the rest may also increase the pregnancy chance (CONSECUTIVE TRANSFER)
Examining the sperm in a more detailed way by increasing the growth with a special microscope for the good quality sperm election in the cases with severe man factor (IMSI), usage of the containers closed with a special substance (hyaluronate) for the election of structurally steady and mature sperm (PICSI) and separation of the sperms with good DNA by competing the sperms in the microtubular channels in their own environment (chip technolocy) may also increase the pregnancy rate.