Patients Who've Had a Failed IVF Cycle Before
The success with IVF treatment is unfortunately not 100%. Even in the best conditions, a
healthy birth is achieved by 35-40%. Well, what kind of a path the couples with unsuccessful
IVF attempts should follow? IVF treatment is a material and spiritual challenge. A process where
expectations are high but when there is a negative result, there are deep disappointments. In
this process, to identify the process correctly, to understand the couples’ need, to review the
process, to evaluate what can be done to individuals specifically, the most important treatment
options in the forefront of cost should be the most important tasks of the IVF centers. First of all,
it is very important to analyze the negative treatment process. In particular, it is more important
to master the process of the treatments that were made in other IVF centers. It is very important
to find the correct answers to questions such as: “Why was the IVF treatment chosen? How
many times the IVF treatment was performed? Was there any additional disease? Were the
initial examinations made? When was it started? How many eggs were collected? Did the
fertilization occur? How were the quality of developing embryos? Was the transfer easy? Etc.”
In particular, in couples with more than 2 unsuccessful in vitro trials, which special
examinations may be requested before new treatment?
First of all, it is useful to review the initial tests and perform the basic tests such as fasting
glucose and thyroid. It is necessary to reveal the egg reserve and repeat the semen analysis.
Following to these,
*Genetic analysis of husband and wife(checked up on the blood tests) could be made.
*Sperm DNA damage test could be performed.
*Office hysteroscopy procedure to evaluate the inside of the uterus could be performed.
*Radiography of uterus to evaluate the condition of the uterine tubes could be checked.
After all these tests, it is essential to discuss with the couples what new techniques are and
what additional therapies will be used before a new treatment plan.
What additional treatments can be recommended to the couples with recurrent failed IVF
The treatment in the previous trial may guide us. Treatment protocols can be modified.
Treatments available include:
*Injection-free IVF treatments-Natural tube baby
*Embryo laser drilling
*Scratching the uterinal tissue
* Pre-implantation genetic screening (Tube baby with genetics)
*A number of effective treatments on the immune system
If a poor quality embryo has been given in the previous unsuccessful attempt, it would be
correct to lean to the processes that improve embryo quality. In this case, it would be correct to
develop a large number of eggs, to apply a special cracking program, to make a good selection
of sperm, to provide the best fertilization and to choose the best embryo.
*For sperm selection: IMSI technique, PICSI technique, chip technique can be used.
*The technique of combining embryos and blood from the mother-to-be called co-culture is
among the recommended methods.
*Hole punching through the embryo membrane is also one of the processes that can help.
*If at least 2 good quality embryos were given in previous trials, then office hysteroscopy or an
X-ray check of uterus may be recommended to determine if there is a problem in the uterus.
If there is no problem in the uterus, the embryos with healthy genetics should be extracted from
the ones with unhealthy genetics before transfer with the process of pre-implantation genetic
The stages of genetic screening include:
1) Egg augmentation with daily injections
2) Collection of eggs
3) Fertilization of collected eggs with selected sperms in laboratory.
4) Obtaining embryos from fertilized eggs
5) Conducting a biopsy on the 5th day embryos and performing genetic tests on them.(New
generation sequencing-high resolution NGS technique)
6) Freezing all embryos
7) Transfer of healthy embryos into the uterus after being unfrozen after genetic test
results, which was prepared with hormones.
Process of IVF with genetics is generally performed with frozen and then unfrozen eggs. Although
these embryos can be damaged after freezing and unfreezing, this risk is very small. The likelihood
of adherence to the uterus of the genetically tested embryo is a lot higher than the genetically