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  • Küçük Resim
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    Effect of Hysteroscopic Surgery Before Frozen Embryo Transfer on Patients with Previous Implantation Failure
    (2022) Cetin, Caglar; Gözükara, İlkay; Çetin, Cihan; Tok, Abdullah; Kaplanoğlu, Dilek; Çetin, Turan M.; Karasu, Ayşe Filiz Gökmen
    Aim: The aim of this study was to evaluate the benefit of hysteroscopy (HS) before single frozen-thawed embryo transfer (sFET) on patients with previous implantation failure. Material and Methods: A total of 1352 infertile women with a previous implantation failure who underwent their first sFET treatment between January 2015 and December 2017 were included in this study. The patients were classified into two main groups in which HS was omitted (Group 1), and who underwent HS (Group 2). Furthermore, Group 2 was classified into two subgroups as patients without any intrauterine pathology (Group 2a), and those with intrauterine pathology (Group 2b). sFET was performed on all patients within 50 days of hysteroscopy. The major outcome measure was the clinical pregnancy rate. Results: The mean number of mature oocytes and fertilization rates were similar between groups. The clinical pregnancy rate was found to be 33.3% (n=70) in Group 1. Comparatively this rate was statistically significantly higher in patients in Group 2. The clinical pregnancy rate was 44.2% (n=378) in Group 2a, and 44.4% (n=127) in Group 2b (p=0.014). There was a significant difference between Group 1 and Group 2a (OR: 1.58, 95% CI: 1.15-2.17, p=0.004), and also Group 2b (OR: 1.59, 95% CI: 1.10-2.31, p=0.013). However, no significant difference was observed between Group 2a and Group 2b (p=0.896). Conclusion: Our findings demonstrate that HS surgery increases the probability of pregnancy rate at least by 1.58 times in patients having previous implantation failure when the hysteroscopic procedure is followed by sFET.
  • Küçük Resim
    Öğe
    Non-Specific Medical Treatment Methods in Female Infertility
    (Düzce Üniversitesi, 2022) Kaya Kaplanoğlu, Dilek; Tok, Abdullah
    Infertility, which is defined as the inability to conceive despite one year of unprotected sexual intercourse, affects 15% of couples. Any patient with infertility by definition or at high risk of infertility may be offered an infertility evaluation. In women older than 35 years, this waiting period can be limited to 6 months, and then infertility evaluation can be started. In women older than 40 years, more urgent evaluation and initiation of treatment is the most important option. Evaluation of infertility must be done by experienced and trained physicians and necessary treatments must be followed by these physicians. Alternative treatment methods can be used in patients who do not respond after standard evaluation steps and generally accepted treatment options. Various supportive treatments come to the fore here. These options are used both to obtain better quality oocytes before treatment and to ensure that more follicles participate in stimulation. Antioxidants and metformin are the most commonly used agents before treatment in women who are thought to have insulin resistance, especially considering that oocyte mitochondrial DNA damage increases in advanced female age. On the other hand, agents such as growth hormone that should be used in a controlled manner by experienced specialists have been found effective in many publications. In the presented article, non-conventional treatment options for infertility are explained.