Hysteroscopic Injury (Fallow)

Some problems in the lining of the uterus may prevent a quality embryo from attaching to the uterus. In the months before the embryo transfer, hysteroscopy is used to investigate the presence of a problem in the uterus that may prevent pregnancy and small incisions are made. After these incisions, the uterus is left fallow. Thus, the potential for revival of uterine cells and retention of the transferred embryo increases. This method increases the pregnancy rate and also reduces the miscarriage rate.

Supported/Combined Fallow Technique:

In this application, in addition to the Fallow Technique described above, a liquid called granulocyte colony enhancing factor (G-CSF), which increases and stimulates the special burial support cells in the uterine membrane, is injected into the uterus. With this application, the aim is to thicken the uterine lining through the immune cells, and by ensuring that the immune cells in the uterus communicate with the healthiest embryo, it increases pregnancy rates and reduces miscarriage rates.

Fallow 2 application:

It has been understood that medications given to promote egg development can reduce the uterine lining. For this reason, in some patient groups, it is recommended to freeze and store good quality embryos formed during treatment without transferring them in the month of drug treatment, and to transfer them in the following months without using egg enhancing drugs.

Freeze All

(Freezing them all technique) This method, also called; It is applied in cases of PCOS, endometriosis, immune system disorders, and diseases that reduce intrauterine blood flow.

Era Test (Endometrium Receptivity Assay)

In order for a healthy pregnancy to occur, the ability of the inner membrane of the uterus (endometrium) to accept the embryo is of great importance, as is the quality of the embryo. When patients with repeated in vitro fertilization failure were examined, it was revealed that the intrauterine acceptability period was different in some women. This problem can be solved with an advanced molecular biology-based test known as ERA, which determines the optimal time when the uterus will accept the embryo. It can be determined with high accuracy whether the uterus is suitable for embryo transplantation by genetic analysis of the tissue taken from the uterine lining on a certain day during the patient's natural menstrual cycle or during a hormone-stimulated treatment process.

Microorganism Balancing (EMMA / ALICE)

It has been determined by recent studies that the embedding system, which allows the uterine membrane to accept the embryo, is also regulated by various microbes in the uterus. The decrease in these beneficial microbes, called Lactobacillus, can significantly reduce pregnancy rates despite good embryo transfer. For this reason, especially in cases of recurrent in vitro fertilization failures and pregnancy losses, the investigation of microbes that have positive and negative effects in the uterus is carried out with Alice and Emma or some tests developed in our country.

It has been shown that the success rates of in vitro fertilization treatment increase after supportive treatments are performed in the uterus in cases where beneficial microorganisms are low. These tests and treatments are performed individually in our clinic when necessary.

Intrauterine Detox: G-Csf Application (Intrauterine Immune Support)

It has been understood that the immune system plays a very important role in the attachment and embedding of embryos into the uterus. Granulocyte colony stimulating factor (G-CSF), which is applied to the thin endometrium, especially to the thin endometrium, with a special catheter that can affect the uterus in the cycle before in vitro fertilization treatment, which supports the healthy embedding of the embryo into the uterus; It increases the chance of pregnancy. This practice can also prevent miscarriages in women who have previously had early miscarriages or who have difficulty in becoming pregnant, which is called biochemical pregnancy.

PBMC Infusion (Balancing the uterine membrane immune system)

The aim of the Fertility Vaccine is to obtain substances that will enable the embryo to be embedded in the uterus by using the woman's own special blood cells. On the day of egg collection, blood is taken from the woman and cells called monocytes are separated through special processes; These cells are propagated by placing them in special culture solutions.

In order for cell reproduction to be appropriate and continuous, and for the desired substances to be released in sufficient amounts, the hormone called CRH, released from the brain, or the hormone called HCG, which strengthens the uterine membrane, is added to the reproductive fluids.

After two days of culture, cytokines and growth hormones that will help the embryo embed in the uterus are released by monocytic cells and accumulate in the reproductive fluid. The liquid obtained in the laboratory, also called 'fertility vaccine', is injected into the uterus, preferably two days before the day the embryos will be placed in the uterus, or at a time to be determined according to the patient's condition. This process makes the inside of the uterus suitable for the embedding of embryos that will be transferred later, in other words, for pregnancy to occur.

Our study found that the intrauterine membrane prepared in this way will accept the good quality embryos at a higher rate, that is, it will help pregnancy occur. In addition, with this type of application, pregnancy losses, namely miscarriages, can be prevented as a healthier pregnancy will occur.

In the studies we have been carrying out since 2009, a 40% pregnancy rate has been achieved in women who could not conceive despite previously being given high-quality embryos. In addition, this technique has improved the miscarriage rates seen after in vitro fertilization treatment by approximately 30%.

GÜRGAN CLINIC In Vitro Fertilization Center uses this application:

• In vitro fertilization failures despite good quality embryo transfer
• In cases where intrauterine thickness does not increase
• In the womb; It is performed in cases where it is determined by various tests that there is an implantation problem, and in women with PCOS, Endometrioma, and Immune system disorders, and significant increases in pregnancy rates are observed.

Serum Treatment

During the embryo's implantation in the uterus, there are cells (NK Cells), popularly called killer cells, which limit/prevent implantation by attacking the benign support cells in and around the uterus, and some substances (cytokines, interferon, etc.) released from the vessels. If the cells secreting these substances are excessive in number and activation, embryo embedding is disrupted and pregnancy may not occur. This problem is one of the reasons for recurrent in vitro fertilization failure and is recognized by investigation with special tests.

In this case, the chance of pregnancy is increased by deactivating these cells and their negative effects through the serums developed. Our aim; The aim of the Fertility Vaccine is to increase the cells that will have a positive effect on fertility and the substances they release, as well as to increase the chance of success by suppressing the cells that have a negative effect when necessary.

It provides intrauterine balancing by affecting the immune system of the expectant mother, which prevents the embryo from adhering. This application is given to patients intravenously in the form of serum; It is carried out on the day of embryo transfer and at regular intervals in the following period.

Operative Endoscopic Applications

Endoscopic applications are mainly performed in two ways. In the technique called laparoscopy, the reproductive organs, the uterus, ovaries and uterus (fallopian tubes), are evaluated by entering the abdomen through a small incision made under the belly. Diseases and problems that may negatively affect the success of in vitro fertilization treatment are investigated. Adhesions caused by inflammation or other reasons, myomas, fluid accumulation due to obstruction in the uterus (hydrosalpinx), chocolate and ovarian cysts, various anomalies are identified and operated on with special techniques without opening the abdomen.

By paying attention to the rules called microsurgery, organ damage and re-adhesions are prevented. After these operations, time is given with supportive treatments for the patient to become pregnant spontaneously, depending on her condition. If these operations are performed under appropriate conditions, on time and by experienced physicians, they increase the success of in vitro fertilization.

Another form of endoscopy is surgery performed through the cervix, called hysteroscopy. Polyps, myomas, adhesions, uterine development disorders, and bleeding of unknown origin, which are discovered after observing the inside of the uterus with hysteroscopic surgeries, are recognized and treated. When these diseases and problems disappear, in vitro fertilization applications are more successful. Hysteroscopic application is also used in NADAS 1 and NADAS 2 applications to increase the intrauterine immune system and blood circulation.

Combination Treatments

Any application or treatment developed in accordance with the Balancing Concept will be added to the treatment and application list if it will contribute to the solution of the couple's problems. Thus, couples will have the chance to learn about all kinds of innovations, discuss their benefits and use them when necessary. Another important issue in this concept is to prevent the couple from receiving unnecessary treatment and to ensure that they have a healthy baby in the most economical way. The new treatments and practices listed above can be applied together, one can be chosen instead of the other, or changed depending on the situation of the couple. These approaches are called Combination Therapies.

It should not be forgotten that everything that is closest to nature is the best. Sometimes too much of the treatment may be harmful and too little may be enough.

 

Alternative Treatment Applications

Acupuncture

Acupuncture treatment regulates the limbic system, increases resistance to stress and offers the opportunity to reduce anxiety in expectant parents. It supports the possibility of embryo implantation with its positive effect on the thickening of the uterine wall of expectant mothers, which cannot reach sufficient thickness. It contributes to the formation of hormones and egg quality regulated by the autonomic nervous system.

There are many studies comparing the pregnancy rates and continuation rates of expectant mothers who underwent transfer with acupuncture treatment and those who underwent transfer without acupuncture treatment. These studies also show that women's stress is significantly reduced and they feel relaxed with acupuncture treatment.

Ozone Therapy

Ozone therapy; It is an auxiliary treatment that has been used for many years to eliminate circulatory disorders, increase blood circulation and revitalize organic functions. It is used in in vitro fertilization treatments by improving the blood flow in the uterus with its detoxifying properties and eliminating circulatory disorders, thus increasing the probability of implantation of transferred embryos. Ozone gas can be applied intravenously, or it can be applied into the uterus at certain intervals with the help of special tools and can help the lining of the uterus become more embedded.