The proper classification of patients, evaluation of couples, the findings in their tests, and the results of previous treatments make no patient or partner are equal, so it requires an individualization, in order to offer the best options treatment.
The clinical case of each pair more complex studies show if necessary, convenience (or not) of more elaborate techniques aimed at achieving reproduction or specific aspects are. In this sense, a woman with a hormonal disorder (polycystic ovaries type), require gentle treatments that avoid hyperstimulation. If high levels of estradiol appear better delay embryo transfer at a time when these levels are not harmful to the implementation. However, if the problem is a low response, the possibilities expert in assisted reproduction are the use of androgens, the accumulation of embryos or blastocysts (transfer or practice them previous genetic studies), or just hope for the best cycle the ovaries they can develop.
What to do when there are repeated failure of embryo implantation
When a couple has several disappointments by repeated treatments without success, even with transfers of good embryos must assess the determinants of implantation failure:
- Study of endometrial receptivity (even with arrays)
- Possibility of genetic alterations
- hematological disorders
- immunological disorders
- Chronic endometritis (hysteroscopic evaluation)
After analyzing these aspects, recourse may be had to the introduction of more advanced, blastocyst embryos, which can improve the chances of the couple. It may also change the time of implantation, according to various possibilities.
When the couple, even with sample of "normal" sperm, fertilization rate has low or failures in fertilization, embryos of poor quality and even good fertilization and embryo transfer good but not pregnancy is achieved, it will be necessary to assess other techniques. Some will be DNA fragmentation or FISH studies in espermatoizoides, which will give a genetic sample information.
To all this must be a suitable operation by the laboratory, with high levels of quality, acting jointly with clinicians to try to find a solution for each pair, as closely as possible to their needs. It will be essential to carry out all the necessary tests to make a correct classification of the patient, so that the treatment success rate is higher.