When infertility therapies have failed and especially after various PMA attempts (IUI, IVF, ICSI, TESE) the Biofertility center wants to delve into the causes as much as possible because only in this way can a targeted corrective action be set up.
We first ask ourselves whether the ovarian reserve and oocyte quality were sufficient.
If both are reduced or are suspected to be reduced, they can often be improved with drugs and supplements such as DHEA, high-dose Coenzyme Q 10, vitamin B complex and melatonin.
There are many types of ovarian stimulation protocols that must be personalized to the maximum because it is not prudent to use the same one for everyone or to insist on the previous one if it has not given satisfactory results.
Has adequate ultrasound and hormonal monitoring been carried out? To prevent progesterone and estradiol from rising too high and producing poor receptivity of the endometrium or hyperstimulation, one must not spare oneself even on the weekend for perfect control of the ovarian response.
The uterus and in particular the endometrium must be studied well with hysteroscopy and sometimes with a biopsy that looks for hormonal imbalances or endometritis, all treatable problems.
Stress can play a role in the failures of therapies such as PMA and high levels must be identified and lowered with special and personalized programs.
Furthermore, andrological deficits must also be identified, measured and treated.
Finally, it cannot be ruled out that there is more than one problem underlying couple infertility.
Indeed, sometimes the cause is not discovered but in this case one should not think that without having identified it the problem cannot be solved.
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