Couples with IVF failure commonly demand different treatment modalities from their doctors. Most of such treatment however are empirical. This means their efficacy have not been shownin randomized prospective studies. These treatments are:
Anticoagulants (heparin, aspirin,..): There are 5 studies related to the use of low dose aspirin in IVF trials. 3 of them showed no benefit but 2 studies proved higher pregnancy rates. Meta-analysis found no benefit of aspirin. Thus, we do not recommend use of aspirin. Futhermore, it can cause bleeding problems after OPU.
Heparin is an anticoagulant used by subcutaneous injections. It is especially useful in the presence of antiphospholipid syndrome (APLs). APLs decreases the chance of a pregnancy and in the presence of the syndrome intrauterine fetal loss risk is increased. The syndrome may also cause recurrent IVF failure. In the absence of APLs, heparin use has not been shown to increase IVF success.
Viagra: In patients with inadequate endometrial thickening during IVF, vaginal viagra has been used to increase blood flow to the endometrium and one study revealed good results. But, no other study gave similar results. Our experience with viagra did not reveal that much good results. Inadequate development of endometrium during IVF is usually due to intrauterine adhesions and for diagnostic and therapeutic purposes, hysteroscopy is performed.
Co-cultures: In this procedure, some endometrial tissue is obtained in the secretory phase of the preceding menstrual cycle. Embryos are then cultured in a medium where this endometrial tissue is added. Although once popular, co-cultures are not widely used actually. Only one study showed a benefit (Spandorfer 2003). We do not recommend use of co-cultures.
Embryo glue: There are some studies pointing to a benefit of embryo glue. In our center, we performed 2 studies. We noticed some certain benefit but couples should not consider embryo glue as a miracle in IVF treatment.
Lymphocyte vaccine: In this procedure, lymphocytes obtained from the male partner are injected subcutaneously to the female partner. This method was once thought to ameliorate pregnancy rates in patients with recurrent IVF failure by altering immune mechanisms (Ober 1999), but its efficacy has not been found significant even in this group. We do not recommend this treatment.
Successive embryo transfers: This consists of transfer of some embryos on days 2 and 3 and some others on days 5 and 6. This technique has been abandonned after restriction of number of embryos to be transferred.
.jpg)