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Non-Specific Medical Treatment Methods in Female Infertility

Year 2022, Volume: 24 Issue: Special Issue, 86 - 89, 30.10.2022

Dilek Kaya Kaplanoğlu Abdullah Tok

https://doi.org/10.18678/dtfd.1191606

Abstract

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.

Keywords

Infertility treatment non-specific agents

References

  • Wise J. Show patients evidence for treatment “add-ons,” fertility clinics are told. BMJ. 2019;364:I226.
  • Sunkara SK, Pundir J, Khalaf Y. Effect of androgen supplementation or modulation on ovarian stimulation outcome in poor responders: a meta-analysis. Reprod Biomed Online. 2011;22(6):545-55.
  • Nagels HE, Rishworth JR, Siristatidis CS, Kroon B. Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction. Cochrane Database Syst Rev. 2015;(11):CD009749.
  • Luo S, Li S, Li X, Qin L, Jin S. Effect of pretreatment with transdermal testosterone on poor ovarian responder undergoing IVF/ICSI: a meta-analysis. Exp Ther Med. 2014;8(1):187-94.
  • Datta AK, Campbell S, Deval B, Nargund G. Add-ons in IVF programme - hype or hope? Facts Views Vis Obgyn. 2015;7(4):241-50.
  • Duffy JM, Ahmad G, Mohiyiddeen L, Nardo LG, Watson A. Growth hormone for in vitro fertilization. Cochrane Database Syst Rev. 2010;(1):CD000099.
  • Eftekhar M, Aflatoonian A, Mohammadian F, Eftekhar T. Adjuvant growth hormone therapy in antagonist protocol in poor responders undergoing assisted reproductive technology. Arch Gynecol Obstet. 2013;287(5):1017-21.
  • Nardo LG, El-Toukhy T, Stewart J, Balen AH, Potdar N. British Fertility Society Policy and Practice Committee: Adjuvants in IVF: evidence for good clinical practice. Hum Fertil. 2015;18(1):2-15.
  • Tso LO, Costello MF, Albuquerque LE, Andriolo RB, Freitas V. Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2009;(2):CD006105.
  • Vanky E, Stridsklev S, Heimstad R, Romundstad P, Skogøy K, Kleggetveit O, et al. Metformin versus placebo from first trimester to delivery in polycystic ovary syndrome: a randomized, controlled multicenter study. J Clin Endocrinol Metab. 2010;95(12):E448-55.
  • Ruder EH, Hartman TJ, Blumberg J, Goldman MB. Oxidative stress and antioxidants: exposure and impact on female fertility. Hum Reprod Update. 2008;14(4):345-57.
  • Showell MG, Mackenzie-Proctor R, Jordan V, Hart RJ. Antioxidants for female subfertility. Cochrane Database Syst Rev. 2017;7(7):CD007807.
  • Ben-Meir A, Burstein E, Borrego-Alvarez A, Chong J, Wong E, Yavorska T, et al. Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell. 2015;14(5):887-95.
  • Griesinger G, Kolibianakis EM, Venetis C, Diedrich K, Tarlatzis B. Oral contraceptive pretreatment significantly reduces ongoing pregnancy likelihood in gonadotropin-releasing hormone antagonist cycles: an updated meta-analysis. Fertil Steril. 2010;94(6):2382-4.
  • Smulders B, van Oirschot SM, Farquhar C, Rombauts L, Kremer JAM. Oral contraceptive pill, progestogen or estrogen pre-treatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques. Cochrane Database Syst Rev. 2010;(1):CD006109.
  • Siristatidis CS, Dodd SR, Drakeley AJ. Aspirin for in vitro fertilisation. Cochrane Database Syst Rev. 2011;(8):CD004832.
  • Groeneveld E, Lambers MJ, Lambalk CB, Broeze KA, Haapsamo M, de Sutter P, et al. Preconceptional low-dose aspirin for the prevention of hypertensive pregnancy complications and preterm delivery after IVF: a meta-analysis with individual patient data. Hum Reprod. 2013;28(6):1480-8.
  • Kutteh WH, Yetman DL, Chantilis SJ, Crain J. Effect of antiphospholipid antibodies in women undergoing in-vitro fertilization: role of heparin and aspirin. Hum Reprod. 1997;12(6):1171-5.
  • Zhang Y, Song Y, Xia X, Wang J, Qian Y, Yuan C, et al. A retrospective study on IVF/ICSI outcomes in patients with persisted positive of anticardiolipin antibody: Effects of low-dose aspirin plus low molecular weight heparin adjuvant treatment. J Reprod Immunol. 2022;153:103674.
  • Sher G, Feinman M, Zouves C, Kuttner G, Maassarani G, Salem R, et al. High fecundity rates following in-vitro fertilization and embryo transfer in antiphospholipid antibody seropositive women treated with heparin and aspirin. Hum Reprod. 1994;9(12):2278-83.
  • Sher G, Matzner W, Feinman M, Maassarani G, Zouves C, Chong P, et al. The selective use of heparin/aspirin therapy, alone or in combination with intravenous immunoglobulin G, in the management of antiphospholipid antibody-positive women undergoing in vitro fertilization. Am J Reprod Immunol. 1998;40(2):74-82.
  • Qublan H, Amarin Z, Dabbas M, Farraj AE, Beni-Merei Z, Al-Akash H, et al. Low-molecular-weight heparin in the treatment of recurrent IVF-ET failure and thrombophilia: a prospective randomized placebo-controlled trial. Hum Fertil (Camb). 2008;11(4):246-53.
  • Nardo L, Chouliaras S. Adjuvants in IVF-evidence for what works and what does not work. Ups J Med Sci. 2020;125(2):144-51.
  • Boomsma CM, Eijkemans MJ, Hughes EG, Visser GH, Fauser BC, Macklon NS. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update. 2006;12(6):673-83.

Kadın İnfertilitesinde Spesifik Olmayan Medikal Tedavi Yöntemleri

Year 2022, Volume: 24 Issue: Special Issue, 86 - 89, 30.10.2022

Dilek Kaya Kaplanoğlu Abdullah Tok

https://doi.org/10.18678/dtfd.1191606

Abstract

Korunmasız bir yıl cinsel ilişkiye rağmen gebe kalınamaması olarak tanımlanan infertilite, çiftlerin %15'ini etkilemektedir. Tanım gereği infertilitesi olan veya infertilite riski yüksek olan herhangi bir hastaya infertilite değerlendirmesi önerilebilir. 35 yaşından büyük kadınlarda bu bekleme süresi 6 ay ile sınırlandırılabilir ve sonrasında infertilite değerlendirmesine başlanabilir. 40 yaşından büyük kadınlarda daha acil değerlendirme ve tedaviye başlama en önemli seçenektir. İnfertilite değerlendirilmesi mutlaka deneyimli ve bu konuda eğitimli hekimler tarafından yapılmalı ve gerekli tedaviler bu hekimler tarafından takip edilmelidir. Standart değerlendirme basamakları ve genel olarak kabul edilen tedavi seçeneklerinden sonra cevap alınamayan hastalarda alternatif tedavi yöntemlerine geçilebilir. Burada çeşitli destek tedavileri öne çıkmaktadır. Bu seçenekler hem tedavi öncesi özellikle daha kaliteli oosit elde etmek için gerekse de hem de daha fazla folikülün stimülasyona katılmasını sağlamak için kullanılmaktadır. Özellikle ileri kadın yaşında oosit mitokondrisi DNA hasarı arttığı düşünüldüğünde, insülin direnci olduğu düşünülen kadınlarda antioksidanlar ve metformin tedavi öncesi en yaygın olarak kullanılan ajanlardır. Diğer yandan büyüme hormonu gibi deneyimli uzmanlar tarafından kontrollü bir şekilde kullanılması gereken ajanlar tedavide pek çok yayında etkin bulunmuştur. Sunulan makalede infertilite için konvansiyonel tedavi dışı seçenekleri anlatılmıştır.

Keywords

İnfertilite tedavi non-spesifik ajanlar

References

  • Wise J. Show patients evidence for treatment “add-ons,” fertility clinics are told. BMJ. 2019;364:I226.
  • Sunkara SK, Pundir J, Khalaf Y. Effect of androgen supplementation or modulation on ovarian stimulation outcome in poor responders: a meta-analysis. Reprod Biomed Online. 2011;22(6):545-55.
  • Nagels HE, Rishworth JR, Siristatidis CS, Kroon B. Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction. Cochrane Database Syst Rev. 2015;(11):CD009749.
  • Luo S, Li S, Li X, Qin L, Jin S. Effect of pretreatment with transdermal testosterone on poor ovarian responder undergoing IVF/ICSI: a meta-analysis. Exp Ther Med. 2014;8(1):187-94.
  • Datta AK, Campbell S, Deval B, Nargund G. Add-ons in IVF programme - hype or hope? Facts Views Vis Obgyn. 2015;7(4):241-50.
  • Duffy JM, Ahmad G, Mohiyiddeen L, Nardo LG, Watson A. Growth hormone for in vitro fertilization. Cochrane Database Syst Rev. 2010;(1):CD000099.
  • Eftekhar M, Aflatoonian A, Mohammadian F, Eftekhar T. Adjuvant growth hormone therapy in antagonist protocol in poor responders undergoing assisted reproductive technology. Arch Gynecol Obstet. 2013;287(5):1017-21.
  • Nardo LG, El-Toukhy T, Stewart J, Balen AH, Potdar N. British Fertility Society Policy and Practice Committee: Adjuvants in IVF: evidence for good clinical practice. Hum Fertil. 2015;18(1):2-15.
  • Tso LO, Costello MF, Albuquerque LE, Andriolo RB, Freitas V. Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2009;(2):CD006105.
  • Vanky E, Stridsklev S, Heimstad R, Romundstad P, Skogøy K, Kleggetveit O, et al. Metformin versus placebo from first trimester to delivery in polycystic ovary syndrome: a randomized, controlled multicenter study. J Clin Endocrinol Metab. 2010;95(12):E448-55.
  • Ruder EH, Hartman TJ, Blumberg J, Goldman MB. Oxidative stress and antioxidants: exposure and impact on female fertility. Hum Reprod Update. 2008;14(4):345-57.
  • Showell MG, Mackenzie-Proctor R, Jordan V, Hart RJ. Antioxidants for female subfertility. Cochrane Database Syst Rev. 2017;7(7):CD007807.
  • Ben-Meir A, Burstein E, Borrego-Alvarez A, Chong J, Wong E, Yavorska T, et al. Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell. 2015;14(5):887-95.
  • Griesinger G, Kolibianakis EM, Venetis C, Diedrich K, Tarlatzis B. Oral contraceptive pretreatment significantly reduces ongoing pregnancy likelihood in gonadotropin-releasing hormone antagonist cycles: an updated meta-analysis. Fertil Steril. 2010;94(6):2382-4.
  • Smulders B, van Oirschot SM, Farquhar C, Rombauts L, Kremer JAM. Oral contraceptive pill, progestogen or estrogen pre-treatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques. Cochrane Database Syst Rev. 2010;(1):CD006109.
  • Siristatidis CS, Dodd SR, Drakeley AJ. Aspirin for in vitro fertilisation. Cochrane Database Syst Rev. 2011;(8):CD004832.
  • Groeneveld E, Lambers MJ, Lambalk CB, Broeze KA, Haapsamo M, de Sutter P, et al. Preconceptional low-dose aspirin for the prevention of hypertensive pregnancy complications and preterm delivery after IVF: a meta-analysis with individual patient data. Hum Reprod. 2013;28(6):1480-8.
  • Kutteh WH, Yetman DL, Chantilis SJ, Crain J. Effect of antiphospholipid antibodies in women undergoing in-vitro fertilization: role of heparin and aspirin. Hum Reprod. 1997;12(6):1171-5.
  • Zhang Y, Song Y, Xia X, Wang J, Qian Y, Yuan C, et al. A retrospective study on IVF/ICSI outcomes in patients with persisted positive of anticardiolipin antibody: Effects of low-dose aspirin plus low molecular weight heparin adjuvant treatment. J Reprod Immunol. 2022;153:103674.
  • Sher G, Feinman M, Zouves C, Kuttner G, Maassarani G, Salem R, et al. High fecundity rates following in-vitro fertilization and embryo transfer in antiphospholipid antibody seropositive women treated with heparin and aspirin. Hum Reprod. 1994;9(12):2278-83.
  • Sher G, Matzner W, Feinman M, Maassarani G, Zouves C, Chong P, et al. The selective use of heparin/aspirin therapy, alone or in combination with intravenous immunoglobulin G, in the management of antiphospholipid antibody-positive women undergoing in vitro fertilization. Am J Reprod Immunol. 1998;40(2):74-82.
  • Qublan H, Amarin Z, Dabbas M, Farraj AE, Beni-Merei Z, Al-Akash H, et al. Low-molecular-weight heparin in the treatment of recurrent IVF-ET failure and thrombophilia: a prospective randomized placebo-controlled trial. Hum Fertil (Camb). 2008;11(4):246-53.
  • Nardo L, Chouliaras S. Adjuvants in IVF-evidence for what works and what does not work. Ups J Med Sci. 2020;125(2):144-51.
  • Boomsma CM, Eijkemans MJ, Hughes EG, Visser GH, Fauser BC, Macklon NS. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update. 2006;12(6):673-83.
There are 24 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Invited Review
Authors

Dilek Kaya Kaplanoğlu 0000-0003-0980-960X

Abdullah Tok 0000-0003-0998-5531

Publication Date October 30, 2022
Submission Date August 26, 2022
Published in Issue Year 2022 Volume: 24 Issue: Special Issue

Cite

APA Kaya Kaplanoğlu, D., & Tok, A. (2022). Non-Specific Medical Treatment Methods in Female Infertility. Duzce Medical Journal, 24(Special Issue), 86-89. https://doi.org/10.18678/dtfd.1191606
AMA Kaya Kaplanoğlu D, Tok A. Non-Specific Medical Treatment Methods in Female Infertility. Duzce Med J. October 2022;24(Special Issue):86-89. doi:10.18678/dtfd.1191606
Chicago Kaya Kaplanoğlu, Dilek, and Abdullah Tok. “Non-Specific Medical Treatment Methods in Female Infertility”. Duzce Medical Journal 24, no. Special Issue (October 2022): 86-89. https://doi.org/10.18678/dtfd.1191606.
EndNote Kaya Kaplanoğlu D, Tok A (October 1, 2022) Non-Specific Medical Treatment Methods in Female Infertility. Duzce Medical Journal 24 Special Issue 86–89.
IEEE D. Kaya Kaplanoğlu and A. Tok, “Non-Specific Medical Treatment Methods in Female Infertility”, Duzce Med J, vol. 24, no. Special Issue, pp. 86–89, 2022, doi: 10.18678/dtfd.1191606.
ISNAD Kaya Kaplanoğlu, Dilek - Tok, Abdullah. “Non-Specific Medical Treatment Methods in Female Infertility”. Duzce Medical Journal 24/Special Issue (October 2022), 86-89. https://doi.org/10.18678/dtfd.1191606.
JAMA Kaya Kaplanoğlu D, Tok A. Non-Specific Medical Treatment Methods in Female Infertility. Duzce Med J. 2022;24:86–89.
MLA Kaya Kaplanoğlu, Dilek and Abdullah Tok. “Non-Specific Medical Treatment Methods in Female Infertility”. Duzce Medical Journal, vol. 24, no. Special Issue, 2022, pp. 86-89, doi:10.18678/dtfd.1191606.
Vancouver Kaya Kaplanoğlu D, Tok A. Non-Specific Medical Treatment Methods in Female Infertility. Duzce Med J. 2022;24(Special Issue):86-9.
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