Infertility treatments

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Ovarian stimulation

The goal of ovarian stimulation is to obtain ovulation in anovulatory patients (PCOS patients). Sperm analysis should be normal. Stimulation can be performed by letrozole, clomiphene citrate and gonadotropins. Couple tries to achieve pregnancy by sexual intercourse.

Artificial insemination

Artificial insemination is fertility treatment when sperm (partner’s or donor’s) is introduced in female uterus and fallopian tubes, often in couples with unexplained infertility and light male factor as well as azospermia (donor’s). Insemination can be done in natural cycle or with light ovarian stimulation (higher risk for twins).

Surgical treatment

Fibroids, endometriosis, some uterine malformations, intrauterine polyps and adhesions may be treated surgically, often by laparoscopy or hysteroscopy. In some case open surgery must be performed.

Fertility preservation

Cancer treatment including chemotherapy and radiation can damage both female and male gonads. Consultation with fertility specialist should be performed before cancer therapy with the goal to tailor fertility preservation method. There are following fertility preservation methods: sperm, egg, ovarian tissue and embryo freezing as well as ovarian transposition.

Uterus transplantation

Women who was born without uterus or surgically removed uterus can achieve motherhood by uterus transplantation, the procedure developed by professor Mats Brännström and his team. IVF and embryo cryopreservation performs before surgery. 6-12 months after transplantation embryo transfer can be done. There are 13 livebirths in the world, of which 8 in Sweden and 1 in Italy after uterus transplantation performed in Belgrade. Uterus transplantation is still regarded as experimental procedure.

In vitro ovarian activation

Funkciju jajnika 1% žena izgubi pre 40 godine, to jest uđe u prevremenu menopauzu što je verovatno posledica genetskih promena. Jedan deo žena izgubi funkciju jajnika usled lečenja citostaticima i zračenjem. S obzirom na to što te žene najverovatnije imaju određeni broj jajnih ćelija, koje ne mogu da se aktiviraju i razvijaju, razvijena je metoda gde se jedan jajnik operativno odstrani, zatim aktivira u laboratoriji i jedan deo vrati (transplantira) u trbušnu duplju, na mesto gde se i nalazi jajnik. Posle intervencije se kontroliše funkcija jajnika i radi IVF. Ostatak jajnika se zamrzne za eventualnu sledeću transplantaciju. Operacija se izvodi laparoskopski kao dnevna hirurgija ili sa jednim noćenjem u bolnici. Metoda je između ostalog razvijena na univerzitetima u Geteborgu i Stokholmu. Do sada je rođeno dvadesetak dece u svetu, od toga jedno u Zagrebu. Metoda se smatra eksperimentalnom. Donacija jajne ćelije je jedina klinički etablirana metoda kod žena sa prevremenom menopauzom.