Non-Specific Medical Treatment Methods in Female Infertility

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

Kadın İnfertilitesinde Spesifik Olmayan Medikal Tedavi Yöntemleri

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

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