Tekrarlayan YÜT başarısızlıklarına nasıl yaklaşalım

Tekrarlayan YÜT başarısızlıklarına nasıl yaklaşalım

Tekrarlayan YT baarszlklarna nasl yaklaalm Dr. Hakan zrnek PGS Tekrarlayan IVF baarszlnda PGS ile ilgili sadece 2 randomize kontroll alma var. Her ikisi de ileri anne ya ile ilgili; PGS canl doum oranlarn arttrmyor.

Anderson&Pickering 2008 PGS 38 yandan kk 3 veya daha fazla IVF baarszl olan hastalarda PGS yaplm. 54 PGS grubu, 86 kontrol grubu FISH 13,16,18,21,22,X ve Y PR PGS grubu %14.8, kontrol grubu %26.7 IR PGS grubu %11.9, kontrol grubu %18.4 Anlaml fark yok.

Yakn K, et al., 2008 Histeroskopi Tekrarlayan YT baarszlnda histeroskopide uterin patoloji bulma ihtimali %40-43 kadardr. Polip Submkz veya intramural myomlar Septum

ki randomize kontroll almada histeroskopi sonras gebelik oranlarnn artt grlm. Bozda G, et al., 2008 Kromohisteroskopi 64 hasta standart histeroskopi ile herhangi bir patoloji saptanmam Metilen mavisi ile endometriumda koyu boyanan alanlar endometrit tans alm.

Sensitivite %69.2, spesifisite %74 Kk & Safali, 2008 Endometrium gen expresyonu Endometrial biyopsiler alnm Affymetrix Human Genome Chip 1875 gen upregule olmu 1807 gen down regule olmu Devam eden gebelik ve abortlar arasnda

somatostatin, PLAP-2, mucin 4 ve CD 164 up regle olurken, glikodelin, IL-24, CD 69, LIF ve prolaktin reseptr down regle olmu Bersinger NA, et al., 2008 Telomeraz Tekrarlayan implantasyon baarszl olan

hastalarn endometriumlarn da fertil kontrol grubundan farkl olarak telomeraz immunreaktivitesi gsterilmitir. Ancak telomeraz uzunluklar asndan her iki grupta da fark yoktur. Hapangama DK, et al., 2008 Progesteron reseptr polimorfizmi 66 tekrarlayan IVF baarszl 75 fertil kontrol

H770H, V660L, 306 bp Alu insertion in Exon 7 Her iki grup arasnda fark yok. Coulam CB, Jeyendran RS, Roussev R, 2008 p53 tumr supresyon geni polimorfizmi Tekrarlayan implantasyon kayb olan

hastalarda p53 tmr supresyon geni polimorfizminin istatistiksel anlaml olarak daha yksek olduu tespit edilmitir. Kay C, Jeyendran RS, Coulam CB, 2006 uNK Tekrarlayan IVF baarszlklarnda uterusta CD56(bright) CD16 uterin natural killer celllerin arttn gryoruz. Bu hcreler uterin arter rezistansn dryor.

uNK hcrelerin art angiogenezi ve peri implantasyon kan akmn arttryor bu da oksidatif strese sebep oluyor. Quenby S, et al.,2008 PAI - VEGF 70 tekrarlayan YT baarszl hastas, 73 fertil kontrol grubu PAI 4G/4G ve VEGF-1154AA genlerinin aratrma grubunda kontrol grubuna oranla

daha yksek olduu gsterilmi. Goodman C, Jeyendran RS, Coulam CB, 2008 HLA-G s HLA-G seviyesinin dk olmas IVF baarszlnn bir belirtecidir. ?

Sipak-Szmigiel O, et al., 2008 LIF N=149 En az iki IVF baarszl rLIF 7 gn veya plasebo Gebelik oranlar: rLIF grubu: %17.6 kontrol grubu: % 34.0

Brinsden PR, et al., 2008 Glukokortikoid Meta analiz IVF: snrl gebelik art ICSI: gebelie etkisi yok AH: gebelik art Antikor varl: gebelik art Boomsma & Macklon; 2008

AH Tekrarlayan implantasyon baarszl vakalarnda lazer assisted hatching bir sonraki tedavide baar oranlarn arttrmyor. Valojerdi MR, et al., 2008 Kokltr 17 prospektif randomize almann

metaanalizi Klinik Gebelik Oranlar (9 alma) Kokltr kullanmn ile klinik gebelik saysnda %8.1 art Devam Eden Gebelik Oranlar (7 alma) Ko-kltr kullanmn ile devam eden gebelik saysnda %8.7 art olduu hesaplanmtr. Kattal N, et al., Fertil Steril, 2008 Dier yntemler

IVIG Paternal lenfosit as Akupunktur Hipnoz Embryo glue Sperm mknats MACS

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