Intrauterin Inseminasyon, IVF/ICSI

İnfertilite düzenli ilişkiye rağmen bir yılın sonunda gebe kalamama olarak tanımlanmaktadır. Bu aşamadan sonra başlayan değerlendirme süreci ile tedavi ihtiyacı ve tedavi seçeneği belirlenmektedir. Tedavi temel olarak over stimulasyonunu takiben zamanlı ilişki, intrauterin inseminasyon (IUI) ve in vitro fertilizasyon (IVF)/intrasitoplazmik sperm enjeksiyonunu (intracytoplasmic sperm injection, ICSI)’nu içermektedir. Burada uygun hasta ve uygun tedavi yönteminin seçilmesi kritiktir ve birçok faktöre bağlıdır. Anne yaşı ve infertilite etiyolojisi tedavi seçiminde ana belirteçtir. 38 yaş üzeri hastada hızla IVF/ICSI seçimi hakkında düşünmek ne kadar önemli ise çok düşük sperm parametreleri varlığında beklemeden yardımcı üreme tekniklerine geçmek de o kadar önemlidir. Uygun olmayan endikasyon tedavi en iyi şekilde bile yapılsa başarısız olacaktır. Uygun hasta seçimi ve tedavi aşamalarında hastaya yeterli süre verilmesi başarıyı artıracaktır. Sunulan makalede infertilite nedenlerine göre IUI ve IVF/ICSI hasta seçim kriterleri değerlendirilecektir. Burada hasta değerlendirmesinin hangi sıra ile yapılacağı ve basamaklı infertilite tedavisinde IVF/ICSI’ya giden yolda geçilmesi gereken basamaklar detaylı ve açıklayıcı olarak değerlendirilecektir.

Anahtar Kelimeler:

İnfertilite, intrauterin inseminasyon, in vitro fertilizasyon, tedavi

Intrauterine Insemination, IVF/ICSI

Infertility is defined as the inability to conceive after one year despite regular intercourse. The need for treatment and treatment option are determined by the evaluation process that starts after this stage. Treatment mainly includes ovarian stimulation followed by timed intercourse, intrauterine insemination (IUI), and in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Choosing the appropriate patient and appropriate treatment method is critical here and is based on many factors. Maternal age and infertility etiology are the main determinants of treatment selection. As important as it is to think about IVF/ICSI selection quickly in patients over 38 years of age, it is equally important to switch to assisted reproductive techniques without waiting in the presence of very low sperm parameters. An inappropriate indication will fail even if the treatment is done in the best way. Appropriate patient selection and giving enough time to the patient in the treatment stages will increase success. In the presented article, IUI and IVF/ICSI patient selection criteria will be evaluated according to the causes of infertility. Here, the order in which the patient will be evaluated and the steps to be taken on the way to IVF/ICSI in the treatment of staged infertility will be evaluated in detail and descriptively.

Keywords:

Infertility, intrauterine insemination, in vitro fertilization, treatment,

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