{"id":2800,"date":"2020-09-10T00:00:00","date_gmt":"2024-10-10T01:09:09","guid":{"rendered":"https:\/\/www.oakclinic-group.com\/wp\/info\/2800\/"},"modified":"2025-01-09T17:40:38","modified_gmt":"2025-01-09T08:40:38","slug":"info107","status":"publish","type":"info","link":"https:\/\/www.oakclinic-group.com\/en\/info\/info107\/","title":{"rendered":"Oak Clinic: Our approach when success is hard to reach"},"content":{"rendered":"<p class=\"mb-5\" style=\"font-size: 1.5em\">\r\n  For patients with negative pregnancy tests\r\n <\/p>\r\n\r\n<p>\r\n  There are several known potential issues to discuss and explore.\r\n <\/p>\r\n<h2 class=\"section-dept__content02_title mt40\">\r\n  1. Fertilized egg condition\r\n <\/h2>\r\n<div class=\"section-dept__content02_text\">\r\n<p>\r\n   The ability of eggs to be collected and fertilized successfully may account for up to 70% of the progress toward success.\r\n   <br\/>\r\n   Therefore, the best way of moving toward success is to continue collecting and fertilizing eggs.\r\n   <br\/>\r\n   Even a low-grade embryo (but which is good enough to freeze) may very well implant and become a healthy child, so never get distressed by the grade of embryos.\r\n   <br\/>\r\n   The biggest factor in viability is chromosomes, which cannot be seen with the naked eye, only guessed at.\r\n   <br\/>\r\n   Sometimes a \u201cperfect\u201d grade embryo may have chromosomal abnormalities or a lower grade embryo may have excellent chromosomes. It cannot be seen only by looking.\r\n   <br\/>\r\n   There are many possible problems, but the impact of age is strong.\r\n  <\/p>\r\n<p>\r\n   Collecting eggs sooner than later is therefore the most important step to take.\r\n   <br\/>\r\n   It is OK to delay transfer in order to collect more eggs sooner, as the results of age on transfer are less severe than the results of age on egg health.\r\n  <\/p>\r\n<p>\r\n   Chromosomes can be examined through a special test.\r\n  <\/p>\r\n<\/div>\r\n<h2 class=\"section-dept__content02_title mt40\">\r\n  2. Endometrium condition\r\n <\/h2>\r\n<p style=\"bold\">\r\n  Tests to know the condition: IFCE [HF (hysteroscopy) + endometrial biopsy], ERA, ALICE, EMMA1\uff09\r\n <\/p>\r\n<div class=\"section-dept__content02_text\">\r\n<p>\r\n   1\uff09Physical factors: we can see them with hysteroscopy\r\n   <br\/>\r\n   \u25cfUterine fibroids may be compressing the endometrium.\r\n   <br\/>\r\n   \u25cfThere may be hydrosalpinx or abscess, and implantation may be hindered by the flow of secretions from the fallopian tubes to the uterus.\r\n   <br\/>\r\n   \u25cfMenstrual blood may accumulate in a scarred part of the incision after cesarean section and inhibit implantation.\r\n   <br\/>\r\n   \u25cfThere may be a fibroid or polyp in the endometrium.\r\n  <\/p>\r\n<p>\r\n   2\uff09Qualitative issues: IFCE, ERA, EMMA, ALICE\r\n   <br\/>\r\n   \u25cfChronic endometritis (prone to inflammation): IFCE [HF (hysteroscopy) + endometrial biopsy]\r\n   <br\/>\r\n   \u25cfImplantation window may out of alignment: ERA (Endometrial Implantation Ability Test)\r\n   <br\/>\r\n<span class=\"rem12\">\r\n    \u30fbBacterial flora (intrauterine flora) may be not well balanced: ALICE (infectious chronic endometritis test)\r\n    <br\/>\r\n    \u25cfLactic acid bacteria ratio may be troublesome: EMMA (endometrial microbiome test)\r\n   <\/span>\r\n<br\/>\r\n   Endometrial biopsies have been reported to increase implantation rates slightly, but cannot be repeated frequently due to the risk of intrauterine adhesions.\r\n   <br\/>\r\n   Regarding the diagnosis of EMMA and ALICE, they are less conclusive than other examinations, but those who wish to have a test can take it.\r\n  <\/p>\r\n<\/div>\r\n<h2 class=\"section-dept__content02_title mt40\">\r\n  3. Personal Environment\r\n <\/h2>\r\n<p style=\"bold\">\r\n  Inspections used to consider personal environment are mostly blood tests and tests related to implantation failure.\r\n <\/p>\r\n<div class=\"section-dept__content02_text\">\r\n<p>\r\n   Implantation failure may correspond to the repetition of very early miscarriage, suggesting that antibodies involved in infertility may themselves be causes of implantation failure.\r\n   <br\/>\r\n   For example, anti-cardiolipin \u03b22GPI antibody is known to cause miscarriage.\r\n   <br\/>\r\n   Abnormalities in the coagulation system (prone to blood clots) occur, resulting in a miscarriage.\r\n   <br\/>\r\n   Ultimately, there are numerous possible causes of implantation failure, however, and many items which are suggested to be related.\r\n  <\/p>\r\n<p>\r\n   Implantation failure tests performed at this hospital can be divided into the following main categories.\r\n   <br\/>\r\n   1.\u00a0Those that cause abnormalities in the coagulation system (examination of recurrent pregnancy loss \u2013 test categories \u2460 and \u2461)\r\n   <br\/>\r\n   2.\u00a0Immune function is too strong (recurrent pregnancy loss test category \u2462 - weekday only, by appointment)\r\n   <br\/>\r\n   3.\u00a0Chromosome test of couple (recurrent pregnancy loss test category \u2463 - weekday only, by appointment)\r\n   <br\/>\r\n   4.\u00a0Nutrition problems such as vitamin D (test for recurrent pregnancy loss category \u2464)\r\n  <\/p>\r\n<\/div>\r\n<div class=\"section-dept__content02_text mt10\">\r\n<p>\r\n   Depending on the result, we will consult with you and propose treatment for correction.\r\n   <br\/>\r\n   As a rule of thumb, we often propose an implantation failure test after 2-3 implantation failure events.\r\n   <br\/>\r\n   However, if the chances of a transplant are low, such as in old age or with ovarian dysfunction, we may make a proposal before the first attempted embryo transfer.\r\n   <br\/>\r\n   Not all items are definitely related or a cause, but we can do our best to make the environment as good as possible.\r\n   <br\/>\r\n   Some items are often positive, and if they are positive, you will have to take medications, injections, and related blood tests before giving birth to correct them.\r\n  <\/p>\r\n<p>\r\n   Since there is a possibility of excessive medical treatment in the case of positive results, we will propose tests while considering the balance.\r\n   <br\/>\r\n   However, if a patient truly wishes to inspect all items before the first attempted embryo transfer, we can accommodate that wish.\r\n  <\/p>\r\n<p class=\"align_right mt30 mb30\">\r\n<span style=\"font-size:1.2em\">\r\n    Oak Clinic Group\r\n   <\/span>\r\n<\/p>\r\n","protected":false},"featured_media":0,"template":"","info_category":[2],"clinic":[24],"class_list":["post-2800","info","type-info","status-publish","hentry","info_category-news","clinic-oak","en-US"],"_links":{"self":[{"href":"https:\/\/www.oakclinic-group.com\/wp-json\/wp\/v2\/info\/2800","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.oakclinic-group.com\/wp-json\/wp\/v2\/info"}],"about":[{"href":"https:\/\/www.oakclinic-group.com\/wp-json\/wp\/v2\/types\/info"}],"wp:attachment":[{"href":"https:\/\/www.oakclinic-group.com\/wp-json\/wp\/v2\/media?parent=2800"}],"wp:term":[{"taxonomy":"info_category","embeddable":true,"href":"https:\/\/www.oakclinic-group.com\/wp-json\/wp\/v2\/info_category?post=2800"},{"taxonomy":"clinic","embeddable":true,"href":"https:\/\/www.oakclinic-group.com\/wp-json\/wp\/v2\/clinic?post=2800"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}