Summary of "Co zrobić, by in vitro się powiodło? Rozmowa z dr Bartoszem Chrostowskim"

Summary of Key Wellness Strategies, Self-Care Techniques, and Productivity Tips for Successful IVF (In Vitro Fertilization)

1. Preparation Before IVF Stimulation

Proper patient preparation is essential, especially for those with specific issues like low egg reserve or metabolic disorders.

Supplementation (e.g., Coenzyme Q10, D-Chara, testosterone gel) can be helpful but should be started 10-12 weeks before stimulation.
Monitor side effects carefully; discontinue supplements if severe symptoms (e.g., hair loss, acne) occur.
Synchronizing follicles before stimulation (e.g., using antagonistic protocols in the second phase of the cycle) can help follicles mature simultaneously.
Endometrial scratching (causing a small wound before embryo transfer) may improve implantation chances but is recommended only after transfer failures.
Modified stimulation protocols (e.g., double stimulation or stimulation in the luteal phase) can be used for patients with low ovarian reserve or previous failures to increase egg quantity and quality.

2. Semen Analysis and Management

Additional semen tests (oxidative stress, DNA fragmentation, sperm maturity) can guide treatment.
Antioxidant supplementation may be used in cases of oxidative stress but should be based on test results to avoid harm.
Advanced sperm selection techniques (e.g., microfluidic selection) can improve sperm quality used for fertilization.
In cases of no sperm or poor sperm quality, testicular biopsy with microscopic evaluation can be a rescue option.

3. Modifications During IVF Stimulation and Fertilization

Adjust stimulation protocols based on previous cycle outcomes (e.g., switch from antagonist to long protocol if poor egg quality).
Triggering final follicle maturation can be modified (e.g., using HCG, GnRH analogues, or combined triggers) depending on follicle development.
Consider frozen embryo transfers if fresh transfers repeatedly fail due to endometrial issues.

4. Embryo Culture and Selection

Time-lapse embryo monitoring systems allow continuous observation without disturbing embryos, improving selection of viable embryos.
Culture media are generally similar; however, enriched media may help in cases of repeated transfer failure.
Shortening embryo culture to day 3 may benefit patients who fail to reach blastocyst stage in vitro.
Preimplantation genetic testing (PGT) is recommended especially for patients over 35 or with previous failures to select genetically normal embryos, saving time and avoiding unnecessary transfers.

5. Embryo Transfer Techniques and Endometrial Preparation

Tailor endometrial preparation based on patient’s hormonal status and cycle regularity.
Pituitary suppression (desynchronization) before transfer can help in cases like endometriosis.
Use medications to inhibit uterine contractions before and after transfer to improve implantation chances.
Testing the window of implantation (e.g., Endometrial Receptivity Array) can optimize timing of embryo transfer.
Hyaluronic acid-enriched transfer media may improve implantation in patients with previous transfer failures but is not routinely needed for all.
Progesterone supplementation before and after transfer supports implantation; monitoring progesterone levels is important to avoid failure due to low levels.

6. Addressing Common Concerns and Questions

Multiple IVF techniques can be combined to optimize outcomes, especially after previous failures.
Uterine contractions can be managed with medications like atosiban to reduce ectopic pregnancy risk and improve implantation.
Genetic abnormalities in embryos are the leading cause of IVF failure (70-80%), followed by uterine factors (20-30%).
Endometriosis and insulin resistance negatively impact egg quality and implantation; lifestyle changes (diet, exercise) and medical treatment can help.
Chronic endometrial inflammation may require antibiotic treatment.
First IVF attempts generally do not require additional advanced techniques unless indicated by specific problems.

Presenters/Sources

Dr. Bartosz Chrostowski (main expert and presenter)
Ms. Sylwia (assisted with presentation slides)
Host/Moderator (unnamed)

This summary captures the main strategies, techniques, and considerations discussed for improving IVF success, emphasizing individualized treatment, diagnostic testing, and careful management of each stage of the IVF process.