Abstract
Background Restorative reproductive medicine represents a comprehensive approach to subfertility (infertility and miscarriage) with investigations, diagnoses, and treatments combined with fertility charting to restore optimal reproductive function. Restorative reproductive medicine assumes that multiple factors need to be identified and treated (cycle optimization) for up to 12 cycles to achieve a successful pregnancy. Conception can occur during normal intercourse without intrauterine insemination or in vitro fertilization.
CASE PRESENTATION: A 35-year-old Croatian female presented for fertility treatment in May 2019 with a previous diagnosis of polycystic ovaries, infertility of 16 years duration, and 8 unsuccessful embryo transfers with in vitro fertilization and intracytoplasmic sperm injection. She was gravida 3 para 0, with 2 miscarriages after spontaneous conception at 5-6 weeks gestation in 2002 and 2004, followed by a miscarriage after in vitro fertilization at 12 weeks gestation in 2011. We initially found poor follicle function and suboptimal progesterone levels. Restorative reproductive medicine treatment resulted in conception after two cycles of treatment. This pregnancy ended in miscarriage at 7 weeks 4 days. Additional investigations found a balanced Robertsonian translocation (13, 14) and a uterine septum. We achieved repeat fertilization with restorative reproductive medicine after three cycles of treatment following resection of the uterine septum and ovulation induction with letrozole and human chorionic gonadotrophin. She had a full-term healthy pregnancy and live birth in 2021.
Conclusion We propose that a full evaluation of underlying factors, and up to 12 cycles of cycle optimization, should be offered to subfertile patients before considering in vitro fertilization treatment.
restorative reproductive medicine case report, naprotechnology after failed ivf, recurrent miscarriage treatment success, cycle optimization infertility treatment, fertility charting pregnancy achievement, repeated ivf failure alternative treatment, pcos infertility restorative approach, robertsonian translocation pregnancy outcome, uterine septum resection fertility, letrozole ovulation induction success, 16 years infertility natural conception, cycle charting after ivf failure
Keywords
Abortion, Habitual/therapy, Adult, Embryo Transfer/methods, Female, Fertilization in Vitro, Humans, Infertility, Pregnancy, Reproductive Medicine, Sperm Injections, Intracytoplasmic, Case Report, Infertility, Polycystic Ovarian Syndrome, Recurrent Miscarriage, Repeated Failed IVF