Acıbadem Health Group IVF Center Coordinator Dr. Yeni New methods such as hysteroscopy, comparative genomic hybridization, ERA testing are the new treatments that end the failure of IVF ”. The number of couples who need treatment to have children is increasing day by day. The World Health Organization's warning that the problem of infertility would become more widespread in 2050 accelerated the scientific studies in this field. The reason for recurrent in vitro fertilization failure is the most important solution. Science is defined as a 'recurrent in vitro fertilization failure' in which 3 couples have been transferred to a total of at least 4 quality embryos in a trial. The quality of embryos is influenced by the success criteria. If couples develop quality embryos but the embryo is unable to hold onto the uterus, both embryo and uterine factors need to be carefully examined.Transfer Timing Very Important One of the causes of recurrent IVF failure is the timing of embryo transfer. For successful treatment, embryo transfer should be performed at the appropriate time when the uterus can accept the embryo. The problems that prevent the continuation of the pregnancy after the attachment of the embryo or even the attachment should be identified and corrected. Because in scientific studies, it is determined that in 25% of recurrent IVF failures, transfer is not made at the right time when the uterus can accept the embryo. The first choice for the solution of the problems arising from the uterus should be visualization of the uterus by hysteroscopy method. There are many scientific studies showing that the potansiyel Office Hysteroscopy öncesi performed before the IVF trial increases the potential of the uterus to accept the embryo. Hysteroscopy is a procedure that requires experience… Hysteroscopy is used for diagnosis and treatment of intrauterine and uterine diseases. Because the method; minimizes the risk of error in diagnosis and diagnosis. However, it is a process that requires experience. Complications may occur if not performed by experienced and knowledgeable specialists. Entering into the uterus with a hysteroscope takes images from the inside and wall of the uterus. It is more reliable than similar operations. Hysteroscopy, which eliminates uterine removal, is used in the treatment of almost any uterine disease. Method; diagnostic and surgical. Diagnostic hysteroscopy is the imaging of the inside of the uterus for diagnosis and diagnosis. Surgical hysteroscopy is for therapeutic purposes. The diagnostic method is also called “Office Hysteroscopy.. It is used in the detection of problems such as uterine fibroids, polyps, adhesion and curtain. Diagnostic hysteroscopy can sometimes be performed alone or sometimes with laparoscopy. Office hysteroscopy is also used in the diagnosis of abnormal bleeding before and after menopause other than infertility. In addition, if the woman who will start IVF treatment does not have a cervical film previously taken, it can be determined by using diagnostic hysteroscopy to determine whether the uterus is suitable for treatment. Surgical hysteroscopy is a method that requires expertise and requires attention. Failure and carelessness during administration can seriously threaten the patient. Uterine perforation is the most common complication. Reliable, Fast, Advantageous: CGHCGH (Comparative Genomic Hybridization) Genetic Testing to Embryos; In order for an embryo to hold, the chromosome number of that embryo must be normal. There are 23 pairs of chromosomes in humans. Among these 46 chromosomes, the chromosomes determining the sex are XX in women and XY in men. Comparative Genomic Hybridization Briefly CGH; All chromosomes of the embryo can be examined and changes in the amount of DNA are evaluated comparatively. False-negative and false-positive results are much less reliable than the FISH technique. In addition, the result can be obtained in as little as 12-24 hours with CGH method. Evaluation of PGT by taking a cell from the 3rd day embryo may have a damaging effect on the embryo. This has negative effects on pregnancy rates. On the other hand, it is more advantageous in PGT procedure performed on the 5th day embryo because it is possible to work with 4-5 cells from the tissues that make up the placenta. On the 5th day, it was determined that the success of pregnancy can be increased in cases of recurrent IVF failure and advanced female age by evaluating the cells taken from the tissue forming the placenta, not from the embryo.ERA (Endometrium Receptivity Assay) TestERA is a very advanced genetic test that determines the optimal time for the uterus to accept the embryo. With this test, a piece of the uterus is removed and a total of 238 genes are examined and it is determined whether the uterus is suitable for embryo delivery with high accuracy. It can be applied to women who have recurrent implantation failure, that is, at least 4 high quality embryos from past 3 IVF trials but cannot become pregnant. Blastocyst embryos obtained from the couples planned for ERA test by using IVF method on the 3rd day or 5th day are frozen without being transferred to the uterus. At least two months later, tissue biopsy is performed with a special instrument after the treatment for uterine thickening and the tissues are sent to the genetic center in a special tube. Appropriate days for the attachment of the embryo to the uterus are determined. If the uterus is suitable for transplantation of the embryo for the specified days, embryo dissolution-transplantation treatment is planned for the next menstrual period. In short, the ERA test; endometrium is a test that determines when the embryo will be accepted. According to the results of the research, 27 -30 percent of couples experiencing recurrent failure have achieved success.