During the course of treatment, the treatment cycle may have difficulties that result in cancellation or reduced success, as well as complications of treatment that become more difficult with pregnancy.


** Inability of the woman to apply the times and doses appropriately and correctly in the treatment: To explain and understand the days, hours and doses of the treatment very well, to write all the information clearly and to always be in communication prevents this problem completely. In injection applications, subcutaneous applications can often be performed successfully by the woman herself. This training is given by applying the first injections together. If women do not want to make their own injection, and in intramuscular applications, nurse assistance is required.

** No egg development or insufficient egg growth with ovulation drugs: Requires cancellation of the treatment cycle. Planning is done to start the new cycle with the next menstruation. Low ovarian reserves or older women are encountered. Women with treatment-resistant polycystic ovaries may also experience difficulties in egg development.

** No egg hatching or quality and mature eggs cannot be found during egg collection: In this case, there will be no eggs to micro-enjection, or there will not be enough eggs for microinjection. In this case, the cycle will have to be cancelled.

** The absence of sperm during TESE: In azoospermia, sperm may not be found during TESE in 40% of cases and the cycle is cancelled.

** No fertilization after microinjection: In the absence of fertilization, the embryo will not be obtained and the cycle will be cancelled.

** No expected division in the embryo: Failure to reach the expected number of cells in the embryo after fertilization also means that the quality to be transferred cannot be obtained and the cycle is cancelled.

** Difficulty in transfer: Some women may have difficult transfer due to anatomical or acquired difficulties in the cervix and cervix. In this case, there are occasional uterine contractions and the chance of pregnancy decreases.

** Bleeding before pregnancy test: In the days before pregnancy test, woman may have vaginal bleeding. This shows that the chance of pregnancy decreases in proportion to the severity of bleeding, but it does not indicate that there will be no pregnancy.

** Hyperstimulation syndrome: This is a problem that occurs with excessive egg sac formation, especially in women with polycystic ovary syndrome. Details on the prevention and treatment are described in the relevant section. However, it may be necessary to start stimulating hormone doses to a minimum and to be very careful while increasing the dose, to be noticed early while following, to decrease the dose or to stop the stimulant drugs a day or a few days before collecting eggs.

Other medication options or the dose of HCG may need to be reduced for maturation as it triggers the HCG syndrome applied to ripen eggs. Special serum like HES and Cabergoline application during egg collection also helps to control the severity of the syndrome.

Since pregnancy aggravates hyperstimulation syndrome, embryos can be frozen and transfer can be performed by preparing the endometrium in the next cycle. If the degree of hyperstimulation is appropriate, a single embryo transfer can be performed, or up to two embryo transfers can be made by sharing the risks very well with the couple.

In cases such as swelling in the abdomen, pain, palpitations, shortness of breath, rapid weight gain, and rapid increase around the waist, the team should be contacted immediately. In addition to salt restriction, abundant fluid intake, resting and pain relief basic therapy, inpatient follow-up, fluid-electrolyte therapy, and occasional fluid removal may be required by parasynthesis.