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ABSTRACT: This case reports a couple with infertility due to male factor asthenozoospermia and increased sperm DNA fragmentation along with a slightly thin endometrial lining of the female partner. The male partner received 1 g/day of acetyl-L-carnitine and 2 g/day of L-carnitine for 3 months, following which sperm motility was improved, and DFI was reduced from 45% to 20%. Intracytoplasmic morphologically selected sperm injection (IMSI) was utilized during the in vitro fertilization (IVF) cycle to utilize sperms with optimal morphological characteristics for fertilization selectively. To improve endometrial receptivity, the female partner underwent estrogen and platelet-rich plasma (PRP) treatment and the endometrial thickness increased from 6.5 mm to 8 mm, improving endometrial receptivity. A frozen embryo transfer was then carried out after 1 month of the initial cycle. Two weeks after the transfer, a subsequent serum β-hCG level measured 302 mIU/mL, indicating a pregnancy. This case demonstrates the importance of the combined management of acetyl-L-carnitine and L-carnitine supplementation alongside IMSI and PRP in treating the complex etiology of both male and female infertility and leading to successful IVF pregnancy. The systematic approach to focus on aspects that included improving sperm quality as well as the endometrium was therefore important in yielding the result. [ABSTRACT FROM AUTHOR]

ABSTRACT: Infertility in patients with reduced ovarian reserve and thin endometrial lining continues to pose a great challenge for successful in vitro fertilization. In the present case, a patient with a thin endometrium and low ovarian reserve resulted in a positive pregnancy with a specific IVF treatment plan. It included plasma-rich growth factors, growth hormone, supplementation along with some interventional support of endometrial scratching, and assisted hatching. Endometrial scratching and assisted hatching further optimized implantation potential. The use of these interventions hence promoted successful implantation of the embryo that contributed to positive pregnancy outcome and the birth of a healthy baby at 39 weeks. This case showed how individual ongoing comprehensive treatments definitively made a huge difference in the success of reproductive medicine. [ABSTRACT FROM AUTHOR]

ABSTRACT: The paper describes the treatment of a 27-year-old woman with a history of infertility, heavy menstrual periods, and severe endometriosis with bilateral hydrosalpinx. The patient received hormonal treatment with triptorelin acetate, a GnRH agonist, to treat her endometriosis and regulate her menstruation. Hysterosalpingography confirmed the presence of bilateral hydrosalpinx, thus suggesting IVF as the most suitable method to conceive. The patient went through a long protocol using GnRH agonist and 14 oocytes were retrieved from her with 10 being fertilized. To avoid ovarian hyperstimulation syndrome (OHSS), all the embryos were frozen and thawed after six months of hormone replacement therapy for the preparation of the endometrium, and a single blastocyst was transferred. The patient conceived, and a subsequent β-hCG level of 256 mIU/mL proved good pregnancy status 14 days after the embryo transfer. This case demonstrates how a personalized and holistic treatment approach to the management of infertility, especially in patients with such conditions as endometriosis and hydrosalpinx, can be very fruitful. [ABSTRACT FROM AUTHOR]