scholarly journals Evaluating recurrent implantation failure in the setting of euploid elective single-embryo transfer: Is three really the magic number?

2021 ◽  
Vol 115 (1) ◽  
pp. 70-71
Author(s):  
Kate D. Schoyer ◽  
Shunping Wang ◽  
Robert T. Rydze
2016 ◽  
pp. 80-84
Author(s):  
Thi Tam An Nguyen ◽  
Minh Tam Le ◽  
Ngoc Thanh Cao

Background: Laser assisted hatching technique based on the hypothesis to make an artificial hole on zona pellucida (ZP) that can help embryo hatching out of ZP easily. This technique has been shown to increase implantation and pregnancy rates in women of advanced age, in women with recurrent implantation failure and following the transfer of frozen–thawed embryos. This study described the outcome of frozen–thawed embryo transfers with laser assisted hatching (LAH), which is one of the safest method in nowadays. Purpose: To assess the effect of assisted hatching technique on the clinical outcomes in vitrified-warmed transfer cycles. Method: A total of 65 thawed-transfer cycles with 153 thawed-embryos undertaken within a 12-month period were analysed, Assisted hatching with laser zona thinning was performed with one-quarter of the zona pellucida circumference. The overall thawed-embryos (day 3) were kept in culture overnight. Patient were prepared the suitable endometrium and transferred embryos advantageously. Results: In which, having the rate of survival embryos were 143 occupying 94.3%, the percentage of grade 1 and 2 embryos occupied 55.9% and 29,3% respectively, and that were enrolled LAH before transfering of frozen–thawed embryos. The average transferred embryos were 2.4±0.8, The rate of implantation per transferred embryos and per transferred embryos cycles was 19.5% and 43.1% respectively. The rate of clinical pregnancies per embryo transfer cycles occupied 33.8% with percentage of early miscarriages (biochemical pregnancies and early clinical miscarriages) was 12.3%. The rate of ongoing pregnancies was 30.8% and multiple pregnancies was low just 12.3%. This result was equal or higher than other researchs in embryos transfer had or no LAH. Conclusion: LAH contributed to stable frozen–thawed embryos transfer effectiveness. Key words: Laser assisted hatching, frozen–thawed embryos transfer, zona pellucida (ZP)


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M P Rimmer ◽  
N Black ◽  
S Keay ◽  
S Quenby ◽  
B. H.A Wattar

Abstract Study question What is the effectiveness of IV Intralipid (IVI) in improving pregnancy rates in women undergoing IVF with history of Recurrent implantation failure (RIF) to improve reproductive outcomes. Summary answer The evidence to support the use of IVI at the time of embryo transfer in women with RIF is limited. More RCTs are needed. What is known already: Optimising the implantation process following embryo transfer remains a clinical challenge with 10% of couples undergoing IVF affected by (RIF). Immunotherapy could help to optimise endometrial receptivity and increase the chances for successful conception in women with history of RIF. Intra-venous Intralipid (IVI), a fat-based emulsion of soybean oil, glycerine, phospholipids, egg, and polyunsaturated fatty acids, has been evaluated in several trials as a potential intervention to downregulate the uNK cells and macrophages as well as inhibit the pro-inflammatory mediators including T1 helper cells. Evidence synthesis is needed to evaluate the effectiveness of this intervention. Study design, size, duration We performed this systematic review using a prospectively registered protocol (CRD42019148517) and reported in accordance with the PRISMA guidelines. Participants/materials, setting, methods: We searched MEDLINE, EMBASE and CENTRAL for any randomised trials evaluating the use of IVI at the time of embryo transfer in women undergoing assisted conception until September 2020. We extracted data in duplicate and assessed risk of bias using the Cochrane Risk of Bias tools. We meta-analysed data using a random effect model and reported on dichotomous outcomes using risk ratio (RR) and 95% confidence interval (CI). Main results and the role of chance We included five randomised trials reporting on 843 women with an overall moderate risk of bias. All trials used 20% IVI solution at the time of embryo transfer compared to normal saline infusion or no intervention (routine care). The IVI group had a higher chance of clinical pregnancy (172 vs 119, RR 1.55, 95%CI 1.16–2.07, I2 44.2%) and live birth (132 vs 73, RR 1.83, 95%CI 1.42–2.35, I2 0%) post treatment compared to no intervention. Limitations, reasons for caution Our findings are limited by the small sample size and the variations in treatment protocols and population characteristics. Wider implications of the findings: Our meta-analysis offers an overview on the value of IVI to help women affected by RIF. Given the limitations and the quality of included trials, adopting the use of IVI a-la-carte to couples undergoing IVF remains immature. IVI should not be offered until larger RCTs demonstrate a persistent benefit. Trial registration number CRD42019148517


GYNECOLOGY ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 270-274
Author(s):  
Gunai R. Asfarova ◽  
Veronika I. Smol'nikova ◽  
Natalia P. Makarova ◽  
Iuliia S. Drapkina ◽  
Anastasiia P. Sysoeva ◽  
...  

Cumulus cells are essential during oocytes growth and development, as well as during their maturation and fertilization. Research results have shown that embryo co-cultivation with autologous cumulus cells increases the frequency of blastocyst formation, and also improves the effectiveness of ART programs. Embryo transfer in such programs is recommended to be carried out using the CAT technology (Cumulus-Aided embryo Transfer), which includes embryo cultivation on a layer of cumulus cells and embryo transfer with a certain amount of diluted cumulus cells. Patient G., 38 years old, came to the department with infertility for 15 years and recurrent implantation failure in history. The patient had ART program with autologous co-cultivation of embryos with cumulus cells and a new CAT transfer technology. The patient fell pregnant and gave birth to a healthy child. Autologous cumulus cells can be a source of biologically active substances and improve embryological parameters and implantation rate in ART programs. Embryo co-cultivation with cumulus cells is especially important for patients with recurrent implantation failure. This technique can become an alternative for optimizing human embryos culturing.


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