Role of Hysteroscopy in Repeated IVF/ICSI – ETs Failure and its Impact Effect on Subsequent Attempts

2021 ◽  
Vol 19 (5) ◽  
pp. 86-94
Author(s):  
Shaima Gaber Mohmeed Gadalla Elgebally ◽  
Mahmoud Salah El Din Hamouda ◽  
Ahmed Tawfeek Soliman ◽  
Dina Gamal El Deen El-Kholi
Keyword(s):  
Prospective Observational Study ◽  
Uterine Cavity ◽  
Clinical Pregnancy ◽  
University Hospital ◽  
Cervical Canal ◽  
Vitro Fertilization ◽  
Reproductive Unit ◽  
Infertile Patients

Background: Recurrent implantation breakdown is characterized as a complication to accomplish a clinical pregnancy subsequent to transfer of 4 or further high-quality embryos in a least amount of 2 in vitro fertilization (IVF) cycles in a woman less than the age of 40. This investigation intended to the responsibility of hysteroscopy in repeated IVF/ICSI failure and its impact on subsequent trials. Methods: Prospective observational study was conducted at assisted reproductive unit in obstetric and gynecology department in Tanta University Hospital from Jan 2018 to Jan 2020. Included 50 infertile patients with more then two IVF/ICSI failure in spite of transmit of as a minimum two better quality embryos. All patients were subjected to 4D US examination with same device (Siemens acuson X300). Results: We found that from the 30 patients who had normal findings in hysteroscopy, 25 had normal findings also in 4DUS, 2 had polyps, 2 had myoma and 1 patient had septum. From the 3 patients who had polyps in hysterectomy, 1 had normal findings in 4DUS, and 2 patients had polyps. Regarding the two patients who had myoma by hysteroscopy, 1 had normal findings in 3DUS and the other had Myoma. While for the 3 considered patients who had septum in hysteroscopy, all had normal findings in 4DUS. Conclusion: According to this study, hysteroscopy is regarded the gold standard not only for envisaging the cervical canal and uterine cavity, however also for healing several types of benign pathologies localized to that area, it is a secure and uncomplicated process.

scholarly journals The Role of Follicular Fluid Anti-Mullerian Hormone in Success Rate of Intracytoplasmic Sperm Injection

2020 ◽  
Vol 8 (B) ◽  
pp. 962-965
Author(s):  
Hiathm Ahmed Baha El-Din ◽  
Essam Ahmed El Gindy ◽  
Ahmed Kotb Ahmed ◽  
Osama Ahmed Ibrahim ◽  
Ayman Nady Abdelmegeed
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Ovarian Function ◽  
Implantation Rate ◽  
Inverse Correlation ◽  
Clinical Pregnancy ◽  
University Hospital ◽  
Blastocyst Development ◽  
Vitro Fertilization

BACKGROUND: The role of anti-Mullerian hormone (AMH) in the ovary is to participate in the regulation of ovarian function, especially in follicle development and selection. It inhibits the initiation of human primordial follicle growth and prevents multiple selection of a dominant follicle by reducing the sensitivity of follicles to follicle stimulating hormone. MATERIALS AND METHODS: In this prospective clinical trial, outcomes were followed in 60 women undergoing cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) within El-Minia University Hospital. AMH concentration was estimated in pooled follicle fluid (FF) on day of oocyte pickup. Cycles were sorted into low and high groups according to median (50th centile) values of measurement. The fertilization rate (FR), implantation rate, blastocyst development, embryo quality, chemical pregnancy, clinical pregnancy, and ongoing pregnancy after ICSI were counted as the main outcomes. RESULTS: Low FF AMH group shows significantly higher percentage of top-quality oocytes (67.1 ± 24.3 vs. 49.6 ± 30.3 %, p = 0.014), FR (83.9 ± 20.9 vs. 72.4 ± 21.4%, p = 0.021), clinical pregnancy (57.57 vs. 16.67%, p > 0.0001), and embryo implantation rates (57.7 vs. 16.7%, p = 0.001) compared to high FF AMH group. FF AMH shares an inverse correlation with FF E2 (Pearson r = −0.409, p < 0.001) and clinical pregnancy (Pearson r = −0.618, p < 0.001). Threshold value of FF AMH for pregnancy is >1.75 ng/mg protein. CONCLUSION: FF AMH is a plausible specific indicator of functional viability and quality of oocyte in IVF cycles.  

The scattered puzzle effect: implantation disorders in chronic endometritis

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 93-100
Author(s):  
Victor E. Radzinsky ◽  
Mekan R. Orazov ◽  
Liliia R. Toktar ◽  
Liudmila M. Mihaleva ◽  
Pavel A. Semenov ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Special Role ◽  
Inadequate Response ◽  
Chronic Endometritis ◽  
Vitro Fertilization ◽  
Endometrial Cells ◽  
Adverse Pregnancy ◽  
Relationship Of

Chronic endometritis (CE) is defined as a state of inflammation localized in the endometrium, accompanied by edema, dissociated maturation of epithelial cells and fibroblasts, increased stromal density and the presence of plasma cell infiltrate in it. The connection between chronic inflammation in the endometrium and infertility deserves special attention. Inadequate response of immunocompetent endometrial cells, including impaired synthesis of proinflammatory cytokines, dysreceptiveness, disorders of proliferation and differentiation processes are the main links in the formation of infertility in patients with CE. Despite the fact that the presence of a normocenosis of the uterine cavity today is not in doubt this is a physiological norm, persistent bacterial infection of the endometrium is still called the main etiopathogenetic factor of CE and, therefore, the main point of application of therapeutic agents. Nevertheless, a number of works have emphasized the special role of not bacterial, but viral etiology of endometritis, especially in the context of infertility developing against this background. It seems that the role of viral endometrial infection in adverse pregnancy outcomes and in vitro fertilization programs is underestimated. Further research is needed to clarify the relationship of viral infection as a trigger of implantation failure in infertile women with CE.

scholarly journals Comparative Study Between Mock Embryo Transfer Prior To The Treatment Cycle and Real Embryo Transfer In In Vitro Fertilization

KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Hilma Putri Lubis
Keyword(s):  
In Vitro Fertilization ◽  
Embryo Transfer ◽  
Treatment Cycle ◽  
Uterine Cavity ◽  
Pregnancy Rates ◽  
Clinical Pregnancy ◽  
Vitro Fertilization ◽  
Significant Difference ◽  
Clinical Pregnancy Rates

<p><strong>Introduction</strong><strong></strong></p><p>A trial or mock embryo transfer (ET) may influence pregnancy rates and it performed prior to ET allows the clinician to assess the uterine cavity and the utero-cervical angle. The aim of this study is to compare the consistency of the type of ET in mock ET with real ET.</p><p><strong>Material &amp; Methods</strong></p><p>A retrospective comparative analysis of  patients who underwent in vitro fertilization or ICSI cycle from January 2014 to December 2014 in Halim Fertility Center was done. The type of transfer was divided into two groups: ‘easy’ or ‘difficult’. An easy ET was defined as a transfer that occurred without the use of manipulation or other instrumentation and difficult ET was considered when additional instrumentation was required.</p><p><strong>Results</strong></p><p>From the study, 103 patients who underwent Mock-ET, we  found 58 patients (56.3%) with easy ET and 45 patients (43.7%) with difficult ET, which with hard catheter ET in 17 patients (16.5%), with osfander assistance in 20 patients (19.4%) and with stylet in 8 patients (7,8%). 58 patients with Easy Mock ET group were entirely easy real ET (100%) and 45 patients with difficult Mock ET group also entirely were difficult real ET (100%). The Statistical analysis shows no significant difference between the mock ET and real ET groups (p&gt;0,05). In easy real ET, clinical pregnancy rates were 32.8% and in difficult real ET, clinical pregnancy rates were 26.7% with no significant difference between the  groups (p&gt;0,05).</p><p><strong>Conclusion:</strong></p><p>Mock ET prior to the treatment cycle is consistent with real ET.</p>

scholarly journals The Role of Laparoscopic Investigation in Enabling Natural Conception and Avoiding in vitro Fertilization Overuse for Infertile Patients of Unidentified Aetiology and Recurrent Implantation Failure Following in vitro Fertilization

2019 ◽  
Vol 8 (4) ◽  
pp. 548 ◽  
Author(s):  
Agni Pantou ◽  
Mara Simopoulou ◽  
Konstantinos Sfakianoudis ◽  
Polina Giannelou ◽  
Anna Rapani ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
In Vitro Fertilization ◽  
Primary Outcome ◽  
Unexplained Infertility ◽  
Vitro Fertilization ◽  
Natural Conception ◽  
Infertility Patients ◽  
Infertile Patients

The present study aims to explore the effectiveness of laparoscopic surgery on women presenting with infertility, of unidentified aetiology according to the standard infertility investigation, and recurrent failed In Vitro Fertilization (IVF) attempts. Identifying and correcting possible underlying pathologies by laparoscopy may subsequently enable natural conception in an effort to address infertility and avoid IVF overuse. One-hundred and seven (107) women with unidentified aetiology of infertility and recurrent failed IVF attempts met the inclusion criteria. Laparoscopic surgery was performed as the endpoint of the patients’ diagnostic journey, aiming to identify a possible underlying factor as the cause of infertility. Sixty-two (62) out of 107 patients (57.94%) that underwent laparoscopy were diagnosed with endometriosis, 25 out of the 107 patients (23.3%) were diagnosed with periadnixal and pelvic adhesions, and 20 cases (18.69%) presented with no pathology and remained unexplained. Following identification and correction of endometriosis and pelvic adhesions, patients were invited to conceive naturally. For the patients that laparoscopic investigation failed to reveal any pathology they were categorized as unexplained infertility and were subjected to a single IVF cycle. Natural conception success rate within the first postoperative year was the primary outcome. Within the first postoperative year, 30 out of 62 patients (48.38%) diagnosed with endometriosis following laparoscopic investigation achieved a natural conception, and 28 out of them (93.4%) reported live-births. Additionally, 11 out of 25 patients (44%) diagnosed with periadnixal and pelvic adhesions achieved natural conception within the first operative year. Regarding the group of unexplained infertility patients, only four out of the 20 patients (20%) achieved clinical pregnancy in the first post-operative IVF cycle. In conclusion, laparoscopy appears to be a promising approach, addressing infertility, providing significant diagnostic findings, while avoiding IVF overuse regarding patients of unidentified infertility presenting with recurrent failed IVF attempts.

503. SUCCESSFUL IN VITRO FERTILIZATION (IVF) AFTER PRIOR FAILED IVF UTILIZING A PROPRIETARY BLEND OF SUPPLEMENTS

2009 ◽  
Vol 21 (9) ◽  
pp. 104
Author(s):  
B. Poursharif ◽  
J. Paden ◽  
B. Acacio
Keyword(s):  
In Vitro Fertilization ◽  
Egg Quality ◽  
Clinical Pregnancy ◽  
Ivf Outcome ◽  
Positive Role ◽  
Vitro Fertilization ◽  
Embryo Fragmentation ◽  
History Of

Background: To date, little is known about the effect of supplements on the outcome of in vitro fertilization (IVF). The data on this matter is limited to measuring the overall pregnancy rate on a population of women who took a specific supplement, and not on IVF patients. Objectives: To demonstrate the positive role of an investigated supplement in the outcome of patients undergoing IVF. Method: 18 women undergoing IVF treatment were placed on a proprietary combination of vitamins and antioxidants designed to encourage blood flow and improve egg quality. The women were selected for this protocol mostly due to prior poor egg quality and/or large amount of embryo fragmentation .The women took supplementation twice daily for 4–12 weeks prior to transfer. The charts of the patients who used the supplements were used to obtain data. Previous failed IVF was defined as negative pregnancy. Successful IVF outcome was determined by positive chemical pregnancy and clinical pregnancy after one attempt. Range and mean was calculated for patient's age and number of failed previous IVF attempts. The previous IVF attempts were performed in different centers without using this supplement in all patients. Results: Eighteen patients used the supplement before and during their IVF cycles. Patient's age ranged from 28 to 44 with mean of 36.4 years. They had on average, 2 prior failed IVF attempts. Seventeen of 18 patients had successful IVF outcome. The failed patient required frozen testicular extraction of sperm (TESE), prior to IVF. Summary: Seventeen of 18 patients who used our supplements had successful IVF. These patients failed an average of 2 previous IVF attempts without using our supplements. Conclusion: Usage of our supplements is associated with improved rates of success in patients undergoing IVF with a history of prior failed IVF attempts. Larger studies need to be conducted.

scholarly journals LIF level is a predictive marker for clinical pregnancy following IVF-ET of patients with fallopian tube obstruction

2020 ◽  
Author(s):  
Zewu Li ◽  
Ruimei Li ◽  
Huiying Dai ◽  
Xiaoyun Li ◽  
Xiao Han ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Embryo Culture ◽  
Culture Medium ◽  
Predictive Marker ◽  
Clinical Pregnancy ◽  
Vitro Fertilization ◽  
Embryo Culture Medium ◽  
Infertile Patients ◽  
Ivf Et

Abstract Background: Leukemia inhibitory factor (LIF) has played a vital role in a series of reproductive events, including follicle growth, embryo growth and differentiation. However, it is unclear whether the level of LIF in embryo culture medium can be used as a marker for clinical pregnancy. In this study, we aimed to investigate whether LIF level in embryo culture medium can act as a predictive marker for pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET) in infertile patients due to tubal problems.Methods: A total of 104 infertile patients due to tubal problems underwent IVF-ET treatment. The patients were divided into two groups according to whether they were clinically pregnant. The level of LIF in the embryo culture medium was measured, and the correlation between LIF level and embryo quality and clinical pregnancy outcome was analyzed. The embryo culture medium was collected on the day of blastocyst transplantation.Results: Compared to non-pregnant group, LIF level in the embryo culture medium on the day of blastocyst transplantation was significantly higher in the pregnant group.Conclusions: LIF level in the embryo culture medium may be used as a non-invasive auxiliary biomarker for predictive clinical pregnancy in infertile patients with tubal problems that using single blastocyst transfer method.

scholarly journals The role of chronic endometritis in development of infertility in terms of etiological factors

2021 ◽  
pp. 22-27
Author(s):  
Ihor I. Chermak ◽  
Volodymyr I. Chermak ◽  
Mariia A. Matvian ◽  
Mansi Singh
Keyword(s):  
In Vitro Fertilization ◽  
Preterm Labor ◽  
Recurrent Miscarriage ◽  
Uterine Cavity ◽  
Implantation Failure ◽  
Chronic Endometritis ◽  
Vitro Fertilization ◽  
Persistent Inflammation

Chronic endometritis (CE) is a persistent inflammation of the inner lining of the uterine cavity caused by bacteria such as Enterococcus, Streptococcus, Staphylococcus, Enterobacteriaceae. A majority of CE produces no signs or sometimes mild symptoms, and the prevalence rate of CE is 10-15%. Several studies have shown that it is a condition frequently associated with repeated unexplained implantation failure at in vitro fertilization, recurrent miscarriage, as well as preterm labor. In this study, we reviewed how chronic endometritis plays an important role in the development of infertility. Also, we discuss the importance of hysteroscopic procedures in the diagnosis of chronic endometritis.

scholarly journals LIF level is a predictive marker for clinical pregnancy following IVF-ET of patients with fallopian tube obstruction

2020 ◽  
Author(s):  
Zewu Li ◽  
Ruimei Li ◽  
Huiying Dai ◽  
Xiaoyun Li ◽  
Xiao Han ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Embryo Culture ◽  
Culture Medium ◽  
Predictive Marker ◽  
Clinical Pregnancy ◽  
Vitro Fertilization ◽  
Embryo Culture Medium ◽  
Infertile Patients ◽  
Ivf Et

Abstract Background: Leukemia inhibitory factor (LIF) has played a vital role in a series of reproductive events, including follicle growth, embryo growth and differentiation. However, it is unclear whether the level of LIF in embryo culture medium can be used as a marker for clinical pregnancy. In this study, we aimed to investigate whether LIF level in embryo culture medium can act as a predictive marker for pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET) in infertile patients due to tubal problems.Methods: A total of 104 infertile patients due to tubal problems underwent IVF-ET treatment. The patients were divided into two groups according to whether they were clinically pregnant. The level of LIF in the embryo culture medium was measured, and the correlation between LIF level and embryo quality and clinical pregnancy outcome was analyzed. The embryo culture medium was collected on the day of blastocyst transplantation.Results: Compared to non-pregnant group, LIF level in the embryo culture medium on the day of blastocyst transplantation was significantly higher in the pregnant group.Conclusions: LIF level in the embryo culture medium may be used as a non-invasive auxiliary biomarker for predictive clinical pregnancy in infertile patients with tubal problems that using single blastocyst transfer method.

scholarly journals Effect of embryo transfer depth on IVF/ICSI outcomes: A randomized clinical trial

2020 ◽  
Author(s):  
Robab Davar ◽  
Seyedeh Mahsa Poormoosavi ◽  
Fereshteh Mohseni ◽  
Sima Janati
Keyword(s):  
Assisted Reproductive Technology ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Uterine Cavity ◽  
Reproductive Technology ◽  
Clinical Pregnancy ◽  
Vitro Fertilization ◽  
Group A ◽  
Group B

Background: Although there has been remarkable advancement in the field of assisted reproductive technology, implantation failure remains a significant issue in most infertile couples receiving these treatments. Embryo transfer is important in assisted reproductive technology and directly affects the implantation rates and pregnancy outcomes. Objective: To assess the effect of two different distance embryo transfer sites from fundal endometrial surface on the outcomes of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Materials and Methods: A total of 180 women who were candidate for IVF/ ICSI/ embryo transfer in Yazd Research and Clinical Center for Infertility were equally assigned to two groups based on the distance between the fundal endometrial surface and catheter tip to investigate implantation, chemical and clinical pregnancy (group A: 15 ± 5 mm and group B: 25 ± 5 mm, respectively). Results: The subjects in the group B showed significantly higher implantation rate, chemical and clinical pregnancy rate compared to the group A (p = 0.03, 0.01, 0.04, respectively). The rate of ongoing pregnancy and miscarriage indicated no significant differences between groups (p = 0.21, 0.27, respectively). Conclusion: In conclusion, our study showed that the depth of embryo replacement inside the uterine cavity at a distance of 25 ± 5 mm beneath fundal endometrial surface have better effects on the pregnancy outcomes of IVF/ICSI cycles and can be considered as an important factor to improve the success of IVF cycles. Key words: Embryo transfer, Endometrium, Pregnancy outcomes, IVF, ICSI.

Sign in / Sign up

Export Citation Format

Share Document