Comparison of a fixed and dynamic protocol for embryo replacement in an IVF/ET programme

• Published in: Human reproduction (Oxford) 1988-08, Vol.3 (6), p.747-750
• Main Authors: Feldberg, Dov, Goldman, Jack A., Shelef, Michal, Ashkenazi, Jack, Dicker, Dov, Yeshaya, Aryeh
• Format: Article
• Language: English
• Subjects: Chorionic Gonadotropin - therapeutic use; Drug Therapy, Combination; embryo replacement; Embryo Transfer - methods; Estradiol - blood; Female; Fertilization in Vitro - methods; Follicle Stimulating Hormone - therapeutic use; Humans; implantation; IVF; Menotropins - therapeutic use; Oocytes - cytology; Time Factors
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/oxfordjournals.humrep.a136777

Implantation after embryo transfer is considered a major obstade in terms of pregnancy rates after in-vitro fertilization. A flexible approach to the date of replacement, based on the fact that the most suitable embryonic structure for proper implantation is the four- to eight-cell embryo, has been studied. One-hundred-and-twenty patients with various aetiologies of infertility were stimulated with HMG or combined HMG and FSH, then treated by three different methods of embryo replacement. In group I embryos were replaced in mothers 48 h after ovum retrieval; in group II replacements were carried out 72 h after retrieval; and in group III replacements were related to embryonic cleavage development. Mean levels of oestradiol when HCG was given averaged 1301 ± 121 pg/ml, 1016 ± 96 pg/ml and 1182 ± 101 pg/ml in the three groups, respectively. There was no significant difference in the average number of embryos transferred among the various groups. The pregnancy rates per transfer were 21.8, 24.2 and 38.7%, respectively (P < 0.001). Although more investigation is required, a dynamic approach to embryo replacement might significantly improve pregnancy rates, because of improved interactions between the embryos and the uterus.