C-Improving embryo culture & implantation

* To enable ART programs to achieve ideal pregnancy rates it is important to have a state of the art IVF laboratory with embryologists that are well trained in the different techniques of the process. The laboratory requires state of the art incubators maintaining near physiologic conditions for the developing embryo as well as laminar flow with selective filters to remove organic solvents. In addition, specialized lighting protocols may improve clinical outcomes. Also, selecting the type of the controlled media where embryos grow.

* More recently, data has been presented suggesting delayed embryo transfer until day 5/6 following fertilization versus day 3 may improve implantation rates (the percentage of an embryo to embed in the uterine wall) from 20% to 50%.With an average of 2-3 blastocysts transferred, pregnancy rates approach 70%. This technique may provide superior pregnancy rates with fewer embryos transferred, minimizing multiple gestation rates. This is especially important for women less than 35, the highest risk group for multiple gestation. Recent data published in January 2005 from the US registry of reproductive centers has shown increase in pregnancy rates from 4% to 16% for those above 40 years of age when blastocysts are transferred.

D- Improving Embryo Transfer

* Variations in embryo transfer technique among physicians have been demonstrated to have a profound impact on individual pregnancy rates in the same institution. At Ganin all necessary precautions and pre cycle information are identified to insure “smooth” atraumatic embryo transfer.

* In conclusion, maintaining superior pregnancy rates requires a multifaceted, disciplined approach. Previously mentioned factors may influence IVF pregnancy rates. Providing the highest possible pregnancy rates require continual evaluation of IVF laboratories, stimulation protocols, patient selection, luteal phase protocols and embryo transfer techniques. With multiple physicians, individual pregnancy rates must be determined since variations may occur with stimulation protocols and embryo transfer techniques.