Factors affecting embryo implantation after human in vitro fertilization: a hypothesis

Article Abstract:

Couples having difficulty conceiving may resort to in vitro fertilization (IVF), in which the woman's eggs are retrieved, fertilized with sperm outside the body so that embryo cell multiplication begins, and transferred back to the uterus, hopefully to be followed by embryo implantation into the uterine wall and subsequent development of the placenta and other important structures necessary for pregnancy. However, the majority of IVF procedures do not succeed, chiefly due to low rates of implantation. The pregnancy rate, and therefore implantation, improves when multiple embryos are transferred to the uterus. To better describe the likelihood of embryo implantation following IVF, a mathematical model has been developed and is discussed in this article. In this model, embryo implantation is presented as the outcome of interaction between embryo quality, endometrial (uterine lining) receptivity, and transfer efficiency. Each of these factors is discussed. Using this model, embryo implantation data from an IVF program were analyzed; three groups of patients were described. The donor program uses donated eggs for women without ovaries. In addition, participants were selected from a standard IVF program and an IVF program which does not use the same program of hormonal stimulation. The donor group had an implantation rate of 35 percent and a clinical pregnancy rate of 67 percent. The standard group had an implantation rate of 11 percent and a pregnancy rate of 39 percent. The unstimulated group had a 21 percent implantation rate and a 21 percent pregnancy rate. These results are scrutinized in terms of the mathematical model, and the idea of endometrial receptivity or embryo quality being limiting factors for implantation, depending on the type of IVF program, is discussed. Further development of this type of analysis is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Models, Human embryo, Fertilization in vitro, Human embryo transplantation

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Recipient's age does not adversely affect pregnancy outcome after oocyte donation

Article Abstract:

Older women undergoing fertilization with donor eggs are equally likely as younger women to conceive and bear children. The results of 307 donor egg cycles were reviewed and compared between women younger or equal to age 42 or older than age 42. All egg recipients had a normal uterine cavity and a normal mid-cycle uterine response to hormones as shown by biopsy. On-going pregnancy and birth rates were 30% among younger women and 31% among older women. Ten percent of younger women versus 16% of older women miscarried, a statistically nonsignificant difference. Declining fertility, a known effect of aging among women, appears to be related strictly to aging eggs, not an aging uterus. However, older women were more likely to have borne a child, which may tilt the odds of success with an in vitro procedure in their favor.

Physiological aspects, Pregnancy, Middle aged women, Pregnancy in middle age

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