The focus is upon previous IVF failures despite adequate ovarian response. The purpose of this study was to compare IVF hospital in Hyderabad outcome following sequential embryo transfer (ET) with that following the transfer of early cleavage embryos among patients with previous multiple IVF failures but the adequate ovarian response.
Multiple pregnancies (most of them twins) were significantly more common in women undergoing sequential transfer. Sequential transfer of embryos can indeed be indicated for women with repeated IVF cycles, but the number of embryos transferred must be limited in order to prevent multi-fetal gestations. More data are needed to support this approach.
Transfer of blastocysts was actually introduced in an attempt to improve the outcome of couples undergoing it. This approach confers the supposed benefits of blastocyst transfer without endangering the cycle owing to the failure of embryos to survive the prolonged culture. The efficacy of this procedure, however, is still a matter of debate.
Cytogenic analysis of the embryos and pre-implantation genetic diagnosis may in higher pregnancy rates in patients with repeated failures but these techniques are expensive. The outcome of this IVF treatment which follows sequential ET was therefore compared with that after early-cleavage ET in women with a history of at least three IVF failures despite adequate ovarian response.
The focus has been on stimulation protocol and were subsequently compared with the study group women for maternal age, basal FSH concentrations, a reason for infertility treatment in hyderabad, ovarian stimulation protocols, number of previous IVF cycles, number of oocytes retrieved and number of embryos transferred.
Embryo quality is in fact determined according to the number of cleaved cells on day 3 and embryo fragmentation. Ovaries were stimulated and oocytes retrieved according to conventional IVF protocols in which mid-luteal gonadotrophin-releasing hormone (GnRH) agonist administration is followed by ovarian stimulation by gonadotrophins. The number of embryos available as well as their morphology, as well as maternal age, IVF history, and the number of prior implantation failures, have been taken into account when deciding on the number of embryos for replacement.
A Soft Pass™ transfer catheter (Cook) has been made use of for both ET procedures. Treatment options do include a transfer of two to four of the best-cleaved embryos on day 3 for patients who were not planned for sequential transfer. In the group of women who offered sequential transfer, one or two best-cleaved embryos on day 3 were transferred, followed by one or two blastocysts on day 5/6.
In rare cases of multiple IVF failures of unknown cause, or when embryo quality was poor, more than four rather transferred after detailed discussion with the couple concerning the risks of multiple pregnancies. The implantation rate in each group has been defined as the total number of gestational sacs (observed by ultrasound) divided by the total number of embryos/blastocysts transferred.
Clinical pregnancy rates were rather calculated as the number of ultrasound tests showing a heartbeat at 7 weeks of pregnancy divided by the number of women in the group. Also recorded were no doubt the numbers of cryo-preserved embryos, the numbers of multiple pregnancies, and pregnancy outcome. Statistical analysis was carried out making use of the chi-squared test or the Fisher Exact test for categorical variables and the unpaired two-way Student’s t-test for continuous factors.
A value of P 0.05 was rather accepted as statistically significant.
Women with repeated IVF treatment failures had significantly higher rates of both implantations as well as pregnancy after sequential ET compared with a matched group of women who underwent a transfer of day 3 embryos only.