Endometrial Assessment in the Prediction of Pregnancy Outcome after Embryo Transfer

John Emil Boulos Grace;

Abstract


In vitro fertilization or fertilization (IVF) is a process by which an egg is fertilized by sperm outside the body: in vitro ("in glass"). The process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova (egg or eggs) from the woman's ovaries and letting sperm fertilize them in a liquid in a laboratory. The fertilized egg (zygote) is cultured for 2–6 days in a growth medium and is then implanted in the same or another woman's uterus, with the intention of establishing a successful pregnancy.

The first successful birth of a "test tube baby", Louise Brown, occurred in 1978. Louise Brown was born as a result of natural cycle IVF where no stimulation was made. Robert G. Edwards, the physiologist who developed the treatment, was awarded the Nobel Prize in Physiology or Medicine in 2010. With egg donation and IVF, women who are past their reproductive years or menopause can still become pregnant. Adriana Iliescu held the record as the oldest woman to give birth using IVF and donated egg, when she gave birth in 2004 at the age of 66, a record passed in 2006. After the IVF treatment many couples are able to get pregnant without any fertility treatments.

Intracytoplasmic sperm injection (ICSI) is an in vitro fertilization procedure in which a single sperm is injected directly into an egg. Defective sperm function remains the single most important cause of human infertility. Although certain severe forms of male infertility have a genetic origin, others may be the result of environmental factors. During the past decade, ICSI has been applied increasingly around the world to alleviate problems of severe male infertility in human patients who either could not be assisted by conventional IVF procedures or could not be accepted for IVF because too few motile and morphologically normal sperm were present in the ejaculate of the male partner.



In a clinical point of view, practitioners need to have some objective measurements to determine the probability for a healthy pregnancy in both aspects of embryo and endometrium, in a given human cycle. Assisted reproductive technology (ART) cycles allow us to understand human biology in detail and to develop some objective clinical parameters to measure and in turn to determine successful implantation. Currently, although the classical embryo grading system seems to be a subjective measurement to determine for choosing the best embryo, bestembryo selection has being improved by 'embryo-metabolomics' that the initial results are very promising.

As endometrial biopsy is invasive and hormonal milieu assessment inaccurate, the need to evaluate endometrial development encouraged the use of high-resolution ultrasonography as an alternative non-invasive method of assessment for uterine receptivity. Endometrial biopsy for determination of various kinds of gene products is not a feasible and reasonable method. However, in the clinical point of view, the assessment of endometrial thickness using gray-scale ultrasound seems to be an easy and reliable method.


Other data

Title Endometrial Assessment in the Prediction of Pregnancy Outcome after Embryo Transfer
Other Titles تقييم بطانة الرحم في التنبؤ بنجاح حدوث الحمل بعد عملية نقل الاجنة
Authors John Emil Boulos Grace
Issue Date 2015

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