Knowing a cross-talk between embryo and endometrium can help to achieve successful pregnancy outcome in recurrent implantation failure
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20170415Keywords:
Embryo, Hysteroscopy, Implantation, ICSI, IVF, Oocyte, Recurrent implantation failureAbstract
Recurrent implantation failure is most distressing condition to both couple as well as doctor in the field of reproductive medicine. Patients have already undergone various ART treatments with no favourable outcome and are drained emotionally as well as economically. To overcome this obstacle a comprehensive approach is needed. In this case report, we are addressing a couple who came to us with primary infertility of 15 yrs, with recurrent IVF failures (four cycles of IUI, seven cycles of ICSI both fresh and frozen and with ovum donation in last two cycle), with poor ovarian reserve and male factor infertility for surrogacy as a last option. After complete evaluation of couple, recurrent Implantation failure is thought to be due to poor endometrium and bad embryo quality, and we counselled couple to go for ovum donation and ICSI before considering surrogacy. To improve endometrial receptivity we performed local endometrial injury, oral estradiol therapy, intrauterine G-CSF instillation and IVIG etc. Simultaneously for better quality of embryo we decided to choose ovum donation due to poor ovarian reserve and advance age of the patient and ICSI was done with husband sperm after treatment of male factor infertility and ET was performed. Patient conceived in first cycle with single live intrauterine pregnancy, her antenatal course was uneventful and delivered a healthy baby at term without any complication.
References
Coughlan C, Ledger W, Wang Q, Liu F, Demirol A, Gurgan T, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online. 2014;28(1):14-38.
Shufaro Y, Schenker JG. Implantation failure, etiology, diagnosis and treatment. Int J Infertil Fetal Med. 2011;2:1-7.
Andersen AN, Gianaroli L, Felberbaum R, de Mouzon J, Nygren KG. Assisted reproductive technology in Europe, 2001. Results generated from European registers by ESHRE. Hum Reprod. 2005;20:1158-76.
Achache h, revel a. Endometrial receptivity markers, the journey to successful embryo implantation. Hum Reprod Updat. 2006;12:731-46.
Narvekar SA, Gupta N, Shetty N, Kottur A, Srinivas M, Rao KA. Does local endometrial injury in the nontransfer cycle improve the IVF-ET outcome in the subsequent cycle in patients with previous unsuccessful IVF? A randomized controlled pilot study. J Hum Reprod Sci. 2010;3(1):15-9.
Kumar P, Mahajan S. Preimplantation and postimplantation therapy for the treatment of reproductive failure. J Hum Reprod Sci. 2013;6:88-92.
Gleicher N, Vidali A, Barad DH. Successful treatment of unresponsive thin endometrium. Fertil Steril. 2011;95(2123):e13-7.
Coulam CB, Acacio B. Does immunotherapy for treatment of reproductive failure enhance live births? Am J Reprod Immunol. 2012;67(4):296-304.
Ghanem H, Shaeer O, El-Segini A. Combination clomiphene citrate and antioxidant therapy for idiopathic male infertility: a randomized controlled trial. Fertil Steril. 2010;93(7):2232-5.
