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Studies Offer More Hope for Successful IVF


a blog by Laurence A. Jacobs, M.D., Fertility Centers of Illinois, October 24, 2012

There are two topics that have been in the news lately that are contributing to the success of in vitro fertilization and offer hope for many couples.

The first is egg freezing, also known as oocyte vitrification. The egg freezing process has just had its "experimental" label lifted by the American Society for Reproductive Medicine (ASRM). The research has found that advances in egg-freezing techniques now produce rates of pregnancy and healthy babies comparable to those of IVF with fresh eggs.

While ASRM did not go so far as to recommend egg freezing in order for a woman to slow down her biological clock, this procedure is an option for women to consider for whatever reason they may want or need to preserve their fertility.

If a woman has a male partner and wants to preserve her fertility for the future, embryo freezing is the first choice. But if a woman is under 40, with a normal FSH hormone level and normal AMH — and cannot or does not want to get pregnant now either due to medical reasons, lack of a male partner or other personal reasons such career, travel or education — then egg freezing may offer her the best chance for having a genetic child that she otherwise might not have had.

Once the eggs are frozen, they will remain that way until the woman chooses to have them thawed and fertilized in preparation for an embryo transfer. In my fertility practice, currently, a woman ideally must be less than 50 years old to have embryos transferred in an attempt to become pregnant.

It is also extremely important that women who are undergoing cancer treatment that could potentially destroy their fertility be aware of the option of egg freezing. In order for a woman who has cancer not to delay her potentially life-saving treatment, we offer expedited, targeted care at a discounted rate for egg freezing prior to that treatment.

Recently, another study by British researchers — “Local endometrial injury and IVF outcome: a systematic review and meta-analysis” — was published in the journal Reproductive Medicine Online. Researchers did a retrospective review of studies on endometrial biopsy — also known as “womb scratching” — and found that women who undergo this procedure prior to in vitro fertilization (IVF) are twice as likely to become pregnant.

Endometrial biopsy scratching is a gentle endometrial injury that is caused by scratching the woman’s uterine lining several weeks prior to the embryo transfer. It is performed with a flexible catheter that is pushed through the cervical canal and scratches the endometrial tissue.

How does womb scratching work? The theory is that endometrial biopsy produces an inflammatory reaction with increased white blood cells that secrete growth factors and cytokines, which are needed for proper implantation. However, the exact reasons why this technique may aid in successful IVF are not completely known.

In my fertility practice, I use endometrial biopsy “scratching” for women who have good embryo quality, but have failed IVF. With this technique, I have had successes, and patients have gone on to have a successful pregnancy and birth after IVF failures.


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