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Staggered In Vitro Fertilization (St-IVF): Rational Expectations


by Geoffrey Sher, M.D. and Levent Keskintepe Ph.D.

Our reported IVF results following egg biopsy, our unique experience in the performance of CGH, and our preliminary and growing experience with St-IVF, suggest a 55-65% chance of a live birth following the transfer of up to two “competent” blastocysts to a “receptive” uterus.

A. Introduction

The ability of an embryo (the “seed”), upon reaching a “receptive uterine environment (the “soil”) to successfully implant and develop into a healthy baby (the “plant”), is no different than what takes place in a regular agricultural setting. In simple terms, it is determined by establishing an ideal “seed/soil relationship”. It follows that it is no more possible to achieve a viable healthy pregnancy when a “competent” embryo (one that upon reaching a “receptive” is 50-60% likely to develop into a viable pregnancy) is transferred to a “non-receptive” uterus that when an “incompetent” embryo is transferred to a “receptive uterus”.
Throughout human reproduction, the establishment of an ideal “seed-soil” relationship is pivotal, since both embryo “competency” as well as uterine receptivity is indispensable to the development of a healthy baby. It is however an undeniable fact that reproductive failure (i.e. failed implantation, miscarriages and major birth anomalies) are far more likely to be due to embryo “incompetence” (70-75%) than to a lack of uterine receptivity (25-30%).

Successful treatment of reproductive failure demands full prior identification and treatment of those factors that adversely influence both embryo “competence” as well as uterine receptivity (i.e., thickness of the uterine lining, immunologic modalities, anatomical integrity of the uterus as well as infective and biochemical factors).

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