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In the Western world, the techniques of
Assisted reproduction They have taken on a special role in the face of the increase in problems for couples to conceive. Especially because of the delay in the age to be parents. Only in Spain, between 2014 and 2018 the cycles of In Vitro Fertilization (IVF) increased by 28% and approximately 9% of newborns are the result of assisted reproduction treatment, according to data from the Spanish Fertility Society.
Although IVF increases the chances of achieving a pregnancy, success rates are variable and depend on multiple factors. Now, a research team from University College London (UCL), University College London Hospitals NHS Foundation Trust (UCLH), the University of Birmingham and University Hospitals Coventry and Warwickshire NHS Trust has carried out a comprehensive review to investigate the effectiveness of 38 interventions different made at the time of the embryo transfer. The results are published in the journal “Human Reproduction”.
The IVF process involves several integrated steps: stimulating the ovaries to obtain multiple eggs, fertilizing the eggs to form embryos in the laboratory, and finally transferring an embryo back to the mother’s uterus. The embryo transfer process is particularly delicatesince optimal conditions must be met to maximize the chances of implantation and clinical pregnancy.
After analyzing the data from 188 randomized controlled trialsmore than 59,530 participantsthe study found that performing an embryo transfer under ultrasound guidance increased the chances of pregnancy by 26%.
Other promising interventions were the use of soft catheters embryo transfer, which may cause less trauma to the lining of the uterus, compared to hard ones (12% improvement); and the use of a substance called hyaluronic acid it could also help improve the implantation of the embryo in the uterus.
One of the main findings of the study was that the prolonged bed rest (for more than 20 minutes) immediately after embryo transfer was associated with a 15% reduction in chances of pregnancy clinical. It was the only intervention in this review that significantly reduced clinical pregnancy rates, suggesting that women should be encouraged to continue their daily activities after the embryo transfer procedure.
“This is the first study to present a comprehensive overview of all the interventions offered to couples undergoing IVF to help us decide what is the best practice when performing an embryo transfer,” said Dr. Bassel H. Al Wattar, from the UCL Institute for Women’s Health and UCLH Reproductive Medicine Unit), and lead author of the study.
With this review of trials, the researchers also identified several “promising interventions» at the time of embryo transfer, such as «the use of the drug Atosiban and the pregnancy hormone HCG, which could help improve the chances of embryo implantation». “These drugs seem to improve the receptivity of the uterus to the transferred embryo, however, we need larger studies to accurately assess how effective and safe these interventions are,” warns Dr. Bassel H. Al Wattar.
In the opinion of the study’s lead author, while current evidence remains imprecise for these additional interventions, they should not be routinely offered to all couples undergoing IVF, pending further research to assess their efficacy and safety.
“IVF is becoming a standard treatment around the world to help millions of couples start their family life and get pregnant. Given that many couples are subject to additional interventions at great cost, both from a health and financial perspective, there is a critical need for high-quality, comprehensive research to identify the best interventions that can be used to optimize the IVF process,” concludes Dr. H. Al Wattar.
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