Introduction: Controlled ovarian hyperstimulation is an integral part of infertility treatment. Despite many years of use, some aspects of controlled ovarian stimulation have not yet been clarified, especially the role of the functional status of the ovaries before hormonal stimulation. Aim of the research: To assess the effect of the functional status of the ovaries on the embryological results of controlled ovarian hyperstimulation. Material and methods: The retrospective study included female patients treated for infertility. The patients were divided into two groups depending on the ultrasonographic appearance of the ovaries before controlled ovarian hyperstimulation. Patients with small antral follicles < 6 mm in diameter were selected for group I. Patients with five or more antral follicles ≥ 8 mm in diameter in each ovary were included in group II. Patients from both groups underwent the same treatment process. We performed a detailed analysis of the number, type and quality of the obtained embryos. Results:The number of two-and three-blastomere embryos were comparable in the two groups. There were significantly more four-blastomere embryos in group I than II (p > 0.05). The numbers of A, C, D quality embryos were comparable between the groups (p > 0.05). There were more B quality embryos in group I than II (p > 0.05). The embryo growth rate was significantly faster in group I than II. Conclusions:The results of the present study indicate that the functional status of the ovaries before controlled ovarian hyperstimulation plays a pivotal role in treatment outcome.
The retention of the embryo in the transfer catheter after embryo transfer (ET) during in vitro fertilization is a very common phenomenon, encountered by even the most experienced operators, and embryos retained in the transfer catheter or its sleeve require a repeat transfer. The exact mechanism of embryo retention has not been explained. Therefore, the present study aimed to investigate the mechanism of embryo retention in the catheter during embryo transfer by using a transparent uterus model equipped with pressure sensors and a video recorder. The results indicate that pressure changes in the uterine cavity during ET can influence the distribution of the transferred fluid containing the embryo. Under certain conditions, the transferred fluid can flow backward in the catheter, which may lead to retention of the embryo in the catheter.
Embryo transfer (ET) has been recognized as a vital step which influences pregnancy rates in patients undergoing the in vitro fertilization process (IVF). The safe placement of embryos inside the uterine cavity is essential to obtain an optimal pregnancy rate. However, there is no guarantee that the embryos will remain in the uterine cavity after the procedure. Embryos have been found in catheters, on the cervix, and on the vaginal speculum. The performance of an atraumatic ET is essential to IVF success. The other factor influencing ET are contamination of the catheter with blood, mucus or endometrial tissue, as well as the occurrence of retained embryos. Embryo retention in the catheter is a common phenomenon, encountered by even the most experienced operators. Embryo retained in the transfer catheter or its sleeve require repeat transfer. Pregnancy rates after IVF-ET decrease in a stepwise fashion with the increasing frequency of uterine contractions. To achieve state of maximal uterus relaxation during embryo transfer it is advised to perform ET gently without excessive stimulation of the cervix. Despite revolutionary changes in the embryological laboratory, little has changed with process of ET over past 20 years. Even thought, ET seems to be relatively easy procedure it should be performed by the most experienced operators.
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