The success opportunities in IVF & ET – In Vitro Fertilization and Embryo Transfer are not 100% and it is improving day by day due to various innovations in this field of assisted Conception. The success rate of conventional IVF is 25 – 35 % and the latest modality called Blastocyst Transfer has the maximum of 70%.
There are multiple factors to decide the implantation potential of the embryo and the endometrium. The “embryo maternal dialogue“ is the prime factor which is not yet fully understood . Many Researchs
are on going to find out and conquer the obstacles of implantation.
When the best embryo is placed inside the womb we expect better success
opportunity. Unfortunately 40-50% of embryos do not get implanted,
ending in vain due to improper support from endometrium. To fully
understand the probability of pregnancy after embryo transfer in IVF & ET, ERA test
is available now. Our laboratory has collaborated with a Spain based
laboratory for this test – ERA- Endometrial Receptivity array test- DNA
array based test, which will give us some idea about the day of Embryo
transfer in Cryopreserved – Vitrified embryo transfer cycle in near future for the patient.
When the best embryo is transferred in
the best prepared endometrium the success opportunity will be roughly
70-75% in day 5 embryo transfer called “BLASTOCYST TRANSFER”. We are following this method of blastocyst transfer since 2000 May and the first baby of its kind was born in our centre on 25th June 2001 as the first blastocyst baby of Tamil Nadu. Since then our research department is strenuously working on improving the quality of embryo culture strategy to promote “Only Blastocyst Transfer“ for all patients.
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| The first BLASTOCYST BABY of Tamil Nadu……….on 25.6.2001 |
In natural cycle of fertilization and
conception, the egg is released from the ovary, reaching the
infundibulum of the fallopian tube and wait for sperms to come. If sperm
are deposited in the vagina after natural coitus, the sperms travel
from the vagina through womb to the tubes and meet the egg. Out of many millions of sperms only one will enter
the egg sheath and once it reaches the cytoplasm, the outer cortical
layer will get closed preventing multiple entry of sperms. Then the fertilized egg , now called as embryo
gets rolled by the rhythmic movements of the tubes and uterus inside
the fallopian tube and takes 5 days to reach the uterine surface. By the
time the single cell becomes ball of 60 – 90 cells. The uterine surface
takes at least 5 full days after ovulation to get prepared with
adequate collection of Glycogen to accept the embryo for further
nutrition of nidation and growth.
The blastocyst culture
mimics the natural cycle as above said factors are followed for five
full days in the artificial culture protocol in trigas incubators. In
conventional IVF the embryos are transferred back to uterus on day 2 or
day 3, which will be placed in the endometrial cavity in a hostile
condition before it gets stabilized for a nidation on 5th day
after ovulation. When Blastocysts are ready with 60-90 cells for
nidation, there are many molecules that play important role in
augmenting the attachments of the outer cell layer of the blastocyst to
the endometrial lining.
Embryo Glue is a hyalurunon molecule
which plays a crucial role in the implantation of the blastocyst into
the endometrium for further growth. When this vital molecules are added
to the blastocysts before being placed inside the endometrial cavity
(womb) the success opportunities are obviously increased, which is being
proven by various studies and our study too.
With these molecules, one Blastocyst was transferred to the 64 years old woman’s womb in 2003; she succeeded in conception and delivered of an alive healthy male baby on 23rd February2004.
This video gives you some idea about how
embryo glue works inside the womb around the blastocysts to promote the
attachment of blastocyst and inner lining of the womb to lead on to
implantation, further, helping the embryo to grow more.
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