Hysteroscopic Endometrial Embryo Delivery (SEED/HEED): Improving IVF Success Rate (Pages: 0-0)


Michael Kamrava *, Asha Bhargava , Jerry Hall ,

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Since the inception of in vitro fertilization (IVF) the procedure has seen many advances that have significantly improved pregnancy rates as well as a reduction in complication rates. The benefits of blastocyst stage transfer have been established for the routine blind transfer technique of catheter introduction into the uterine cavity when a patient produces a large number of oocytes or has proven capacity to produce blastocysts. However recent recommendations in using lower medication dosages for the controlled ovarian hyperstimulation and in patients with lower response or advanced age the number of developing embryos are limited and cleavage stage embryo transfers may be more advantageous. Also since a significant number of embryos develop poorly beyond day three early transfer is clinically prudent. 32 consecutive patients with Infertility of various origins underwent Hysteroscopic Endometrial Embryo Delivery (HEED) on day two or three or day five after fertilization. Controlled ovarian hyperstimulation was done using standard protocols. Transvaginal oocyte retrieval was performed under local anesthesia with mild sedation. All women received some type of luteal support be it progesterone or hCG. Oocytes were fertilized and cultured in early cleavage medium (Irvine Scientific) at 37 degrees C and 5% CO2 in air. Embryos were transferred at 48-120 hours post fertilization. The percent of total ongoing live births per transfer is not different between transfer on day two and three and percent of ongoing pregnancies occurring with transfers on day five is higher than transfers on day three or two. (Chi square value for day two vs. five = 1.36 0.5