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Implementation of blastocyst transfer in IVF

Wednesday, 21 May, 2008 - 17:00
Campus: Brussels Health Campus
Faculty: Medicine and Pharmacy
auditorium R. Vanden Driessche
Evangelos Papanikolaou
phd defence

The current thesis represents the sequence of
several studies concerning the transfer of
embryos at the blastocyst stage in IVF and
whether this has implications on the probability
of achieving a pregnancy. In young patients, it
was shown that a single blastocyst transfer
significantly increases the probability of
pregnancy and birth of a child compared to single
cleavage-stage embryo transfer. Similarly, it was
demonstrated that once a patient has at least
four morphologically good embryos on the third
day of embryo culture, extending culture to day 5
and transferring two blastocysts, results in a
significantly higher live birth rate. As plausible
explanations, it was proposed a better genetic
euploid status of survived embryos reaching the
blastocyst stage and a better synchronization
with endometrium at the site of implantation. The
latter seems to be distressed by steroid levels
and especially progesterone at the late follicular
phase. Nevertheless, the fragmentation rate and
the developmental stage of an advanced
blastocyst quantitated by a systematic scoring
system, affects its implantation potential. Finally,
a meta-analysis of published studies indicated a
significant trend towards higher delivery rate,
when blastocysts are utilized for embryo transfer.