20.02.2015

Chances of pregnancy after ivf implantation

IVF can be used as an effective treatment for infertility of all causes except for women with infertility caused by an anatomic problem with the uterus, such as severe intrauterine adhesions. For example, if we transfer 2 embryos to the uterus and the female becomes pregnant - if there is one fetal heartbeat seen on early ultrasound (single pregnancy) the implantation rate is 50% (1 of 2 implanted). Implantation rates are considered by fertility doctors when talking with couples about their chances for IVF success rates and multiple births. Implantation rates are used by in vitro fertilization labs to measure internal quality control. Our implantation rates for 2003-2005 were 47% for women under 35 years old, 33% for age 35-39, and 18% for women 40-42. Before you choose an in vitro fertilization clinic for your treatment, make sure you know the IVF success rates of the clinics you are considering. Both SART and the CDC (US government agency) make this easy by posting success rates for all reputable IVF clinics on their websites.
The rate of embryo implantation varies according to multiple factors including the quality of the IVF program and female age. Implantation rate is defined as the percentage of embryos that were transferred that develop at least to the stage of fetal heart activity documented by pregnancy ultrasound.


There seems to be some variation in the timing of implantation, based on blood levels of the pregnancy hormone (hCG) and variations in ultrasound development at 4 to 6 weeks of pregnancy. IVF failure seems to be due to issues with embryo quality and not uterine issues in the large majority of cases. After fertilization the human embryo begins a 4 day long journey down the fallopian tube and into the uterus.
Human blastocysts should hatch from the shell and begin to implant 1-2 days after day 5 IVF blastocyst transfer. The inferred window of implantation may extend from day 18 to day 24 of an idealized cycle. Women that have had tubal ligation and are considering tubal reversal surgery as well as men that are considering vasectomy reversal surgery might also consider IVF.
The implantation rate is usually defined as the percentage of embryos transferred that implant and develop to the stage of ultrasound documented fetal heartbeat. If there are two fetal heartbeats seen on early ultrasound (twin pregnancy) the implantation rate is 100% (both embryos implanted).
If the rates drop significantly it should trigger a thorough evaluation of the entire IVF system.


The graph below shows national average implantation rates from the 2012 CDC IVF report from the US government. Part of the evidence for this comes from egg donation success rates that are excellent - even in couples that have failed IVF repeatedly using their own eggs.
They studied 33 pregnancies from egg donation or frozen-thawed cycles (FET) with serial blood HCG levels on the mothers to find the time of the "first embryonic signal". In a natural situation (not IVF), the blastocyst should hatch and implant at the same time - about 6 to 10 days after ovulation.
Reduced egg quantity and quality is usually treated with either IVF, or with IVF with egg donation. The purple arrows on the chart above show that some embryos will possibly be frozen after the embryos for transfer are selected.
They had pregnancies when the recipient's cycle was from 4 days in front of to 3 days behind the donor's uterus at ovulation.



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