The In-Vitro Fertilisation (IVF) technique is the most effective form of assisted reproductive technology that enables couples struggling to have children to achieve this goal.
During the procedure, doctors take eggs from a woman and fertilise them with sperm outside the body.
The fertilised eggs, known as the embryo, can then be transferred to the woman’s uterus or womb, where it will follow the normal infant development stages and enable the mother to deliver after nine months.
The transfer process, which makes it possible for the embryo to be implanted in the uterus is a critical step that determines whether pregnancy happens or not. It is particularly delicate as optimal conditions need to be in place to maximise the chances of embryo implantation and pregnancy success.
As such, there are usually many guidelines that stipulate what should be done to maximise the chances of the implantation taking place successfully.
In as much as these guidelines are used widely, the effectiveness of some of the recommended actions is unclear and has therefore been posing challenges to health practitioners.
To address this challenge, a team of health specialists based in the United Kingdom embarked on a comprehensive research project aimed at investigating the effectiveness of 38 different interventions performed at the time of embryo transfer.
The team comprised researchers from the University College London (UCL), University College London Hospitals NHS Foundation Trust (UCLH), University of Birmingham, as well as the University Hospitals Coventry and Warwickshire NHS Trust (UHCW).
During the study, the researchers analysed data involving more than 59,530 individuals that had participated in 188 research trials looking at the significance of various IVF health recommendations.
The findings of the study, which were published Human Reproduction Update Journal offer fresh insights on the utility of existing guidelines governing embryo transfer and implantation.
Key among them was the fact that prolonged bed rest (for more than 20 minutes) immediately after embryo transfer, is associated with a 15 percent reduction in the chances of clinical pregnancy.
The researchers, therefore, recommend that contrary to the recommendations in existing guidelines, women undergoing IVF should be encouraged to continue doing their routine daily activities after the embryo transfer procedure, instead of taking a breakthrough bed rests.
The study also indicates that performing an embryo transfer under ultrasound guidance increases the chances of pregnancy by 26 percent and should therefore be encouraged.
Other promising interventions highlighted include the use of soft embryo transfer catheters, which cause less trauma or harm to the lining of the womb (compared to hard ones), as well as using a substance called hyaluronic acid to help improve embryo implantation in the womb.
“This is the first study to present a comprehensive overview of all interventions offered to couples undergoing IVF to help us decide what is the best practice when performing an embryo transfer,” stated Dr Bassel Wattar, the lead author of the study from the UCL Institute for Women's Health and UCLH Reproductive Medicine Unit.
“And it is reassuring to see that some of the interventions that are used regularly, such as using ultrasound guidance and soft embryo transfer catheters, appear to increase the likelihood of pregnancy.
Dr Bassel Wattar noted that the new study went further to identify novel promising interventions that can be used around the time of embryo transfer to increase pregnancy success rates.
“The use of a drug known as Atosiban and pregnancy hormone HCG could help to improve the chances of embryo implantation. These drugs seem to improve the womb receptivity of the transferred embryo.
“However, we need larger studies to accurately evaluate how effective and safe these inventions are. We, therefore, call on major health funders to urgently invest in IVF research so as to help couples in need start a family.’’
According to the researchers, many more studies are required to assess the effectiveness of all IVF interventions as the technique is increasingly becoming a standard treatment worldwide to help millions of couples start their family life and get pregnant.
“As many couples are subjected to additional interventions at great cost, both from health and financial perspectives, there is a crucial need for comprehensive high-quality research to identify the best interventions that can be used to optimise the IVF process.”