Repeated implantation failure in oocyte donation. What to do to improve the endometrial receptivity?

Abstract

Objective: To determine the role of polyvalent endometrial treatment in patients undergoing IVF-ET who had recurrent implantation failure (RIF) in a program of oocyte donation (OD). The results were expressed in terms of live birth rate (LBR). Secondly analyze changes of endometrial leukocyte population evaluated by flow cytometer (FC) and histopathology.

Methods: Prospective study of a model-based control with analog abductive methodology. Over initial population of 75 patients with RIF in ovodonation, thirty cycles / patient of IVF/ET were selected in this study. A control group of 12 patients was established to variables FC. All patients were transferred to day 5-6 with a maximum of 2 expanded blastocysts with at least one of optimum quality. A versatile treatment was applied in all cases with both assessments in pre and postreatment.

Results: Chronic endometritis was diagnosed in 14/30 (46.7%) with endometrial identifying germs in 12/30 (40%) and 6/30 (20%) was associated with endometrial thinning. A significant increase in endometrial thickness associated with a decrease in abnormal histopathology and Li/PC was observed at postreatment in relation with a pretreatment (P=0.047 and P=0.002) respectively. An increase of uterine killer cells (Nku) was observed in postreatment in absence of pregnancy. CD4/CD3 was established with prognostic value when their values are close to those of the control group.

Conclusion: Our findings demonstrate the reversibility of endometrial histological changes, both sonographics as immunological in RIF group under a polyvalent therapeutic; which is capable of modifying the immunology and endometrial histopathology and to obtain live birth.

Keywords: Chronic Endometritis; Endometrial Biopsy; Endometrial Flow Cytometry; In vitro fertilization; Recurrent Implantation Failure.