Complementary therapies for IVF treatment

A holistic approach to fertility

IVF complementary medicine is diverse and provides a supportive, personal and holistic approach.

Complimentary therapies are often referred to as adjuvants or ‘Add On’s”. These alternative therapies can be used in combination with standard ART treatment regimes, with the aim of improving pregnancy success rates as well as¬†providing many benefits as part of an integrated health plan.

Couples who combine their IVF treatment with¬†complementary medicine frequently report¬†becoming¬†calmer, emotionally stronger and more able to cope with the demands of the IVF regimen –¬†and importantly, they also feel more hopeful about the outcome.

It is important to understand that many complementary medicines have little or no supporting evidence on their effectiveness, risks and side effects. There is also likely to be additional costs associated with these treatments. Despite this, your Fertility Specialist may recommend these treatments to you based on your medical history and previous treatment outcomes.

 

Complementary therapies

Alternative Therapies

Acupuncture

AcupunctureAcupuncture is a branch of traditional Chinese medicine that dates back thousands of years. It involves the insertion of fine needles into specific points on the body to produce a therapeutic effect.

Acupuncture is underpinned by the notion of an energy flow¬†known as “Qi”, which circulates continuously throughout the body via channels or meridians. According to Chinese medicine, disease arises due to either an imbalance of the channels or¬†from internal factors that cause a disruption to the Qi flow. Acupuncture seeks to re-establish the flow by balancing the channels and bodily systems and promoting health and wellbeing (homeostasis). It has been used for centuries to regulate the female reproductive system.

Mounting evidence¬†indicates that acupuncture provides a¬†benefit for a variety of disorders and may increase the efficacy of some conventional treatments, including IVF. The evidence suggests acupuncture prepares the uterine lining, improves hormone levels, reduces the stress and anxiety associated with IVF, and may increase pregnancy rates.¬†More than 10 studies¬†support the use of acupuncture with IVF to “improve rates of pregnancy and live birth among women undergoing in vitro fertilisation”. This is in contrast to only one study claiming acupuncture had little effect.

In the scientific literature, two separate 2008 meta-analyses of reliable studies so far suggest that combining acupuncture with IVF is beneficial. In all studies, the IVF patients received acupuncture before and after embryo transfer for 25-30 minutes each session. All studies used the same points.

One of the meta-analyses published in the British Medical Journal combined the results of seven previous studies and involved a total of 1366 women. It found that acupuncture increased the odds of falling pregnant by 65%. The benefits of acupuncture include better implantation results as well as increased rates of clinical pregnancy and live births. There are three potential reasons for these improved outcomes.

  • Acupuncture influences the menstrual cycle, ovulation and fertility by indirectly stimulating the secretion of gonadotrophin-releasing hormone.
  • Acupuncture may¬†boost the blood flow to the uterus, which in turn increases the thickness of the endometrial lining, aiding implantation.
  • Acupuncture may inhibit the stress response by regulating blood levels of adrenal hormones in people undergoing IVF. This latter positive effect of acupuncture was also noted in another¬†study, which concluded that the women involved were more relaxed and optimistic.

Anecdotal evidence suggests that another benefit of acupuncture for IVF patients is the reduction of the side effects of the fertility drugs. Acupuncturists treating IVF patients report a reduction in abdominal pain, better sleep and less emotional fragility.

Male-factor sperm problems are implicated in almost 40% of infertile couples. Several studies suggest that acupuncture can benefit men who have low sperm readings. For example, a 2005 study published in Fertility and Sterility concluded that acupuncture provides a general improvement in sperm quality.

There are usually no side effects associated with acupuncture and there is little discomfort from the procedure itself.

In conclusion, both meta-analyses indicated that combining IVF with acupuncture, before and after embryo transfer, may increase the chance of achieving a pregnancy.

If you are interested in having acupuncture as part of your IVF treatment, contact the Australian Acupuncture and Chinese Medicine Association (AACMA) for a list of qualified practitioners in your area.

Free call: 1300 725 334 or visit www.acupuncture.org.au.

Yoga

Yoga is thought to improve the general reproductive health of women trying to conceive.

Yoga is thought to enhance the general reproductive health of women trying to conceive, increasing the blood flow to the pelvis, toning and strengthening the muscles that support reproductive organs, improving spinal alignment, enabling better circulation and boosting the capacity and quality of respiration. It can also be said that the most powerful impact of regular yoga practice on a person’s fertility is through the calming, restorative effects on the mind and body.

A researcher at Harvard Medical School conducted a study that enlisted infertile women (who had been trying to fall pregnant for at least a year) and placed some of them on a 10-week mind-body program that included yoga, meditation, nutrition and exercise to try to help change negative thought patterns. Fifty-five per cent of participants conceived within the first 12 months, compared with 20% of women in a control group.

One of the most pervasive mind-body¬†challenges for couples undertaking fertility treatment is¬†stress and feeling ‚Äúout of control‚ÄĚ. Stress hormones generate chemicals¬†that weaken the body’s immunity and suppress fertility hormones, which may impair conception. Yoga, because of its use of relaxation and breathing techniques, provides an antidote to the negative emotional and physical impacts of stress, anger and depression resulting from infertility or fertility treatments.

Although there is little direct evidence to suggest that practising yoga will guarantee pregnancy, the known benefits of relaxation and reducing emotional and physical stresses can be a useful adjunct when undertaking fertility treatments.

Meditation and hypnosis

Hypnosis, meditation and relaxation exercise can serve as empowering processes that can be used while undergoing fertility treatment. The relationship between stress and infertility is complex. There is minimal evidence that anxiety contributes significantly to infertility, but increasing research that depression may.

Several studies have shown that infertile women who learn a variety of stress-reducing practices, including relaxation, have higher pregnancy rates than women who do not adopt such techniques.

Physiologically, hypnosis, meditation and/or relaxation exercises are known to lower blood pressure, heart rate and the production of stress hormones. The connection between stress and decreased fertility is thought to be directly related to our biological evolution. The mind-body connection knows that in situations of extreme tension our sex organs are our most expendable parts. The mind-body link knows that stressful times do not lend themselves to making a baby.

Meditation also stimulates the pineal gland. This gland produces several hormones, two of which are serotonin (necessary for libido and wellbeing) and melatonin (another hormone connected with feelings of relaxation and wellbeing), which in turn stimulate the pituitary gland. The pituitary is the gland that predominantly regulates female reproductive hormones such as FSH (follicle-stimulating hormone, which matures the eggs in the ovaries), estrogen, progesterone and oxytocin in labour.

It is possible for hypnosis, meditation and relaxation techniques to enhance and/or change the level of certain hormones in your body. If you are interested in consulting a qualified hypnotherapist within your area, contact the Australian Hypnotherapists Association (AHA) on (free call) 1300 552 254 or go to www.ahahypnotherapy.org.au.

Aromatherapy and massage therapy

Essential oils have been used for thousands of years to help promote health and wellbeing. Specific essential oils in aromatherapy may help in the following ways: inducing relaxation, calming the mind, counteracting stress, and easing tension and frustration.

Selected essential oils used in conjunction with massage therapy may help by:

  • Improving blood circulation to the muscles and tissues.
  • Detoxifying the body by clearing away toxins.
  • Calming the body.
  • Relaxing the mind.
  • Relieving stress and contributing to a greater sense of wellbeing.

Couples may find that using essential oils at home and regular aromatherapy massages help to provide physical and emotional support when planning for a baby. Always consult a qualified therapist for advice and guidance before using essential oils. Some oils may not be safe to use while trying to conceive and during pregnancy.

Herbal therapies

Many herbal remedies are considered beneficial to overall wellbeing and can be taken safely before or between treatments. However, at City Fertility we advise you to stop using herbal remedies when you start taking medications during treatment. Many herbal remedies will cause a hormonal action that may interfere with or counteract the effect of your fertility medications.

Herbs should be used with the same caution you would adopt with any other drug. If you are taking herbal supplements, or your partner is, please advise your clinician. If you are interested in making herbal therapies part of an integrated health plan before or in between IVF treatments, contact the National Herbalists Association of Australia (NHAA) for a list of qualified practitioners in your area.

Phone: (02) 9797 2244  or go to www.nhaa.org.au.

 

Clinical Adjuvants

Dehydroepiandrosterone (DHEA)

DHEA is an androgen (steroid hormone) that helps produce oestrogen and testosterone.

  • Use in IVF: As androgen production levels decrease with age, DHEA is believed to be a good supplement to increase oestrogen production which may lead to positive outcomes in IVF patients.
  • Possible benefits & supporting evidence: Some studies have stated that DHEA in IVF may have a role in increased follicle development, improved egg quality and pregnancy rates, however there is very insufficient evidence to support this.
  • Potential side effects/risks: Acne, hair loss, oily skin, increased energy levels and increased libido are common. More severe side effects from prolonged use include worsening of cardiac arrhythmias and hormone sensitive tumours, increased risk of diabetes and bowel cancer.
  • Use in Pregnancy: DHEA is a Category D drug and is not safe to use in pregnancy. Category D drugs have caused, are suspected to have caused or may be expected to cause, an increased incidence of human foetal malformations or irreversible damage. The use of androgens such as DHEA should only be used prior to an IVF cycle.
  • Risk-benefit evaluation: To date, there is limited evidence of the benefits of androgens such as DHEA. Use should be limited to patients who have had prior poor response to standard IVF protocols.

Testosterone

Testosterone is an androgen (steroid hormone) that predominantly stimulates the development of the male reproductive system.

  • Use in IVF: Testosterone can be used in IVF patients with the aim of improving the number and quality of the oocytes.
  • Possible benefits & supporting evidence: There is some evidence to suggest that testosterone can improve the quality and number of oocytes, as well as promoting the growth of larger follicles in poor responding women. Further studies on larger samples are required to provide more substantial evidence on its effectiveness.
  • Potential side effects/risks: The main common side effects from the use of Testosterone is excessive hair growth, acne, and oily skin. Additionally, side effects such as headaches, libido changes, breast tenderness and irritation at the patch site may occur. These are generally reversible based on dose and duration used. Excessive or prolonged use of Testosterone could result in irreversible deepening of the voice. Side effects can also differ depending on the method of delivery.
  • Use in Pregnancy: Testosterone is a Category D drug and is not safe to use in pregnancy. Category D drugs have caused, are suspected to have caused or may be expected to cause, an increased incidence of human foetal malformations or irreversible damage. The use of androgens such as testosterone should only be used prior to an IVF cycle.
  • Risk-benefit evaluation: To date, there is insufficient evidence of the benefits of androgens such as testosterone. Use should be limited to patients who have had prior poor response to standard IVF protocols.

Melatonin

Melatonin is a hormone that occurs naturally in the body and a powerful antioxidant involved in the regulation of sleep patterns.

  • Use in IVF: It has been associated with the prevention of damage to a women’s eggs by oxidative stress, which could lead to an increase in the quality of these eggs and higher fertilisation rates in IVF.
  • Possible benefits & supporting evidence: At present there is limited evidence from the small studies that have been undertaken, showing any benefits of melatonin use in IVF. Larger studies are required to provide conclusive recommendations.
  • Potential side effects/risks: Melatonin’s most common side effects are daytime drowsiness, headaches, dizziness, mild anxiety, irritability, and nausea. Other side effects reported include confusion, abdominal pain, and vivid dreams.
  • Use in Pregnancy: Currently there is not enough research to confirm that taking melatonin supplements in pregnancy is safe.
  • Risk-benefit evaluation: At present, there is no evidence to conclusively prove Melatonin is of benefit in IVF treatment.

Growth Hormone

Growth hormone is produced by the pituitary gland. It has many functions including stimulating the growth of tissue and bone (in children) and maintaining metabolism.

  • Use in IVF: Growth hormone may lead to a potential improvement in the stimulation of follicles, egg development and egg maturation in an IVF cycle. Growth hormone plays a role in increasing the natural female hormones that play an important role in ovarian function.
  • Possible benefits & supporting evidence: Women who have previously experienced poor egg response in past IVF treatment cycles may see some benefit from the use of growth hormone on the number of eggs collected after use of growth hormone.
  • Potential side effects/risks: The most reported side effects include headaches and injection site rashes, along with some joint swelling. Rarer side effects include carpal tunnel syndrome and increased risk of developing type two diabetes. Long term use of growth hormone is not recommended as this can lead to significant health concerns such as swelling of extremities and internal organs.
  • Use in Pregnancy: Currently there is not enough research to confirm that taking growth hormone in pregnancy is safe.
  • Risk-benefit evaluation: From the small number of studies that have been conducted to date, there has been no significant improvement in pregnancy rates or birth outcomes when growth hormone was used in combination with an IVF cycle. More research and larger studies are required.

Aspirin

Aspirin is a non-steroidal anti-inflammatory drug (NSAID) that is used to reduce pain, aches, fevers, or inflammation.

  • Use in IVF: Low dose aspirin has been broadly used as an additional treatment in IVF, predominantly with patients who have had recurrent miscarriages.
  • Possible benefits & supporting evidence: Aspirin is thought to improve blood flow to the uterus. There is insufficient evidence from studies undertaken to show that low dose aspirin increases the chance of pregnancy or live birth.
  • Potential side effects/risks: Side effects could include gastrointestinal ulcers, gastritis, indigestion, headache, nausea, bleeding and bruising. Aspirin may also exacerbate Asthma symptoms therefore the use of aspirin is not recommended in patients who suffer from Asthma.
  • Use in Pregnancy: Low dose aspirin is safe to use throughout pregnancy and is often prescribed for women at high risk of pre-eclampsia.
  • Risk-benefit evaluation: Due to the lack of quality evidence, there is little to no benefit from using aspirin as a complementary therapy in IVF.

Heparin

Heparin is an anticoagulant medication (blood thinner) that is used to prevent blood clotting.

  • Use in IVF: The use of heparin in IVF treatment is to prevent thrombosis (clotting) at the implantation site of an embryo. Heparin may be given to patients who have experienced recurrent implantation failure or recurrent miscarriage in hopes of preventing any coagulation complications in early pregnancy.
  • Possible benefits & supporting evidence: It is suggested that heparin may improve the intrauterine environment by increasing growth factors to improve attachment of the embryo to the lining of the uterus.
  • Potential side effects/risks: Heparin can cause bleeding, bruising at the injection site, osteoporosis if used over a long period of time and heparin induced thrombocytopenia. Complications are uncommon when Heparin is used in low doses over short periods of time.
  • Use in Pregnancy: There has been no evidence to date that indicates an increased risk in bleeding in pregnancy or in congenital malformations in children born to mothers having taken anticoagulants in pregnancy.
  • Risk-benefit evaluation: At present, there is no significant evidence from the research studies that have been completed, to indicate any benefit to increasing implantation, pregnancy rate or overall birth outcomes.

Antioxidants ‚Äď CoQ10

Coenzyme Q10 (CoQ10) is an antioxidant that is produced by the body naturally. It produces energy that is imperative for growth and maintenance.

  • Use in IVF: Antioxidants such as Coenzyme Q10 are increasingly being used in IVF to improve the natural reproductive potential.
  • Possible benefits & supporting evidence: CoQ10 is an important antioxidant within every cell of the body and may improve mitochondrial function in the eggs. Some evidence suggests the use of CoQ10 can be beneficial in improving the ovarian response to stimulation, increase the number of eggs collected and improve embryo quality.
  • Potential side effects/risks: While rare and mild, side effects could include nausea, heartburn, diarrhoea, low blood pressure.
  • Use in Pregnancy: Evidence is lacking as to the safety of taking CoQ10 in pregnancy, therefore it should only be taken if prescribed by a doctor.
  • Risk-benefit evaluation: CoQ10 is a powerful antioxidant and whilst there is not substantial evidence of it improving pregnancy outcomes, it may be beneficial to a patient‚Äôs wellbeing overall.

 

Endometrial Adjuvants

Corticosteroids

Corticosteroids are hormones with strong anti-inflammatory and immunosuppressive properties that can be used to treat a variety of autoimmune and inflammatory conditions.

  • Use in IVF: In IVF, corticosteroids are being used to suppress the immune system with the potential to improve pregnancy rates.
  • Possible benefits & supporting evidence: It is the opinion of many IVF clinicians and specialists that implantation failure may be linked to an underlying immune dysfunction, for example the occurrence of natural killer cells in the uterus, which may be reduced using corticosteroids. There is currently very limited evidence that this type of treatment would result in improved pregnancy outcomes.
  • Potential side effects/risks: There are many common side effects from corticosteroid use ‚Äď thinning and discolouration of skin, sleep and mood disturbances, weight gain, acne, increased body hair growth, hair loss. As corticosteroids suppress the immune system, high dose and prolonged use can cause more severe side effects such as infection, delayed wound healing, pregnancy complications, avascular necrosis of the femoral head and Cushing‚Äôs Disease.
    Infections and fever are known to reduce the chance of pregnancy and increase the risk of miscarriage, so the immunosuppressive properties of corticosteroids can have a negative impact on pregnancy outcomes.
  • Use in Pregnancy: During pregnancy there is an increased risk of gestational diabetes and hypertension, as well as risk of congenital heart defects, cleft lip/palate, incomplete formation of the anus in the fetus.
    People with diabetes, GORD/stomach ulcers or glaucoma should avoid using corticosteroids. Furthermore, gradual weaning off corticosteroids is recommended.
  • Risk-benefit evaluation: Corticosteroids are not recommended in IVF treatment as there is a distinct lack of sufficient evidence to support any benefit in pregnancy outcomes, and the additional risk of serious and potentially irreversible side effects.

Endometrial Scratch

Also referred to as endometrial injury, the endometrial scratch is a procedure where the fertility specialist ‚Äúscratches‚ÄĚ the endometrium using a pipelle catheter.

  • Use in IVF: The aim of the endometrial scratch procedure is to improve receptivity of the endometrium and increase the rate of implantation.
  • Possible benefits & supporting evidence: The procedure is thought to increase the chances of implantation due to the scratching triggering an inflammatory response within the endometrium. It is unclear exactly how this occurs, and there is limited reliable evidence at this time to support the theory. Further controlled trials are required.
  • Potential side effects/risks: It is common for women to have mild bleeding, cramping and pelvic pain similar to that of period pain. In very rare cases, pelvic infection or uterine perforation could occur.
  • Use in Pregnancy: N/A – Endometrial scratch is done prior to fertility treatment and should not be performed during pregnancy.
  • Risk-benefit evaluation: Although there is limited sufficient evidence of its efficacy, the endometrial scratch procedure may be recommended to patients who have had recurrent implantation failure.

ERA diagnostic test

Endometrial Receptivity Analysis (ERA) is a diagnostic test designed to identify the most optimal window of time that the endometrium is receptive to embryo implantation.

  • Use in IVF: ERA is carried out at the time an embryo transfer would usually take place. Similar to the endometrial scratch procedure, a biopsy is taken to analyse the endometrium’s gene expression.
  • Possible benefits & supporting evidence: It is thought that some women may not receive an embryo transfer at a time when the endometrium is most receptive, and therefore ERA can provide a more personalised embryo transfer time in the hope of increasing the chance of pregnancy. However, there is limited evidence to support whether ERA is superior to the standard timing of embryo transfer.
  • Potential side effects/risks: Some bleeding, cramping and pelvic pain is common, but usually mild. In very rare cases, pelvic infection or uterine perforation could occur.
  • Use in Pregnancy: N/A – ERA testing is done prior to the embryo transfer procedure and should not be performed during pregnancy.
  • Risk-benefit evaluation: Women with recurrent implantation failure may be recommended ERA by their fertility specialist, with the caveat that its effectiveness is unproven and further studies are required.

Platelet Rich Plasma (PRP) therapy

Platelet Rich Plasma (PRP) therapy

Please note, you must be a patient with City Fertility to access PRP therapy.

  • Use in IVF: PRP is used to help improve the uterine lining (endometrial) thickness and/ or the endometrial receptivity to improve pregnancy outcomes.
  • Possible benefits & supporting evidence: PRP has been used to assist in the treatment of recurrent implantation failure experienced over multiple IVF cycles and for patients who have a thin endometrium. Some studies have shown improvements in endometrial thickness which could lead to increased pregnancy rates, however further studies are required to provide more conclusive evidence.
  • Potential side effects/risks: Potential side effects that may occur from the phlebotomy include mild pain at the site of the blood collection, some mild bruising or bleeding at the site, and possible localised irritation or infection. From the PRP procedure patients may experience mild cramping, pain, bloating/swelling or spotting. More serious side effects such as possible fever, infection and cervical shock are possible but are extremely rare.
  • Use in Pregnancy: N/A – PRP is typically undertaken 48 hours prior to the anticipated embryo transfer and should not be performed during pregnancy.
  • Risk-benefit evaluation: There is limited conclusive evidence of the effectiveness of PRP. Evidence-base will continue to grow as the therapy is used more frequently and studies are undertaken, so patients should have detailed discussions with their fertility specialist about whether PRP is suitable for them.

Granulocyte colony-stimulating factor (G-CSF)

G-CSF is a glycoprotein that stimulates bone marrow to produce specific types of white blood cells. The use of G-CSF is usually prescribed for patients with neutropenia who have a high risk of infection.

  • Use in IVF: It is thought that G-CSF can play a role in helping to improve embryo implantation in IVF by increasing the blood flow to the endometrium and promoting the regeneration of cells. G-CSF can be administered via intrauterine infusion or subcutaneous injection.
  • Possible benefits & supporting evidence: It has been suggested that the use of G-CSF may improve IVF outcomes by increasing endometrium thickness, particularly for those with persistent thin endometrium. However, there is insufficient evidence that G-CSF improves pregnancy rates at this stage and further studies are required.
  • Potential side effects/risks: Fever, pain, nausea, syncope, cough and headaches could occur. Whilst rare, more severe side effects could include chest pain, hypoxemia and anaphylaxis.
  • Use in Pregnancy: N/A – when used in IVF, G-CSF is done during the cycle and not performed during pregnancy.
  • Risk-benefit evaluation: Some studies have shown that G-CSF can improve endometrial thickness, however further studies need to be undertaken and as such, fertility specialists may recommend the use of G-CSF for patients who are fully informed about the lack of substantial evidence.

 

Laboratory Adjuvants

Assisted Hatching

Assisted hatching is an advanced scientific IVF technique where a laser is used to create a small gap in the outer layer of the embryo (zona pellucida).

  • Use in IVF: In some situations, the zona pellucida is abnormally thick. Usually done three days after fertilisation, assisted hatching creates the opening for the embryo to breakthrough in order to facilitate the implantation into the uterus.
  • Possible benefits & supporting evidence: The less difficulty the embryo has in hatching, the better its chance of attaching or implanting into the wall of the uterus. This gentle and safe procedure is widely available to patients prior to embryo transfer.
  • Potential side effects/risks: Interfering with the natural hatching process makes the embryo more susceptible to damage. Incomplete hatching and risk of Monozygotic twins is also possible, although rare.
  • Use in Pregnancy: N/A – Assisted hatching is done prior to the embryo transfer.
  • Risk-benefit evaluation: Assisted hatching may improve clinical pregnancy rates for patients who have had recurrent unsuccessful cycles, poor quality embryos or who are aged over 37 years old. However, studies undertaken show inconclusive evidence of increased live birth rate. Assisted hatching may be recommended by a fertility specialist for patients with recurrent implantation failure.

Artificial Oocyte Activation (Calcium Ionophores)

Artificial Oocyte Activation (AOA) is a laboratory procedure where the oocytes are artificially stimulated by adding the chemical calcium ionophore to the culture media to initiate the development of the embryo.

  • Use in IVF: The addition of calcium ionophore to culture media may mimic oocyte activation, a process that is typically triggered when the egg and sperm meet, starting the embryo development process.
  • Possible benefits & supporting evidence: In patients who have had previous fertilisation failure, it is thought that if fertilisation is successful with AOA then embryo implantation and pregnancy rates would be similar to that of ICSI. However, there is insufficient evidence at this time to conclusively prove this.
  • Potential side effects/risks: Simulating the activation of eggs artificially could theoretically result in embryos having an abnormal number of chromosomes, which may potentially lead to miscarriage, however there is not enough evidence to support this.
  • Use in Pregnancy: N/A – AOA is done during a treatment cycle.
  • Risk-benefit evaluation: Given the complexity of artificially inducing oocyte activation and limited evidence to support its effectiveness, fertility specialists should be cautious when recommending AOA to their patients.

Hyaluronic Acid (Embryo Glue)

Embryo Glue is a transfer medium that is enriched with a glycoprotein named hyaluronan.

  • Use in IVF: The embryo selected for transfer is placed in a small volume of this glue-like medium, then loaded into the catheter and released into the uterus. Embryo Glue does not make the embryo ‚Äústickier‚ÄĚ in any way, but maximises the chances of implantation into the uterus.
  • Possible benefits & supporting evidence: Research shows that hyaluronan plays an important role in assisting embryos to implant. Hyaluronan is a naturally occurring substance found in the uterine cavity and fallopian tubes. Studies have shown an increase in the implantation rate and pregnancy rate when the embryo transfer media has contained hyaluronan.
  • Potential side effects/risks: There are no known risks or side effects.
  • Use in Pregnancy: N/A ‚Äď Embryo Glue is used for the embryo transfer procedure only.
  • Risk-benefit evaluation: There is some evidence to suggest that females aged over 38 show the most benefit, with a significant increase in pregnancy rates, when a transfer medium with hyaluronan is used (Balaban et al., 2004). There have also been studies indicating embryos that were frozen and thawed may have increased pregnancy rates through the use of a hyaluronan-enriched transfer medium.

PGT ‚Äď A

Preimplantation genetic testing for aneuploidy (PGT-A) screens embryos for the number of chromosomes. A small sample of chromosomes. By definition ‚Äėaneuploidy‚Äô is the presence of an abnormal or unbalanced number of chromosomes.

  • Use in IVF: PGT-A is used to help select embryos with the right number of chromosomes, by taking a small sample of cells from the embryo to be sent for genetic testing.
  • Possible benefits & supporting evidence: PGT-A may increase IVF conception rates by helping to identify the embryos most likely to produce a pregnancy, allowing them to be prioritised for transfer. Additionally, PGT-A can reduce the incidence of miscarriage, reduce the risk of a live born child with a chromosomal abnormality and reduces the number of IVF cycles necessary to achieve a successful outcome.
  • Potential side effects/risks: The chances of these occurring are usually minimal, but possible risks include damage to the embryo, inconclusive or misdiagnosis, and having no normal embryos.
  • Use in Pregnancy: N/A ‚Äď In cycle procedure only.
  • Risk-benefit evaluation: PGT-A may increase IVF conception rates by helping to identify the embryos most likely to produce a pregnancy, allowing them to be prioritised for transfer. PGT-A does not diagnose any specific diseases but looks more generally at the chromosomal make-up of the embryo.

EmbryoGen / BlastoGen

EmbryoGen/BlastoGen are new sequential culture media used in the laboratory to optimise embryo development by supporting metabolic and physiological phases before implantation.

  • Use in IVF: Fertilised and cleavage-stage embryos (zygote to day three) are cultured with EmbryoGen, followed by the culture to the blastocyst stage with BlastoGen. For the embryos cultured with this system, BlastoGen is the recommended medium for embryo transfer.
  • Possible benefits & supporting evidence: There have been many studies that have shown a significant increase in the survival of transferred embryos, increase in pregnancy rates and lower miscarriage rates. It is suitable for all patients.
  • Potential side effects/risks: There are no known negative effects of culture embryos in these culture media.
  • Use in Pregnancy: N/A ‚Äď In cycle procedure.
  • Risk-benefit evaluation: Improvement of embryo culture has contributed significantly to the increase in the overall success rates in assisted reproductive technology (ART). EmbryoGen and BlastoGen are recommended for patients who have experienced recurrent biochemical pregnancy loss, miscarriage recurrent implantation failure or unexplained infertility.

 

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