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Year : 2018  |  Volume : 5  |  Issue : 1  |  Page : 27-32

Tracking the implantation window: Synchronizing endometrial preparedness for implantation with stage of blastocyst to be transferred in antagonist IVF cycles involving single blastocyst transfers

Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, Maharashtra, India

Correspondence Address:
Bindu N Chimote
Vaunshdhara Clinic and Assisted Conception Centre, 9, Dr. Munje Marg, Congress Nagar, Nagpur, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fsr.fsr_21_18

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Introduction The day of menstrual period is usually not taken into account during embryo transfer in IVF cycles. Aim We sought to track the relevance of ‘implantation window’ by contemplating a correlation between stage of blastocyst transferred and endometrial preparedness for implantation with respect to day of menstrual period in antagonist in vitro fertilization (IVF) cycles. Design, Materials and Methods This study involved retrospective analysis of 443 cycles in women undergoing antagonist treatment protocol followed by oocyte-retrieval approximately between days 12 and 16 (rarely on days 17 and 18 in case of long follicular phase) of their menstrual period. All cycles involved day 5/6 single blastocyst-transfer (sBT) of top (AA) or good (AB/BA) quality blastocysts of various stages. Slightly modified Gardner’s system for blastocyst-stage grading was followed. Inner cell mass, trophectoderm, were graded as A, B, C as per Gardner’s system. Clinical pregnancy rate (CPR) and live birth rate (LBR) were main outcome measures. Results Overall CPR = 26.64% (118/443), whereas LBR was 21.67% (96/443). CPR was influenced by transfer of various stages (1–6) of the blastocysts on different days of menstrual period (days 17–24, covering the implantation window). Our results indicate that as day of menstrual period advances during the window period, higher stage blastocyst-transfer enhances the odds of a live birth. Conclusion Synchrony between stage of blastocyst transferred and the endometrial preparedness for implantation with respect to day of menstrual cycle has a definitive influence on LBR in IVF cycles. Asynchrony and out of phase BT may lead to missing out the implantation window and unnecessarily hamper CPR/LBR.

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