Esther Marbán, MD
Gynecologist & Fertility Specialist at Clinica Tambre, Clinica Tambre
Category:
Advanced Maternal Age, Success Stories
Normally, I recommend a single embryo transfer, so it is true that in the past, we knew that if we transferred 2 embryos, maybe 1 embryo could help the other embryo to implant. Nowadays, it’s known that if the embryos are good quality ones, in the end, we are increasing a twin pregnancy. Especially if you have a fibroid in the uterus, it’s outside, so it’s not supposed to affect implantation, but in the end, if you have that fibroid, I would also recommend just doing a single embryo transfer.
In general, we always recommend doing a single embryo transfer if the embryos are of good quality.
We know that approximately 50% of the embryos that starts developing on day-1 reach the blastocyst stage. However, this is in general, so it’s impossible to know how the embryos may develop from day-3 to day-5. We already know that in most cases, when a male factor occurs, it could affect embryos from day-3. If there is any problem with the sperm, it’s quite typical that the embryos stop their development from day-3. That’s the reason we normally recommend culturing them for all our patients. It’s about getting an idea of how the embryos are developing. That way we can transfer the embryo that could have good chances of implantation, if possible.
Regarding transferring 1 or 2 embryos, as I’ve mentioned before, it’s true that the implantation rate in patients over 40 are not high, but I would recommend doing a single embryo transfer anyway because if there is any chance of having a twin pregnancy at that age, it’s not good news. If possible, I would suggest doing a single embryo transfer. I would say that is recommended almost for all patients, but especially for patients of advanced maternal age.
Some procedures may affect the endometrial lining, it’s difficult to make it grow, but it’s possible to use different protocols. We can add aspirin, pentoxifylline to try to make the endometrium thicker.
We have different protocols, including estradiol, and it’s also possible to perform a mild stimulation in the ovaries so that all the hormones that those ovaries will produce could also impact the lining and help that lining be thicker.
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