Egg Implantation Success - Naturally or with IVF
When a patient is trying to conceive, as practitioners we tend to focus a lot of attention on the quality of the gametes (eggs and sperm). And this is for good reason. Ideally, folks should use the 100 day recruitment window during folliculogenesis to enhance egg quality, and the 75 day sperm cycle to enhance sperm.
But once we have optimized the embryo to the best of our ability, the next step in this journey is the wild and varied process of embryo implantation.
When it comes to implantation, there is a time, and there is a place. The optimal time is between cycle days 19 and 21, that is clear. The precise determination of this window in individual patients - right down to the hour - can lead to higher pregnancy rates in IVF procedures. There is also an optimal place in the endometrium. Implantation of a blastocyst, whether in a natural cycle or via IVF, involves a series of micro-processes in a complex interaction between specialized cells in the embryo (called Trophoblasts) and the uterine lining (Endometrium). These interactions are mediated by certain hormones and enzymes. While the process is vastly more complex than can be illustrated here (literally textbooks have been written on the topic), the basics are this: the trophoblasts secrete an enzyme which “digests” the endometrium, thus leading the embryo to burrow deep into the lining, attaching itself to the uterine wall. These cells also have many other roles such as regulating certain inflammatory, immune, and hormonal influences. In short, the process is an interaction between a healthy embryo and a receptive lining.
Given the complexity of this process, the importance of optimizing the endometrial receptivity can not be overstated. A relatively new area of research involves a closer look at the bacterial environment of the endometrium. This includes bad bacteria, and also the optimal presence of friendly bacteria. It turns out that a healthy microbiome in the uterus is key for implantation success.
One explanation for implantation failure and recurrent pregnancy loss is chronic endometritis, a subclinical bacterial infection of the endometrium. The presence of bacteria and subsequent inflammation can disrupt the delicate processes involved in implantation, no matter how healthy the embryo. Often, patients don’t know they have endometritis, as the symptoms are either absent or vague, for example bloating. As a result, the infection can be present for a very long time undetected. There is a test called the TREO, involving collecting three samples from the lining and testing them for good bacteria, bad bacteria, and progesterone. This test, often conducted in the context of an IVF transfer cycle, can rule out infection, help optimize healthy lacto-baccili counts, and also accurately predict the best implantation window for each individual patient.
What can you do?
Something I recommend to my patients, for either natural conception or ART, is the use of vaginal suppository probiotics for ten days beginning after the menstrual bleeding is done. An optimally populated endometrial lining has been shown to support fertility and implantation.
And, finally, I cannot state strongly enough my support of acupuncture and laser therapy. It has been shown to improve blood flow, reduce inflammation, pain, and oxidative stress. In fact, the use of LLLT has been suggested as a standard therapy for fertility treatments given its improvement in optimizing the endometrial lining.
If you have any questions, or would like to discuss your personal health picture, call Acubalance today to book a complimentary 15-minute discovery call. You can also book online.