Fertility treatments (IVF / ICSI) throughout the world have concentrated a lot of effort on culture and choice of the best quality embryo(s) to optimise success rates. However, until recently, not much attention was paid to the womb environment where the embryo(s) should implant.
Some good quality embryos with the capability to implant would not lead to a pregnancy, or miscarry early, due to abnormalities within the womb cavity. These abnormalities include uterine polyps, fibroids growing into the womb cavity (sub mucous fibroids), womb scarring, and long standing womb infections (chronic endometritis) among others.
Recent developments, through research, as well as clinical experience confirm that management of the womb during fertility treatments almost doubles success rates. This involves investigations of the womb cavity (saline infusion sonogram / hysteroscopy) to rule out abnormalities, and treatment of abnormalities (through hysteroscopy).
Evidence has also emerged that intentional trauma to the lining of the womb (Pipelle biopsy) during treatment doubles the chances of implantation.
At Herts and Essex Fertility centre, we continually review our practice to further improve success rates. We have introduced 3D ultrasound and saline infusion sonography to thoroughly assess the womb cavity. Where problems are identified, surgical management is available.
A Pipelle Biopsy, which has also been described in the media as ‘the magic wand’ is performed at the same time. Oral antibiotics for a week after not only minimises the risk of infection, but also treats chronic womb infections (it is thought that 1 in 3 women with recurrent implantation failure have a chronic womb infection).
These simple, inexpensive measures have become standard practice especially in the USA and Israel. We are among the first clinics in the UK to offer them, with very encouraging results.