Repeated Implantation failure

Wednesday May 3 2023

Why my IVF cycle failed

Ahmad Saber Soliman

A guide to learn from your failed IVF cycle

Objectives

bull Definition of repeated IVF failureHow many attempts How many embryos

bull Avoidable causes of IVF failureFailure in the presence of potential obstacles

Definition

Its definition is dynamic and depends on the population of patients studied as well as the type and quality of clinical practice Mitri et al 2016

no universally accepted definition for RIF despite many publications on this topic (Das and Holzer 2012 Laufer and Simon 2012 Penzias 2012 Simon and Laufer 2012ab Urman et al 2005)

Implantation failure after transfer of three high-quality embryo or with transfer of ge10 embryos in multiple transfers with exact numbers to be determined by each center

[Thornhill AR ESHRE PGD Consortium et al Best practice guidelines for clinical preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS) Hum Reprod 200520(1)35ndash48]

Should be revised after the era of SETDET

Recurrent implantation failure vs

Recurrent IVF failureRIF is not the same as recurrent IVF

failure Recurrent IVF failure is the failure to achieve a pregnancy after several IVF attempts a common cause being poor response to ovarian stimulation (Ferraretti et al 2011)

The term lsquorecurrent implantation failurersquo is a subgroup of recurrent IVF failure and should not be used to replace it Wednesday May 3 2023

What is implantation rate number of embryos which have produced US evidence of an intrauterine gestational sac per the total number of embryos transferred into the uterine cavity (Zegers-Hochschild et al 2009)

when day-2 or -3 embryos are transferred is about 25 But when day-5 or -6 embryos are transferred is usually higher about 40

Is chemical pregnancy considered as implantation

failure

Clinically Implantation failure refers to the failure of the embryo to reach a stage when an IU gestational sac is recognized by ultrasonography

ie the only clinical evidence of implantation is appearance of IU gestational sac

The common defendants

Embryo transfer

technique( Angelini et al 2006)

Uterine receptivity

(Modi et al 2012 Strowitzki et al 2006)

EggEmbryo quality

(Karlstrom et al 1997)

Age is the most important single variable affecting outcome in ART (Rosenwaks et al 1995)

Effect on oocyte quality and endometrial receptivity

cause or prognosticator

Pregnancy depends on implantation of a

developmentally competent embryo to dip in a receptive

endometrium

Establishing the relationship between soilseed

Endometrium embryoSoilseed

Maternal bullEndometrial Factors bullUterine Factors

bullObesity

bullThyroid

bullEndometriosis(13 of them has NK cell activation )

bullImmunological Factors (maternal tolerance to the baby )immunologic system plays a role in the process of implantation and in the subsequent maintenance of pregnancy Chaouat et al 2007Singh et al 2011

Embryo bull Gamete (Sperm DNA damage-Oocyte quality)

bull Zona Hardening

bull Inadequate culture

Doctor

Bad ET technique

Management of RIF

Over thinking may create false problems

Try to find and evidence

previous IVF treatment cycles

Clinical drugs used during ovarian stimulation number of oocytes retrieved

Lab method used for fertilization fertilization rate embryo development

Clinical day and ease of embryo transfer procedure

Detailed history

Counseling should precede the investigative process to

ensure patients understand the rationale potential benefit and cost implications of the proposed testsPreferablyinformation leaflets should augment the counseling process

High-resolution ultrasound scanning

Hysteroscopy

Screening for congenital and acquired thrombophilic conditions

Evidence-based investigations should include

Other commonly performed investigations with weaker evidence base include

karyotype analysis for the couple laparoscopy for diagnosis and treatment of

endometriosis and endometrial biopsy Has it had a place in

modern practice

The role of immunologic testing for natural killer cell counts and cytotoxicity assay remains controversial

Anatomical uterine factors

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

bull Polypsbull adhesions bull submucous fibroids (FIGO 0-2) bull endometritis

Rationale Searching for correctable pathology in up to 45 of patients with RIF

Even in the absence of identifiable pathology there is evidence that performing hysteroscopy could still improve the likelihood of pregnancy in the subsequent IVF cycle [El-Toukhy et al 2008 systematic review and metaanalysis ]

Hysteroscopic resection of the septum improves the reproductive outcome of infertile women (Bakas et al 2012 Mollo et al 2009)

Uterine septum

bull After polypectomy

patients can undergo ovarian stimulation after their next menses after a polypectomy without affecting assisted reproductive treatment outcomes (Pereira et al 2016)

Postpone assisted reproductive treatment for 2 months after hysteroscopic septoplasty and for 3 months after myomectomy or adhesiolysis Yang et al (2013(

Hydrosalpinx

Does it affect IVF results

altered endometrial histology and a lack of expression of endometrial adhesion molecules )integrins( which may play important roles in the implantation process )Meyer et al 1997(

Reflux of hydrosalpinx results in mechanical factors diminishing embryonic endometrial apposition )Sharara 1999(

Hydrosalpinx fluid contains embryotoxic inflammatory compounds )Mukherjee et al 1996(

Two meta-analyses estimated that hydrosalpinges diminished implantation rates by 35ndash50 And also responsible for early pregnancy loss (Zeyneloglu et al 1998 Camus et al 1999)

Laparoscopic salpingectomy or proximal tubal occlusion

Options for management

Bilateral salpingectomy results in improved implantation as well as pregnancy rates compared with controls who harbor hydrosalpinges (Bredkjaer et al 1999) Dechaud et al 1998 Strandell et al 1999All studies were done on females aged lt39 years Improved pregnancy rates in patients who had hydrosalpinges and underwent laparoscopic salpingectomy after experiencing repeated implantation failure (Dechaud et al 2000)

Complications of salpigectomy

salpingectomy prior to IVF may impair ovarian response Fan et al 2016 Fetril Steril Meta-analysis

For women with diminished ovarian reserve either interruption of tubal uterine patency or ultrasound-guided drainage of hydrosalpinges might also be considered

Endometrial thickness

and receptivity

Asprin

Sildenafil

Endometrial scratching High dose estrogen

Endometrial scratching before IVF

bull Mechanical manipulation was shown to be associated with decidual formation in guinea pigs

bull Endometrial scratching during the progestational phase of estrous cycles provoked a rapid growth of decidual cells

Loeb L Zentralblatt fur allgemeine Pathologie und pathologischeAnatomie 18 563ndash565 1907

The 1st evidence is reported at the

beginning of the 20th century

In women with RIF inducing local injury to the endometrium in the cycle prior to starting ovarian stimulation for IVF can improve pregnancy outcomes However large studies are required before this can be adopted in routine clinical practice Potdar et al 2012 a systematic review and meta-analysis

Timing Endometrial injury performed between day 7 of the previous cycle and day 7 of the embryo transfer )ET( cycle is associated with an improvement in live birth and clinical pregnancy rates in women with more than two previous embryo transfers

Not advised in day of oocyte retrieval as it was associated with a reduction of clinical and ongoing pregnancy rates

[Cochrane Database Syst Rev 2015]

Poor Endometrium

Inadequate endometri

umRefractory endometriumendometrial

thickness or pattern seem inadequate

where it seems difficult or impossible to make it grow

endometrial thickness under 7 mm would define a refractory endometrium with compromised success rates (Dix and Check 2010 Kasius et al 2014) Although prevalence is low )24 according to Kasius et al 2014( it still represents a challenge today

Causes of refractory endometrium

Surgicaldilation and curettageD amp C a risk factor for adhesion formation )40 of cases o IUA) )Hooker et al 2014(

partial ablationmyomectomypost-Strassman

RadiotherapyInfections (endometritis)Congenital Muumlllerian anomaliesIdiopathic Wednesday May 3 2023

US assessment of endometrial receptivity of clinical significance

bull Thicknessbull Echogenicitybull Doppler assessment of uterine and spiral artery flow

imaging technologies can provide information about endometrial receptivity up to a certain stage as pregnancies have been described even in thin endometria lt5 mm as well as in hyperechogenic endometria So molecular technologies will help us to further understand endometrial receptivity but still needs to be validated in a prospective trials (Cruz and Bellver 2014)

hypoechogenic endometrium was more receptive than the iso- or hyperechogenic endometrium before hCG triggering ie progesterone effect (Check et al 1993)

Echogenicity

no agreement has been reached on endometrial thickness Although most clinicians empirically prefer endometria gt7 mm available evidence does not support any specific thickness as pregnancies with similar success have been described from 5 mm to more than 15 mm )Cai et al 2011 Remohn et al 1997(

Is their is minimal endometrial thickness required to establish a clinical pregnancy after

Endometrial pattern

A triple line multilayered pattern seems to be associated with conception cycles in IVF

Dickey et al Hum Reprod 1992 Serafini et al Ferti Steri 1998

Chronic endometritis

women with CE show altered uterine contractility may explain the symptoms related to CE and infertility (Pinto et al 2015)

Kasius et al 2011 reported a 28 prevelance of chronic endometritis among

infertile women

Clinical relation between RIF and CE

Diagnosing CE

Hysteroscopy is reliable in diagnosing Chronic endometritis and it can assess clinical effectiveness of antibiotic therapy )Among 211 patients with CE diagnosed by hysteroscopy 200 cases were confirmed histologically( (Guo et al 2013)

(B) At histologystroma of micropolyps is characterized by an accumulation of inflammatory cells )lymphocytes plasma cells or eosinophilic granulocytes( intermingled with normal stromal cells around small vessels and glandular structures

)A(Endometrial micropolyps

Micropolps is considered a reliable diagnostic sign for CE )Ettore et al 2005(

Criteria proposed by Cicinilli et al 2005 to establish the diagnosis of chronic

endometritisbull Hyperemia the vascular pattern seen accentuated

at the periglandular area

bull Stromal edema if the endometrium examined during proliferative phase it was seen thickened and pale

bull Micropolyps small vasecularized pedunculated protrusions of the uterine mucosa lt1mm )PPV 984)

And they concluded that absence of stromal edema and hyperemia has a )NPV 988)NB presence of itrauterine synechia is a severe form on long term sequalea of chronic endometritis

Prehysteroscopic diagnosis No pathognomonic features While may be suspected by indirect features bull Tender probing bull women with CE show altered endometrial patterns in both

the periovulatory and midluteal phases (Pinto et al 2015)

bull ECF

bull Folliculo-endometrial asynchorony )increased endometrial thickness asynchronous with follicular growth(

bull Intracavitary synechiae ) 3D SIS (Wednesday May 3 2023

Management of refractory endometrium

Medical therapeutic strategies

Wednesday May 3 2023beneficial

Evidenve with is lacking Not of benefit

Hormonal strategies

Route OralType in Market oestradiol valerate (Lignieres et al 1986)

Duration for up to 9 weeks with no adverse effects such as endometrial hyperplasia or bleeding (Chen et al 2006 Remohiacute et al 1995)

Dose )6 minus 8 mg or up to 16 mg( continuously from cycle day 1 unless tolerance is poor In general 2 mg suffice to block HPO axis

No value of progressive step-up increase in the dose that simulates a natural cycle (Coughlan et al 2014 Shen et al 2013)

Q does estrogen addition as an adjuvant to progesterone in the luteal support of value

or not

Estrogen increase clinical pregnancy rate

but its role in management of refractory endometrium is still

lacking an evidence

HCG injection in the proliferative phase

Where receptors of hCG present

Granulocyte-colony stimulating factor (G-CSF)

G-CSF supplementation modulated expression of genes that play a role in endometrial vascular remodelling local immune regulation and cell adhesion )Rahmati et al 2014)Limited experience in women with recurrent miscarriage )Santjohanser et al 2013( and repeated implantation failure )Wurfel et al 2010( after undergoing IVF with G-CSF supplementation is available

when a well-designed adequately powered proper RCT was done by the pioneers of this concept they were unable to demonstrate any effect of G-CSF on either endometrial growth or pregnancy rates in women undergoing IVF )Baradet al 2014)

Low-dose aspirin

After wide application of doppler US and assessment of subendometrial blood flow

The patients who received aspirin showed a higher pregnancy rate )184 versus 9( as well as an improved endometrial pattern although the endometrial thickness and uterine vascular flow parameters remained unchanged )Hsieh et al 2000)

Use of LDA to improve pregnancy rate in patients undergoing IVF treatment if not supported Dentali et al 2012 Meta analysis ndash systematic review

Pentoxifylline

synthetic derivate of methylated xanthine

Mechanism of action intracellular cAMPVD-increased RBCs deformability

Dose 800 mg pentoxifyllin plus 1000 IU vitamin E for 6 minus 8

months

Its administration is associated with increased ET (Letur-Konirsch and Delanian 2003) Acharya et al (2009)

Effect is enhanced when co-administered with vitamin E )Chiao and Lee 2005(

Administration should be suspended before ET

Nitroglycerin

There is no current evidence to support the use of nitroglycerin patches in women with a thin endometrium

Nitric oxide )NO( is involved in endometrial cycle control and uterine preparation for pregnancy

Sildenafil

Sildenafil citrate is a selective inhibitor of 5-phosphodiesterase the enzyme that hydrolyses cGMPMode of action bull enhances the vasodilator effect of nitric oxide by

reducing cGMP degradationbull endometrial growth facilitating effectbull reduce natural killer cell activity which may be of

interest for women with recurrent miscarriages (Jerzak et al 2008)

Dose 25 mg6 h in vaginal suppositories in the proliferative phase and administration was stopped prior to HCG administration or embryo transfer Sher and Fisch (2000)Zinger et al (2006) described two successful cases in women with Asherman syndrome

endometrial epithelial cell culture has been reported to have a very moderate effect on cell proliferation but no significant changes were found in nitric oxide concentrations (Khazaei et al 2011)

So although biological conflict with the clinical evidence exists any evidence for the clinical benefit of sildenafil in women with a recurrent thin endometrium is weak and very few publications on non-randomized studies have been found with very few patients included

No benefit of sildenafil on endometrial growth in a prospective randomized study Check et al (2004)

Conversely

GnRH analogues

According to Qublan et al (2008) the administration of GnRH )triptorelin 01 mg on the day of oocyte retrieval day of embryo transfer and 3 days later( plus conventional luteal phase support significantly improved implantation and pregnancy rates However no other study has validated these findings

Luteal phase GnRH agonists in cases of RIF

A RCT done by Simin et al 2015 concluded that in addition to routine luteal phase support using progesterone administration of 01 mg of Decapeptil 6 days after oocyte retrieval in women with previous history of 2 or more IVFICSI failures led to a significant improvement in implantation and pregnancy rates after ICSI following ovarian stimulation with GnRH antagonist protocol

In a meta-analysis evaluating Administration of single-dose GnRH agonist in the luteal phase in ICSI cycles (Oliveira et al 2010) they conclude that luteal-phase single-dose GnRH-a administration can increase implantation rate in all cycles and CPR per transfer and ongoing pregnancy rate in cycles with GnRH antagonist ovarian stimulation protocol

Thrombophilia LMWHAspirin

Immunological factors

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

Immunological implantation dysfunction

bull Autoimmunity Misdirected immune response when an immune system attacks its own tissues

bull Alloimmunity The immune system attacks foreigen tissues from the same species eg graft rejection

More than 85 of immunological causes of RIF is autoimmune in

origin

Autoimmune implantation dysfunction

Primary bull SLEbull Rhumatoid arthritis bull Hashimoto thyroidiits bull OthersSecondary ( Reactionary )bull EndometriosisIdiopathic

All are associated with increased levels of ANA ( relation to RIF or RPL)

bull Hepriniods Enhance phspholipid production by

trophoblast Repel APA production from trophoblast Anti- ThromboplastinDecrease platelet adhesiveness

bull Intralipids gtgtgtgtgtgtgtgt aNK suppressors

bull Immunoglobulins )IVIG( very expensive many risks

bull DexamethazonePrednisone gtgtgtgtgtgtgtgtgtgt CTL suppressors

Twice dailty 14 days before ET day till 10th week gestation

bull Others ) LITHumeraAspirins(

Implantation immunotherapy

Intralipid 20

Routinely used for parenteral nutrition intralipid is a fat emulsion that was reported to suppress abnormal NK cytotoxic activity in peripheral NK cells from women with recurrent reproductive failure both in vitro and in vivo Roussev et al 2008

Content Intralipid 10 1000ml contain )purified soybean oil 100g purified egg phospholipids 12g glycerol anhydrous 22g water for injection It is composed of 10 soybean oil 12 egg yolk phospholipids 225 gylcerine and water

Dosage 2g of fatkg body weightday )20ml 10ml and 67mlkg of intralipid 10 20 and 30 respectively(

Infusion rate The drip rate is about 2 to 3 mlmin for intralipid 10 It should be started at half the infusion rate during the first 30mins under supervision

IVF protocol bull 7-14 days prior to ET bull Repeated on the day of ET bull Repeated again with a positive pregnancy test and

administer every month until the 20th week Wednesday May 3 2023

propofol is widely used and in volume doses that are higher than those suggested for the treatment of RIF

many IVF programs perform egg retrieval by general anaesthesia applying propofol as a short acting hypnotic agent Propofol solution contains the same components of intralipid emulsion )10 soybean oil and 12 purified egg phospholipid with 225 glycerol( supplemented with 1 propofol

Role of IVIG

The only properly conducted prospective RCT by stephenson amp Flucker (2000) involving 51 women with 2 or more IVF failure showed IVIG of no benefit

Role of steroids

A meta analysis of 13 RCT by Boomsma et al ( Cochrane data base 2007 ( showed no evidencing benefit routine use of steroids in women undergoing IVF

Empiric use of Aspirin

bull No benefit in cases of RIF ( Gelbaya et al Hum Reprod 2007 )

Anticardiolipin antibodies

bull Two studies showed higher prevalence of ACA in women with RIF ( Kaider et al 1996 amp Qublan et al 2006 )

bull However the only RCT in the use of LDA or Heparin in cases of high levels of ACA shows no benefit in cases of RIF (stern et al 2003 )

Alloimmune implantation dysfunction

Repeated exposures to matching implanting embryos lead to NK cells activation that become permanent

Screening for Inherited and acquired thrombophilic conditions

when summarizing all studies focusing on gene polymorphisms and the thrombophilia trait it seems that prothrombotic disorders are more prevalent in RIF patients than in controls [Toth et al 2011]

Relation between thrombophilia and RIF

While empiric treatment with heparin is not justifiable Altogether it is recommended that patients diagnosed with RIF be investigated for acquired as well as hereditary thrombophilia disorders and be treated accordingly Berker et al 2011Seshadri et al 2011Urman et al 2009

serum testing for congenital and acquired thrombophilia could be useful in identifying patients who could benefit from adjuvant LMWH and low dose aspirin [Qublan et al 2008]

What about empiric use of LMWH in ART patients

Embryonic factors

Blastocyst transferAssisted hatching

Sequential transfer

Co-culture system

EmbryoGlue

Male factor contribution IMSI

Genetic factors PGD

The embryo

bull Qualitybull Number transferredbull Stage of developmentbull Storage protocol

IVM-IVF as an alternative in cases of repeated IVF failure

Rate limiting step in human reproduction

Is morphological grading is sufficient

Embryonic interventions that may improve IVF success

Pre implantation genetic diagnosis and other methods for embryo selection

preimplantation genetic screening (PGS) hellip Time lapse imaging

Blastocyst transfer

Assisted hatching

Sequential ET

Not suitable for all patients bull to patients who are younger in age and

produce over six oocytes[Levitas et al 2004]

Blastocyst transfer

activation of the embryonic genome occurs at the eight- to 10-cell stage )day 3 of culture(

Embryos that cleave after day 3 in culture therefore are no longer dependent on maternal RNA transcripts and have made the successful transition from maternal to embryonic genomic control

Why blastocyst is more competent

Q Is blastocyst transfer is a successful treatment in cases of RIF

live birth after fresh IVF is significantly higher after blastocyst-stage embryo transfer as compared to cleavage-stage embryo transfer when equal number of embryos are transferred in the two groups compared Papanikolaou et al 2008 systematic review and meta-analysis

Assissted hatching (AH)

It was also noted that cleavage-stage embryos with a reduced zona thickness seemed to have a good prognosis for implantation (Cohen et al 1989)

Methods Mechanical or with a piezo-micromanipulator )Nakayama et al1998( or by laser )Hsieh et al 2002(Hazardsbull Direct damage to blastomeres-Incomplete hatching-

Premature hatching

AH was related to increased clinical pregnancy and multiple pregnancy rates in women with RIF Das et al 2009 Cochrane review Meta-analysis 2011 Martins et al

AH slightly improves clinical pregnancy rates particularly in poor prognosis patients including those with RIF Poor quality embryo and Older women )38 or more( while routine practice is not supported ASRM 2007 committee opinion

Preimplantation Genetic Diagnosis (Aneuploidy Screening)

Extraordinary genetic diversity of the human embryos at implantation

That put another question about the value of PGS before embryo transfer

Is it a help or a hype

Guideline

Available evince of does not support the use of PGS for patients with RIF ASRM committee opinion 2007

What about 2nd generation PGS

Whole genome amplification (WGA)

Hyaluron enriched embryo transfer medium (EmbryoGlue)

In 42 women undergoing IVF embryos were transferred into 50 μL of EmbryoGlue for 10 min prior to transfer inside uterine cavity In the control group )n = 42( embryos were transferred to conventional blastocyst culture medium in patients with recurrent implantation failure it may be considered as a useful transfer medium Neeta et al 2015

Evidence suggests improved clinical pregnancy and live birth rates with the use of functional concentrations of EmbryoGlue as an adherence compound in ART cycles However the evidence obtained is of moderate quality The increase in multiple pregnancy rate may be the result of use of a combination of an adherence compound and a policy of transferring more than one embryo Further studies of adherence compounds with single embryo transfer need to be undertaken Cochrane review 2015

Two tests encountered with cases of RIF

Sperm Chromatin Structure Assay )SCSA( Sperm chromatin dispersion test )SCD(

DNA fragmentation index gt27 RIF )Larson et al2000 Larson-Cook et al 2003)

Sperm as a cause of RIF DNA fragmentation

sperm DNA fragmentation is not an important cause of RIF and there is a significant differences between test methodologies in interpreting the data Carol et al 2015

SDF is not related to chromosomal anomalies in embryos from patients with implantation failure Furthermore the different methods used to evaluate DNA fragmentation may produce different results F Bronet human reprod 2012

The results of DNA testing alone can not predict reproductive outcome in patients of ART

IMSI is a real-time method where sperm is selected before the microinjection takes place to identify spermatozoa devoid of surface vacuoles

By using an inverted microscope that is able to provide much greater magnifying power )around 6000 times( than that normally used in reproductive laboratories )400 times( to carry out ICSI (Bartoov et al 2003)

The only confirmed indication for IMSI is RIF while routine use in IVF practice still not recommended (Boitrelle et al 2014)

ET Technique as a cause of IVF failure

bull Mock transfer in prior cycles Introducing infection Better to map your transfer technique before

bull Full Bladder

bull US guidance Their in no excuse for non US guided ET

bull Sequential embryo transfer bull Interval double ET )on days 2 and 4 or 5(

improves CPR in RIF (Loutradis et al 2004 Almog et al 2008)

Is FET cycles is an easy and good alternative

Vitrification is Ultra-Rapid freezing method the keep the biological and chromosomal

integrity of the embryo

Frozen Embryo Transfer Baby born January 1991 now age 21 Michael with his mum Karen Robinson

One in 4 females has displaced window of implantation so need PET and ERA

Personalized embryo transfer (pET)

ERA test to determine endometrium is receptive or not

pET performed on the day designated by the ERA 500 PR and 385 IR (Ruiz-Alonso et al 2013)

bull Many known and unknown reasons for RIF and we do not have the tools to diagnose in each case the exact cause

bull The management of RIF should be individualized multidisciplinary

RCT beneficial Hysteroscopy

procedures Endometrial injury IU administration of

autologous PBMC Peripheral

blood mononuclear cell Blastocyst transfer Assisted hatching Salpingectomy for

tubal disease

RCT Not or may not beneficial Aspirin heparin IVIG intralipid does not

have a clear impact on ttt outcome

Co cultures sildenafil transfer of six embryos natural IVF and PGS await further clinical assessment

Thank you

Objectives

Definition

Recurrent implantation failure vs Recurrent IVF failure

What is implantation rate

Is chemical pregnancy considered as implantation failure

Pregnancy depends on implantation of a developmentally competen

In women with RIF inducing local injury to the endometrium in

Inadequate endometrium

US assessment of endometrial receptivity of clinical significan

Endometrial pattern

Diagnosing CE

Criteria proposed by Cicinilli et al 2005 to establish the dia

Prehysteroscopic diagnosis

Q does estrogen addition as an adjuvant to progesterone in the

Estrogen increase clinical pregnancy rate but its role in man

Low-dose aspirin

After wide application of doppler US and assessment of subendom

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Q Is blastocyst transfer is a successful treatment in cases o

Guideline

Vitrification is Ultra-Rapid freezing method the keep the biolo

One in 4 females has displaced window of implantation so need P

Objectives

bull Definition of repeated IVF failureHow many attempts How many embryos

bull Avoidable causes of IVF failureFailure in the presence of potential obstacles

Definition

failure

Embryo transfer

Uterine receptivity

EggEmbryo quality

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Definition

failure

Embryo transfer

Uterine receptivity

EggEmbryo quality

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

failure

Embryo transfer

Uterine receptivity

EggEmbryo quality

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

failure

Embryo transfer

Uterine receptivity

EggEmbryo quality

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

failure

Embryo transfer

Uterine receptivity

EggEmbryo quality

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

failure

Embryo transfer

Uterine receptivity

EggEmbryo quality

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

failure

Embryo transfer

Uterine receptivity

EggEmbryo quality

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Embryo transfer

Uterine receptivity

EggEmbryo quality

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Embryo transfer

Uterine receptivity

EggEmbryo quality

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

endometrium

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bullObesity

bullThyroid

bull Zona Hardening

Doctor

Bad ET technique

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Management of RIF

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Detailed history

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Hysteroscopy

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

modern practice

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Salpigectomy

myomectomy

polypectomy

metroplasty

Adhesolysis

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Uterine septum

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Hydrosalpinx

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

and receptivity

Asprin

Sildenafil

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Poor Endometrium

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Echogenicity

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Endometrial pattern

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

infertile women

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Diagnosing CE

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull ECF

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Hormonal strategies

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

or not

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

lacking an evidence

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Low-dose aspirin

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Pentoxifylline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

months

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Nitroglycerin

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Sildenafil

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Conversely

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

GnRH analogues

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Intralipid IVIG

Steroids

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Uterine receptivity

Uterine lesions

Immunological

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

origin

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Intralipid 20

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Role of IVIG

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Role of steroids

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Embryonic factors

Sequential transfer

Co-culture system

EmbryoGlue

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Genetic factors PGD

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

The embryo

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Blastocyst transfer

Assisted hatching

Sequential ET

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Blastocyst transfer

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Premature hatching

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

bull Full Bladder

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

tubal disease

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Thank you

Objectives

Definition

Endometrial pattern

Diagnosing CE

Low-dose aspirin

Nitroglycerin

Sildenafil

GnRH analogues

Intralipid 20

Role of IVIG

Role of steroids

The embryo

Guideline

Repeated Implantation failure

Education

Effective transcatheter valve implantation after pulmonary.....

TranscatheterAortic Valve Implantation implantation: Tipsp.....

Immunological Considerations of Implantation Failure and ...

Recurrent Implantation Failure-update overview on etiology.....

Association between endometrial and peripheral blood ... ·...

FOGSI MATTER PAGE 29-31IMPLANTATION+FAILURE.pdf ·...

IVF & Recurrent Implantation Failure · Definition Failure....

院訊醫學中心 - femh.org.tw1.The endometrial...

REPRODUCTION - Weizmann Institute of Science ›...

02 af Present ERA eng online oct 2019 - Igenomix ·...

miR-145 suppresses embryo–epithelial juxtacrine ... ·...

Embryo Implantation Possible Involvement of miRNA-23band...

Repertoire implantation

Low molecular weight heparin and recurrent Implantation...

The failure of the Californian Mondavi’s...

Recurrent Implantation Failure-update overview on etiology.....