Four times IVF, four times failed... This year, she finally welcomed the baby double tiger!

Qianjiang Evening News Hour News Correspondent Jin Nanxing reporter Zhang Bingqing

4 IVF, 4 times no implantation and no pregnancy, why do the hard-working embryos fail to implant repeatedly? When she thinks about it, Ms. Zhang (pseudonym) always can't help but burst into tears.

Ms. Zhang, 34 years old, married in 2016 and has not yet conceived. In 2018, she underwent uterine laparoscopic surgery in other hospitals due to "bilateral hydrosalpinx", and actively tried to conceive after surgery, but unfortunately had an ectopic pregnancy, resulting in the surgical removal of bilateral fallopian tubes again.

In 2019, Ms. Zhang tried to conceive through IVF technology in other hospitals, and received 4 embryo transfers in two years, unfortunately, 4 times she did not implant and did not become pregnant.

In 2 years, she ran more than 20 trips to the hospital, from monitoring ovulation and egg retrieval to embryo freezing and embryo transfer, but the result was disappointed again and again, was she doomed to be unable to be a mother?

1 year ago, under the recommendation of her friend, Ms. Zhang came to the Reproductive Medicine Center of the Fourth Hospital of Zhejiang University to find Xu Jian, a well-known reproductive medicine expert in China and director of the Reproductive Medicine Center of the Fourth Hospital of Zhejiang University.

"But, Dr. Xu, I've tried 4 times, and every time the embryo transfer fails..."

"Don't worry, I will customize the pre-transfer plan for you, we have advanced scientific methods to accurately determine the best implant window for embryos, and improve the success rate of pregnancy."

Chief Physician Xu Jian explained that the synchronization of embryos and endometrium is a necessary condition for embryo implantation, and the health of the endometrium is crucial for a successful pregnancy. Studies have shown that the incidence of embryonic and endometrial dissynchronization in infertile patients is about 37.5%. This is because during the assisted reproductive cycle, the endometrium can only accept the embryo for a specific period of time and allow it to implant successfully, and this time becomes the "implant window". That is to say, once the time of the best "planting window" is accurately grasped, the implantation success rate of the transferred embryo can be greatly improved.

"At present, the timing and length of planting windows are not the same, and the theoretical time limit for planting windows is at least 48 hours. Clinically, there are a small number of patients with short implant window time limit, implant window displacement (forward or backward), once the implant window is missed, it will lead to embryo implantation failure without bed. For repeated embryo implant failures, there is a high probability that the implant window will shift and the transplant will be required at the optimal time during the endometrial tolerance period, which may lead to embryo transfer failure in the early or late stages of tolerance. ”

The advanced technology he said refers to "endometrial receptivity analysis (ERA)", which uses second-generation sequencing to analyze gene expression status, analyze the expression of 248 genes related to endometrial receptive cell function, judge the patient's optimal implant window, and judge the implant window shift as low as 12 hours, which can improve the synchronization of embryos and endometrium and improve the implant success rate.

Later, Ms. Zhang retrieved eggs under the customized ovulation promotion protocol to obtain 3 blastocysts and 4 D3 embryos. Due to the thin endometrium during ovulation, half a year later, the hysteroscopy in the hospital was performed to assess the uterine cavity environment, and Chen Xiao, deputy director of the Reproductive Medicine Center, gave an artificial cycle to prepare the patient's endometrium, and took out a small amount of endometrium for examination and sent it for endometrial tolerance analysis.

Ms. Zhang's ERA examination results showed that the optimal time for embryo transfer was delayed by 12 hours compared with the conventional calculation time. In September 2021, Director Chen Xiao postponed the patient to receive the transplanted embryo 12 hours according to the patient's ERA sequencing results, and the patient successfully implanted the embryo for the first time! In November, hospital ultrasound prompted intrauterine double live fetuses.

Image source: Time China

"This year can finally welcome the baby double tiger, and our whole family is particularly grateful to Secretary Xu, Director Chen and the reproductive center team for their care and dedication!" During the Spring Festival, Ms. Zhang sent another text message to the doctor to thank her.

Xu Jian said that at present, more than 4,000 fertility centers around the world have carried out ERA examinations, but it is not recommended for routine use, only for patients who have failed repeated embryo transfers, through personalized embryo transfer, as far as possible to help patients successfully conceive.

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