Endometrial Factor and Displaced Window of Implantation | Real Patient Success Stories

Embarking on the journey to parenthood can be a challenging and emotional process, particularly for couples facing fertility struggles. However, advancements in reproductive medicine offer hope and innovative solutions. One such groundbreaking approach is Dual IVF, which involves multiple egg retrievals to maximize the chances of success. In this blog article, we will explore two compelling case studies from Clínica Tambre, where a displaced WOI (window of implantation) and Dual IVF played a pivotal role in the fertility journeys of their patients.

What is Dual IVF?

Dual IVF is an advanced fertility treatment approach that involves two separate egg retrieval cycles, with the aim of maximizing the chances of a successful pregnancy. This innovative technique addresses various fertility challenges and increases the number of high-quality embryos available for transfer.

In a conventional IVF cycle, a woman’s ovaries are stimulated to produce multiple eggs, which are then retrieved and fertilized with sperm in the laboratory. The resulting embryos are typically cultured for a few days before one or more are selected for transfer into the woman’s uterus. Any remaining viable embryos may be cryopreserved for future use.

Dual IVF takes the process a step further by incorporating two separate cycles of egg retrieval. This approach offers several potential benefits. Firstly, it allows for the collection of a larger number of eggs, which can increase the chances of obtaining a greater number of high-quality embryos. This is particularly beneficial for patients who may have a limited ovarian reserve or a history of unsuccessful IVF cycles.

Moreover, Dual IVF enables the opportunity for family planning. By undergoing two egg retrieval cycles, a patient can freeze additional embryos for future use, preserving the option to expand their family without further ovarian stimulation and egg retrieval procedures.

Dual IVF is often combined with other advanced techniques, such as preimplantation genetic testing (PGT-A), which assesses the genetic integrity of the embryos, and endometrial receptivity testing (ES Time), which evaluates the optimal timing for embryo transfer based on the receptivity of the endometrium.

This personalized approach to fertility treatment allows for a more tailored and individualized strategy, increasing the chances of successful implantation and pregnancy.

Ultimately, Dual IVF offers hope to couples struggling with displaced Windows of Implantation by providing them with a comprehensive and advanced treatment option that maximizes their chances of achieving a successful pregnancy and realizing their dream of starting a family.

 What is the Displaced WOI (Window of Implantation)?

The displaced window of implantation (WOI) refers to a condition in which the timing of the endometrial receptivity is altered, disrupting the optimal time frame for embryo implantation during the menstrual cycle. The window of implantation is the brief period of time when the endometrium, the lining of the uterus, is receptive to the implantation of a fertilized embryo.

In a normal menstrual cycle, the window of implantation typically occurs around days 19-21 of a 28-day cycle, coinciding with the mid-luteal phase when the endometrium is at its most receptive state. This window provides an optimal environment for embryo attachment and implantation.

However, in some cases, the window of implantation may be displaced or shifted either earlier or later in the menstrual cycle. Various factors, such as hormonal imbalances, uterine abnormalities, or disruptions in the signalling between the embryo and the endometrium can cause this displacement.

When the window of implantation is displaced, it can lead to difficulties in achieving successful embryo implantation and pregnancy. If the window is shifted earlier, the endometrium may not be adequately prepared for implantation, resulting in a decreased chance of successful attachment. On the other hand, if the window is shifted later, the endometrium may have already started to degenerate, making it less receptive to embryo implantation.

The displaced window of implantation can be diagnosed through techniques such as endometrial biopsy or molecular markers analysis. Treatment options may involve hormone therapy to adjust the timing of the window or procedures to correct any underlying uterine abnormalities.

It’s worth noting that research and medical understanding are continuously evolving, so it’s always important to consult with a healthcare professional or fertility specialist for the most up-to-date information and personalized advice regarding specific fertility concerns.

In this case study, we will explore the successful fertility journey of a patient who struggled with a displaced WOI and underwent Dual IVF treatment at Clínica Tambre, a renowned fertility clinic. The treatment was supervised by Dr Laura Garcia de Miguel, MD, the Medical Director, Gynaecologist, and Fertility Specialist at Clínica Tambre.

Patient Case Study No. 1:

The female patient had a BMI of 24.9 and no previous pregnancies (GAP0). She had been diagnosed with infertility and her anti-Mullerian hormone (AMH) level was 1.3, indicating a normal ovarian reserve for her age range. The male partner had no diagnosed fertility issues, and the DNA fragmentation test on his sperm showed normal parameters.

The patient had previously undergone two cycles of in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing for aneuploidy (PGT-A). In each cycle, the patient had achieved one euploid embryo, resulting in two transfers. Unfortunately, both transfers were unsuccessful, indicating a potential issue with the patient’s implantation window.

Diagnostics and Treatment:

To investigate the potential issue with the patient’s implantation window, an endometrial receptivity test (ES Time) was conducted. This test involved biopsying tissue from the endometrium lining and using microarray technology to assess the receptivity of the endometrium.

The ES Time results indicated that the patient was post-receptive, suggesting that the timing of embryo transfer might have been off in the previous cycles. Based on these findings, a dual IVF cycle involving two separate egg retrieval procedures was recommended. This approach would not only increase the chances of obtaining more high-quality embryos but also offer the patient the possibility of future family planning.

Results and Pregnancy:

During the dual IVF cycle, a total of 18 eggs were retrieved from the two cycles, resulting in 5 blastocysts and 3 euploid embryos. One euploid embryo was transferred into the patient’s receptive endometrium, which had been identified through the ES Time test. The patient successfully conceived and went on to give birth to a healthy baby boy in February 2023.

Significance of Dual IVF and Endometrial Receptivity Testing:

The use of Dual IVF in this case allowed for the retrieval of a greater number of quality embryos, increasing the chances of success. Additionally, the endometrial receptivity test provided crucial information about the patient’s implantation window, guiding the timing of the embryo transfer and improving the likelihood of pregnancy.

 

Patient Case Study No. 2:

The female patient, age 39, had a BMI of 23.5 and no previous pregnancies (GAP0). She had a normal ovarian reserve for her age range, with an AMH level of 1.3. The male partner had no diagnosed fertility issues, and the DNA fragmentation test on his sperm showed normal parameters.

The patient had previously undergone two cycles of IVF with ICSI and PGT-A. In each cycle, one euploid embryo was obtained, resulting in two transfers. However, both transfers failed to result in a pregnancy.

Diagnostics and Treatment:

Similar to the first case study, an endometrial receptivity test (ES Time) was performed to evaluate the patient’s implantation window. The test indicated that the patient was post-receptive, suggesting that the timing of the embryo transfer might have been a contributing factor to the previous failures.

Based on the findings, a dual IVF cycle was recommended to increase the chances of success and provide the patient with the option for future family planning. Two separate egg retrieval procedures were conducted, resulting in a total of 15 eggs and 3 blastocysts, with 3 euploid embryos.

Results and Pregnancy:

One euploid embryo was transferred into the patient’s receptive endometrium, as identified through the ES Time test. The embryo transfer was performed 12 weeks after the initial consultation. The patient achieved a positive result and went on to give birth to a healthy baby girl in April 2022.

Significance of Dual IVF and Endometrial Receptivity Testing:

Dual IVF was chosen in this case to increase the number of quality embryos available for future transfers, while the endometrial receptivity test helped determine the optimal timing for the embryo transfer. These personalized approaches played a crucial role in the successful outcome for the patient.

Frequency of Similar Cases at Clínica Tambre:

Approximately 30% of patients at Clínica Tambre experience a displaced window of implantation, leading to negative outcomes. Identifying and addressing endometrial receptivity issues through techniques like Dual IVF and ES Time has become an integral part of fertility treatment at the clinic.

Final Thoughts from Dr Laura Garcia de Miguel

“If good quality embryos have been achieved, and yet patients are not achieving pregnancy, it is essential to investigate the endometrium. The implementation of Dual IVF and endometrial receptivity testing allows us to address these factors and improve the chances of a successful pregnancy for our patients.”

Both cases highlight the success of Dual IVF and the importance of assessing endometrial receptivity in fertility treatments. The individualized approach provided by Clínica Tambre, under the guidance of Dr Laura Garcia de Miguel, has helped many couples overcome fertility challenges and realize their dreams of starting a family.