Preparing the endometrium to maximize success: The dynamics of artificial cycles

Abstract

In vitro fertilization (IVF) was developed for women with diseased or absent Fallopian tubes. Rapidly however, the clinical successes witnessed in IVF opened in their wake the doors to the until-then uncharted realm of oocyte exchanges. Together with its variant for male factor infertility - intracytoplasmic sperm injection (ICSI) - IVF is now called the assisted reproductive technology (ART). Logically, therefore, we refer to oocyte donation - with either IVF or ICSI - as donor-egg ART (DE-ART). Using donated oocytes for women whose ovaries have failed - in DE-ART - implied however that endometrial receptivity may be attained through the prescribed use of exogenous hormones. At the outset, at a time when results of general IVF were relatively meager, the need to rely solely on artificially prepared endometrium in recipients tarnished any prospect that DE-ART would be successful. Hence, the improbable and rapid unraveling that placed the results of DE-ART not only at par but most often above those of the corresponding regular ART programs was certainly a surprise