title: What can the clinician do to improve implantation?
abstract: Implantation is a complicated process that requires the orchestration of a series of events involving both the embryo and the endometrium. Even with the transfer of high quality embryos, implantation rates remain relatively low. The growing tendency towards transferring fewer embryos provides further incentives to improve implantation rates. In this article, the various clinical strategies employed to increase the chance of implantation are reviewed. Embryo transfer technique is a critical step in assisted reproductive technology cycles. Recent studies have shown significant improvements in clinical pregnancy rates resulting from careful embryo transfer technique, appropriate catheter type and placing for embryo transfer. Increasingly, adjuvant pharmaceutical therapies are also being applied with the aim of improving embryo implantation. However, the evidence for their efficacy and safety is limited. Recent evidence suggests that adoption of milder ovarian stimulation regimens may provide a more effective clinical approach to improving implantation, since beneficial effects have been shown for both endometrial receptivity and embryo quality.
authors.affiliation: Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, The Netherlands. c.m.boomsma@umcutrecht.nl
authors.forename: C M
authors.initials: CM
authors.lastname: Boomsma
authors.forename: N S
authors.initials: NS
authors.lastname: Macklon
mesh_terms: D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001205:Ascorbic Acid / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D010064:Embryo Implantation; D004624:Embryo Transfer; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008687:Metformin / Q000627:therapeutic use; D020030:Nitric Oxide Donors / Q000627:therapeutic use; D010062:Ovulation Induction / Q000379:methods; D018579:Patient Selection; D011247:Pregnancy; D011374:Progesterone / Q000008:administration & dosage / Q000627:therapeutic use; D027724:Reproductive Techniques, Assisted
chemical_list: D047072:Aromatase Inhibitors; D004791:Enzyme Inhibitors; D005938:Glucocorticoids; D007004:Hypoglycemic Agents; D020030:Nitric Oxide Donors; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D008687:Metformin; D001205:Ascorbic Acid; D001241:Aspirin