title: Recurrent implantation failure in IVF: features of cycles that eventually ended in conception.
abstract: OBJECTIVE
  To evaluate the characteristics of patients and IVF cycles with recurrent implantation failure who eventually succeeded to conceive compared to those who failed to do so.
  
  
  METHODS
  In a retrospective study, we explored our database for patients younger than 35 years old who underwent at least three unsuccessful fresh IVF cycles. The following parameters were analyzed: cause of infertility, FSH level, stimulation cycle characteristics, fertilization rate, the type of luteal support, and cycle outcome. Uterine cavity assessment was also included. The relationship between endometrial scratching and the outcome of the following IVF cycle was assessed for the subsequent pregnancy rate.
  
  
  RESULTS
  The study included 184 patients who underwent 854 IVF cycles. There were no statistically significant differences between patients who eventually conceived and those who did not in terms of ovarian reserve and response to gonadotropin treatment. IVF cycles that eventually ended with conception were characterized by shorter stimulation (10.87 ± 2.17 versus 11.34 ± 2.33 days, p < 0.05), higher estrogen level on the day of hCG administration (1661 ± 667 versus 1472 ± 633 pg/ml, p = 0.009), more fertilized oocytes via ICSI (5.04 ± 4.29 versus 3.85 ± 3.45, p = 0.002), and more embryos available for transfer (5.98 ± 3.89 versus 5.12 ± 3.31, p = 0.002). Combined estrogen and progesterone luteal support combined with endometrial scratching prior to the subsequent IVF cycle has been positively related to increased pregnancy rates.
  
  
  CONCLUSIONS
  Young patients with RIF having a normal ovarian reserve and satisfactory ovarian response to superovulation should be encouraged to pursue IVF, even though the probability to conceive is relatively low compared to the general IVF population.
authors.affiliation: Fertility and in Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. bord@012.net.il.
authors.forename: Ilia
authors.initials: I
authors.lastname: Bord
authors.affiliation: Fertility and in Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Belle
authors.initials: B
authors.lastname: Tamir
authors.affiliation: Fertility and in Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Avraham
authors.initials: A
authors.lastname: Harlev
authors.affiliation: Fertility and in Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Iris
authors.initials: I
authors.lastname: Har-Vardi
authors.affiliation: Fertility and in Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Eitan
authors.initials: E
authors.lastname: Lunenfeld
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.affiliation: Fertility and in Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Eliahu
authors.initials: E
authors.lastname: Levitas
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006062:Gonadotropins / Q000008:administration & dosage*; D006801:Humans; D007246:Infertility / Q000628:therapy*; D065851:Ovarian Reserve; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D006062:Gonadotropins; D011374:Progesterone
keywords: IVF outcome; Pipelle-endometrial scratching; Recurrent implantation failure