Extended hypo-estrogenic treatment might enhance implantation in those who have failed to conceive after multiple embryo transfers

What exactly do we mean by ‘recurrent implantation failure’? A systematic review and opinion

“…In this group, the treatment cycle involved the use of IVF in 11 cases (Chou et al, 2011;Fukui et al, 2006;Gianaroli et al, 1997;Huang et al, 2011;Ivanov et al, 2012;Kalu et al, 2008;Martinuzzo et al, 2005;Matsubayashi et al, 2001;Sermondade et al, 2012;Spandorfer et al, 2002;Vaquero et al, 2006), ICSI in two cases (Berker et al, 2011;Oliveira et al, 2011), IVF or ICSI in two cases (Eyheremendy et al, 2010;Lodigiani et al, 2011) and was not clarified in 10 studies (Foulk et al, 2007;Hiraoka et al, 2008;Kahraman et al, 2000;Petersen et al, 2005;Schoolcraft et al, 2010;Stephenson and Fluker, 2000;Takahashi et al, 2011;Tsoumpou et al, 2010;Urman et al, 2009;Valojerdi et al, 2008). Six of the authors identified the transferred embryos as being 'fresh and or frozen' (Eyheremendy et al, 2010;Hiraoka et al, 2008;Petersen et al, 2005;Stephenson and Fluker, 2000;Takahashi et al, 2011;Urman et al, 2009). Stage of embryo transferred was mentioned in one study as 'cleavage stage' but precise data were not given (Hiraoka et al, 2008).…”

“…A negative serum b-HCG 2 weeks following embryo transfer was used to define treatment outcome by eight authors (Coulam et al, 2006;Debrock et al, 2009;Firouzabadi et al, 2009;Goodman et al, 2008Goodman et al, , 2009Sacks et al, 2012;Sauer et al, 2010;Urman et al, 2009). Other treatment outcomes included 'conception' (Chou et al, 2011;Fragouli et al, 2010;Huang et al, 2011;Takahashi et al, 2011), 'clinical pregnancy' (Huang et al, 1999;Johnston-MacAnanny Table 2 Studies using a definition of RIF of two or more failed treatment cycles, alone or in combination with the number of embryos replaced. Lodigiani et al, 2011;Sermondade et al, 2012;Vialard et al, 2007), 'positive serum HCG and subsequent miscarriage' (Germeyer et al, 2010), 'negative urinary pregnancy test or chemical pregnancy loss' (Coulam et al, 2008), 'failure to maintain a pregnancy' (Varla-Leftherioti et al, 2007) and 'failure to implant, biochemical pregnancy failure or spontaneous abortion of less than 8 weeks gestation' (Stephenson and Fluker, 2000).…”