Back to basics : Why a fertile women don't achieve pregnancy in each cycle though the couple is not using any contraceptives whatsoever?? What is the normal fecundity rate in humans & animals?? What is preventing pregnancy in each month?? Why Nature don't want Traffic Jam (Overpopulation). ?? It is the endometyrium which keeps an vigil on this. Endometrium controls population growth by not receiving phone calls from incoming embryo or blastocyst .So So there is no cross talk between the womb & Honorable guest(this includes blastocsyt transfer)? All these boils down to ABC of Endometrial Receptivity:: .Query.1. what are the different Stages of fertilized Ova before implantation? - There are basically 3 stage of nidation. Firstly embryo when enters in ut cavity at 8-16 cell stage morula. -->at cavity it becomes 32-64 cell stage, blastocyst. Then the blastocyst Apposition, Stable attachment-adhesion, and then local invasion-penetration of blastocyst inside the endometrium. Endometrium becomes receptive += 6 days postovulatory.
Query .2. what is meant by Window of implantation (WOI) Process: - It is the time frame when the endometrium will allow the blastocyst to get adheres and implant. It lasts for about 4-5 days about 6 days after ovulation .The receptivity persists for restricted time frame days 20-24 of cycle.
Query 3. What are the clinical conditions that need to be addressed before ART is implanted and/or L Support is mandatory?
Pelvic disease like endometriosis, Myomas, intrauterine adhesions, endo polyp, endometritis, ut septum, endometriosis, PID, Koch's, Hydrosalpinx. Adenomyosis, PCOS, Autoimmune diseases.
Query 4. How to improve ER? Endometrial receptivity (thin Endometrium): can be improved by 1) Low dose aspirin, 2) LMWH 3) Vaginal Sildenafil, 3) L-Arginine, 4) Tocopherol, 5) Pentoxyphylline. 6) Chinese herbal medicines may improve receptivity.
Query 5.. what are the agents in pipeline to improve the endometrial thickness and Receptivity?:- IV-immunoglobulin’s, Intralipid, Allogenic Lymphocyte therapy, Local injury, Traditional Chinese herbs and acupuncture NSAID-all can improve Thin endometrium.
Query 3. What are the clinical conditions that need to be addressed before ART is implanted and/or L Support is mandatory?
Pelvic disease like endometriosis, Myomas, intrauterine adhesions, endo polyp, endometritis, ut septum, endometriosis, PID, Koch's, Hydrosalpinx. Adenomyosis, PCOS, Autoimmune diseases.
Query 4. How to improve ER? Endometrial receptivity (thin Endometrium): can be improved by 1) Low dose aspirin, 2) LMWH 3) Vaginal Sildenafil, 3) L-Arginine, 4) Tocopherol, 5) Pentoxyphylline. 6) Chinese herbal medicines may improve receptivity.
Query 5.. what are the agents in pipeline to improve the endometrial thickness and Receptivity?:- IV-immunoglobulin’s, Intralipid, Allogenic Lymphocyte therapy, Local injury, Traditional Chinese herbs and acupuncture NSAID-all can improve Thin endometrium.
Query 6.. Prerequisites of Successful implantation:-Competent blastocyst and receptive endometrium are essential. So, Blastocyst competency and endometrial receptivity both are essential. The ideal time implantation in a 28 days cycle is day 20-24 days of cycle-called implantation window.
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