Hysteroscopic Subendometrial Embryo Delivery (SEED), Mechanical Embryo Implantation

Background: A major hurdle to improved in vitro fertilization (IVF) success rate is defective endometrial receptivity and implantation. Various techniques have been advocated to increase implantation while reducing side effects. Currently, embryo transfer (ET) is performed blindly without direct visualization. As such, we sought to develop a technique utilizing a flexible minihysteroscope with a flexible catheter for direct implantation of the blastocyst(s). Materials and Methods: This was a case study performed at West Coast IVF Clinic, Inc., Beverly Hills, California 90212. A total of 15 IVF Cycles in 13 patients (average age = 29) underwent visually directed ET and endometrial implantation. All women received luteal support. The main outcome measure in this study, both clinically and procedurally, was the relevant development and assessment of a novel surgical technology. Results: In this study, eight (60%) pregnancies ensued [5 (62.5%) clinical and 3 (37.5%) biochemical]. Of note, there was no uterine scratching, uterine bleeding, or ectopic pregnancies. Significantly, high-order pregnancies were decreased; only one twin was conceived. Conclusion: Preliminary data suggest mechanically assisting implantation with a hysteroscopic blastocyst ET (SEED) offers a viable option for improving pregnancy outcome.