Objective: Evidence derived from egg donation studies suggests that oocyte quality may be the most important factor determining implantation failure and pregnancy loss. The potential role of a uterine factor, other than in cases with detectable uterine pathology, is more controversial. The aim of this study was to assess the contribution of a possible uterine factor on implantation and pregnancy loss by comparing embryo transfers into surrogate and non-surrogate recipients. By considering only egg donation cycles, the confounding effects of oocyte quality were controlled.

Design: A retrospective analysis of IVF/ICSI fresh and frozen (FET) egg donation cases performed at one center over a five-year period, 1997-2002. Women with detectable uterine pathology were excluded.

Materials and Methods: A total of 172 fresh cases (53 IVF and 43 ICSI non-surrogate, and 56 IVF and 20 ICSI surrogate) and 64 frozen transfers (37 non-surrogate and 27 surrogate) were evaluated. Surrogate and non-surrogate cycles were compared with respect to age of oocyte donor (for FET cycles, age when embryos were frozen), age of embryo recipient (surrogate/patient), number of embryos transferred, and implantation, clinical pregnancy and miscarriage rates using chi-square or unpaired t-tests, as appropriate, for statistical analysis. The same clinical protocol was used to prepare the endometrium in both groups.

Results: There were no significant differences in the number of eggs retrieved, fertilization rate or number of embryos transferred between the surrogate and non-surrogate groups. Implantation rates following fresh embryo transfers were significantly higher for surrogates (42%) than for non-surrogates (33%, p<. 05). Surrogates also had a higher implantation rate (28%) than non-surrogates (15%, p<. 01) in FET cycles. Although there were no significant differences in clinical pregnancy rates between the surrogate (73%) and non-surrogate (65%) groups for fresh embryo transfer cycles, surrogates had a significantly higher pregnancy rate (74%) than non-surrogates (43%, p<. 025) in FET cycles. There were no significant differences in miscarriage rates between these groups.

Conclusions: Implantation rates are enhanced in fresh and frozen egg donation cases using gestational surrogates as compared to non-surrogates. This increase in implantation rates in surrogates is seen in both male factor and non-male factor cases. The lower clinical pregnancy rates seen with non-surrogates in FET cycles may result from the transfer of embryos that remain after the highest quality have been transferred in fresh cycles. This data suggests that, in addition to the previously reported effects of oocyte quality, a uterine factor may contribute to implantation failure, and it supports the use of a gestational surrogate for patients with repeated pregnancy failure using egg donation.

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Our fertility specialists at The Reproductive Sciences Center, or RSC, are conveniently located in La Jolla California in San Diego County. We have worked hard to create and maintain our reputation as the first-rate San Diego fertility clinic and sciences center. RSC has become synonymous with comprehensive and successful female and male infertility treatment, egg donor programs and surrogacy options, in vitro fertilization, ICSI and more.

While we have provided services to hundreds of patients throughout the Temecula, Murrieta, La Jolla, Riverside,San Bernardino and Encinitas areas, we also help many people from across the United States, Europe, Australia , Asia, Africa and the Americas who make us their final destination for treatment with infertility in San Diego. We lead the area as one of the leading fertility centers in the world.

Our fertility center has long been established as having one of the highest fertility success rates in the world, and with more than 75 years of combined medical training, experience and ongoing continuing education, our fertility specialists set the bar for the industry. Our medical director and leading fertility doctor is one of the most well-respected experts in the world.

Successful fertility treatment in San Diego is only possible with the best fertility specialists and staff in OrangeCounty. We have been providing unsurpassed treatment for infertility in San Diego, including IVF (In Vitro Fertilization) and other San Diego fertility services in La Jolla for more than a decade.

Some of our successful options for fertility treatment in San Diego include natural fertility treatment, advanced fertility treatment, IUI (Intrauterine Insemination), San Diego In Vitro Fertilization (IVF), ICSI for severe male infertility, genetic testing, embryo donation, blastocyst transfers, assisted hatching, and more. We are the top professionals of fertility options for women with cancer and fertility options for men with cancer in San Diego as well.

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