(photo credit: Ariel Jerozolimski)
Employing gravity and biomechanical processes to calculate the optimal time and angle to implant embryos in in-vitro fertilization could increase a woman's chances of producing a healthy baby through IVF beyond the current 30 percent and reduce the need for multiple implants, according to research conducted at Tel Aviv University.
New studies by Prof. David Elad from the university's department of biomedical engineering suggests that prospective parents and their fertility experts should also look at the role of biomechanical forces in their efforts to help couples produce a healthy baby.
As hopeful moms-to-be learn, there are important considerations that can lead to the successful implantation of a fertilized human egg. A calm environment, regular hormonal injections and the timing of the implantation can all affect the outcome of an in-vitro procedure.
"I am specifically studying how the uterus contracts before the embryo implants itself onto the uterine wall," says Elad, who has published his suggestions to enhance IVF success rates in the journal Fertility and Sterility. These contractions play a vital role in keeping the embryo in the uterus, and knowledge of its mechanics can indicate the optimal time and site for implantation. Physical positioning of the woman and the shape and size of her uterus also affect the results of IVF implantation, he adds.
"We are all subject to the earth's gravity forces, and all biological process must also obey Newton's basic laws of physics," says Elad, who has been studying the biomechanical engineering of pregnancy for more than 15 years. "Uterine contractions push the fluid inside a woman's womb in a peristaltic fashion, which helps sperm reach the ovum in the fallopian tube. And after fertilization, this same peristalsis propels the embryo to its implantation site in the uterine wall. It's a fluid mechanics issue."
By thinking about these biomechanical processes during IVF treatments, he explains, "we can help physicians and prospective parents, see better outcomes."
"There is no such thing as a standard uterus," he insists. "Our research offers best practices for women of all shapes and sizes."
To increase the chances of a successful implantation, women can opt for three or more viable embryos to be implanted in the womb during one cycle. Many, emotionally and financially exhausted, take this chance even if it means one or more embryos will have to be sacrificed in the womb to ensure the health of another. Elad's research could spare women from having to make this difficult ethical decision.
"Besides recent reports that IVF babies are slightly more prone to genetic diseases, there is a general notion that when there is more than one embryo in the uterus, all the fetuses are subjected to risks of mild and sometimes severe medical problems in the future," he says. "Parents naturally want to avoid this circumstance."
Through advanced bioengineering research, Elad - who is now a visiting professor at New York's Columbia University - is continuing to provide "stimulating evidence" to the IVF medical community. He is working on a computer simulation program of embryo transport in the uterus, in both natural conception and after IVF procedures, to model how and when artificially inseminated embryos should be implanted in the uterus.