Optimization of cryocycles by using pinopode detection in patients with multiple implantation failure: preliminary report

Abstract 

The aim of this study was to investigate pinopode formation patterns in patients with a history of multiple IVF failures and to evaluate if their detection with subsequent modification of protocols using frozen–thawed embryos could help to increase the pregnancy and live-birth rates in these patients. The study included 55 women with at least three implantation failures. On-time pinopodes were present in only 12.7% of cases, the rest showed acceleration, delay, arrest or asynchronization of pinopode formation. Patients with anomalies of pinopode development were divided into two subgroups, one of which had the standard protocol and the other a modified protocol, in which the duration of progesterone administration before embryo transfer was changed according to pinopode formation pattern. In nine patients with the modified protocol, with asynchronized and arrested pinopodes, simultaneous transfer of embryos of different ages was fulfilled. The implantation, pregnancy and take-home-baby rates for the modified and standard protocols were 28.0% versus 6.0%, 52.4% versus 12.0% and 47.6% versus 12.0%, respectively. Detection of inappropriately timed pinopode formation with subsequent synchronization of embryonic development and endometrial maturation allowed improvements in the effectiveness of programmes using frozen–thawed embryos in women with multiple implantation failure.

Keywords: endometrium, implantation window, IVF, pinopodes, scanning electron microscopy, uterine receptivity