Successful Implantation from the Embryonic Aspect.

PROBLEM Implantation failure is common in women with advanced maternal age, partly because of the increased number of aneuploid embryos. These women constitute the majority of patients for IVF treatment. As multiple pregnancies is a major hazard of preterm delivery, the aim is to select a competent embryo for single transfer. This study reviews currently used methods for selecting the competent embryo. METHOD OF THE STUDY Literature search. RESULTS The clinical value of currently used tests, for example pre-implantation genetic screening for aneuploidy, embryo morphology, morphokinetic measurements, extended culture to the blastocyst stage, as well as analysis of the follicular fluid and amino acid and glucose metabolism as well as oxygen consumption in embryo culture media, are discussed. CONCLUSION Several approaches look promising, but the clinical value of these is yet to be confirmed in randomized clinical trials. Furthermore, some of the methods are too complicated for routine clinical application.