Failed embryo implantation is a critical factor in infertility, early miscarriage and IVF failure. Successful implantation requires a competent embryo and a receptive endometrium.  As embryo quality is increasingly being evaluated, there is an acute need for a greater understanding of the endometrial factors associated with successful implantation. 

The goal of this MD project, a collaborative research endeavour between UCD, MFC and NMH, is to define how dysregulation of inflammatory pathways affect embryo implantation and pregnancy, using next-generation sequencing and real-time PCR. Dr. David Crosby, Clinical Research Fellow and Specialist Registrar Obstetrics & Gynaecology, MFC and NMH, was recently awarded a highly competitive research grant by the UCD and SFI-HRB-Wellcome Trust Biomedical Research Partnership fund for this work.

Collaborators: Prof Fionnuala McAuliffe, Prof Donal Brennan and Prof Brendan Loftus

The role of natural killer (NK) immune cells in infertility is the subject of much controversy in reproductive medicine. It is important to note that circulating blood NK cells and NK cells found in the uterus have very different profiles and functions. Scientific studies in animals indicate that NK cells are in fact essential for pregnancy and development of the placental blood supply.

A recent collaborative study between Merrion Fertility Clinic and Trinity College Dublin found more immature uNK cells in uterine tissue from women with endometriosis as compared to healthy patients. Further analysis of these endometrial tissue samples revealed reduced levels of a growth factor called SCF in women with endometriosis, which may underlie the impaired maturation of uNK cells.

Collaborator: Prof C O’Farrelly

This collaborative study with Dr Lynne O’Shea, UCD, investigates functional, biochemical and molecular factors in follicular fluid and granulosa cells which may predict oocyte quality and competence. Follicular fluid is collected from women undergoing IVF/ICSI treatment at MFC.

Work to date has demonstrated differences in follicular fluid AMH and P4 concentrations between fertilized oocytes that developed successfully to blastocyst stage and those which failed to do so. This research is ongoing.

Collaborator: Dr Lynne O'Shea

Research in this area by Dr Yvonne O’Brien has focused on several topical issues in the area of fertility awareness, testing and fertility preservation. These include:

• the attitudes of women in the general population towards ovarian reserve screening and whether they would prioritise life goals if informed and empowered with knowledge of their individual ovarian reserve
• women’s attitudes towards oocyte vitrification for non-medical reasons in an effort to avoid unintended childlessness due to delayed childbearing
• the emotional responses of women to being informed of their AMH result and coping mechanisms that were beneficial
• knowledge and desire for fertility preservation options in a transgender population  imaginations of parenthood

Collaborators: Prof Donal O'Shea, Prof Cecily Kelleher

• Development of a sperm friendly vaginal lubricant
• Out-patient hysteroscopy – cost analysis
• Clinical trial involving a device for hysteroscopic tubal occlusion (Altaseal ®)

For more information visit https://merrionfertility.ie/about/research-teaching/