Here is my wish list for 2022:

Note: I also wish for clearer skin, to eat less sugar, and get more sleep BUT this is my fertility wish list!

• Better define who benefits from endometrial receptivity testing.  Should every patient do this test before a frozen embryo transfer or just those who fail a transfer?
• Improved accuracy of non-invasive PGT. Currently we have to biopsy embryos to determine their chromosome status.  We, along with others centres, have been studying the fluid around a developing embryo to determine if the free genetic material floating in that fluid can tell us about the chromosome status of the embryo.  So far, it is not as accurate but hopefully things will advance.
• More data on the value (or lack of value) to suppressing endometriosis prior to a frozen embryo transfer.  My patients with severe disease will be suppressed 1-3 months before a transfer.  While there is good evidence they should be suppressed (e.g. with Lupron injections) before a fresh embryo transfer, it is less clear prior to a frozen embryo transfer.
• Fewer injections with the same/better ovarian stimulation!
•  Better understanding of immune regulation of implantation.  This is an acute need particularly for those with failed transfers of chromosomal normal embryos. I do the evidence-based testing after a failed embryo transfer, but when people start to fall in the 1% of cases evidence is harder to find.  Randomized control trials do not exist for these unique situations.  We then need to dig deeper and elsewhere for answers and oftentimes pursue treatment that “makes sense” but don’t come with years of research to back it’s use. A good example is intralipid.
• More access to hysterosalpingograms (HSG) for BC patients!

Whatever happens this year I am optimistic fertility care will improve.  I am optimistic that we will keep helping thousands of patients conceive successful pregnancies and that COVID will lessen its grip on our lives.

With great optimism for 2022,

Dr. Beth Taylor