Abstract
Objective: To identify causes of embryo implantation failure after Intra cytoplasmic sperm injection (ICSI); by correlation of positive pregnancy outcome with age, number and grading of embryos, day of egg collection, endometrial lining and progesterone levels on the day of egg collection and embryo transfer.
Materials and Methods: Descriptive case series conducted on 40 couples of Assisted Reproductive Clinic in Islamabad from June till August 2011.Down regulation of females aged 18-35 with Gonadotrophin releasing hormone agonist was followed by calculated stimulation with gonadotrophins (Injection Puregon). Fertilized eggs were graded, blastocysts transferred on day 13, 14 and 15 of treatment cycle on the basis of follicular maturation and endometrial lining measured by trans vaginal scan. Serum progesterone was measured by Enzyme Linked Immuno Sorbent Assay on the day of egg collection and embryo transfer.
Results: Rise of progesterone in secretory phase of endometrial cycle more so on the day embryo transfer(ET) is associated with positive pregnancy outcome, however female age, number and grading of embryos, day of ET, endometrial linning and other biochemical parameters had no significant effects.
Conclusion: Estimation of serum progesterone on the day of ET is highly specific and sensitive test for prediction of positive pregnancy outcome as was detected by rise in â hCG (Human Chorionic gonado trophin).

Key words: : Intra cytoplasmic sperm injection, Embryo transfer, Egg collection, Progesterone, â hCG.