At the Agora we are mindful that failing to conceive after an IVF cycle can be a very distressing event. It can be even more disheartening if everything has gone to plan in the cycle and a beautiful embryo (or two) has been transferred into the womb but no pregnancy results.
Your follow-up medical consultation after a failed IVF cycle is a time where our Consultant will help you come to terms with the outcome and explore the reasons the cycle might not have worked. A new treatment plan individualised to your needs and based on everything that has been learned will be drawn up for you.
Why do some IVF cycles fail?
The vast majority of failed IVF cycles are due to the abnormal genetics in the embryo chosen to be transferred. This cannot be predicted by the appearance of the embryo prior to transfer. These errors can come from either the sperm or the egg genetics but they do occur with increased frequency in older women. Techniques such as PGT-A which involve taking a biopsy of the embryo to study its genetics have not led to an overall improvement in the chances of a live birth.
Implantation failure is the term used to describe the situation when an IVF cycle fails despite there being a top quality embryo. It is a relatively rare cause of IVF cycle failure but one which has fascinated IVF research scientists over the last two decades.
Many patients have been given false hope as first one and then another new treatment is proposed to treat implantation failure. What has become very clear in recent years is that most of these treatments, now referred to as ‘add ons’, have not been shown to improve the chances of the IVF cycle working in properly conducted scientific research trials. We have been very careful at the Agora of not offering false hope with ‘add ons’ that are costly and are not backed up by good scientific evidence. You can find out more by reading the HFEA guidance on treatment add-ons .
At the Agora we are currently investigating the benefit of the endometrial receptor assay on implantation failure. We may suggest the use of the Time lapse incubator the Embryoscope if you have had two or more failed IVF cycles.
Endometrial Receptor Assay (ERA)
The ERA is a genetic test developed to check that your womb lining is perfectly synchronised to receive embryos in an IVF cycle. It uses a technology called Next Generation Sequencing (NGS) to measure endometrial receptivity.
The test involves having a small biopsy of your womb lining in a ‘dummy’ cycle and then using the test results to identify your individualised ‘perfect window’ of implantation.
We might advise you to have the ERA if you’ve had a number of IVF cycles but the embryos haven’t implanted, despite being of good quality. Research is still being done into this area so we only offer this test once we’ve clearly explained its limitations and the current evidence available to support it.
Time Lapse Incubators
The Embryoscope is a state-of-the-art incubator that uses time-lapse imagery to help our embryologists select the embryos that give you the best chance of pregnancy. The Embryoscope also makes it possible for the embryos to remain in the incubator environment and for their development to be continuously monitored without the need to remove them and examine them under a microscope each day, something that’s necessary with conventional incubators.
We may advise you to have your embryos cultured in the Embryoscope as part of your IVF cycle.
How does the Embryoscope work?
The Embryoscope incubator has a built-in camera and microscope. Images are taken of the embryos every ten minutes. As a result, time-lapse videos of individual embryos are generated while the embryos stay undisturbed in their stable culture environment. Advanced software allows the embryologist to use the embryo development information in order to select the best single embryo
Will it make a difference to my chances of conception?
Research is still being carried out to discover the extent to which the Embryoscope can improve success rates. You can find out more by reading the HFEA guidance on treatment add-ons . Our own data suggests it may be a good option for patients who have had two or more failed cycles using a conventional incubator, recurrent miscarriages and those who have either low egg or low sperm quality. Your doctor will advise you if they feel this might be of benefit to your treatment cycle.