Analysing a failed IVF cycle

A failed IVF cycle can be heartbreaking, but the important thing is to analyze what went right and what didn't go right , so that we can plan better for the future.

Now there are only three tangible variables we can dissect.

One is the thickness and texture of the endometrium - what's called the endometrial receptivity. If the endometrium on the ultrasound scans was trilaminar and more than 8 mm thick, this means it was receptive. If it wasn't ideal, then additional tests such as a hysteroscopy could be done to analyze the uterine cavity. However,   if the uterine lining was optimal, then additional tests such as the expensive ERA ( Endometrial Receptivity Assay ) tests are a waste of time and money. Read more at https://www.drmalpani.com/knowledge-center/articles/why-thse-new-expensive-endometrial-receptivity-tests-are-useless

The second is the embryo - its grade, and the number of cells it has.  This is why embryo photos are so important. You can see what embryos should look like at www.drmalpani.com/knowledge-center/ivf/embryos. If the embryos aren't good, then you need to change the lab, or the superovulation protocol. If the embryos were top quality, then a new highly hyped test which promises to provide more information about top quality embryos is called PGS, where we analyse the genetics of the embryo. Sadly,  PGS reduces pregnancy rates. Read more at http://blog.drmalpani.com/2015/05/how-pgs-overpromises-and-underperforms.html

The third is the actual mechanical process of the embryo transfer. If this was technically smooth, then there's no need to make any changes in this.

All these fancy new test such as ERA and PGS are very profitable for the doctor to do, but they aren't clinically useful at all , so please don't waste your money on them , because they don't provide any useful clinically actionable information.

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