First attempt more likely or not?
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Must compliment you on this excellent message board.
My sister (age 35) has gone through a full IVF cycle and a second attempt with frozen embryos.
a few questions:
1. First attempt (implanting one embryo) failed. She was told the first try often has less success. She read elsewhere it has best success rate. Is there any difference between success rate of attempts?
2. On the attempt to implant (2) defrosted embryos they had been thawing for 16 hours. She was told that they normally start dividing within 24 hours. These ones hadn't after 16 hours but they went ahead without waiting to see. did she really stand much chance of becoming pregnant?
3. She has been told she may have endometriosis. From reading up on endo, the main effects on fertility seem to be prior to implantation.
If endometriosis is present but eggs can be retrieved and fertilised, is the outlook good for further attempts?
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A1. Theoretically, the chances are the same for the first 3 attempts. However, in practice, we learn a little more about the patient each time we perform IVF. With the added information from each failure, we are able to tweak the subsequent cycle to try to improve the chances of success. So I'd say that the second attempt has a marginally better chance of success than the first.
A2. Its pretty routine to transfer frozen-thawed embryos before they divide again. However, I agree that waiting would provide additional information about the embryo's developmental capacity prior to transfer. In our program, we only transfer and/or freeze blastocyst stage embryos, so we know a lot more about there developmental capacity (compared to Day 3 transfer and/or freezing).
A3. If there is a suspicion of endometriosis, it should be diagnosed and treated before a subsequent IVF attempt. Endometriosis can and does affect the viability of transferred embryos and the implantation process. Endometriosis can be diagnosed by laparoscopy and treated by laser and/or medication. However, the endometriosis does eventually come back, so IVF should be attempted within 3 months of laparoscopy.
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