Below are different options that can be added onto your treatment cycle. Add-ons are optional extras that can be added on top of your standard IVF or ICSI cycle at an additional cost. None of which have any detrimental impact, however, proven clinical benefit is yet to be statistically confirmed. For further information on their effectiveness please refer to the HFEA’s online guide (https://www.hfea.gov.uk/treatments/explore-all-treatments/treatment-add-ons/) and if you are considering using any of these please discuss with our clinical team for further guidance.
At Thames Valley Fertility, embryos are usually transferred anytime between day 2 and day 5. Blastocyst transfer is a selection tool which helps us to identify the strongest embryo/s for transfer and is a good technique to use where more good quality embryos have developed by day 3 than are needed for transfer.
Hyaluronon is a naturally occurring substance present in follicles, tubes and cavity of the womb. Its effect is to make the fluid in these areas more viscous (sticky) and to encourage implantation of embryos. Therefore embryglue can be used for ET to improve implantation potential of embryos transferred.
It is shown in recent studies that an ‘endometrial scratch’ may improve implantation rates in patients who have had multiple failed IVF cycles, despite good quality embryos. Embryo implantation can often fail due to poor ‘endometrial receptivity’, and an endometrial scratch may help to improve the womb lining’s receptivity to an embryo. It’s a straightforward appointment. There is an ultrasound scan, and then a procedure similar to a smear test, where a catheter is inserted into the womb through the cervix, and used to lightly mark the womb lining. It’s suitable for patients trying to conceive in a natural cycle, as well as patients going through IVF cycles.
A new time-lapse technology called the Embryoscope™ involves culturing embryos in an incubator equipped with a special microscope, camera and computer. Available since 2011 it has already led to the birth of thousands of healthy babies. Each individual embryo is imaged separately and monitored every 15 minutes allowing subtle changes in development to be detected. This allows selection of embryos with the highest pregnancy potential – so-called morphokinetics.
Up to 70% of embryos appear normal when observed on a daily basis using older incubation systems yet do not go on to give successful pregnancy after transfer. The ability to more accurately select an embryo capable of pregnancy on the basis of the time-lapse imaging is an exciting development. It is also thought that embryos identified in this way are less likely to lead to early pregnancy loss than other systems and preliminary results are excellent.
PICSI is a modification to the standard ICSI procedure which involves the identification of mature sperm by using a specialised culture dish and the subsequent selection of those sperm for injection.
The recommendation for PICSI is based on the percentage of mature sperm in the semen sample, this is assessed by a sperm HBA (hyaluron binding assay) test . If the level of mature sperm in the sperm sample is <80%, we would be recommended that PICSI treatment is performed.
Chromosomal abnormality is one of the most common causes of unsuccessful pregnancy. If an embryo has too many or too few chromosomes (a condition called aneuploidy) this can have a serious effect on its chances of developing normally into a fetus and then a baby. In many cases, embryos with the wrong number of chromosomes stop growing by themselves, and this unfortunately often results in miscarriage.
This is no less common with IVF treatment. However, the IVF process enables us to monitor the development of multiple embryos at the same time. We can provide various levels of genetic screening during treatment, to help us select embryos with normal chromosomes, which have the best chance of developing into a healthy pregnancy.
Please refer to our page on ‘Genetic Screening’ for more information on this technique.