From the Guidelines
Success rates do not typically increase after two failed IVF PGT-tested embryo transfers, and in fact, may slightly decrease with each failed transfer. The decision to proceed with another transfer should be based on a comprehensive evaluation of the individual's specific circumstances, taking into account factors such as age, number of euploid embryos available, and underlying medical conditions. According to the American College of Medical Genetics and Genomics (ACMG) 1, the success of IVF is most significantly affected by the age of the egg and the number of euploid embryos, which may limit the embryo selection options.
After two failed transfers with PGT-tested embryos, it is essential to undergo a thorough evaluation to identify potential underlying issues that may be contributing to the failed transfers. This evaluation should include:
- Endometrial receptivity analysis (ERA) to assess the optimal timing for embryo transfer
- Testing for chronic endometritis to rule out underlying infection
- Hysteroscopy to check for uterine abnormalities that may be affecting implantation
- Immunological testing to identify any potential immune factors that may be contributing to the failed transfers
Treatment modifications may be necessary based on the results of these evaluations, and may include:
- Endometrial scratching to improve endometrial receptivity
- Adjusting progesterone exposure timing based on ERA results
- Antibiotic therapy if endometritis is found
- Adding immunomodulatory medications like low-dose aspirin, prednisone (5-10mg daily), or intralipid infusions to address immune factors
As noted in a recent study 1, the clinical utility of PGT-A to select euploid embryos remains controversial due to the lack of proof of efficacy in increasing live births. Therefore, it is crucial to weigh the potential benefits and risks of PGT-P and IVF, considering the individual's specific circumstances and medical history.
From the Research
Success Rates After 2 Failed IVF PGT Tested Embryo Transfers
- The provided studies do not directly address the question of whether success rates increase after 2 failed IVF PGT tested embryo transfers 2, 3, 4, 5, 6.
- However, a study on IVF outcomes of embryos with abnormal PGT-A biopsy previously refused transfer found that transfer of PGT-A abnormal embryos can result in live births, although the success rates are not explicitly compared to those after 2 failed transfers 4.
- Another study on pregnancy outcomes following IVF-FET with or without PGT-A in women with recurrent pregnancy loss found that PGT-A use was associated with improved live birth rates, but this study does not specifically address the question of success rates after 2 failed transfers 6.
- There is no direct evidence in the provided studies to support a conclusion about the success rates after 2 failed IVF PGT tested embryo transfers.
Factors Affecting Success Rates
- The quality of the embryos, as evaluated by PGT-A, can affect the success rates of IVF transfers 2, 4.
- The age of the woman, the number of previous failed transfers, and the presence of recurrent pregnancy loss can also impact the success rates of IVF transfers 6.
- However, the specific question of whether success rates increase after 2 failed IVF PGT tested embryo transfers is not addressed in the provided studies.
Limitations of the Studies
- The studies provided do not directly address the question of whether success rates increase after 2 failed IVF PGT tested embryo transfers 2, 3, 4, 5, 6.
- The studies have different focuses, such as the use of PGT-A in IVF, the outcomes of abnormal embryo transfers, and the effects of progesterone elevation on pregnancy outcomes, but do not provide a direct answer to the question.