Very small holes can be made in the outer coating of an embryo with a laser to encourage hatching of embryos. We may suggest using the process with multiple failed cycles of treatment or in the case of frozen embryo transfer where the outer coating may become tougher.
At Boston Place we offer embryo transfer 7 days a week. 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.
New techniques allow us to examine all of the chromosomes and to see if an embryo lacks or has additional chromosomes, a condition called aneuploidy. This technique may be helpful in those patients that have had multiple IVF failures or for older women who produce more genetically abnormal eggs. More recent research suggests that younger women may also produce large numbers of abnormal eggs during IVF treatment and may also benefit from this procedure by achieving higher than average success rates and limiting multiple pregnancies.
Hyaluranon 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.
A 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.
Boston Place Clinic was the first UK IVF lab designed specifically to use Embryoscope™ incubators and to maximise the potential of your embryos.
At Boston Place we offer a procedure called an ‘Endometrial Scratch’. Recent studies have suggested that the endometrial scratch may improve implantation rates in patients who have had multiple failed IVF cycles despite good quality embryos. Embryo implantation into the womb may fail due to poor embryo quality or abnormal embryo genetics. It can also often fail due to poor ‘endometrial receptivity’. This is where the lining of the womb is not favourable for the embryo to implant.
The endometrial scratch is a straightforward out-patient procedure which is relatively painless (similar to a cervical smear test). The procedure involves “scratching” the endometrial lining of the womb with a very small catheter (plastic tube) prior to an attempt to get pregnant.
The procedure is thought to increase the immune system cells and therefore the growth factors at the site of the endometrial scratch. This is believed to make the womb lining more receptive to embryo implantation. Studies have suggested that implantation rates may be twice as high in patients who have an endometrial scratch before attempting to get pregnant.
It is recommended that the endometrial scratch is performed in the cycle before you start stimulation medication. Ideally the procedure should be done between days 19 and 25 of your menstrual cycle.
The scratch can be performed in the same cycle as one in which you are trying to conceive naturally.
The risk of a miscarriage if you get pregnant after the procedure is no more than 1%. Given the increased chance of getting pregnant, the benefits of the procedure outweigh any risks.
You will attend the clinic with a semi-full bladder (drink 300ml of water 1 hour prior to the procedure, and do not empty your bladder during this time). First the Doctor will perform an internal ultrasound scan to assess the shape and position of the womb. A very small catheter will then be inserted through the cervix into the womb. This catheter will be used to scratch 4 areas on the womb lining. You may experience slight discomfort as the catheter is being passed into the womb.
After the procedure, a small amount of vaginal spotting or bleeding is not unusual. You can commence an IVF cycle as normal the following month or try a natural cycle in the same month.
Hyaluranon may also help to isolate mature sperm for use in ICSI (intracytoplasmic sperm injection) cycles helping to increase fertilisation rates.
Eggs and embryos are frozen using a process called ‘Kitazato Vitrification’ (meaning literally turn to glass): a Japanese method that achieves higher success rates than the older and slower freezing methods. Kitazato Vitrification achieve similar success rates in frozen embryo cycles to that of fresh cycles.
Cryopreservation may be useful in the following circumstances: