Dr Hamed Al-Taher, Lead Clinician at the Wymondham-based IVF clinic, is delighted with the new figures: “Over the last 12 months, 56% of our patients under 37 became pregnant, compared to the national average of 47% (http://www.hfea.gov.uk/docs/HFEA_Fertility_Trends_and_Figures_2013.pdf p28). This is very good news for our patients and staff.”
One of the major factors influencing the improving success rates is the increased use of ‘blastocyst transfer’, which happens when the embryo is five days old.
Naturally, the embryo takes about five days to travel from the ovary down the fallopian tube, so it would have reached blastocyst stage just as it reaches the womb. This is when the cells in the embryo will have divided rapidly and started to differentiate so they can become different parts of the baby and the placenta.
Blastocyst stage is reached during IVF treatment by allowing an embryo to develop in the incubator before it is transferred to the womb. Embryos that reach blastocyst stage are ready to implant in the womb and offer the highest chance of a successful pregnancy.
The embryos are closely observed to check which are dividing rapidly and likely to reach blastocyst. Not all embryos are able to do this and the decision might be made to transfer an embryo earlier. This embryo would still be capable of resulting in a healthy pregnancy.
In addition to manual observations, which require the embryos to be taken from the incubator for viewing, Bourn Hall has invested in some new incubators fitted with the Eeva system. This is a video capture system that images the embryos every few minutes and uses a special algorithm to calculate which embryos are most likely to reach blastocyst.
Dr Al-Taher says that each embryo is still observed by the embryologist but Eeva provides some additional benefits:
”In the lab we try to replicate as closely as possible the natural environment of the body. The big benefit of Eeva is that it allows us to monitor the embryos with very little disturbance. It also provides an objective assessment of the viability of the embryo which can be helpful when two embryos look identical or when an earlier transfer is required.”
For patients concerned about their egg quality and likely response to stimulation drugs, the AMH (Anti-Mullerian Hormone) test, provided either as part of a suite of fertility tests or on its own, can provide some helpful information that can be used to advise about treatment options.
The AMH test gives an indication of the reserve pool of eggs left in the woman’s ovaries (not the exact number) and whether it would be worth attempting ovarian stimulation for egg collection and IVF.
Even if the AMH level is low, if other factors look good and the patient wants to try, then ovarian stimulation might still be possible, although it may be necessary to use a higher dose of drugs.
These are some of the types of options that are discussed as part of the initial consultation. Both NHS and self-funded patients can have all their fertility testing done at Bourn Hall, which means that they have continuity of care through every stage of their fertility journey.
To learn more about Eeva at Bourn Hall click here.