How long should I wait before beginning a new course of treatment following unsuccessful IVF? 0In vitro fertilisation (IVF) treatment is not always successful. The reasons for this can include the cycle being cancelled during the stimulation phase or during the fertilisation and embryo development processes in the laboratory; or embryo implantation failing to take place following transfer and a negative pregnancy test result.

An extensive analysis of both the recent unsuccessful course of treatment and the patient’s medical history needs to be carried out in all such cases. The prospects are still favourable in most patients and the most reasonable option is to attempt a new course of IFV treatment taking into account any necessary changes in order to try and improve the prognosis.

Once the decision to undergo an additional course of treatment has been taken, the optimum time for doing so needs to be determined. Some people are of the opinion that the sooner treatment begins, the greater the chances of success. Others, however, believe that a few months’ wait are necessary in order to improve the chances of success.

When treatment using frozen embryos or egg donation is carried out (that is, when the ovary does not need to be stimulated and only the uterus needs to be prepared for implantation), treatment can be scheduled immediately without this having an impact on results in any way. Preparatory steps in order to transfer frozen embryos often begin immediately after the pregnancy test.

In courses of IVF requiring renewed stimulation, the matter of when the ovary is in optimum condition in order to be newly stimulated is much more controversial. However, studies carried out have not found differences between results obtained when stimulation begins after just one month’s wait.

Therefore, and based on current experience, stimulation can be scheduled to start alongside the next period 2 to 3 days after the beta hCG pregnancy test result. This is particularly important if we are to comfort couples who, for personal or medical reasons, cannot delay beginning a new course of treatment.

However, it is not only medical issues that need to be taken into account. The couple’s emotional status is perhaps the most important factor when deciding when the most appropriate time for attempting a new course of treatment has come. It is often necessary for some time to go by in order to internalise the stress generated during the previous course of treatment and to be ready to start afresh.

Dr Joaquín Llácer, Co-Director of Medicine. Reproductive Medicine at Instituto Bernabeu.

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How long should I wait before beginning a new course of treatment following unsuccessful IVF?
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