We see many patients who have failed an IVF cycle after transferring their frozen embryos. They aren’t sure why their IVF cycle failed, and are clearly upset. The doctor labels this as “failed implantation”, which is just a waste-paper basket catch-all term which doctors use to cover their ignorance. However, the reality is often the cycle fails because the quality of the embryos after the freezing and thawing embryos was poor, and bad quality embryos have a much lesser chance of implanting.
However, doctors hide this information from the patient, which is why they come to me for a second opinion. In order to provide this intelligently, I need to see embryo photos – images of the frozen embryos after they were thawed, to be able to judge the quality of the embryos. Sadly, doctors often refuse to share this with patients.
And this is why we tell patients , that whenever you freeze embryos, you need at least three photographs , taken at three different times , before the embryos are transferred.
One is the embryo at the time of freezing, which is its baseline state – the fresh embryo before it was vitrified. The second photograph should be taken immediately after the embryo is thawed. At this point, you can check whether the embryo is viable or not, because dead embryos will have dark cells. However, this in itself is not enough information. And that’s why we tell patients that you should ask the embryologist to thaw the embryos at least 2-3 hours before transfer, and then take the final embryo photograph just before the transfer, about 2-3 hours after the thaw, at which point you can compare what the embryo looked like immediately after the thaw, and then 2-3 hours afterwards. If it’s a viable embryo, you’ll be able to see that the embryo continues growing after the thaw. For example, when it’s a blastocyst which we’ve frozen and thawed, we usually freeze them in a collapsed stage, which means when we thaw them, they still remain collapsed, which is why it’s very hard to make out whether they are viable or not. However, after we thaw them, if we wait for 2-3 hours, the same collapsed blastocyst will expand, and once you see this, this is very reassuring , because you know that this is 100% clear evidence that your embryo is alive after the vitrification and the thaw.
The survival rates in a good IVF clinic after vitrification are nearly 100%, but lots of laboratories aren’t very good at vitrifying embryos or at thawing them. This is why many of the embryos which they transfer are dead, but they don’t share the truth with patients ! This is the real reason why the IVF cycle failed – and this is why the success rates with frozen transfers in these clinics are so poor.
Rather than depend blindly on your doctor to tell you the truth, you need to be proactive and demand this information so that your doctor doesn’t take you for a ride, because this is an expensive error you can’t afford to make!
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