A failed IVF cycle can be because of poor egg quality, sperm quality or uterine lining. It is assumed that all the stimulation egg pick up, laboratory procedures and embryo transfers have been done meticulously in previous attempts. We offer certain modifications in an IVF cycles for optimizing outcome in couples suffering from failed IVF attempts- Optimized stimulation protocol: The short antagonist protocol offers the best results in terms of selection of the best oocytes (eggs) in most cases. Selection of Sperm: In many cases, Intra Cytoplasmic Sperm Injection (ICSI) is offered as it has been suggested that it may improve fertilization rates and hence, overall pregnancy outcome. Our embryologist takes special care to select the best sperms for doing ICSI. Hysteroscopy: The hysteroscope aids us in picking up uterine abnormalities which are sometimes missed at routine ultrasound e.g., small polyps. It is also useful in washing and cleaning the uterus which sometimes may help in improving the outcomes. Endometrial scratching is also done at the same setting to improve the uterine receptivity. Intravenous Immunoglobulin (IYIg): IVIg seems to directly affect NK cell level and activity, by reducing their absolute numbers and increasing the expression of inhibitory receptors CD94 which potentially can improve pregnancy outcome. Vitamins and Antioxidants: DHEA, L Arginine, Zinc, selenium etc. are given to women and men as indicated to improve the egg and sperm quality. Atosiban: This is a uterine relaxant which is given during the embryo transfer. It helps in relaxing the uterus and therefore, improving the endometrial receptivity. Laser Hatching: Laser hatching of the embryos is performed on the day of embryo transfer to ensure that the shell of the embryo hatches easily. This allows the embryo to implant better. This is mainly suitable for embryos with thick shell, advanced age group and frozen embryos. ERA: ERA presumably detects the phase of the endometrium in which the embryo best implant. However, there is controversy regarding the actual benefit of this in improving the live birth rate. PGS: PGS is a way of detecting abnormal embryos thus may help in improving the pregnancy rates. However, each case must be individualized. Day of Transfer: Not all women will be benefitted by Blastocyst (Day 5 ) transfer as many seem to believe by studying the internet. The day of transfer should be individualized for each patient. Meticulous Transfer Technique: Embryo transfer is the final and one of the most crucial step of IVF. All embryo transfers at AFGC are performed by Dr Kaberi Banerjee who has taken special training in embryo transfer from UK.

2. Failed IVF cycles
Dr Kaberi Banerjee
Medical Director- Advanced Fertility and Gynaecology Centre, New Delhi
Chairperson Delhi State Chapter ISAR
MBBS and MD in Obstetrics & Gynecology (AIIMS, New Delhi)
FRCOG, London, UK
Commonwealth Fellow in Reproductive Medicine, London UK.
More than 8000 IVF, ICSI, Donor and Surrogacy Cases

3. To provide ethical state of art fertility services with
utmost honesty & transparency to the customers
through quality standards as well as an atmosphere of
empathy and comfort.
Failed IVF cycles
A failed IVF cycle can be because of:
• poor egg quality,
• sperm quality or
• uterine lining.

4. To provide ethical state of art fertility services with
utmost honesty & transparency to the customers
through quality standards as well as an atmosphere of
empathy and comfort.
Certain modifications offered
• Optimized stimulation protocol
 The short antagonist protocol offers the best results in
terms of selection of the best oocytes(eggs).
• Selection of Sperm
 Intra Cytoplasmic Sperm Injection (ICSI) improves
fertilization rates and hence, overall pregnancy outcome.
 At AFGC, our embryologist takes special care to select
the best sperms for doing ICSI.

5. To provide ethical state of art fertility services with
utmost honesty & transparency to the customers
through quality standards as well as an atmosphere of
empathy and comfort.
Certain modifications offered
• Hysteroscopy
 The hysteroscope aids us in picking up uterine
abnormalities which are sometimes missed at routine
ultrasound e.g., small polyps.
 It is useful in washing and cleaning the uterus which
sometimes may help in improving the outcomes.
 Endometrial scratching is also done at the same setting to
improve the uterine receptivity.

6. To provide ethical state of art fertility services with
utmost honesty & transparency to the customers
through quality standards as well as an atmosphere of
empathy and comfort.
Certain modifications offered
• Intravenous Immunoglobulin (IVIg)
 IVIg seems to directly affect NK cell level and
activity, by reducing their absolute number and
increasing the expression of inhibitory receptors
CD94.
 It can improve pregnancy outcome.

7. To provide ethical state of art fertility services with
utmost honesty & transparency to the customers
through quality standards as well as an atmosphere of
empathy and comfort.
Certain modifications offered
• Vitamins and Antioxidants
 DHEA, L Arginine, Zinc, selenium etc. are given to
women and men to improve the egg and sperm quality.
• Laser Hatching
 Laser hatching of the embryos is performed on the day of
embryo transfer
 To ensure that the shell of the embryo hatches easily.
 It allows the embryo to implant better.

8. To provide ethical state of art fertility services with
utmost honesty & transparency to the customers
through quality standards as well as an atmosphere of
empathy and comfort.
Certain modifications offered.
• ERA
 ERA presumably detects the phase of the endometrium in
which the embryo best implant.
• PGS
 PGS is a way of detecting abnormal embryos thus may
help in improving the pregnancy rates.
 NOT AT NEW TREATMENTS MAY OFFER BETTER
PREGNANCY RATES

9. To provide ethical state of art fertility services with
utmost honesty & transparency to the customers
through quality standards as well as an atmosphere of
empathy and comfort.
Certain modifications offered.
• Day of Transfer
 The day of transfers are individualized for each patient.
 Blastocyst transfer may not be for all
• Meticulous Transfer Technique
 Embryo transfer is the final and most crucial step of IVF.
 All embryo transfers at AFGC are performed by
Dr. Kaberi Banerjee who has taken special training in embryo
transfer from UK.