How long should I wait after an unsuccessful reproduction treatment?

We are often asked this question at our clinic because, following an unsuccessful attempt at in vitro fertilisation there is always the hope of another go. The recommendation has always traditionally been to leave a space of 3 months between each ovarian stimulation, which can be stressful for patients whose age is against them.

Research has been carried out with the aim of determining whether or not a wait is necessary. The studies compare a wait of one month with a wait of three months and the results obtained are the same.

It is for this reason that we do not recommend putting off a new attempt for more than one month in patients who need to carry out treatment as soon as possible.

As is to be expected in medicine, things are not always the same for all patients. If ovaries have responded well, we may find ourselves with remains of the previous stimulation procedure, making a wait until they return to a more relaxed condition desirable. Therefore, we believe in personalising each case.

How long should I wait before transferring frozen embryos?

What we are sure of is that it is not necessary to wait when we are dealing with frozen embryo transfers since the ovaries are not involved in treatment of this type. The endometrium is completely regenerated during menstruation and it is ready for a new cycle with a new implantation window.

It has also been shown that, following ovarian stimulation without taking into account the number of oocytes removed, it is not necessary to wait if elective embryo freezing has been carried out. However, if we wish to use the natural cycle strategy for preparing the endometrium for the transfer of frozen embryos (this requires spontaneous ovulation), this may be affected because a failure to ovulate in the first month following controlled ovarian stimulation with an elevated response can be expected.

How long should I wait between egg donation treatment?

For the same reasons, with egg donation  there is no need to wait. A new course of treatment can be started immediately.

How long should I wait following pregnancy loss?

However, following pregnancy or a pregnancy loss, the endometrium does not repair itself so rapidly. In these cases, a wait is recommendable. The endometrium changes structure following pregnancy and becomes known as a decidualisation of the endometrium. It does not always fully regenerate during the first period so at least two normal periods are necessary in order to be sure that the endometrium is once again receptive to a new pregnancy.

MORE RELATED INFORMATION

• Recommendations following embryo transfer
• Implantation failure and repeated miscarriage. Treatment options
• A negative beta hCG test. Now what?
• Several courses of unsuccessful fertility treatment. When has the time come to give up?

Dr Belén Moliner, gynaecologist at Instituto Bernabeu