Is IVF always successful and is there a trick to it? The main factors that determine the success of IVF are the quality of the embryo, the receptivity of the endometrium and whether the two are matched. It is like the relationship between the seed and the soil, in which the embryo is the seed and the endometrium is the soil, and whether the two are compatible or not is the right time to plant the seed. There is also a relationship between the psychological factors of the individual and their persistence and patience. To improve the success rate of IVF, we must start preparing from these four aspects: I. Embryo quality At present, we mainly evaluate the morphology and development rate of embryos, which is simple, easy and non-destructive. However, it is difficult to accurately predict the developmental potential of the embryo, with an accuracy of approximately 60-70%. Morphological assessment: Clinical grading is based on the size and regularity of the cleavage spheres, the refractoriness of the cytoplasm, and the number of fragments. Bourn Hall Clinic (the birthplace of the world’s first in vitro fertilization) classifies embryos into 6 grades: Grade 1: the embryo’s cleavage ball is uniform and regular, the cytoplasm is uniform and transparent, the zona pellucida is intact, and there is no or only a small amount of debris; Grade 2: the embryo’s cleavage ball is not uniform and regular, the refractive property of the cytoplasm is slightly altered, and there is intact debris in the zona pellucida; Grade 3: debris in the cleavage ball of the embryo is < 50%, and the rest of the embryo has a similar condition to Grade 2 embryo. The condition of the globules is similar to that of grade 2 embryos, with complete zona pellucida; grade 4: fragments of the embryonic globules are >50%, the rest of the globules have the characteristics of living cells. The refractive properties of the cytoplasm are greatly altered, and the cytoplasm is blackened and unevenly granulated; Grade 5: Embryos with delayed fertilization or those that develop from re-insemination on the second day after fertilization has failed; Grade 6: Embryos that are inactive, with degraded, wrinkled, and blackened cleavage spheres. Generally, it is considered that grade 1 and 2 embryos are usable embryos, while grade 3, 4, 5 and 6 are unusable embryos. However, there are occasional cases of successful pregnancy after transfer of grade 3 or 4 embryos. 2. Growth rate assessment: The growth rate of the embryo is generally determined by the number of cleavage balls. At 42-44 hours after fertilization, the embryo develops to the 4-5 cell stage; at 66-48 hours after fertilization, the embryo develops to the 6-8 cell stage. It is generally accepted that embryos that develop quickly have a high developmental potential. Before transferring embryos, the quality of embryos is considered comprehensively, and embryos with high development potential are selected for transfer, but the number of embryos should be limited to avoid multiple births. How to improve the quality of embryos starts from improving the quality of eggs and ova, conditioning the body of both parties is fundamental, having good diet and living habits, necessary nutritional supplements to enhance fertility. Endometrial acceptability The endometrial tolerance is also known as the acceptability of the endometrium to the embryo, and the successful establishment of endometrial tolerance in this process is essential to ensure the successful implantation of the embryo, and at present there is no good indicator to assess endometrial acceptability, and it is only assessed according to the morphology of the endometrium. According to the ultrasonographic evaluation, the endometrium is divided into three types: type A: endometrium with obvious trilinear signs; type B: with insignificant trilinear signs; and type C: with disappearance of trilinear signs. In the clinic, it was found that some patients with type A, despite the presence of uterine adhesions, still showed the trilinear sign, which masked the lesions within the endometrium and misled the embryo transfer. In fact, the best diagnosis of the endometrium is made in patients with high embryo quality who are not pregnant after transfer. Hysteroscopy is recommended for this group of patients to rule out uterine pathology. According to my clinical findings, certain patients can develop uterine adhesions, resulting in embryo transfer failure, despite having no history of pregnancy or curettage. After hysteroscopic adhesion disintegration treatment, the embryo transfer was successful. Third, the right time for embryo transfer, there is an optimal window of time for transfer, that is, the age of the embryo should coincide with the age of the endometrium. At present, the incidence of uterine adhesions is high, is the main factor affecting the failure of IVF, patients are advised to pay attention to the diagnosis and treatment of this problem. To summarize, for patients who are ready to undergo embryo transfer, the first thing they need to do is to keep asking themselves is my lining OK? If it is OK, then prepare to schedule the embryo transfer. The doctor’s personalized ovulation program and medication The doctor’s experience and program also play an important role in the treatment, because being able to obtain a large number of dominant follicles is one of the main goals of ART. The amount of medication used should not be too large or too small, and how to accurately control the use of medication is a test of the doctor’s clinical experience and comprehensive examination and diagnosis of the patient. V. Psychological state Heavy psychological pressure will affect the endocrine level, and therefore will also affect the success rate of IVF. High psychological pressure often makes women nervous, causing uterine muscle contraction disorders, resulting in the embryo not being able to properly attach to the bed leading to IVF embryo transfer failure. Patients should actively cooperate with the doctor’s treatment, the more the doctor knows about the patient, the higher the chance of success. The secret of success in IVF lies in more study, effort and persistence, and the earlier you do it, the easier it is to succeed. This is because the number one reason for failed transplants remains old age! Women’s most precious thing – ovaries – gradually decline with age, the quality of eggs will become worse and worse, due to the aging of egg cells, the chances of chromosomal aberrations significantly higher, and at the same time, due to poorer health, pregnancy will cause a great burden on the heart, kidneys and liver, whether the physical condition can withstand the entire process of pregnancy, and the high age of women in the process of delivery of pregnancy complications increase. Men likewise have poorer sperm quality as they age, so. When you decide to have a baby prepare before it’s too late.