What the last cycle showed, and what we would do differently.
A second opinion after one or more unsuccessful IVF cycles is a structured review of your previous records: the stimulation protocol and doses, the number of eggs and embryos at each stage, embryo quality and any genetic testing, the transfer and the womb lining. The aim is to find what can be changed, and to say honestly when nothing should. At Oxford Medical Kuwait it is a stated focus of Professor Scott Nelson's practice.
A second opinion is worth having after one cycle with a poor response or few embryos, after two or more cycles with no pregnancy despite good embryos, after a miscarriage following IVF, when you are over 40 and deciding whether to continue, or whenever you have been offered a repeat of the same protocol without an explanation of what will change.
Bring every record of your previous cycles: the stimulation protocol with drug names, doses and dates; the embryology report with the number of eggs collected, mature, fertilised and reaching blastocyst, with grades; any genetic-testing results; the transfer notes; your AMH, hormone results and scan reports; and your husband's semen analysis. Photographs of paper records are fine.
If you do not have the embryology report, ask your previous clinic for it; in most countries you are entitled to a copy of your own record. A protocol sheet alone tells us the plan; the laboratory report tells us what actually happened.
You can send the records by WhatsApp before the appointment so that they are read in advance. Please do not send them to any number other than the clinic's, +965 6620 2241.
The review goes stage by stage through your previous cycle: whether the stimulation dose and protocol matched your ovarian reserve; how many eggs were mature and how many fertilised; how many embryos reached the blastocyst stage; how and on which day any biopsy was taken; how the lining was prepared and how many embryos were transferred; and what any pregnancy loss showed.
| Stage | What we look at | What might change |
|---|---|---|
| Stimulation | Dose against AMH, antral follicle count, age and weight; the protocol; the trigger drug and its timing; the day-by-day hormone and follicle record. | An individualised dose; a different protocol; a dual trigger; a different trigger time. |
| Eggs | Mature eggs as a share of eggs collected; eggs collected as a share of follicles seen. | Trigger timing and type; the interval to collection. |
| Fertilisation | The fertilisation rate; IVF or ICSI; how the sperm was prepared and what the analysis showed. | A fuller sperm assessment; a different preparation or selection technique. |
| Embryos | The blastocyst rate; the grades; the day and method of any biopsy; what was frozen and how. | Culture to Day 5; a Day 5 trophectoderm biopsy instead of Day 3; freeze-all. |
| Transfer | Lining thickness and pattern; progesterone; the number transferred; the ease of the transfer; the hormone levels afterwards. | A frozen transfer in a prepared cycle; one embryo; a hysteroscopy before the next transfer. |
| Pregnancy loss | Whether the embryo was tested; the genetics of the loss if known; the recurrent-miscarriage investigations. | PGT-A; the recurrent-miscarriage workup and its treatments. |
You leave with a written opinion: what the previous cycle showed, what we would do differently and why, which tests (if any) are worth doing first, an itemised cost estimate, and an honest view on whether another cycle is worthwhile at all. You are not asked to decide on the day, and you are free to take the opinion back to your own clinic.
Sometimes the honest conclusion is that the previous clinic did the right things and the result was chance; IVF has a large element of it. Sometimes it is that a different approach is worth trying. And sometimes it is that further treatment with your own eggs is unlikely to succeed. We will say which.
Sometimes. Where the previous stimulation was poorly matched to your ovarian reserve, a Day 3 biopsy was used, two embryos were transferred routinely, or no one looked for a cause of implantation failure, there is something specific to change. Where the previous cycle was well run, the gain is mainly a clear plan and an honest estimate of the odds. No clinic can promise more than that.
Professor Scott Nelson's stated clinical focus at Oxford Medical Kuwait is complex IVF, repeated unsuccessful cycles, recurrent implantation failure and low ovarian reserve; he co-authored the externally validated AMH nomogram that is used to set expectations for stimulation. His background and sources are on his profile. How to judge any IVF doctor, ours included, is set out in how to choose an IVF doctor in Kuwait.
No. A second opinion is a separate appointment and you take the written opinion with you. Many patients use it to ask their own clinic better questions; some choose to continue with us. Either is fine.
Yes. Frozen embryos, eggs or sperm can be transferred in from another centre with the couple's written consent, the originating clinic's freezing and screening records, and a documented hand-over. We issue a letter of acceptance to the sending clinic before anything is shipped.
Professor Scott Nelson, Medical Director of Oxford Medical Kuwait and Muirhead Professor of Obstetrics and Gynaecology at the University of Glasgow. He sees second-opinion patients himself and consults in English or Arabic.
Ask in writing for a copy of your own medical record, including the embryology report; you are entitled to it. If some records cannot be obtained, bring what you have. A protocol sheet, the medication boxes, your scan dates and your own notes are all useful.
Whenever you feel ready. There is no medical reason to wait, and coming before your next period lets any tests be timed to the cycle. If you are still waiting for a genetic-testing result or a pregnancy-loss result, it is worth having it first.
By WhatsApp or phone on +965 6620 2241. Say that you would like a second opinion after IVF, and send your records in advance if you can. The clinic is at Building 20, Mohamed Rafie Marafie Street, Bneid Al Qar, Kuwait City, open Saturday to Thursday 10:00 to 20:00.
Send your previous protocols and embryology reports by WhatsApp before the appointment so they are read in advance. You decide afterwards whether to go further, and with whom.