USE CASE: Using MAGENTA™ to Distinguish Between “Seed” vs. “Soil” in Recurrent Implantation Failure

When implantation fails in IVF, the key question becomes: is the issue the “seed” (embryo) or the “soil” (uterus)? MAGENTA™ provides objective insights into oocyte quality, helping to clarify that distinction. When oocyte scores are high, but implantation still fails, it can prompt a shift in focus toward uterine or other non-embryonic factors.

SAMPLE PATIENT CASE:

PATIENT BACKGROUND:

34-year-old female, G1P1, presented with recurrent implantation failure (RIF)
She initially sought treatment for primary infertility and underwent a complete fertility workup, which was classified as unexplained.

First IVF cycle at age 32 (resulted in a live birth):

12 oocytes retrieved
- 9 mature → 7 fertilized
- 3 high-quality blastocysts formed
Outcome:
- 1 blastocyst transferred → healthy live birth
- 2 blastocysts cryopreserved

Two years later, she returned to grow her family. Both frozen embryos were thawed and transferred in two separate FET cycles, but neither resulted in implantation.

Second IVF cycle at age 34:

13 oocytes retrieved; 10 mature
MAGENTA™ results: 4 oocytes of low-medium quality, 3 oocytes of medium-high quality, 3 oocytes of high quality
ICSI performed → 8 oocytes fertilized
3 top-grade blastocysts developed (based on morphokinetics and grading)
No PGT-A performed
1 fresh and 2 frozen embryo transfers were all unsuccessful

MAGENTA™ INSIGHTS: IDENTIFYING THE LIMITING FACTOR

This case reflects a common and emotionally difficult scenario: recurrent implantation failure following a previously successful transfer.

IVF success requires both a viable embryo (the “seed”) and a receptive endometrium (the “soil”). Determining which is the limiting factor can be challenging — especially when both gametes appear normal and the cycle has previously resulted in pregnancy.

In this case, MAGENTA™ revealed a spectrum of oocyte quality, including several high-quality oocytes that led to top-grade embryos. While PGT-A screening was not performed, the presence of high MAGENTA™ scores suggests that at least some embryos likely had strong developmental potential.

Given the repeated implantation failures despite seemingly viable embryos, clinical attention shifted toward the endometrium and other contributing factors.

THE MAGENTA™ REPORT:

CLINICAL VALUE OF MAGENTA™ IN THIS CASE:

Helps isolate the issue: In a 34-year-old patient with a prior live birth, high MAGENTA™ oocyte scores, and high-grade embryos based on morphological assessment, the findings—even in the absence of PGT-A—suggest a shift in clinical focus from the “seed” (embryo) to the “soil” (endometrium) as a potential limiting factor.
Supports personalized care: Enables a more targeted evaluation of uterine factors, helping to avoid unnecessary repeat IVF cycles or premature consideration of donor gametes, such as donor eggs.
Improves patient counselling: Provides a clear, data-driven rationale for recommending advanced endometrial testing, helping patients better understand the next steps in addressing recurrent implantation failure.

If you’ve found this examples helpful in understanding how MAGENTA™ can be incorporated at your clinic or have feedback on other aspects related to your use of Future Fertility’s egg quality assessments, please share it with us at info@futurefertility.com.

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