Reasons Why IVF Fails And What To Do Next
Pregnancy is a complicated process, whether it's through natural conception or assisted reproductive technology (ART). IVF has now become the most successful fertility treatment that overcomes many causes of unexplained infertility. Your doctor uses medication to accelerate the development of numerous eggs in a controlled, exact process, after which the eggs are harvested. Your partner's (or a donor's) sperm is used to fertilize viable eggs in a laboratory setting. The embryos develop, and the doctor transfers the healthiest ones to your uterus. The embryo should attach and grow into a healthy baby in the ideal scenario.
Nevertheless, what if you miscarry shortly after or if the embryo fails and does not adhere to your uterus? Regardless of the effectiveness of IVF, pregnancies do not always occur from the procedure. Multiple IVF attempts can fail, which is undoubtedly heartbreaking for couples who want to have a child.
It may sometimes be challenging to consider the following actions after you've had several IVF failures. Here, we examine a few causes of IVF failures and suggest some next steps based on medical advice.
Reasons For IVF Failure
Less than 50% of IVF attempts worldwide are successful. It indicates that over half of those women who had IVF don't become pregnant, and regrettably, your doctor can't always explain why IVF fails. IVF is an expensive process that has no success assurance. The possibility of success is typically the most crucial query after you are aware of the actual expense of IVF.
Numerous factors can lead to a failed IVF cycle. Repeated implantation failure, which happens after a few days, is one of these causes. It occurs when the developing embryo can not connect with the uterine lining, inhibiting the formation of a bond. The other explanation is a high degree of genetic diversity, low ovarian reserve or issues with embryonic development. IVF failure can be distressing and emotionally taxing, regardless of the underlying cause.
The woman's eggs and the man's sperm are combined in a laboratory during the IVF procedure to generate an embryo. The embryos may appear healthy in the lab, but there is a danger that an undetectable flaw will prevent them from taking root once they are transplanted into the uterus.
Compared to 12% in women over 40, IVF success rates by age among women under 35 embryo implantation is higher (about 50%). Some people are even tempted to use a surrogate at this time, although science advises against it. IVF with donor eggs is more likely to be successful if your uterus is in excellent condition, but the quality of your eggs (and the embryo you get) is subpar. Even putting your eggs into a surrogate's uterus won't help if your eggs are the reason for failed IVF.
Why Does IVF Fail With Good Embryos?
Despite the sophistication of the IVF procedure, an embryo transfer that has failed to implant into the uterine mucosa is one of the most frequent reasons for an IVF cycle failure.
The embryo could not have been transported into the uterus properly, or it might have been there, but the mucosa is incompatible. In addition to having an inappropriate mucous membrane, a woman with a pelvic infection may not be able to implant a fertilized egg.
Age-related declines in a woman's success rates of getting pregnant are well-known, but they also impact the likelihood of a clinical pregnancy or a live birth after IVF.
Ovarian stimulation is provided before an IVF cycle to generate more eggs. It's not a good indicator if you already have a low ovarian reserve or high FSH levels since your body can not react well to the fertility drugs used during IVF treatment. You have a strong chance of having a successful IVF cycle if your body responds well to the medicine and generates more eggs since this shows that your hormones are regularly operating. If it is not the case, your chances of IVF success may also decrease.
Embryos with chromosomal abnormalities can be reasons why IVF fails. It indicates that a chromosomal DNA component is either wrong, excess, or absent from the embryo. When IVF fails − the body rejects the embryo. Chromosomal anomalies can develop during the early stages of embryonic development or be inherited from a parent.
Chromosomally abnormal embryos have become more prevalent starting in women's 30s. These anomalies climb to 75% by the middle of the 40s. Additionally, as a man ages, his sperm has more chromosomal defects. Preimplantation genetic screening or testing discovers chromosomal abnormalities before embryos are placed in the uterus, increasing your chances of success. Some couples resist testing, which may result in numerous IVF failures because the embryo has chromosomal abnormalities.
Abnormal sperm cells are a common cause of failed IVF. It may be brought on by a curvature, double tail, or huge head, among other things. They could find it challenging to reach the egg because of these traits. Even while it would appear to be an odd reason for IVF failure, just four to ten percent of sperm in a sperm sample is aberrant, making this cause quite frequent and unremarkable for success rates. Many elements, including lifestyle and health, might result in abnormal sperm and IVF results
The doctor at the IVF clinic carefully checks the sperm during the IVF treatment for any issues. An aberrant sperm frequently results in an unfertilized egg. For a viable embryo to develop, the sperm must break through the egg's outer membrane and release half of the genetic material. In the absence of a preimplantation genetic screening may be required to detect these possible issues.
How To Find The Reason For The Failure Of IVF?
Why an IVF cycle failed is a common question. Many physicians overpromise before abandoning you after the first cycle. They avoid tough inquiries, and some even offer flimsy scientific justifications for your unexplained infertility. These justifications are not only pointless but frequently false. Three IVF cycles are entirely typical. However, if an IVF cycle failure occurs more than three times, there is a reason to check it.
IVF failures typically occur for one of two reasons:
- A problem with the embryo;
- A problem with the couple.
The doctor does further tests to find the causes of IVF failure three times despite the excellent embryo quality, successful egg retrieval and the healthy uterus.
How Many Times Can IVF Fail?
Multiple IVF failures are defined as three or more unsuccessful IVF cycles with high-quality embryos. The term can be used to describe both women who were unable to get pregnant and those whose early pregnancies ended in miscarriage.
A couple should be ready for at least three IVF rounds to get pregnant. The couple's odds of having a live birth improve to 45–53% through three cycles, which include ovarian stimulation protocol, egg retrieval, fertilization, and embryo implantation. Modern diagnostic procedures assist in finding correctable issues with a woman's uterus or reproductive organs and offer doctors an indication of how successful future attempts will be
First IVF Failed - When To Try Again?
Although every person's situation is individual, the average time between IVF sessions is one whole menstrual cycle. A new IVF cycle should not be performed between two consecutive months without a menstrual cycle. Accordingly, for the prevalence of women, it takes 4-6 weeks to start a new complete cycle after embryo transfer and a negative pregnancy test. Cycles that happen at spaced-out intervals are referred to as delayed cycles. According to a study done by the American Society for Reproductive Medicine (ASRM), there is no statistically significant difference between cycles performed right away and those postponed in terms of pregnancy, birth, or IVF failure rates.
You can choose whether or not to take a break between IVF cycles based on how you feel and the advice of your fertility specialist. When your doctor provides the all-clear, you can begin a new process if you are mentally and physically prepared. The most crucial thing is to pay attention to your body and your feelings.
What Does Repeated IVF Failure Mean?
The IVF process failures, such as unsuccessful IVF or pregnancy loss, may lead to recurrent implantation failure. Anatomical, endocrine, genetic, or autoimmune issues cause around 50% of failures. The etiology of a sizable majority of instances is unknown. A small but considerable portion of cases may be attributed to environmental causes, while some polymorphisms are linked to a higher risk of pathology.
The implanted embryo during the procedure is just one of several variables that affect how well the process goes. Although, some of these aspects may be influenced by the patient's lifestyle. Overall, pre-existing medical disorders and ways of life can be vital. Weight, uterine structure, and smoking habits - impact a woman's ability to get pregnant.
What To Do After IVF Failure?
After an IVF failure, you should prepare your body and mind for a repeat cycle by following these tips:
- Maintain a good attitude and hope;
- Support each other and be patient;
- Get the appropriate tests and take your fertility meds once again;
- Handle side effects of fertility treatments, including discomfort at the injection site, breast soreness, nausea, headache, and bloating;
- You may have to give 8 to 10 doses of medication a day, but it is worth it;
- If you know how to inject, ask a family member or friend to give you your daily meds;
- Refrain from using hot tubs, swimming pools, or saunas during the first several days following a second IVF cycle;
- Prepare yourself physically and psychologically for a second IVF cycle, if necessary.
How To Increase IVF Success Rate
There are several tips for successful IVF:
- Endometrial scraping;
- Lymphocyte injection;
- Platelet-rich plasma (PRP) injection;
- Embryo transfer during the natural cycle;
- Use of high-quality sperm;
- Hatching and removing the embryo's protective coat to improve the odds of implantation;
- Do genetic testing of the embryos and germ cells before transfer.
Take Your Time
Sometimes it takes one failed IVF cycle or more for a couple to succeed. Repeated IVF failures are emotionally and physically draining on everyone involved. After each setback, your doctor will suggest tests to help you to move ahead. For patients who have experienced several IVF failures, doctors prescribe preimplantation genetic testing. IVF success rates are increased by checking embryos for genetic abnormalities before implantation. Depending on the outcomes of the testing, you merely have a decision.
1. In Vitro Fertilization with donor eggs is an additional option for patients whose doctor has determined that age or poor-quality embryos are the roots of IVF failure
2. Gestational surrogacy is a practical solution for people who have an implantation failure repeatedly.
Оbstetrician-gynecologist, reproductive specialist, doctor of ultrasound diagnostics, IVF coordinator.