FAILED IVF: Reasons and what to do next?
- 25 May, 2021
- IVF and Infertility
- infertility
- Medically Reviewed By:
Dr. Nishi Singh - Author: Prime IVF Centre
Expecting your next generation is no more a dream or an illusion as the procedure of In Vitro Fertilization (popularly known as IVF) is a type of Assisted Reproductive Technology (ART) where retrieved eggs are fertilized with the sperm in a laboratory or clinical setup. The fertilized embryos are then safely transferred into the uterus of the expecting mother.
Not every seed sown becomes a plant. On similar grounds, not every embryo embedded may lead to clinical pregnancy. Despite the embryo and the uterus being in good and healthy condition, the success rate of IVF in India with self eggs and the same cycle is low and can depend on numerous factors.
This article gives you an insight on the reason for the low success rate of IVF; tests that can help find the cause of IVF failure, and in case of a failed IVF, What are the steps to be taken?
Table of Contents
Feel free to skip ahead if one topic catches your eye:
- Why does IVF fail?
- Tests can help to identify the failures of IVF
- What can be your next step?
Another attempt of IVF can be an option. This can be done by speaking to your doctor and analyzing the causes of failure and possibly trying for another re-implantation with increased chances of successful pregnancy.
Some women who cannot carry a fertile embryo (for varied reasons); can opt for a gestational carrier who can provide an initial surrounding for embryo development.
Having a donor who can donate eggs/sperms can be a solution for women/men having poor egg/sperm quality concern respectively.
An IVF process includes ovarian stimulation, egg retrieval, sperm retrieval, fertilization, and embryo transfer. Every stage of the procedure is crucial and needs to be well managed.
Failure of this laborious procedure can be stressful and difficult for anyone to cope up. So, understanding the causes of its failure can take you a step closer to having a successful pregnancy.
Here are some of the possible reasons why IVF can fail?
Embryo Quality
Generally, implantation of the embryo is scheduled by day 3 or day 5 of fertilization. Embryos that seem healthy in the initial stages fail to grow beyond a certain stage and fail to attach to the uterine lining. However, the selection of high-quality embryos based on morphological characteristics can reduce the problems caused by inefficient or unproductive embryos.
Problems with the uterus
The uterus acts as a host to the embryo by providing a proper nurturing environment for embryo development. Considering the uterine age to be optimal for carrying an embryo, hormonal changes in between the IVF, development of a uterus infection, the formation of adhesions, polyps or fibroids, thin endometrial lining, thrombophilia, or any other immunological response can affect the cross-talk between the embryo and the endometrium. This can make the uterine environment less favorable or non-receptive for embryo growth.
Sperm quality
Infertility specialists suggest that low sperm quality is due to abnormalities in chromatin arrangements, compactness in the sperm, and increased DNA fragmentation. Improper morphology of sperm cells can lead to low fertilization rate and inferior embryo quality.
Quality of the IVF ovarian stimulation
Ovarian stimulation; the first step of the IVF is a process of inducing ovarian follicle development and oocyte maturation using medications. In very rare cases, hormonal injections and medications during oocyte retrieval can cause certain complications like enlargement of ovaries, abdominal pain, bleeding, infection etc. If so, stimulation and retrieval techniques can be modified to have a safe IVF ovarian stimulation.
Genetic factors and chromosomal anomalies
The embryos undergo a series of cell divisions; improper cell divisions can lead to chromosomal translocations, deletions, duplications, mosaics, and inversions of genetic material. Embryos with abnormal karyotype are one of the major reasons for failed implantation.
Other responsible factors
Age of mother to be, hormonal imbalances, thyroid-related concerns, lifestyle factors are other contributing agents to an IVF failure.
A failed IVF can be disappointing and disheartening for the patients and challenging for the doctor. Some tests can help identify the reasons likely to cause an unsuccessful IVF.
Uterine Evaluation
Uterine evaluation primarily looks at the status of the uterus and fallopian tubules. This test is done before the first IVF cycle and can be a test of choice to evaluate the uterine cavity using a definitive diagnostic tool called hysteroscopy even after a failed IVF.
Endometrial Receptive Array (ERA)
A Biopsy that studies the endometrium using genetic markers can determine the receptivity of the uterus for implantation and provide an accurate result for Endometrial Receptivity. In case of recurrent IVF failure, ERA can help to check if the receptivity of the uterus is the real cause for an unsuccessful IVF.
Sperm DNA Fragmentation test
This diagnosis combines different testing modules like TUNEL and alkaline comet assay to measure genetic constituencies of the sperm. If sperm DNA damage is detected, there are other methods to select healthy sperm with nuclear DNA integrity.
Pre Implantation Genetic Diagnosis (PGD)
PGD is a diagnostic procedure where the embryo is tested for any chromosomal abnormalities or genetic defects and can even find a small amount of error in the embryo influencing implantation failure.
Immunological tests
Imbalances in the immune system and failure of the foetus to achieve immune tolerance is reviewed. However, this test can be chosen when all the other diagnostic tests have been done and yet the exact reason for failed IVF is not obtained.
Unsuccessful implantation is not the end of the road. After the failure of the IVF, the below possible options can be considered:
Take Away
Consult a doctor or an infertility specialist, have a good discussion and clear analysis where all the aspects and the causes of failed implantation are thoroughly studied.
Though IVF is an extensive procedure, understanding the pros and cons of it with accurate tests and diagnosis and following a scheduled routine under the guidance of your clinician can aid a successful IVF.
Faq
1. What happens to your body after a failed IVF?
After a failed IVF cycle, the body will go through a process called "withdrawal," where the hormones used during the IVF cycle will be cleared from the body. This can cause a range of physical and emotional symptoms, such as cramping, bloating, headaches, mood swings, and fatigue.
It is common for women to experience some level of sadness and disappointment after a failed IVF cycle, and it's important to take care of yourself both physically and emotionally during this time.
It is always best to talk with your healthcare provider about any concerns you may have and develop a plan for moving forward.
2. Period after failed IVF: How it Feel?
After a failed IVF cycle, a woman's menstrual period will typically return within 4-6 weeks. The menstrual period may be different than usual, as the hormones used during the IVF cycle can affect the timing and flow.
Moreover, a failed IVF cycle does not mean that you will never be able to conceive. Many couples go on to have successful pregnancies after multiple IVF cycles. You should talk to your healthcare provider about your options for developing a plan that is right for you and your partner.
3. 2-3 IVF cycles fail next: what?
If two or three IVF cycles fail, the next step is usually to consult with an IVF specialist to discuss the possible causes of the failures and to look into other treatment options. This may include genetic testing or further evaluation of fertility issues. The doctor may also recommend a different approach or protocol for the next cycle, such as using a different medication or changing the timing of the transfer.
It is important to have an open and honest conversation with the specialist to understand the reasons for the failures and to explore all options for starting a family.
4. Late period after failed IVF: Could I be pregnant?
It is possible for a woman who has had a failed IVF cycle to still have a late period and be pregnant. Hormonal changes can cause a delay in the timing of menstrual periods. A missed period after an embryo transfer can be a sign of pregnancy, especially if the woman's usual menstrual cycle is regular.
It is essential to take a pregnancy test if your period is late and you have a normal menstrual cycle. It is also important to consult with your IVF doctor to understand the reason for the late period and to consider any potential risks or complications associated with a possible pregnancy.
