When a couple decides to take up IVF treatment as assisted reproductive technique, it means that they are going to live life on the edge for the coming months, or perhaps, years. The reason is that there is no guarantee that the first IVF cycle would be a success, in fact, the odds are not great. Money flows out and emotional and physical stress is on the peak till IVF success is achieved. Failure can drain them financially and traumatize them in body and mind.
So it is feasible to look for the possible reasons of a failed cycle and ensure that the loose ends are tied up so that the situation does not repeat itself. The key lies in identifying the culprit, which lurks behind the picture and can actually influence the outcome of the repeat cycle too. Once the exact cause is pinpointed, steps can be taken to prevent the failure of the subsequent IVF cycle.
Possible Reasons of IVF Failure
The success rate of IVF as a technique is not 100%, but at the same time, it is possible to avoid a lot many of the failures. This comes as great news for couples trying to have a baby using this advanced reproductive technique. The first step is to study the possible reasons of failure, which could broadly be categorized as follows:
It is a well known fact that maternal age has direct bearing on fertility as the number of eggs available for conception (ovarian reserve) keeps deteriorating with every passing year. Whether conception is natural or through IVF, the probability of live birth comes down dramatically for women on the wrong side of late thirties. This means that the rate of IVF failure goes up in older women, though this fact does not guarantee success for the younger ones.
Similarly, poor ovarian response could be another factor causing failure of IVF. The treatment involves ovarian stimulation, which means stimulating the ovaries with medication so that multiple eggs are produced by them. Here, again the maternal age plays a vital role because the response to medication is influenced by it and the chances of IVF success get diminished as ovaries produce fewer oocytes (eggs).
In some cases, the process reaches the stage of embryo culture but the embryo so formed is genetically incapable of developing into a baby. Nature plays its part here and embryos with chromosomal defects or genetic abnormalities do not yield a successful IVF cycle, as these are not fit to become normal babies.
One of the most common causes of IVF failures is implantation issues, which happen when the embryo simply fails to attach itself to the uterine lining for reasons that no one can define. On the other hand, chromosomal defects or physical causes like ovarian cysts can be the reason of implantation failure. Similarly, women whose endometrial receptivity (ability of the endometrial lining to have the embryo implant in it) is poor, also come across implantation issues.
Human errors, on the part of the patients or the medical practitioners, can be another reason for IVF failure. Poor patient compliance, as in their negligence in the timing and dosage of medication, can cause problems related to ovarian stimulation, which is the key parameter for the success of the procedure. Similarly, non-availability of the semen sample on demand can be another tragic event that can cause havoc on the cycle.
There might be some situations where the patient may not be responsible at all and a failed IVF cycle may be attributed to the incompetence of the clinic and the lack of co-ordination of the staff. IVF is a complicated and delicate procedure, the success of which greatly depends on the expertise of the specialists as well as the equipment and technology used by the clinic. For instance, quality control in the culture lab, timing of the superovulation medication administered to the patient, timing of the egg retrieval and experience of the embryologist have a direct impact on the success rate of the cycle.
Whether the IVF failure is caused due to physical factors or human error, it is always the patient who is at the receiving end. So they need to be aware of all that can be done to prevent the same situation in the subsequent attempts. Identification of the reason is actually half the job done.
How can I prevent IVF failure in the subsequent attempt?
The reason of IVF failure may or may not be pinpointed, but this in no way, changes the mindset of the patients, whether they want to take another chance with the procedure. In fact, a majority would rather go for a subsequent attempt, this time armed with more knowledge and information to maximize the chances of IVF success. And definitely, there are certain things they can do to prevent IVF failure in the subsequent attempts.
When it is about handling the physical factors that might have contributed to a failed cycle, the solution lies in reaching the root of the problem. For instance, women of advanced maternal age or the ones with poor embryo quality may be recommended the use of donor egg for the subsequent cycle. Similarly, donor sperm or frozen ones can be used for cases where the issue was on-availability of semen sample on demand.
Blastocyst stage embryo transfer is seen as the option for those with implantation issues while advanced techniques like pre-implantation genetic screening has been used for choosing the best quality embryo for the transfer. Medical treatment for issues such as poor endometrial receptivity, ovarian cysts and ovulation regulation, before trying again can also improve the chances the next time around.
On the other hand, choosing the best IVF clinic is the most crucial aspect of achieving IVF success in a subsequent attempt. A great deal of effort must be put in by the patients to learn about the success rate offered at a clinic and also about the expertise of the medical team as well as the quality measures adopted there. The patients must also be proactive and check out if the clinic provides proper documentation as well as photos of the embryos, as this fixes their responsibility and keeps them on toes.
Besides the elimination of errors on the behalf of the clinic, the patient must also be aware and careful about every minute detail, such as the right dosage and timing of medication and also reading the signals their body has to give. A good patient-clinic co-ordination and open communication can also help and so can a positive attitude.
Not all IVF cycles yield success, at least not in the first attempt. But this does not mean that one should not try because the tunnel may be long, but there is definitely light at the end of it!
Gaudium IVF Centre is a trusted fertility clinic which has helped countless childless couples fulfill the dream of parenthood. If you have been struggling with IVF failure, contact for a free second opinion from Dr Manika Khanna.