Repeated IVF Failures: What Should You Know? Can You Prevent It?

Published in: FIT The Quint Bloomberg

4^th May 2021

IVF Failures can be disheartening, but it isn’t the end of the road. There is still hope.

I have known many people who struggle to conceive, opt for In Vitro Fertilization (IVF) treatment.

Through the guidance of their IVF specialists, most couples achieve the gift of becoming parents.

Parenthood is a beautiful experience, and the challenges that a couple must go through do not matter to them.

We have listed the causes of repeated IVF failures and how you can approach the next steps.

But IVF is not always a smooth sailing process. Many parents who come to us with high hopes often have to face disappointment.

Here is what you should know about IVF failures and how to minimize the risk.

‘Common Causes Of Repeated IVF Failures

• Uterine Abnormalities – Previously diagnosed uterine fibroid/endometrial polyps/septum and so on, can cause implantation failures.
• Poor Endometrium – Poor quality endometrium, i.e., thin endometrium, is not suitable for implantation.
• Embryo Quality – Poor quality embryos or chromosomally abnormal embryos will find difficulty in implantation. Even if they can implant, they may not remain for a long time.

When an embryonic layer present around the oocyte known as the zona is thicker than usual, it contributes to implantation failures. It is because the sperms fail to break the zona during fertilization.

• Genetic Abnormalities In The Gametes – Any defect, including the minor ones like chromosomal microdeletions, can compromise the gamete’s quality and hence embryo.
• Autoimmune Diseases – If you face some autoimmune diseases, you may be at risk of recurrent IVF failures. Usually, screening is performed with repeated pregnancy losses to rule out autoimmune disease.
• Other Diseases In The Mother – Uncontrolled diabetes, thyroid disorders, etc., are conditions that may avoid pregnancy.
• Difficulty In Embryo Transfer – One common reason for failed IVF procedure failure is embryo transfer. Issues at embryo transfer or blood seen at catheter tips suggest a high risk of failure.
• Suboptimal Stimulation Of The Ovaries – This can also raise your risk of repeat IVF procedure failure because of the female partner’s inability to produce eggs for fertilization.

Treatment Options After a Single/Multiple Failed IVF

So your first IVF cycle failed? The unfortunate news of failed IVF might dishearten you. However, it is not the end of hope.

The last resort is not IVF. There are treatments that you can go for considering the treatment’s responsiveness.

There are several fertility procedures, including:

• Intracytoplasmic Sperm Injection (ICSI)

This treatment adds to the success of a basic IVF procedure. Your specialist may perform it after IVF failed once or many times. In this procedure, a single sperm is chosen under a high-definition microscope.

It ensures proper shape and genetic makeup makes it appropriate for fertilization. Then it is injected into the egg to form a healthy embryo, which is of high quality resulting in an improved IVF success rate.

• Preimplantation Genetic Diagnosis

PGD is a screening test done on the embryos in an IVF procedure. It helps to identify any genetic disorder that anyone or both the parents may have. Your specialist may carry out the tests on embryos before transferring to the uterus for a successful pregnancy and delivery.

Failed IVF Cycle; When To Start Again?

There is no time to begin another cycle of IVF after the failure of the first cycle.

However, it is best to wait until your specialist can determine the cause of previous IVF failure.

We understand that an IVF failure is a huge loss for you. We recommend that you opt for the second attempt only if you are ready emotionally and physically.

In the meantime, you can take time if you want to improve your health and change your lifestyle.

How Can You Prevent Repeated IVF Failures?

Here are some things you can do to prevent future IVF failures:

• The first thing that you need to go for is a thorough examination involving ultrasound and blood tests. The latter two helps explicitly in determining the ovarian reserve.
• After that, you can go for a laparoscopic hysteroscopy test to look for and deal with any physical obstacles in conception.
• Your specialist freshens the poor-quality endometrium; also, you would have to send a sample to rule out tuberculosis.
• Hydrosalpinges can be clipped during this time to avoid the embryotoxic fluid from causing IVF failures.
• Following all this, your specialist will choose and start the right ovarian stimulation
• Your specialist will make sure that your endometrium is fit for implantation in thickness and quality.

If you have continuous IVF failure, do not worry.

There are numerous treatments like ICSI and IUI that can help boost your IVF treatment procedure.

Make sure that you are getting your IVF treatment from an experienced IVF centre. The experience of an IVF clinic affects the results of the treatment.

(Dr Hrishikesh Pai has worked as a Consultant Gynaecologist and Infertility specialist at Lilavati Hospital, Mumbai, D Y Patil Hospital, Navi Mumbai and Fortis Hospitals, New Delhi, Gurugram and Chandigarh)

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