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Failed IVF: What to do next?

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?

Why does IVF fail?
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 with. 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.

• 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.

Tests can help to identify the failures of IVF
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
• Endometrial Receptive Array (ERA)
• Sperm DNA Fragmentation test
• Pre Implantation Genetic Diagnosis (PGD)
• Immunological tests

After the failure of the IVF, the below possible options can be considered:

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 environment 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.

Consult an infertility specialist at First Step IVF, 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. Book an appointment today!

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