Monday, April 16, 2012

Why did my IVF cycle fail ? And what can I do differently the next time ?

When an IVF cycle fails , patients want to know what they need to do differently next time. Was there a problem with the eggs ? or with the sperm ? or with the uterus ? While it can be very hard to pinpoint the problem precisely , it's important to think through these questions intelligently .

In the vast majority of patients, if fertilization has been achieved, there is very little role which the sperm have to play. In one sense , sperm are just missiles which Ignore warning carry the husband's DNA ; and once they have fertilized the eggs, there is not much which they contribute to further embryonic development. This is why pregnancy rates even for men with extremely abnormal sperm are very good when we use techniques such as ICSI. If the sperm DNA fragmentation test is abnormal, this causes a lot of anxiety and many doctors will blame a high level of sperm DNA fragmentation for IVF failure , claiming that it's the fragmented sperm DNA which is causing genetic abnormalities in the embryos, as a result of which they fail to implant, but this is not a hypothesis I subscribe to, because there’s no evidence to support it.


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  1. Anonymous6:31 PM

    Dear Dr,

    If endometrium plays an important role in embryo implantation how can we justify ectopic pregnancies like abdominal pregnancy? (I even heard about a few successful abdominal pregnancy cases where both the mom and baby are fine!) Doesn’t ectopic pregnancy point out the passive role of endometrium?

    This is what I read in an infertility clinic website which offers surrogacy for repeated IVF failures - ‘However, success is much more likely using IVF with donor eggs and the infertile woman's uterus compared to using the infertile woman's eggs and a surrogate’. Doesn’t this say it all?

    As you wrote, 'However , it's possible that there is a subset of patients who have a beautiful looking endometrium on the ultrasound scan , but whose endometrium doesn't function properly , which is why the embryos do not implant'. – Do you really think such a possibility could even exist?

  2. Anonymous10:53 PM

    Julia Indichova offers wonderful support from her website and books that can help people conceive regardless of whether there is an IVF cycle or not. Some of the work deals with personal blocks that can interfere.


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