Friday, March 29, 2019

Repeated IVF failure versus recurrent implantation failure

A failed IVF cycle causes a lot of heartburn . It's not just patients who get disheartened and disappointed, and doctors also wonder about what they can do differently the next time to improve the chances of success.

We need to differentiate between repeated IVF failure versus recurrent implantation failure. Recurrent implantation failure means good quality embryos ( usually, a total of 4 top quality blastocysts) have been transferred in the uterus over 3 cycles and yet have failed to implant.

There are many other reason for IVF failure - for example, because the embryos were of poor quality. If we know what the reason is, then this is something we can focus on and try to correct. Thus, if the reason for poor quality embryos is poor quality eggs because of advanced age, we can address this issue by suggesting the use of donor eggs.

However, for patients where we have transferred top quality embryos into a receptive endometrium, but the embryos stubbornly fail to implant, then it becomes a much more complicated issue , because we cannot determine why they are not implanting.

The reality is that we will have to call these unexplained implantation failures, because implantation is still a biological black box which we cannot control !

We need to understand our limitations , and this is why documenting the quality of embryos ( by sharing photographs with patients) is so important for determining what the next steps should be !

What to find an IVF clinic which respects your time and intelligence ?

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