Why does IVF fail the first time?
'Why does IVF fail?' you might question. Friends, family, and the internet have all told us about the effectiveness of in-vitro fertilisation (IVF) procedures. However, we don't often hear about unsuccessful IVF, owing to the fact that it's a very emotive subject for those who want to be parents. This blog post aims to dispel the taboo and discuss some of the reasons why IVF may fail.
According to our most recent success rates, our IVF treatment has a clinical pregnancy success rate of 40.6 percent and a live birth rate of 32.5 percent, as reported to the Human Fertilisation and Embryology Authority (HFEA). When it comes to patients who do not have a clinical pregnancy or live delivery, there are a variety of causes for their IVF failure.
Age of the Female
The quality and quantity of a woman's eggs decreases as she gets older. It's common knowledge that as women age, they have a lower likelihood of becoming pregnant; nevertheless, a decrease in egg number and, more importantly, quality, also decreases the chances of a clinical pregnancy or live birth following IVF treatment.
"According to our success percentages, women under the age of 35 have the highest probability of IVF success: 47 percent for clinical pregnancy and 38 percent for live birth," says Dr. Gorgy, co-founder of The Fertility and Gynaecology Academy and one of the UK's most respected fertility experts.
Quality of Embryos
The female's eggs and the male's sperm are combined together in the laboratory portion of IVF treatment with the goal of generating an embryo. Embryos may appear healthy in the laboratory, but when implanted into the uterus, they may fail to implant due to an undetectable abnormality. Our IVF lab grades the quality of the embryos and selects the best to return to the uterus using a scoring system. We also incubate the embryos until they reach the blastocyst stage using time-lapse imaging (embryoscope) (5 day old embryos). The embryoscope is a closed incubator with a camera that photographs the embryos every 10-20 minutes. We can monitor the embryos' progress using the screen on the outside of the embryoscope, so we don't have to take them out every day to examine them, keeping them in a stable environment. We can also replay the video clip and examine the embryos' progress overnight, allowing us to select the optimum embryo transfer option for achieving pregnancy.
Ovarian Reaction
The female is required to inject a fertility hormone called follicle stimulating hormone (FSH) daily at the start of IVF treatment in order to boost egg production. Some women's ovaries do not respond to this medicine properly, and as a result, they do not generate enough eggs for harvest. Due to the already limited quantity of eggs in older women, this is especially true (low ovarian reserve).
"If you have a poor ovarian response, it doesn't imply the IVF treatment is over," Dr. Gorgy says. Investigations and medication changes may be able to help improve the issue. A blood test for Anti-Mullarian Hormone (AMH) and an ultrasound scan of the antra follicle count are used to determine ovarian reserve. The optimal protocol and dose of hormone to stimulate your ovaries and produce a respectable number of eggs would be determined by your ovarian reserve."
Problems with Implantation
This indicates that the embryos did not successfully implant in the uterus. This could be due to the existence of uterine polyps, a premature spike in progesterone levels, a thin endometrial lining, or a uterine infection. "It's not your fault if an embryo fails to implant," Dr. Gorgy says, "since implantation complications are almost always beyond anyone's control." We assemble a complete set of tests to rule out any potential causes of implantation failure."
Lifestyle
Maintaining a healthy lifestyle before and throughout IVF is likely to aid conception, just as it is with a natural pregnancy. If you smoke, it's a good idea to give up a few months before starting IVF, as smoking has been proved to have a negative impact on fertility. Maintaining a healthy weight, as well as eating a nutritious food and exercising on a regular basis, will all benefit you.
Abnormalities of the Chromosome
IVF can fail due to chromosomal abnormalities in the embryos. This indicates that chromosomal DNA is missing, excess, or irregular in the embryo. The embryo is then rejected by the body, resulting in IVF failure. Chromosomal abnormalities can be inherited from one of the parents or acquired during the embryonic development process.
"Chromosomal abnormalities are most likely to be present in the embryos of women over the age of 35," according to Dr. Malpani. Don't let this deter you, though. We may analyse the embryos for any inherited chromosomal or gene abnormalities on all 23 pairs of chromosomes and only replace the normal embryos."
The notion behind reproductive immunology is that an embryo or baby is rejected because the body's immune cells are overactive. If you've tried IVF but been unable to conceive, it's possible that your immune cells are attacking the embryo. Reproductive immunology may be able to explain why your IVF cycles are failing so frequently and, if your immune system is acting up, suggest a treatment plan.
Why Does IVF Fail? : How To Avoid Repeat IVF Failure
It may take two or more IVF treatments to obtain a successful pregnancy. While this can be physically, emotionally, and cognitively draining, knowing that you are not alone in your struggle, that support is available from fertility professionals with decades of experience, and that IVF failure is not your fault may be comforting.
Your doctor will advise you on what caused the failure after each round of IVF and how to use this information to improve your chances of success if you decide to try IVF again. The following are some of the tests that can be used to determine the cause of IVF failure:
- Immunomonitoring
- Infection detection
- Examination of the uterine cavity
- Karyotyping
- Evaluation of sperm
Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!
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