Wednesday, June 29, 2022

How to bounce back after a failed IVF cycle


After an IVF cycle fails , the commonest question patients ask is – Why ?

This seems to be a simple, straight-forward question , given the fact that IVF failure is so common, but the answer can be surprisingly complex . This is because there are so many possible factors which affect embryo implantation , and it can be very hard for doctors to pin point what the exact causes are for an individual couple.

Unfortunately , rather than admit the truth to patientsthat medical science doesn’t have all the answers - doctors often subject them to a whole battery of additional tests . Then, to add insult to injury, since some of these tests are bound to come back as abnormal ( even if they aren’t of any clinical importance), they propose additional invasive and expensive treatments , such as PGD, immune therapy, and ERA testing , and suggest to patients that this additional information will improve the chance of success in the next IVF cycle .

This is completely false , because more information does not increase pregnancy rates , simply because so much of this information is irrelevant, and just causes doctors to go down many rabbit holes, chasing expensive red herrings !

This is why it’s helpful to use a simple framework , so that you know what to do for your next cycle when the first one fails.

Start by simplifying, and breaking down the causes of IVF failure into two groups . One is stuff which you can do something about , and the other is all the rest, which you can't do anything about . For example, you can’t become younger, so if you are older , your ovarian reserve is likely to be poor , and you are likely to be a poor ovarian responder, no matter what protocol the doctor tries. It becomes very difficult for a doctor to fix this underlying problem,  because ovarian reserve is a biological fact of life, and the drop is irreversible.

The good news is that often the cause of IVF failure is something that can be fixed ! The commonest cause of IVF failure in Indian IVF clinics is a poor IVF lab – one that is poorly equipped, or that doesn’t have a full-time experienced expert embryologist.

The good news is that it’s easy to identify these bad IVF clinicsthey hide information from patients by refusing to share photos of their embryos with them.  If your clinic doesn’t do this, it’s easy to identify that they are incompetent, and you need to find a better clinic – one that is open and transparent , respects their patients, does only blastocyst transfers, and provides embryo photos routinely to all their patients.

You can see what embryos should look like at


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