Have you attempted 3 or more IVF cycles and could not conceive? There could be an underlying reason.
IVF is nothing less than a miracle for infertile couples trying to conceive for more than a year and failing. In India, about 15% of couples experience some kind of infertility and may require medical or clinical assistance to conceive. IVF has helped countless couples have a child and start their family.
But, the procedure can be complicated for some couples too. There have been many cases when couples underwent multiple cycles and had repeated failures. But, multiple IVF failures do not happen for no reason. And, you must know what to do next if you encounter a failure in your IVF journey.
This article talks through the common reasons of IVF failures, what should a couple be doing if they happen to have a failed cycle, and some working tips that can escalate their IVF success chances.
Common IVF Failure Reasons
If you have already undergone several in-vitro cycles and they end up failing in the implantation stage or as a miscarriage, it might have an underlying reason. Following are some common reasons that often lead to recurrent in-vitro conception failures:
Quality of The Embryo
One of the most common reasons for IVF failure is that the implanted embryo does not grow or stop growing after some time. It is usually because of the poor quality of the embryo. An incubated embryo (the blastocyst) might seem healthy but may have a fault unidentified in the preimplantation genetic testing (PGT). If such a faulty embryo is implanted, the embryo might simply not grow and lead to conception failure.
Age of Eggs
It is doubtless that women have a limited egg reserve that diminishes as they age. As well as, the quality of the eggs also decreases as the women gets closer to menopause. Women have a limited ovarian egg reserve and ability to produce viable eggs that continue to decline throughout their maternal age, and women who attempt IVF in their mid to late 30s may experience multiple failures.
Autoimmune disorder may cause the embryo implantation to fail as the antibodies start to attack healthy cells or tissues. In case of embryo implantation, the immune system may mistakenly identify the embryo as invading tissues and attack it.
Chromosomal abnormalities are one of the major factors that lead to IVF implantation failures and early miscarriages. Chromosomal abnormality is characterized by the presence of an extra or missing chromosome. Preimplantation genetic screening is generally advised to women who have had multiple implantation failures. The likelihood of developing chromosomal issues are high in women in their mid and late 30s.
The same unhealthy lifestyle habits that fertility specialists advise to get rid of as they increase the risk of miscarriages in natural pregnancies, also affect women who undergo IVF. Habits such as smoking, drinking alcohol, and having a bad nutritional diet can also lead to multiple conception failures. Being underweight or overweight can also affect your in-vitro cycle outcome.
IVF Failed: What is The Next Step?
Did you just undergo an in-vitro fertilization cycle and it failed? What should you be doing? Should you be undergoing another cycle? Should you be looking forward to another pregnancy treatment option? Or, should you be seeing another IVF specialist?
1st IVF Failed: What Next?
If you underwent your first in-vitro cycle and it failed, what you should be doing next is to talk to your fertility doctor about what went wrong in the cycle and its solution. Generally, the chances of conceiving in the very first cycle is uncommon. Several factors such as women’s maternal age, type, cause and duration of infertility, history of previous pregnancies, male factor (sperm count and quality), and lifestyle influence the chance of pregnancy success. Statistically, a woman in her 20s has a 60-70% higher chance of conceiving in the very first in-vitro cycle than a woman in her late 30s. Age plays a crucial role in a woman’s fertility. As a woman gets closer to menopause, her potential of having a pregnancy continues to decline. So, if you have had a failed first in-vitro cycle, your fertility doctor will generally recommend you to undergo another cycle. Because, with each cycle, a woman’s likelihood of conceiving successfully also escalates.
2 Failed IVF Cycles: What Next?
Did you undergo another in-vitro cycle and it failed as well? Most fertility specialists recommend couples to undergo at least 2-3 in-vitro cycles to conceive successfully. In most cases, the female experiencing infertility is a woman in her mid or late 30s or older. Women of that age often have difficulty conceiving also with pregnancy treatments because of the obvious fertility decline due to aging (causing decline in ovarian reserve and egg quality).
After 2 failed in-vitro cycles, it is in most cases recommended that the couple undergo another cycle after the determination of the cause that induced the previous cycle to fail. The fertility doctor will analyze your case and previous cycle and what went wrong with them. Only after that the doctor will conclude if you should be undergoing another cycle or opt for another treatment.
3 IVF Cycles Failed: What Next?
You had 3 consecutive in-vitro failures. You probably have an underlying condition corrupting the in-vitro implantation and leading to repeated failure. Your fertility doctor will likely recommend you to undergo genetic screening of the embryo before implantation. Chromosomal abnormalities in the IVF embryos contribute to about 50% of in-vitro implantation failure cases. Preimplantation genetic testing (PGT) will determine if there is a missing or extra chromosome in the embryo that might cause the embryo to get rejected after implantation. After concluding the problem leading to repeated failures, the fertility doctor will likely suggest you to go for a more specific and advanced pregnancy treatment.
Other Treatments after Multiple Failed IVF
If you have encountered recurrent IVF failures, do not worry. There are still other effective and advanced clinical pregnancy procedures that can help you get pregnant. There might be any reason why you had recurrent conception failures. Once your fertility doctor analyzes your previous cycles and finds out the reason for failures, he or she may likely suggest you undergo one of the following treatments appropriately.
Frozen Embryo Transfer
Frozen embryo transfer, abbreviated as FET, is a procedure that involves freezing extra healthy embryos (blastocysts) from a previous in-vitro cycle and keeping them for use at a later time. The technique has accumulated popularity for its higher success rate than conventional in-vitro cycles. If the couple have got some blastocysts frozen during their previous cycles, they can undergo another cycle and use it.
Intracytoplasmic sperm injection, abbreviated as ICSI, is an advancement in the conventional IVF procedure. In ICSI, the egg is fertilized with a single live sperm by injecting it directly into the egg. In cases of male factor infertility causing repeated failures, ICSI can be a great option to conceive.
Intracytoplasmic morphologically-selected sperm injection, abbreviated as IMSI, is another advancement in the traditional IVF treatment. Similar to ICSI, IMSI also involves injecting a single live sperm into the egg directly to induce fertilization. But, in IMSI, sperm are first analyzed under high magnification and only the single sperm with best morphology is used for injection. IMSI is a good option when multiple failures are caused due to male partner’s sperm quality issues.
If the reason behind your repeated IVF failures is the age or quality of your eggs, a donor egg program is the best option to go for. There are many young women aged 21 to 34 who have healthier eggs and are intending to donate their eggs anonymously. You can talk to your fertility doctor and find a donor who is likely to donate for you.
If for any reason, the woman is incapable of carrying the child on her own, due to some genetic abnormality, a health condition or any reason. Or if the pregnancy repeatedly ends up in a miscarriage, surrogacy is their go-to option. Surrogacy is generally of two types: traditional surrogacy and gestational surrogacy.
- Traditional surrogacy: In this type of surrogacy, the surrogate mother’s own egg is fertilized with the intended father’s sperm (through IUI or IVF). The surrogate then undergoes the complete pregnancy journey.
- Gestational surrogacy: Unlike traditional surrogacy, in gestational surrogacy, the couple uses their own egg and sperm to create the embryo. But the surrogate mother is implanted with that embryo and goes through the complete pregnancy.
Depending on your reproductive condition and the reason behind your recurrent conception failures, your fertility doctor will suggest whether you should opt for traditional or gestational surrogacy.
Tips for IVF Success
IVF is a complicated, time-taking and costly procedure and you may struggle to get your intended result if you do not know what you should be doing and what not. Below are some tips that can help you on your way in the IVF journey.
- Maintain a healthy body weight: Body weight plays a vital role in determining your conception chances. Being underweight or overweight affects the hormonal balance and may lead to issues with conception.
- Take prenatal vitamins: Apart from eating a healthy-nutritious diet, doctors often pregnant women and women trying to conceive take prenatal vitamins. A woman’s body requires extra vitamins and minerals before the pregnancy begins. Prenatal supplements make up for this requirement and support conception.
- Sperm health is essential: Almost 50% of infertility cases are male-factor, meaning half of the cases when a couple is incapable of conceiving is because of poor sperm health of the male partner. Consider taking a good diet, exercising and managing stress to support good sperm health.
- Choose a good fertility specialist: It is very important that you go for a fertility doctor who has a good success rate, is experienced and reputed in the locality. Choosing a good doctor ensures that you will have better chances of conceiving as the doctor would have handled several cases similar to yours.
- Take care of your mental health: Stress accelerates cortisol production that affects ovulation and egg health, leading to lower conception chances. Try to get enough sleep, eat on time, socialize and try meditating for 5-10 minutes.
- Avoid use of unhealthy substances: use of certain substances such as drinking caffeine and alcohol, smoking cigarettes or taking recreational drugs have been found in multiple studies to lead to implantation failures and early miscarriages.
The Bottom Line
IVF is undoubtedly a blessing for those couples who cannot conceive naturally for some reason. The procedure helps infertile couples have a genetic child despite having conditions such as blocked uterine tubes, PCOS, endometriosis, fibroids, poor egg or sperm health, and low ovarian reserve.
However, in-vitro fertilization may have some complications too. Because, most couples who undergo an in-vitro cycle are usually in their mid to late 30s, their likelihood of having certain fertility problems are high. Therefore, it may be possible that they could not conceive in their very first in-vitro attempt. But, what would be the next step for them to take after a failed cycle? Talk to your fertility specialist and figure out whether you should be undergoing another cycle or opt for a more specific and advanced pregnancy treatment. Do not lose hope, there are options.