Failed IVF - Treating IVF failure

What to do if IVF fails?

One of the biggest problems in the IVF treatments is IVF failure.  Although first IVF cycle is often successful at a high quality program, but unfortunately, many couples will not have successful first cycle IVF results and will need to consider a second cycle of IVF. So what should be next after one failed IVF cycle? Let a week or so pass in order to make the difficult adjustment to the devastating news that your cycle did not succeed.

When you feel ready, schedule a consultation with your IVF specialist to go over what might have been learned from the failed IVF attempt. A very important consideration should be whether to change IVF doctors or switch to a different IVF clinic at that point. In vitro fertilization programs are not all equal - some give a much higher chance for success than others.

The first thing that should happen is for the IVF specialist physician to review the failed cycle carefully to possibly learn something from the results of the IVF ovarian stimulation process, or from any issues with egg retrieval, egg quality and/or quantity, fertilization results, embryo development, or any problems with the embryo transfer procedure.

Often there will be an issue in one or more of these areas. The ovarian stimulation protocol and results as well as the embryo development issues should be discussed with the couple. Pictures of the embryos and quality scoring issues, including cell stages, fragmentation and regularity of the cells in day 3 transfer cases, or blastocyst grading and expansion scoring for day 5 transfer cases - should also be reviewed and discussed. Then a plan for a second IVF cycle can be formulated.

Inefficiencies in the IVF process will not always be issues that are "fixable" - but they should be studied and discussed with the couple so that they are educated about their situation and their estimated success rates for a second IVF attempt. Many issues seen in a failed first IVF attempt can be addressed in some manner in order to eliminate or reduce the likelihood of the same issue occurring in a second try with in vitro fertilization.


Causes for IVF Plantation failure

There are a number of reasons that can cause IVF failure and it depends on the unique condition of the patient. One of the most common reasons for failed IVF is the difficulty involved in embryo transfer during the process.

We know that the embryos were transferred to the uterine cavity - particularly if ultrasound guided embryo transfer is done.

When IVF fails there was implantation failure, but we do not know whether the failure to implant was due to a problem with the embryos or a problem with the uterus. Most fertility specialists believe that in more than 95% of IVF failures it is due to arrest of the embryos.

The other common reason for a failed IVF cycle is a poor ovarian response, which means patients get few eggs and few embryos. For this option is  aggressive super ovulation, high doses of HMG, in order to grow more eggs, to have more embryos to transfer.


Is the rate lower for the Second IVF Cycle?

Couples often ask this very reasonable question. However, there is not a good, short answer. Many couples will have a successful second IVF. The chances for that happening depends on many factors, including:

    • Sperm quality - based on examination of sperm in our sperm laboratory
    • Oocyte quality - usually addressed by ultrasound examination and blood tests
    • Prior reproductive history
    • Status of your Fallopian tubes
    • Age
    • Presence of certain medical diseases in either partner
    • Weight
    • Smoking history
    • Results of blood tests

 In order to maximize the chances for a successful second IVF try make sure that your doctor has carefully reviewed the issues above. You might also consider changing doctors between IVF cycles. Some reproductive endocrinologists (infertility and IVF specialists) are pulled in many different directions and are not focused on IVF or on having the best possible IVF lab and clinic.

Having an outstanding IVF program requires constant diligence and consistent execution. This is not an easy proposition - particularly in very large IVF clinic - where thousands of couples are pushed through annually in a mass production approach. That approach to IVF often works much better for the clinic than it does for the eggs, the embryos, or the infertile couples.

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