Why Do IVF Cycles Fail Again and Again? Causes and Treatment

IVF does not always guarantee a successful pregnancy because of a variety of factors. Let's take a look at the causes of IVF failure and how to cope with a failed IVF cycle. 

IVF Cycles Fail, IVF failure
A failed IVF cycle

Why do IVF cycles fail again and again? Possible Causes and Treatment

IVF, first introduced in 1978, has come a long way in the last four decades, thanks to improved drugs, lab equipment, and medical technology.

Like any other technology, IVF does not always guarantee a successful pregnancy because of a variety of factors.

While many people are successful the first time they try IVF, others may need to try twice or three times.

On the other hand, recurrent implantation failure is defined as a failure more than three times. 

Repeated IVF failure can be emotionally, physically and financially draining. While IVF's average success rate is between thirty and thirty-five percent, the procedure has achieved a success rate of more than fifty percent in some cases.

A variety of factors can cause embryo implantation failure. However, the most common are: 

  • Oocyte or sperm
  • Uterine-related factors
  • Embryonic

Another reason for IVF failure is advanced maternal age, becoming more common as couples choose to marry late or plan pregnancy later.

Factors that contribute to poor egg or sperm quality include:

  • Smoking
  • Stress 
  • Obesity 
  • Poor lifestyle
Read Here: Let’s Normalize Talking About Infertility: Your Guide to Fertility

What should I do after a failed IVF cycle?

after failed IVF cycle

Examination of the uterus

The presence of a hostile uterus is one of the most common causes of implantation failure.

IVF failure can be caused by uterine malformations such as:

  • Intrauterine adhesions
  • Endometrial polyps
  • Submucous fibroid

A detailed pelvic scan is a simple way to detect such malformations. Also, depending on the cause, different medical therapies can improve the chances of implantation.

If the uterine scan reveals a large intramural fibroid, it will need to be surgically removed before the embryo can be implanted.

The septum of adhesions in the uterus can be corrected with hysteroscopy if the repeated IVF failure is due to the septum of adhesions in the uterus.

The laparoscopic detachment of fallopian tubes can also help with a hydrosalpinx.

Improving the Selection of Embryos

Embryos could now be cultured until day five or six, thanks to technological advances. Previously, embryos could only be cultured until day two or three.

What exactly does this imply?

The embryo is formed after the egg and sperm have successfully fused.

Even so, it had to be implanted on the second or third day of infusion, leaving little time to evaluate the embryo while it was still in the blastocyst stage.

We can improve the selection process because the implantation of the blastocyst embryo is much higher than the cleavage stage.

It is possible to determine whether an embryo is genetically normal or not using preimplantation genetic screening (PGS).

Patients who have had multiple IVF failures are more likely to have chromosomally abnormal embryos.

Despite their morphological appearance, such embryos do not implant.

If the embryo is euploid or has a regular chromosomal makeup, it has a more elevated implantation rate, indicating an increased IVF success rate.

Read Here: What is Hysteroscopy? Types, Procedure and Recovery

Blood Work

According to the top IVF doctors, in some patients, autoimmune diseases such as abnormal coagulation and SLE can result in embryo implantation failure.

Comprehensive blood work to medically treat the condition is recommended for such individuals before embryo transfer.

Patients are treated with low molecular weight heparin in this setting. Immunomodulatory drugs are recommended if the patient has an immune disorder.

Assessment of Endometrial Receptivity

The state of the endometrium (uterine lining) must be taken into account before an embryo can be implanted to avoid failure. 

A normal transvaginal scan evaluates the endometrium's thickness and pattern. It is considered suitable for implantation if the endometrium measures 8mm or more on the scan.

However, it is critical to assess endometrial receptivity using an Endometrial Receptivity Assay (ERA) in patients who have had multiple IVF failures.

The endometrium can be classified as receptive, post-receptive, or pre-receptive based on the test results.

Then a strategy for transferring the embryo to the patient at the appropriate stage can be devised. Personal Embryo Transfer is the term for this procedure.

Some evidence suggests that endometrial scratching can increase the implantation rate. Still, the trial data is insufficient to be specific.

Autologous platelet-rich plasma is a more aggressive treatment (PRP).

In addition, the endometrium is more receptive in the frozen embryo cycle than in the stimulated cycle.

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It's not only emotionally draining, but it's also frustrating to have failed IVF cycles. If you've tried several cycles of IVF and still haven't gotten pregnant, it's time to think about a more personalized approach.

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