Why does Repeated IVF Failure happen?Dr Chaithra S.K
Parenthood is the most blissful gift to humanity. But if diagnosed with infertility leaves you heartbroken & depressed. Then when you opt for IVF to conceive, facing one or more unsuccessful IVF cycles leaves you devastating and frustrating. When a couple fails to achieve pregnancy following several IVF cycles after using three good embryos are known to be going through a recurrent or repeated implantation failure.
The variables involved in a successful IVF cycle are:
• A healthy egg
• Normal, functional sperm
• A healthy uterus, capable of nurturing the growth of a baby.
Causes of repeated IVF failures are:
Poor Oocyte Quality - A healthy egg is responsible for the birth of a healthy baby. Any abnormalities in the egg can result in a chromosomally abnormal foetus. Egg fusing with the sperm plays a crucial role in cell division and chromosomal duplication to form an embryo. As the oocyte or eggs ages, the spindle apparatus of the structure responsible for the chromosomal separation and equal distribution becomes prone to breakage. It leads to an abnormal distribution of chromosomes. It results in the formation of a chromosomally abnormal embryo. As lady ages, the free radicals or the reactive oxygen species in her body increases. These free radicals present in her ovaries react together with her eggs, causing damage to her DNA and thus reducing its quality.
Poor Sperm Quality Abnormalities within the sperm may cause an unfertilized egg.
There are three roles of a sperm:
• To reach the egg through the fallopian tube
• Penetrate through the outer membrane of the egg
• Release half its genetic material or the sperm DNA to supply an embryo - So it is crucial to select the best quality sperm under high magnification during IVF for successful fertilization. Sometimes even a chromosomally normal good quality sperm may lack enzymes. The enzymes are required to break through the egg’s outer shell. Low quality, morphologically abnormal, and less motile sperm cannot reach the egg to fertilize it.
• Wrong Embryo Selection - plays a crucial role in successful implantation. It is a natural function of the uterus to reject abnormal embryos. It means the chromosomally abnormal embryo cannot survive & it results in implantation failure or miscarriage. Sadly, it’s difficult to distinguish between chromosomally normal foetuses & abnormal ones. So, an investigation of embryo health is necessary for a successful pregnancy.
• Uterine Issues - Successful implantation also depends on the endometrial environment. Various structural, hormonal, and immunological factors affect an ideal uterine environment. Structural uterine factors such as the abnormal shape of the uterus, fibroids, polyps, scarring, difficult cervix, and intrauterine adhesions can lead to an implantation failure. Other main uterine issue includes a thin endometrium due to an early rise in the progesterone before the egg retrieval in an IVF cycle.
• Issues with Maternal and Paternal Health - A successful IVF conception depends on the couple’s health. Consumption of alcohol, smoking, and medicines can cause many complications during implantation and pregnancy. Improper management of systematic diseases like diabetes, hypertension & unhealthy body weight also results in IVF failures. Autoimmune disorders like antiphospholipid syndrome and blood coagulation disorders can cause miscarriages.
• Problems with Embryo Transfer - The embryo transfer is a sensitive non-surgical procedure. Any alteration during this procedure may cause the failure of an IVF cycle. The embryos should implant at the correct location in the uterus. Without performing a trial transfer, it is tough to find the optimal implantation for the embryo placement. In addition to these issues, many other factors can impact the chance of pregnancy with IVF.
• The laboratory environment
• The techniques used in the lab
• The specialist’s skill to perform egg retrieval and embryo transfer.
A solution to repeated IVF Failure:
Despite all of the above challenges, IVF remains extraordinarily successful. A nationwide study revealed that a couple’s chance of delivering a baby is the same in their first three in vitro fertilization cycles. If a couple fails to conceive after three cycles of in vitro fertilization, their chance for a successful conception in another IVF cycle diminishes drastically. Many patients are referred to GarbhaGudi IVF Centres following unsuccessful treatment elsewhere. After reviewing their medical records, our fertility specialist doctors suggest such things as:
• An alternative stimulation regimen
• A different IVF protocol
• The use of ICSI or maybe pre-implantation screening
• Proceeding to donor gametes.
It is necessary to realize that changing IVF centres may approach the same patient differently; therefore, failure at one facility does not mean that you should give up on your dream of having a baby.
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