A failed IVF cycle can be emotionally and financially distressing. Many couples come to Momsoon IVF after failed IVF at other centers. We have helped a large number of patients with previously failed IVF who come to us for second opinion. With our expertise we individualize our approach to best suit individual needs.After a failed IVF, it is advised to review the cycle and come up with answers as to why the cycle failed. A failed IVF could be due to any of the following reasons
1.Poor Egg Quality
The quality of the eggs is considered to be of utmost importance while analyzing the cause of a failed IVF. Age has a great impact on the quality of the egg. After 30, the quality and quantity of eggs decline so that by 40 years of age there are only 10% normal eggs. This results in poor quality of embryos from an IVF procedure. Today most labs select ‘prettier’ looking embryos i.e. with symmetrical cells, larger inner cell masses, fewer fragmentations etc for implantation but they do not guarantee a genetically normal embryo. Only a biopsy of the embryo for chromosomal analysis ensures a normal embryo.
We provide DHEA supplementation to improve egg quality and blastocyst biopsy for chromosomal screening. Changing stimulation protocol and using donor eggs as the last resort are also possible solutions.
2.Poor Sperm Quality
The sperm head may contain abnormal genetic material which cannot be diagnosed during a routine semen analysis. Exposure to chemicals or toxins, tobacco use etc could be attributed to this damage to the sperm DNA. Fertilization of a normal egg using an abnormal sperm results in abnormal embryo.
We suggest Halotest to screen for normal sperm that are used for ICSI.In case of abnormal Halotest results we recommend antioxidants for atleast 3 months prior to starting another IVF cycle.
The stimulation protocol is reviewed for possible improvement such as starting dose of stimulation, type of protocol used, timing of the HCG injection etc. Understimulation with low starting dose or pituitary suppression may lead to low ovarian reserve with fewer numbers of eggs. On the other hand, hyperstimulation can also cause treatment failure. Very high estrogen levels lead to early maturity of the endometrium when compared to the embryo causing implantation failure. Hence at Momsoon, each patient is assessed before designing a stimulation protocol that suits their needs.
Correct timing of HCG (Human Chorionic Gonadotropin) hormone injection is essential. Giving HCG too early results in few mature eggs whereas giving HCG too late results in the endometrium being less receptive to the embryo. It can also affect the eggs such that they do not fertilize well. Incorrect injection technique or the usage of expired medicine or poor absorption of the injection could lead to inadequate HCG. IM (intramuscular) injection of HCG helps deliver it right into the blood stream.
Thin endometrium is one of the major causes of IVF failure. This could be attributed to adhesions from previous surgery or due to poor intra uterine blood flow. An endometrial biopsy is recommended before another stimulation cycle.
This is one of the most important factors that influence the success of an IVF cycle. Sometimes the transfer is traumatic and is associated with bleeding and cramping due to injury to the endometrium. This can be overcome using cervical suture, sonogram guided transfer or by surgery.
The laboratory environment is reviewed to check if it is conducive to the growth of embryos. Embryos that do not grow well in the lab may be transferred early to the uterus which proves to be the best incubator.
Inspite of an extensive and exhaustive review sometimes, no definite reason is found for a failed IVF.