IVF (In Vitro Fertilisation) Failure: Causes, Symptoms & Tips to Cope
In-vitro fertilisation is an advanced and powerful technique that has helped couples struggling with conceiving to get pregnant and have a baby. While IVF has proven to be a successful choice for many couples, there are many cases left behind that don’t yield the desired results. IVF failure can be emotionally draining on couples and their relationships, who have invested their hopes and resources into the process. You might wonder why IVF fails when it is considered to be effective. Not every process comes with a guarantee, and IVF itself depends on numerous factors for its success. In this comprehensive post, we will get into the core of the causes of IVF failure and provide you with valuable tips on coping with the unfortunate situation.
Knowing how IVF works will give you a better understanding of everything required for a successful IVF cycle. Here is what the IVF procedure typically looks like.
1. Hormone Injections
Usually, one egg is released from an ovary each month. However, IVF requires multiple eggs to be retrieved from the body. Hence, follicle-stimulating hormones are injected, so multiple eggs can be released at once, and then retrieved.
2. Retrieval of Eggs
When the eggs have just been released from the follicles, the right time to remove the eggs is determined. The retrieval procedure takes under 30 minutes, during which the doctor locates the follicles in the ovary through an ultrasound and removes them using a hollow needle.
Immediately upon retrieval, the eggs are placed in the same dish as your partner’s sperm or a donor’s sperm to be fertilised.
The embryos (fertilised eggs) are then placed under observation to grow and develop properly. This observation period is usually five days until the embryos reach the blastocyst (advanced) stage.
5. Embryo Transfer
The good-quality embryos with the highest chance of being implanted are picked out and transferred to your uterus in a simple procedure. This is a quick procedure where the doctor inserts a catheter into the uterus and deposits the embryos.
6. Implantation and Pregnancy
The embryos are left to implant or attach to the uterus walls for a successful pregnancy. In cases where this does not occur, it is considered a failed IVF cycle.
Knowing that the IVF procedure has failed barely gives any idea about the reasons that led up to it. The causes of IVF failure can vary, depending on numerous factors. Let’s check some common reasons behind unsuccessful IVFs:
1. Embryo Transplantation
Failed IVF transfer can also be due to unsuccessful embryo transplantation. The average implantation rate in the in vitro fertilisation procedure is about 25%. At times, the embryo that has been fertilised successfully might not latch onto the uterus successfully and fail to implant.
2. Absence of a Conducive Embryo
During the IVF procedure, the doctors might not find any embryo that is healthy and can successfully lead to a pregnancy. This makes it necessary to terminate the process.
3. Failure of Eggs to Fertilize
Even before an embryo formation, the eggs may fail to be fertilised by the sperm. This could be because of issues in either of them or even both.
4. An Absence of Quality Eggs
For an embryo to be formed properly, the eggs need to be of high quality. If those are not obtained in a good amount, the chances of embryo formation are close to none.
5. Inadequate Number of Follicles
This is an early-stage termination of IVF, even before the eggs are obtained from the female partner. If the stimulation fails to create enough follicles for egg generation, IVF cannot proceed.
6. Poor Sperm Quality
It is not only that the quality of eggs matters, but the quality of sperm creates significance, too. Men with genetic disorders or diabetes have poor sperm quality. Poor sperm’s DNA can undergo breakage during and after fertilisation, leading to failed implantation and miscarriage.
7. Oocyte’s Age
Eggs have a peak fertilising potential between the ages of 24 to 34. If you are trying to get pregnant after this age bracket, you may face problems related to IVF failure.
The IVF implantation failure symptoms are quite evident in the absence of any changes. Implantation generally causes changes in the tendency to smell, increased sensitivity of breasts, vaginal discharge, and slight abdominal cramping. If these don’t exist even after a couple of weeks, post IVF, it might be indicative of a failure.
In case you meet with an IVF failure, it would be necessary to meet your doctor to understand what happened and how you can proceed from there.
1. Counselling Sessions
More than the medical aspect of things, the news of IVF failure can be emotionally distressing for both you and your partner. This can even result in depression or anxiety about trying it out again. Undertaking counselling sessions can help you channel your emotions and find a semblance of peace again.
2. Changes in Your Lifestyle
By indulging in conversations with your doctor, there will be some clarity around any specific factors surrounding your lifestyle that might have contributed to an unsuccessful IVF procedure. Certain changes might be prescribed in order to keep your weight in an optimal range, as well as other exercises that can help boost hormones conducive to pregnancy.
3. Carrying Out Genetic Testing Before Implantation
This is generally recommended if many other fertility options have failed to bear fruit. The costs associated with genetic testing are substantial. However, it helps diagnose any problems that might cause a problem with the implantation of the embryo and correct them or mitigate them by choosing an appropriate embryo.
How to Cope With IVF Failure?
Understanding the IVF failure causes is one aspect of coming to terms with the incident. But what’s more important is for you to cope with the incident itself and help yourself return to normalcy in the best way possible.
1. Focus on Doing Things You Enjoy
Make a list of all the things you enjoy doing and start ticking them off. Take a mini-trip with your friends, gorge on tasty foods, and anything that you call a fun time. Give yourself the enjoyment you deserve to take your mind off the sadness.
2. Engage in Conversations With Similar People
IVF failures are observed in many women. Connecting with them either via an online forum or an in-person meeting could help you voice your emotions and concerns and find a friend who understands your experience and can support you through this. Letting out your feelings can make you feel lighter.
3. Carry Out Self-Healing
The body undergoes a massive change during IVF, and now it has to make its way back to its usual state. Your first period can take some time to occur since your menstrual cycle requires a few days to reset itself. When the bleeding does occur, try to celebrate it, since it is a good sign that your body is doing alright. Indulge in acupressure or alternative healing methods that relax your mind and body together.
4. Put Together a Future Plan
Taking a look at various fertility websites and articles, as well as checking out different discussions in forums can start giving you a better idea of the options that you can choose from. It also helps you look forward to the future by creating a plan of action if the other option were to fail as well.
5. Trust the Process
In certain cases, IVF might proceed to a successful pregnancy, only to meet with a miscarriage or require termination of the foetus due to certain medical conditions. Talk to your doctor to understand the reasons for failure in a better manner. These can help you cope with it and accept your experience.
6. Choose Who You Tell About it
The excitement of being a mother via IVF would have you talking to all your friends and family members about it. However, when the procedure fails, it can be awkward and painful to answer their questions over and over again. Look at this as a learning lesson and keep a shorter circle of people who know about any later attempts. Once you have a successful result, you can happily announce your pregnancy.
7. Stop Blaming Yourself For the Results
The IVF procedure is pretty complex and depends on numerous factors to be present in the optimal state for it to be successful. You don’t need to take all the blame of having an unhealthy body or being careless in any way.
How Many Times Can You Try IVF?
Ideally, a couple should be ready to try around six cycles of IVF to get a good result. Since that can be quite costly for many, fertility clinics might have certain plans that can reduce costs or share the risks of failure.
Tests That Will Help to Identify the Failure of IVF
IVF failure can be traumatising. Knowing the reasons for this unfortunate situation can help overcome it. Fortunately, there are various diagnostic tests available to pinpoint the underlying causes behind an unsuccessful IVF cycle:
1. Uterine Evaluation
Uterine evaluation primarily focuses on examining the condition of the uterus and fallopian tubes. It is typically conducted prior to the initial IVF cycle.
2. Sperm DNA Fragmentation Test
This diagnostic method combines various testing modules, such as TUNEL and the alkaline comet assay, to assess the genetic integrity of sperm. If there seems to be any damage to sperm DNA, other methods can be deployed to select a healthy sperm with intact nuclear DNA.
3. Endometrial Receptive Array (ERA)
ERA involves a biopsy of the endometrium using genetic markers. This procedure helps determine the receptivity of the uterus for embryo implantation. In cases of recurrent IVF failures, the ERA can be instrumental in assessing whether uterine receptivity is a contributing factor to the unsuccessful outcomes.
4. Immunological Test
These tests are designed to investigate imbalances in the immune system and assess the body’s ability to tolerate a developing fetus. Typically, immunological tests are considered when all other diagnostic avenues have been explored, and the exact cause of IVF failure remains elusive
5. Pre Implantation Genetic Diagnosis (PGD)
PGD is a diagnostic procedure where embryos are screened for chromosomal abnormalities or genetic defects. This meticulous examination can identify even minor errors within the embryo that might be causing IVF implantation failure.
When to Try Again?
You may not know why IVF fails with good embryos, but that should not keep you from trying again. If you have faced failure in the first IVF, give yourself time to recover and get a checkup done with your doctor. Once your parameters are normal and you are emotionally, mentally, and physically in a good place, you can try again.
Even if you have faced a failure in your first IVF cycle, you can try again to achieve a successful result. The dependency of an IVF procedure bearing fruit in the second attempt lies on a variety of factors.
- The capabilities of the embryo in terms of chromosomes and genetics
- The quality of the embryo itself
- Any existing issues in the uterus
- The number of eggs retrieved
- The professional expertise of the doctor in transferring the embryo, as well as obtaining the eggs
- The upkeep and quality of the laboratory where the IVF procedure is being conducted
- An intended result of conducting a stimulation of the ovaries during IVF
- The amount of sperm that is obtained, as well as its quality
- The number of eggs that are obtained, as well as their quality
- The age of the female partner undergoing IVF.
1. How common is IVF Failure?
No matter where the IVF procedure is performed, the success rate is never 100 per cent, as it depends on multiple factors, including the patient’s age, the lab facility, the quality of eggs and sperm, etc. Women under the age of 35 have a success rate of 35%, and as the age progresses, the rate reduces to around 15%. In short, on average, 35 per cent of IVF procedures work, while the rest, 75%, fail.
2. Can I Get Pregnant after Failed IVF?
Yes, you can get pregnant after a failed IVF procedure. IVF failure is a challenging obstacle on the path to parenthood, but with the right support and mindset, couples can overcome it.
Figuring out what next when IVF fails can be troubling for many couples. The key is to focus on the end result and not blame yourself for things that go wrong. So, take a deep breath, and look forward to a good future.
1. Bashiri. A, Halper. K. I, et al.; Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions; Reproductive Biology and Endocrinology; BMC; https://rbej.biomedcentral.com/articles/10.1186/s12958-018-0414-2; December 2018
2. Simon. A, Laufer. N. Assessment and treatment of repeated implantation failure (RIF); J Assist Reprod Genet.’ PubMed Central; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510376/; November 2012
3. de los Santos. M. J, Mercader. A, et al.; Implantation rates after two, three, or five days of embryo culture; Placenta; Pubmed; https://pubmed.ncbi.nlm.nih.gov/14559025/; October 2003
4. Timeva. T, Shterev. A, Kyurkchiev. S; Recurrent implantation failure: the role of the endometrium; J Reprod Infertil.; PubMed Central; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227974/; October 2014
5. Shaulov. T, Sierra. S, et al.; Recurrent implantation failure in IVF: A Canadian Fertility and Andrology Society Clinical Practice Guideline; Reproductive BioMedicine Online, Volume 41, Issue 5, Pages 819-833; ScienceDirect; https://www.sciencedirect.com/science/article/pii/S1472648320304405; November 2020
6. Margalioth. E. J; Ben-Chetrit. A, et al.; Investigation and treatment of repeated implantation failure following IVF-ET; Human Reproduction, Volume 21, Issue 12, Pages 3036–3043; Oxford Academic; https://academic.oup.com/humrep/article/21/12/3036/2939194; December 2006