- 11. 2. 2021
- Reproductive health
IVF NOT WORKING RIGHT AWAY? WHY TO KEEP TRYING.
A FAILED IVF TREATMENT FEELS DEVASTATING. ALL THE ENERGY INVESTED, EMOTIONS' ROLECOASTER AND OF COURSE THE COST.
IF YOU HAVE TRIED AND NO POSITIVE OUTCOME YET, IS THERE A REASON TO KEEP TRYING?
Infertility treatment is a complex process with many factors in need to fit together. Therefore successful outcome may need more than one cycle. All the factors of successful treatment matter, from egg quality to number of eggs, implantation issues and chromosomal composition.
The chance of becoming pregnant naturally, for women under 35, is about 25% for a cycle. And yes, it usually takes couples more than one try to conceive. Undergoing IVF procedure increases probability of pregnancy significantly, but it still may take more than one round. Despite all the frustration, disappointment and stress, it is important not give up if first attempt fails, or even more than one.
Assisted reproduction is highly innovative field where latest methods and procedures are being implemented constantly to practise, technology keeps improving and the various factors leading to pregnancy success are improving.
REASONS WHY IVF MAY FAIL
To successfully conceive, it means a healthy, good quality egg to be fertilised by a healthy, good quality sperm. Both have to be defect-free. The sperm need to have good motility and no abnormalities to reach the egg. If egg and sperm are of good quality and woman cycle is in ovulation phase and the enviroment is implantation "friendly", fertilisation happens. After the fertilised egg implants into the healthy endometrial in the uterus only then developing into an embryo, a foetus and then a baby can happen. It is a very complex process to get all the pieces working together just right.
WHAT ARE THE MOST COMMON REASONS OF IVF FAILURE?
Women are born with all the follicles they will ever have. With increasing age the number of eggs decreases and, with the age, follicles become less sensitive to the FSH hormone (follicle stimulating hormone). The number of eggs, their quality and their reaction to stimulation are all important factors to successful IVF treatment.
Aging affects eggs quality. Egg quality tends to be higher in younger women. A woman's fertility decreases about the age of 35. The implantation rate for women over 35 using her own eggs decreases significantly. Chance for successful pregnancy with own eggs for women over 40 is very low. Woman over 40 are advised to opt for donor eggs, because IVF success rates using donor eggs equal those of younger women using their own eggs.
For successful IVF treatment it is essential to use best quality eggs and sperm. By the in-vitro procedure are created embryos and those are cultivated in laboratory and evaluated every day. The best quality embryo is implanted in the uterus and others are cryopreserved. Without good quality embryo success rate decreases significantly.
Chromosomal abnormalities (not the correct number of chromosome in embryo) are a common cause of miscarriage in both natural and IVF pregnancies. You may be recommended a preimplantation genetic testing to find out if the correct number of chromosome is present in your embryonic cells.
As eggs age, chromosomal abnormalities become more likely. It is estimated that a woman in mid-40s may have chromosomal abnormalities present in over 50% of her eggs. There are sperm development abnormalities as well in this matter, but at a much lower rate.
Huge impact on your fertility has your lifestyle. Women are advised to lose weight for improving fertility if their BMI is over the limit, but being underweight can be equally problematic. Healthy eating habits including nutrient dense food, exercising moderately and making sure no vitamins are lacking can boost not only overall health but hormonal health and the quality of eggs and sperm.
ALCOHOL AND SMOKING
No doubt that alcohol and smoking is harmful to pregnant women. And it is also harmful when trying to conceive and yes, even by IVF. Odds of failed fertilisation are nearly 50% higher in men and women who drink more than four drinks per week. Smoking is no help either. Also women who drink experience lower peak estrogens levels and have significantly fewer oocytes during their IVF cycles.
WHY TO CONTINUE TRYING?
Infertility is challenging, hard, stressful. And when IVF attempt fails, it is devastating. It is important to aknowledge IVF is not simple or straightforward but a very complex series of procedures. It is a process. And every process may demonstrate unexpected issues, adjustments to the treatment protocol and even result in a failed attempt.
Above mentioned are some of the most common issues, but in fact there are many reasons it can take more than one treatment cycle for a successful pregnancy. Sometimes there are no good quality eggs collected, eggs' fertilisation fails even the eggs are of the top quality. Sometimes eggs and sperm fertilise successfully but the embryo is not developing optimally.
There is no one size fits all solution, because of the complexity of the process and individuality of each one. But there is wide range of advanced methods, tests and treatment options enabling us to support positive outcome. Whether it is EmbryoScope, EmbryoGlue, MACS or genetic and karyotype testing which can be crucial in revealing chromosomal abnormalities. There is an option to choose egg or sperm donor treatment if necessary. Also the adjustment of fertility medications in connection with individual response to those. And lifestyle changes, even tiny little ones, bring you closer to much desired pregnancy.
When your IVF fails, do not get discouraged. Try to keep in mind your doctor and the whole team is on this journey to parenthood with you. And wishes nothing else than to succeed, doing the best to make this dream happen. By being there with you all the way, practising professional expertise and experiencing your interaction to the treatment process, mapping carefully out a path forward for the next round.