IVF failure – causes, reasons, what treatment next ?
Routine PGS (Pre-implantation Genetic screening) for IVF failure patients and repeated abortions.
Specialised trophectoderm biopsy to check genetic material of the embryo before implantation.
Personalised Embryo transfer through Endometrial receptivity array.
- Are you facing repeated / multiple IVF failures ?
- Don’t Lose Hope!
- Women with 7 IVF failures in Outside hospital, pregnant in Iswarya Fertility centre.
Causes of IVF failures ?
The commonest question you ask a fertility specialist is why does my IVF fail with good embryos and a good endometrium.
IVF failure with Donor eggs / embryos ?
IVF cycle can also fail even when Donor egg or embryo is used. There could be a problem in the sperm or implantation failure due to defective endometrial receptivity. Even the best embryo will to give pregnancy if the uterus is not adequate to sustain normal implantation and placentation.
Investigation and treatment of repeated implantation failure following IVF & Embryo transfer
Repeated IVF failure require complete rework of all factors. There are various causes of repeated IVF failure and not just one. Repeated IVF failure is a frustrating experience for the couple in terms of emotions and finance. Evaluation starts from the endometrium. It goes till the sperm morphology and DNA.
Investigating IVF failures
In Iswarya Fertility Centers, We workup IVF failures completely. No factor will be left alone. All aspects will be taken care before going ahead with IVF which is particularly essential in a case of repeated IVF failure .
Treatment of IVF failures Embryo culture environment
Using 5% Oxygen for embryo cultures to get better embryos. Research has shown using low physiologic oxygen during embryo culture will result in faster developing embryos with better implantation chances.
Progesterone route and luteal support :
In one study, with the use of intramuscular progesterone, a circulating level >20 ng/mL was associated with lower implantation rates, suggesting that excessive systemic (or vaginal) absorption could accelerate the pace of endometrial development. In some women , just changing the progesterone support will help.
Endometrial Receptivity Array :
With such methods, its possible to do personalised embryo transfer. We just shift the day of transfer to suite optimal progesterone duration.
Personalized Embryo Transfer :
Correction of the individual displacements of the window of implantation leads to a personalised of the embryo transfer. This means that to allow a synchronized embryo transfer, in addition to information about the embryo, the diagnosis of a receptive endometrium is also obtained.
IVF failure FAQs
- Complete evaluation of all factors
- Good Stimulation protocol
- Get Best quality embryos
- Pre-implantation genetic screening / Diagnosis
- Personalised embryo transfer
- Embryo freezing
To result in a pregnancy and delivery there are certain things which needs to occur perfectly.
- A capable embryo must be accurately deposited and retained in an optimal location of the uterine cavity. The endometrium must be receptive and synchronized to the developmental stage of the embryo.
- The uterus must be physiologically and anatomically adequate.
- There should not be the presence of circulating factors capable of disrupting normal implantation and placentation, nor the absence of specific factors required for endometrial receptivity.
We check for chromosomal problems in both the partners and plan further treatment. Any chromosomal abnormality will require need for pre-implantation genetic screening or diagnosis using the embryos prodcued by IVF.
In order to transfer genetically normal embryos into the uterus , we need to check the genetic makeup of your embryos. We call this as PGD / PGS. We have been doing PGD in Iswarya Chennai routinely to help such couples. You can learn more about PGD in the above mentioned link. IVF is done and the resulting embryos are cultured till blastocyst stage. Few cells from the blastocyst are removed using laser hatching and sent to genetic laboratory. We use NGS (Next Generation Sequencing) platform which is the most advanced method available in the world to do aneuploidy screening. The embryos will then be frozen separately. The frozen "normal" embryos will be transferred to the uterus after the result is ready. With this method we have been getting extremely good pregnancy results.
There are unique problems in women with Endometriosis undergoing IVF.
- Abnormal endometrium
- Progesterone resistance
- Numerous changes in endometrial gene expression occur with ovarian stimulation as well as with the presence of endometriosis.
- The endometrium may be simply too abnormal for some women with endometriosis to have a receptive endometrium in the stimulated cycle.
- Normalization by anovulation
- Personalised deferred embryo transfer
- Endometriosis often remains undiagnosed with the present day infertility evaluation. Hence routine deferred Embryo transfer will help to assure a receptive endometrium.