Currently, the most successful infertility treatment is IVF. This treatment is the answer to overcoming many causes of infertility. In a controllably sensitive process, your doctor uses drugs to stimulate the growth of multiple eggs and then collects the eggs. Your live eggs are fertilized with your partner’s (or a donor’s) sperm in a laboratory environment. As the embryos grow, your doctor inserts the healthiest one into your womb. During this, the embryo(s) will attach and develop into a healthy baby.
However, if the embryo(s) do not attach to the uterus or if you miscarry soon after, IVF may be unsuccessful. Despite how effective IVF is, there are times when the procedure does not result in pregnancy. In fact, IVF failure can occur several times and, as you can imagine, it is incredibly disruptive for couples who intensely desire to have children. (1)
What are Multiple Failures in IVF?
Multiple IVF failures are defined as three or more unsuccessful IVF cycles using high-quality embryos. The phrase describes both infertile people and those whose early pregnancies end in miscarriage. (2)
Repeated implantation failure (RIF) is determined when good-quality embryos cannot be implanted after several cycles of in vitro fertilization (IVF) treatment. (3)
What are the reasons IVF fails?
IVF failure can be caused by a variety of factors, not all of which exclude the chance of future success or are completely attributable to the mother. It is necessary to get to the bottom line of why IVF has failed for you on more than one occasion. (4)
Either maternal or embryonic reasons can lead to implant failure. Thrombophilia, non-receptive endometrium, uterine anatomical abnormalities, and immunological variables are examples of maternal risk factors. Genetic defects or other intrinsic characteristics that limit the embryo’s capacity to develop, hatch, and implant in the womb are linked to a failure of implantation due to embryonic causes.
For IVF patients as well as individuals with RIF, new techniques for faster imaging of embryos and evaluation of their metabolic function may improve embryo selection for transfer and subsequent outcomes. (5)
When is IVF determined to have failed?
When the transferred embryos fail to implant after numerous cycles of in vitro fertilization (IVF) treatment, this is known as repeated implantation failure (RIF). The number of failed cycles or the total number of embryos transferred during these IVF procedures is not, however, defined by any official standards.
As a result, different IVF fertility clinics may utilize various RIF definitions. It is advised that you define RIF as a failure of implantation in at least three consecutive IVF attempts with 1-2 high-quality embryos transferred per cycle, given the current success rate of IVF procedures and the average number of embryos transferred per cycle. (6)
What to do if IVF fails?
Several IVF cycles are necessary for many couples before they are successful. IVF failures on multiple occasions severely harm the participants’ physical and emotional health.
For those who have experienced several IVF failures, doctors advise preimplantation genetic testing. IVF success rates are increased by checking your embryos for chromosomal abnormalities before implantation.
For people whose doctor has established that the age or quality of the eggs was the reason for IVF failure, using donated eggs in IVF is another method to get a successful result. Healthy young women donate their eggs, which are then analyzed in a lab to determine their viability.
If you keep having implantation failure, a surrogate pregnancy may be an option for you. The father’s sperm fertilizes the intended mother’s eggs in a laboratory. The living embryo(s) are implanted by your doctor into the surrogate mother’s womb.
Should I continue after multiple IVF failures?
Deciding whether to continue with in vitro fertilization (IVF) after multiple failures is a deeply personal decision. One must evaluate various critical factors with careful consideration.
Firstly, age and ovarian reserve play a pivotal role in this journey. Generally, younger women with a robust ovarian reserve might find higher success rates in subsequent cycles. Secondly, understanding the root cause of infertility is crucial. This knowledge assists in determining whether pursuing further IVF cycles is a prudent choice. Moreover, considering the number of previous failed cycles is essential. Although success rates tend to diminish with each additional cycle, it’s noteworthy that many achieve pregnancy after numerous attempts. Lastly, the emotional aspect cannot be overlooked. The process is known for being both emotionally and physically taxing. Hence, assessing one’s emotional readiness for continuing the treatment is vital.
In discussions with a healthcare provider, these factors should be thoroughly deliberated to gauge the potential benefits and risks of undertaking more IVF cycles. Alternative options should also be explored:
- Adoption
- Ceasing fertility treatments altogether
Each path offers a different journey towards parenthood or resolving the quest for a family, deserving consideration based on individual circumstances and preferences.
Source:
Sher, G., & Fisch, J. D. (2002). Effect of vaginal sildenafil on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. Fertility and sterility, 78(5), 1073-1076.
