Has someone undergone IVF, but it failed without being able to find out why? Despite following the in vitro fertilization treatment steps closely, a failed cycle can still be confusing, since there are a number of biological events that need to happen in order for the treatment to be successful. Medicines have to work, fertilization has to happen, development of the embryos has to take place, and an embryo has to implant in the uterus. These steps can be influenced by age, egg quality, sperm quality, embryo development, condition of the uterus and other factors. Knowing about these potential causes can guide patients to have an even clearer conversation with a fertility specialist and determine the next course of action.
Egg Quality and Age
The effects of age on fertility treatment are significant. In older women, the eggs will not be as plentiful or good. Also, older women are more likely to have chromosomal abnormalities in their eggs. These alterations can involve the process of fertilization, embryo development and implantation.
Not all eggs retrieved make good embryos. In an in vitro fertilization treatment, eggs also have to go through several stages of development, after being matured and fertilized. Some eggs will freeze and stop developing at a variety of stages. This will not always yield the same number of embryos for collection when several eggs are retrieved.
Problems With Fertilization and Embryo Development
An egg and a sperm cell need to be able to unite to form an embryo. Even if the eggs and sperm seem to be suitable, fertilization may not happen at times. This can be affected by egg maturation, sperm quality and other biological factors.
Physicians might check fertilization outcomes to get a sense of whether the problem was happening prior to the start of the embryo developing. Sometimes fertility experts will talk about lab procedures which can help with getting pregnant. The right answer will depend on the diagnosis and history of the patient’s treatment.
Implantation Failure
Once the embryo has been transferred, it needs to attach to the uterine lining to start a pregnancy. Several biological processes must function to achieve successful embryo transfer and thus implantation.
If there is no implantation, the pregnancy test will be negative. When repeated implantation issues occur, doctors can review the quality of the embryo, uterine health, hormone support and factors related to previous transfers. A healthy-looking embryo may also have a chromosomal abnormality. Such abnormalities may decrease the likelihood of successful implantation or pregnancy. Generally, the chances of chromosomal abnormalities rise as a woman ages.
Uterine and Endometrial Factors
The condition of the uterus can also impact implantation. Certain fibroids, polyps or adhesions may distort the uterine cavity. If the history of treatment indicates a potential uterine problem, imaging or other evaluations may be indicated.
The lining of the uterus must be appropriate for the embryo to implant. During the process of fertility treatment, progesterone is very significant in preparing and sustaining the endometrium.
Sometimes there is a problem with the uterus, but IVF does not fail. Specialists will take into account embryo quality and other factors before suggesting other treatment options.
Male Factor and Sperm Quality
IVF doesn’t eliminate all the impact of male fertility factors. The sperm count, motility, and morphology may affect the process of fertilization and embryo development.
Sometimes, the problem with fertilization or embryo development can be attributed to sperm related factors. A semen analysis can offer the physician information on the health of the sperm and can help determine the possible contribution of male factors.
Ovarian Response and Treatment Factors
Not all patients have as many eggs as they are supposed to have following ovarian stimulation. The number of eggs retrieved may vary with age, ovarian reserve, response to treatment the patient has had before and individual biology.Polycystic ovary syndrome may have an impact on reproductive function and ovulation. Careful planning must be done when using fertility treatment, as doctors have to balance production of eggs with the safety of the patient.
Depending on the diagnosis and treatment, in selected patients, ovulation induction in PCOS may be a part of fertility management. Patients must talk with a fertility specialist about the right path to take for them and their individual situation.
Other Health and Lifestyle Factors
Some diseases may impact the success of pregnancy and fertility. Some thyroid disorders, diabetes, endometriosis and reproductive conditions must be managed correctly prior to or during fertility treatment.
Other factors such as previous surgeries, medicines, weight and reproductive history may also be taken into account when looking at an unsuccessful IVF. Having an underlying health condition does not mean IVF is not possible, but it is important to manage underlying health conditions for safer treatment.
Medications, supplements, smoking, alcohol consumption and other lifestyle factors should be discussed with a healthcare provider.
Fertility Awareness and Treatment Understanding
Patients can better communicate with their doctors about their reproductive health if they understand what to expect from their periods, their own and others, the age-related changes to fertility, and ovulation.
Fertility awareness education can empower women to know their cycle and be more involved in decisions about fertility treatments.
But there are other reasons for IVF failure that cannot be determined with fertility awareness. Even if treatment for fertility is unsuccessful, the medical assessment plays a significant role.
It is also important for patients to know that fertility treatment is always customized for the individual. What is effective for one patient may not be effective for another.
Conclusion
Failure of an IVF cycle may be due to poor egg quality, fertilization issues, embryo development, implantation issues, poor sperm quality, uterine issues and lack of ovarian response. For certain patients, an ovulation induction in pcos can help determine the possible cause and may be used as an alternative to or before IVF. Patients can seek individualised fertility advice from PHS Fertility Clinic and share their fertility history with a trained fertility expert.
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