IVF After Multiple Failed Attempts

In vitro fertilization (IVF) is currently one of the most successful assisted reproductive techniques (ART) treatments that address infertility in couples. IVF starts with the doctor stimulating the growth of multiple eggs using some fertility medication. The eggs are then retrieved from the ovaries when they are properly mature. Then, the eggs are mixed with sperm from either a donor or the woman’s partner leading to fertilization; this is done in the laboratory. 

The resulting embryos are grown in the lab for a few days and then are transferred into the woman’s uterus for pregnancy and the subsequent delivery. That is the ideal sequence of an IVF treatment. However, in some cases, the embryos do not attach to the uterus, or due to certain issues, they are miscarried shortly after implantation. These failures may even occur multiple times and usually, this makes it very difficult for the couple to consider their next steps.

What is Multiple IVF Failure?

In multiple IVF failures, there are three or more failed attempts at IVF with good-quality embryos. The term is also applicable to individuals who fail to get pregnant with a transferred embryo and those who miscarry the pregnancy.

What are the Reasons for IVF Failure?

There are many reasons for IVF failures and many of them will not make future procedures unsuccessful. They are also not all dependent on the female partner. Some of these reasons include:

Quality of the embryo 

This is one of the most common reasons for IVF failures, the embryo, due to one defect or another simply stop developing. This phenomenon is usually due to a genetic factor that was not identified during the preimplantation genetic tests that were carried out on the embryo. This leads to a failure of the embryo to further develop or grow, leading to a failure to implant or an eventual miscarriage.

The eggs 

The quality of a woman’s eggs is affected by age. This is especially so for women that are over the age of 35. This can lead to repeated IVF failures if those eggs are used for the procedure. The eggs of a woman begin to diminish in quality as they age, especially as they approach the age of menopause, making it difficult for viable eggs to be harvested. Women that are under the age of 35 have an implantation rate of about 45%, while women who are over 40 years of age have an implantation rate of around 15%

Chromosomal issues 

These can be a major factor in IVF failure, as seen in natural conception. There is an increase in chromosomal abnormalities in a woman’s eggs from the age of 30. By the time she approaches her mid 40’s, these abnormalities increase by about 75%. There is also an increase in chromosomal abnormalities in sperm as a man ages. Preimplantation genetic testing is aimed at detecting chromosomal abnormalities before the embryo transfer and implantation of an embryo into the uterus. Couples that refuse these tests run the risk of having multiple failures because of genetic abnormalities.

Autoimmune disorders 

These affect a small section of the population, and women make up about 80% of diagnosed cases of these disorders. An autoimmune disorder occurs when a person’s immune system attacks healthy tissue leading to its destruction and inflammation. Examples of autoimmune disorders include Addison’s disease, celiac disease type 1, Lupus, etc. the antibodies that are present in these women with autoimmune disorders can as well prevent the implantation of an embryo leading to multiple IVF failures. Many individuals are unaware of this condition until they begin seeking answers to their inability to conceive.

Lifestyle habits 

The same lifestyle habits that can be an issue in normal conception can also be very detrimental in those that are undergoing IVF treatments. Some of these lifestyle habits that can cause a failed IVF include smoking, alcoholism, poor nutrition, obesity, being significantly underweight, etc. All these factors can significantly affect the chances of IVF success negatively. In women who smoke, twice as many IVF cycles on average are necessary for conception, and they also have a greater chance of a miscarriage occurrence.

What are the Next Steps Following an IVF Failure?

It is normal for some couples for them to have a few cycles of IVF before achieving success. However, it is expected that repeated IVF cycle failures may take an intense emotional and physical toll on the couple involved. The doctor usually gives advice, suggestions, and recommendations on the way forward following failed IVF cycles. They usually also advocate for testing before embarking on the next cycle. This test usually informs the couple of the options that are available to them. 

Preimplantation genetic testing is usually advised for couples experiencing repeated IVF cycle failures. The embryos are screened for any genetic defects or abnormalities that may cause failures before the embryo transfer. This can lead to a higher chance of IVF success. Another option is to carry out the IVF using donor eggs. This option is suggested to those whose physicians have determined that their age or the quality of their eggs is the reason for the IVF failures. A lab will screen the donor eggs for viability, and then harvest them. The eggs can also be gotten from family members or close friends. 

Gestational surrogacy may be a solution for women who experience recurrent implantation failures. The lab fertilizes the intended mother’s eggs with the father’s sperm or donor sperm. The resulting embryos are then transferred the viable embryos into the uterus of the surrogate. Another solution can be intra-cytoplasmic sperm injection in cases where infertility is caused by the factors of the male sperm.