In vitro fertilization (IVF) may not always result in a successful pregnancy, leading to disappointment and uncertainty. After an IVF failure, a patient may wonder what comes next and if their doctor will recommend any additional tests. Here are the common reasons behind IVF failure and the potential tests a doctor may recommend to shed light on the situation:
Reasons IVF Might Not Work
Laboratory and Technical Factors
The process of IVF can be complex, and several variables can influence the outcome. From the quality of the eggs and sperm to the fertilization process, a lot can go wrong. Even small missteps in lab protocols, such as exposure to certain chemicals, can harm embryos and cause them to fail to implant.
Pre-existing Medical Conditions
IVF cannot cure underlying medical conditions that may affect fertility. Conditions like endometriosis, polycystic ovary syndrome (PCOS), and low ovarian reserve can reduce the chances of IVF success.
Lifestyle and Environmental Factors
Obesity, smoking, poor diet, and stress may all impact IVF outcomes. Women who are overweight or obese are at an increased risk of IVF failure due to hormonal imbalances and related fertility issues. Smoking can reduce the quality and quantity of eggs and impact embryo development. Reducing stress through meditation, exercise, or other relaxation techniques may improve IVF outcomes.
Embryo Quality
Embryo quality depends on multiple factors, including age, genetic issues, and embryo formation in the lab. As women age, the quality of their eggs decreases. This can reduce the chances of success. Genetic problems and defects in embryo formation can also lead to poor-quality results.
Implantation Issues
Implantation is the process by which the embryo attaches to the uterine wall and grows into a fetus. During IVF, the embryo is transferred to the uterus at a specific time in the menstrual cycle. If implantation does not occur, the cycle may fail. Several factors may affect implantation, including endometrial thickness, uterine abnormalities, and immune system problems.
Ovarian Response
The ovarian response is how a woman’s ovaries respond to stimulation medications given during IVF. These medications encourage the release of multiple eggs to increase the chances of a successful pregnancy. Some women’s ovaries may not respond to the medications or release eggs too early or too late in the cycle, which may lead to failure.
Tests After IVF Failure
Immunological Tests
Immunological testing is a blood test that measures a range of antibodies and immune cells that could be contributing to IVF failure. These tests are done to identify if the body is making antibodies against sperm, eggs, or the implanting embryo. They may also detect abnormalities in the immune system that may hinder pregnancy.
Endometrial Receptivity Analysis
Endometrial receptivity analysis (ERA) is a test to help determine the best time to transfer an embryo into the uterus. This test analyzes the lining of the uterus and the genes expressed at different points of the menstrual cycle. This is to help determine the optimum time for embryo implantation. If the endometrial lining is not receptive, implantation becomes difficult, potentially decreasing the chances of a successful pregnancy.
Hormonal Evaluation
Hormones promote ovulation and a regular menstrual cycle. Hormonal imbalances may impact fertility, and your doctor may require a hormonal evaluation to identify any abnormalities. A hormonal evaluation involves a blood test to measure hormone levels such as progesterone, follicle-stimulating hormone (FSH), estrogen, thyroid, and prolactin. An abnormality in any of the hormones may interfere with the chances of a successful IVF cycle.
Uterine Evaluation
A uterine evaluation involves an ultrasound, saline infusion sonography (SIS), magnetic resonance imaging (MRI), or hysteroscopy. These evaluation types may give insights into:
- Uterine structure and shape
- Presence of fibroids
- Presence of adhesions and scar tissues
- Thickness and texture of the endometrial lining
The evaluation results may help the doctor determine appropriate interventions, such as surgery or medication needed to prepare your uterus for the next IVF cycle.
Genetic Testing
Genetic testing is a comprehensive test to check for genetic abnormalities in the male and female partners. Genetic testing may identify any chromosomal abnormalities, mutations, or predispositions that may cause infertility. If the female partner is diagnosed with a genetic mutation that causes premature ovarian failure (POF), the doctor may explore other options, such as donor eggs for the next cycle.
There Is Hope After IVF Failure
If a patient experiences a failed IVF cycle, they should schedule an appointment with their fertility specialist to discuss the next steps. A doctor may recommend further testing to identify any factors contributing to the IVF failure and develop a customized plan for the next cycle. By undergoing these tests, patients can better understand what interventions can be made for their next IVF cycle.
