In Vitro Fertilisation (IVF) has become a common process that helps couples with fertility issues to conceive. During the treatment, eggs and sperm are combined in a laboratory to create embryos, which are then transferred into the woman's uterus to initiate pregnancy. The success rates of IVF can vary depending on several factors, including the age of the woman, the cause of infertility, the quality of the embryos, and the expertise of the fertility clinic. But let us take a look at it in detail.
Also Read: Choosing IVF In Your 40s: Is It Too Late?
Causes Of A Failed IVF
Dr M Niharika, Senior Fertility Specialist, Kamineni Fertility, Hyderabad, calls IVF a medical marvel that has given hope to millions of couples struggling with infertility. However, she notes that like any medical procedure, IVF success is not guaranteed, and failures can occur. Some of the common causes include:
Age-related factors
“One of the most significant determinants of IVF success is a woman's age,” shares Dr Niharika, adding, “As a woman grows older, the quantity and quality of her eggs decline, leading to a reduced chance of successful fertilisation and implantation.” According to the doctor, advanced maternal age can affect the overall success rates of IVF cycles, making it crucial for older couples to be aware of this limitation. The Society for Reproductive Technology (SART), a professional body based primarily in the US, states that IVF success rates decline specifically after the mid-30’s.
Poor embryo quality
Dr Fessy Louis T, Clinical Associate Professor, Amrita Fertility Centre, Amrita Hospital, Kochi, states, “During the IVF process in the laboratory, the female's eggs and the male's sperm are combined with the goal of generating an embryo. The IVF laboratory operates within a highly regulated environment, aiming to replicate the conditions that sperm, eggs, and embryos encounter within the female reproductive tract. Any minor alteration in the lab conditions can disrupt the natural environment these embryos rely on, potentially leading to their demise and ultimately resulting in a failed conception during that cycle.”
Uterine abnormalities
A receptive and healthy uterine lining is essential for successful embryo implantation. Uterine abnormalities, such as fibroids, polyps, or adhesions, can hinder the implantation process, leading to IVF failure. Implantation refers to the process in which a fertilised embryo attaches itself to the lining of the uterus, known as the endometrium. This critical step allows the embryo to receive essential nutrients and develop further, helping in conceiving.
Also Read: Is It Possible To Get Pregnant Naturally After Undergoing IVF?
Ovarian response
In addition, Dr Niharika shares, “Some women may have a suboptimal response to ovarian stimulation during IVF, resulting in fewer eggs retrieved.” “This can limit the number of embryos available for transfer and reduce the chances of success. Factors influencing ovarian response include the woman's age, ovarian reserve, and individual hormonal variations,” she adds.
Several lifestyle and health factors can also impact IVF outcomes. Poor diet, smoking, excessive alcohol consumption, and high levels of stress can negatively affect fertility and IVF success rates. Additionally, underlying medical conditions such as Polycystic Ovary Syndrome (PCOS) or endometriosis can contribute to IVF failure if not properly managed.
How To Know The Cause Of Failed IVF
Dr Fessy discusses the most important test to detect a failed IVF, which includes semen analysis. It tests for the count of sperm in semen, motility (moving capacity) of sperm, and shape abnormalities. “Sperm with abnormal shapes are poor in quality, and if used to fertilise the eggs, embryo grading is also bad, which leads to IVF failure,” shares the doctor, adding, “In failure cases, Hysteroscopy should be done to look for any abnormalities in the cavity of the uterus, like polyps, the uterine septum, etc. Diagnostic laparoscopy, along with hysteroscopy, can also be done.”
Some advanced tests are also available, called ERA (Endometrial Receptor Assay), DFI (DNA Fragmentation Index), but most are at the experimental level. One can also opt for a genetic evaluation, which may provide some explanation for the cause of IVF failure. Preimplantation Genetic Diagnosis (PGD) is the genetic evaluation of a known disease in the family, such as Down Syndrome, and thalassemia.
Why Not To Lose Hope
Here are some words of encouragement from Dr Niharika to people who had a failed IVF:
"Facing IVF failure can be incredibly disheartening for couples seeking to start a family. However, it is crucial to remember that each fertility journey is unique, and failure does not equate to the end of the road. As a doctor specialising in reproductive medicine, I have witnessed countless cases where persistence and resilience paid off, resulting in successful pregnancies.”
“I encourage every couple going through a challenging fertility journey to embrace a positive mindset and remain open to exploring different options. Support from loved ones, counselling, and joining support groups can help ease the emotional burden,” she concluded.
