Failed first IVF cycle? What’s next?
If your first In Vitro Fertilization (IVF) cycle has failed, don’t feel disheartened. On average, a couple going for fertility treatments takes about three attempts at IVF to get pregnant and if you are diagnosed with any other preconditions that could impact fertility, the number of IVF cycles needed could be more.
A failed IVF cycle is not an indicator for the success of future attempts – we need to understand what went wrong and take corrective measures to ensure success the next time around. There are three prerequisites for a successful pregnancy – a healthy body, a normal uterus, and an embryo that is viable and each of these aspects – need to be looked into in detail to ensure the success of future IVF procedures.
A healthy body
Before starting the IVF procedure, your doctor would have looked into bodily parameters like thyroid, hemoglobin, blood sugar, Vitamin D levels, among other things. There is no harm in doing a recheck to ensure nothing has been missed out and that all the levels are under control. It is important to bear in mind that IVF is not an exact science. There can be a situation where the success of IVF can have limitations. There are conditions that are difficult to diagnose and doctors may go for some empirical treatments which may or may not work not increase your chances of getting pregnant. This includes the use of blood thinners and certain drugs like intra lipids.
A normal uterus
In the process of IVF, the embryo is created outside the female body and is implanted back into the uterus upon maturity. One of the very important factors for a successful IVF pregnancy is the health of the uterus and its acceptance of the embryo.
Doctors need to evaluate the inside of the womb to make sure it is fit and capable of carrying the pregnancy. There is also something called an endometrial receptivity array which can tell you if the embryo was transferred to the womb at the correct time or if any changes are needed with that.
A viable embryo
Every embryo that looks normal may not be genetically healthy or normal from the inside. Even in a young woman, about 40 percent of all embryos created may not be normal and may not lead to a healthy pregnancy.
Today, there are advanced tests that can be used to determine the quality of embryos and select the best quality ones out of the available pool for implantation, thereby increasing the success of IVF cycles and also of having healthy IVF babies which are free from genetic anomalies.
These are some of the things that you need to discuss with your doctor. Beyond this, there is also an element of luck involved. Even after all the technologies and advanced interventions, we have not been able to reach more than 55 percent success rates for an IVF cycle. Even when everything looks fine, the cycle could fail.
This can be negated by repeated cycles. Patients with more adverse factors such as advanced age of the woman, or poor quality sperms, or pre-existing conditions such as endometriosis, PCOD, etc will require more IVF attempts to get a successful pregnancy. Such couples need to be more patient with the process of IVF and be prepared for multiple cycles.
Dr. Rajeev Agarwal is a Fertility Expert, Laparoscopic Surgeon, Aesthetic Gynaecologist, and Director of Care IVF, Kolkata. He is also the Director of International Fertility Academy and a podcast artist on issues of women’s health.