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Did you know that more than 3 lakh IVF cycles are performed across India annually? Hence, IVF is not 100% successful. Still, advanced technologies have improved IVF success rates and led to thousands of successful pregnancies across India. Sometimes, the whole IVF process seems convincing. The scan looks great; the ovaries are responding well to the medications, and a good number of eggs are being collected.
After fertilization, a healthy embryo seems to develop. The uterine lining can also be suitable while the pregnancy test can come back negative. This can leave couples wondering what went wrong. But a failed IVF cycle doesn’t mean that everything is wrong. Doctors can review the entire cycle thoroughly and examine different aspects of the treatment to identify the cause before planning the next one. But what are the chief causes? Let’s find out!
Do you know that around 26 to 60 per 1000 live births are affected by congenital and chromosomal disorders? It is one of the common misconceptions that if an embryo looks good, then pregnancy tests will be positive. Embryologists can only assess what they see under a microscope. However, it can still carry chromosomal abnormalities that can affect its continued development as the mother’s age increases.
The risk of chromosome-related problems also increases. Therefore, it is important to assess the full embryo history rather than focusing only on embryo quality. It is equally important to understand how many eggs were fertilized, how many embryos were developed, and how many reached the blastocyst stage. It helps doctors understand the pattern and cause of unsuccessful pregnancy in the couple.
A routine uterine ultrasound might reveal important information, but it doesn’t show everything. Scar tissue, various fibroids, polyps, and other changes within the uterine cavity can affect implantation. These changes may not be visible on a basic scan. If there have been multiple unsuccessful embryo transfers, then a fertility specialist may opt for a detailed evaluation of the uterus.
But that doesn’t mean this is the main issue behind all failed IVFs. It is only one of the areas that a fertility specialist assesses when trying to understand repeated implantation failure. A report can say “normal” during a fertility treatment. Still, it does not rule out every possible factor that can increase the chances of a negative pregnancy.
The uterus should be well-prepared before implanting an embryo. Doctors assess how the uterine lining developed during the treatment cycle and how the hormones were used around the time of embryo transfer. Moreover, various thyroid-related or hormone-related issues are pre-assessed by the doctors for the treatment. It is a misconception that after adding test after test, the reason for failed IVF becomes clear. More reports don’t increase the chances of conceiving.
Many fertility tests have limited evidence behind them; the goal should be to identify what’s relevant to the individual patient. “I have seen a couple who underwent 7 IVF cycles. When they visited Seeds of Innocence IVF, Gurgaon, Dr Aditi Bhatnagar and our team focused on identifying more individual-centric issues. We were able to assess the problem, and the couple is finally pregnant after a healthy pregnancy,” Dr Gauri Agarwal, Founder and MD, Seeds of Innocence IVF.
Various reproductive conditions can come into the picture when IVF has failed more than once. Adenomyosis and endometriosis-like conditions can affect reproductive health, and they should be considered depending on a patient’s previous treatment, history, and symptoms. But these are not the only factors that can affect an IVF Cycle.
Every patient has a different medical history, and the same treatment does not work in exactly the same way for everyone. A doctor may consider additional evaluation when there are specific reasons to suspect an underlying condition. Hence, the conversation after an unsuccessful IVF goes beyond whether the uterus and embryo were “normal”.
The most important information is sometimes present in the patient’s previous treatment records. Doctors can review the entire cycle and see what happened at each stage. For example, the total number of eggs collected, embryo development, embryo transfer stages, and the number of failed IVFs. This information can help doctors decide whether the next cycle should follow the same approach or whether something needs to change.
It is often presumed that a failed IVF cycle means the entire IVF treatment has failed completely. A failed IVF cycle provides a lot of information to couples as well as doctors that can be used to fix the next one. The main point is that one unsuccessful cycle doesn’t mean something is wrong with the couple or that they can’t conceive again. There is no doubt that IVF increases the chances of pregnancy.
Still, it cannot guarantee that every embryo will implant and develop into a healthy pregnancy. When everything feels normal, doctors may look beyond the obvious numbers. The aim should be to learn from the past cycle before starting again. That particular review may involve assessing reproductive conditions, hormone preparation, the uterus, the embryo, or previous patterns from past cycles.
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