Causes Of Failure In IVF Treatment

Starting a new cycle will start anticipation and building excitement, you will hope this will be your family's start but you will worry at the same time. An unsuccessful IVF cycle can reveal very upsetting emotions.

The most important factors determining the success rates in IVF treatment are the correct diagnosis of the problem, correct patient selection, and choosing the most appropriate treatment plans and methods for the couples, and individualize their treatment options. Besides these the age of the woman, the duration of infertility, the male factor, obtaining good quality embryos, eliminating the additional problems in man and woman before starting treatment, the experience of the physician are important factors affecting the success.

The factors that cause failure in IVF treatment are

These appear as factors that can negatively affect the success of IVF treatment:

• Age of the female partner,
• The cause of your infertility,
• Poor ovarian reserve,
• Uterine issues,
• Hydrosalpinx in tubes,
• Thin inner layer of womb (thin endometrium) during treatment cycle,
• Presence of endometriosis cysts (endometrioma),
• Severe sperm problems,
• Sperm quality,
• Smoking,
• Being overweight or underweight,
• Long duration of marriage,
• Recurrent IVF failures,
• Ovarian stimulation – dependent on the skills of the physician controlling this process,
• Egg retrieval skills,
• Number of eggs retrieved,
• Egg quality and egg quantity,
• Embryo developmental rates, embryo quality, and rates of embryonic arrest during development in the lab,
• Genetic and chromosomal competence of the embryos.

Lifestyle Factors

What you eat affects the health of you or your partner’s eggs and sperm. Women can decrease infertility risk due to ovulation disorders by 80% with healthy dietary changes. Numerous scientific studies have found improved fertility rates with an IVF diet centred around vegetables, fruits, plant-based proteins, whole grains, fish, monounsaturated fats healthy fats like olive oil and nuts (A Mediterranean diet).

How you exercise can also impact your success with IVF. Moderate exercise (15-60 minutes) can reduce the risk of infertility, and improve sperm quality. Extreme exercise can cause infertility.

We advice to stop smoking at least three months before starting IVF treatment. Studies show that smoking increases your risk for infertility by 13%. Smoking also increases your risk for a miscarriage and can cause birth defects. Women who smoke need twice as many IVF cycles to conceive.

Women who are overweight or underweight are less likely to have successful IVF treatment. If you are overweight, losing as little as 10 percent of your body weight can make a positive difference in your ability to get pregnant.

12 Tips For Couples For A Successful IVF Treatment

Ovarian Response

Sometimes a woman’s ovaries do not respond to the fertility medications strongly enough to produce multiple eggs. Poor response is not a rare occurrence in ovarian stimulation. These patients have lower pregnancy rates compared with normal responders, following a standard ovarian stimulation protocol. Particularly, if a woman is over 37 or has higher FSH levels she may not produce enough eggs to result in a number of embryos for screening and potential implantation. In these cases, the risk of IVF failure increases.

The main reason here is that eggs taken from older women are more prone to genetic defects such as aneuploidies (presence of the wrong number of chromosomes) and contain incorrect or insufficient genetic information required to create a healthy baby. The embryos formed when such eggs are fertilized are also genetically deficient embryos. These embryos will not implant or result in early miscarriage if they are implanted. Rarely, if the birth occurs, the newborn baby may be genetically defective. This clearly shows that embryo competency plays a major role in implantation. Women under 35 using their own eggs for IVF have an implantation rate of about 45 percent. Women 40 to 42 years old using their own eggs have only about a 15 percent chance of implantation. This is why older women require more attempts than their younger counterparts to succeed with IVF.

How Age Affects IVF Treatment Success

Chromosomal Abnormalities

One of the major factors in IVF failure is chromosomal abnormalities in the embryo. These abnormalities are the reason behind most miscarriages as well as failure to implant in an IVF cycle.

In IVF failures preimplantation genetic screening (PGS) is recommend. With the advent of comprehensive chromosome screening, it is now possible to screen all 24 chromosomes (22 autosomes and 2 sex chromosomes) for the presence of aneuploidy. However, the effectiveness of PGS to increase live birth via IVF in clinical practice is still not proven.

Uterine Factors

Problems of the uterus and uterine lining that can cause or contribute to IVF treatment failure or to recurrent miscarriage:

• Uterine Polyps.
• Uterine Fibroids – (medical terminology is myoma or leiomyoma).
• Intrauterine adhesions – scar tissue within the uterine cavity, also called Asherman’s Syndrome. This can interfere with conception, or can increase the risk of a miscarriage.
• Congenital uterine malformations, such as a bicornuate uterus, a T-shaped uterus, or a uterine septum.
• Luteal phase defect – an uncommon condition that involves inadequate development of the microscopic and cellular changes in the endometrial lining of the uterus after ovulation and exposure to the hormone progesterone.
• Thin endometrial lining – this is an uncommon problem. The pregnancy rates are higher when a lining of at least 8 mm in thickness measured by ultrasound at the time of ovulation trigger during the treatment cycle.
• Adenomyosis -Endometriosis in the womb – Adenomyosis is a benign disorder where heterotopic endometrial glands are found in the myometrial tissue of the womb. The presence of ultrasound diagnosed adenomyosis was associated with a significant reduction in successful implantation of good quality embryos in patients undergoing IVF treatment.
• Hydrosalpinx in tubes – Many studies have shown that hydrosalpinx is associated with poor IVF outcome. The mechanism of the actual cause is not yet fully understood. A surgical intervention increase implantation rates in patients with bilateral hydrosalpinges. A preventive salpingectomy (removal of the fallopian tubes by surgery) can be recommended for patients with hydrosalpinges enlarged enough to be visible on ultrasound and in particular for those affected bilaterally.