The first IVF cycle is often successfully completed, especially before the age of 35. However, a 100% chance of success is not possible. Many couples will have to repeat the procedure. Because IVF is the greatest hope in the treatment of infertility, a negative outcome can be devastating. Many patients who failed the first attempt are discouraged from trying again. Some give up for financial reasons, and others consider that they have no chance. Many couples are disappointed and frustrated that they have no clear reason to explain their failure and do not know what they can do differently next time to improve their chances of success.
What follows after a failed IVF cycle?
Let at least a week pass, to detach yourself from the emotion of finding out the result and to reorganize your thoughts. When you feel ready, schedule an online or clinical consultation to discuss how the IVF cycle went, the options, and the chances of future treatments.
The quality of embryos and their development potential
The vast majority of embryos conceived naturally or by IVF do not implant at all or stop evolving in the first weeks of pregnancy. The percentage of embryos with abnormal development increases significantly with age.
According to international studies:
- At age 30, 1 in 3 embryos transferred to the uterus implants
- At age 38, 1 in 6 embryos transferred to the uterus implants
- At age 40, 1 in 10 embryos transferred to the uterus implants
- At age 42, 1 in 20 embryos transferred to the uterus implants
- After 44 years, less than 2% of embryos will cause a pregnancy
After implantation, on average 1 in 5 pregnancies is lost through miscarriage in the first 3 months.
Genetic studies on embryos show that over 50% of embryos that evolve normally in the laboratory, up to the blastocyst stage, have chromosomal abnormalities.
There may be other defects besides the genetic ones that cause abnormalities of the embryo.
The age, smoking or obesity of one of the partners increases the risk of embryonic abnormalities, implantation failure or miscarriage, both in natural pregnancies and in IVF.
What can we learn from a failed IVF cycle?
Cu ocazia consultației după FIV, specialistul reevaluează istoricul medical, stilul de viață, investigațiile efectuate și modul în care s-a desfășurat procedura. Informațiile obținute pot ajuta la identificarea unor probleme necunoscute până atunci, la aprofundarea investigațiilor sau la modificarea planului de tratament, pentru a îmbunătăți șansele de succes. Donarea de ovule, spermă sau embrioni pot fi opțiuni viitoare cu șanse foarte mari de succes, dar ele nu se iau de obicei în calcul după primul ciclu FIV nereușit. De cele mai multe ori, există șanse mari ca sarcina să se obțină la a doua procedură. Și în cazul cuplurilor fertile, majoritatea embrionilor nu se implantează; sarcina naturală poate apărea după mai multe luni de încercări. Nu se poate trage o concluzie după primul sau al doilea embrion care nu a evoluat. Adesea, sarcina se obține după mai mulți embrioni transferați în uter, mai ales după 35 de ani.
Why does an IVF cycle not complete successfully?
There is no short and simple answer to this justified question. With current diagnostic methods, we cannot know whether implantation failure is caused by an embryo problem or a uterine problem. Scientific data show that, most often, it is a problem in the development of the embryo.
In rarer cases, the uterine environment may be unfavorable, either due to anatomical problems (fibroids, synechiae – intrauterine adhesions, very thin endometrium), or due to functional problems (hormonal changes, infectious or endometrial receptivity). Most uterine problems can be detected through investigations: ultrasound, hysteroscopy, hormonal tests in the treatment cycle. In case of repeated embryo implantation failure, advanced tests for endometrial evaluation may be recommended: investigation of uterine receptivity (ERA-test), chronic endometritis or uterine microbiome (eg special tests ALICE, EMMA, EndomeTrio).
What can you do?
A failed IVF cycle is not the end of the road. Many patients succeeded after several attempts without changing treatment. For others, it may become obvious that a different approach is needed, such as the use of donated oocytes. There is a solution for everyone.
- Schedule a consultation to review the procedure and future options
- Look for solutions in the Wellness Program to overcome difficult times and improve your chances of success
- Don’t give up without having all the information and without considering all the options
- Do not lose hope!