5 causes of failed IVF

First IVF baby was born in 1978 and since then approximately 5 million babies have been born with the help of IVF technique. Success rates of IVF procedure varies from 20% to 80% depending upon many factors. The whole process of IVF is not only an economic burden but also takes a huge toll on emotional & mental wellbeing of the couple. Its really too much distressing for the couple as well the treating doctor when a cycle results with negative pregnancy test. There are many causes of failure of an IVF cycle. Five most important factors are as follows-

1. Poor Quality & Quantity of eggs-

A woman has a fixed number of eggs in her ovaries. This reserve of eggs continue to decline throughout life more rapidly after 35yrs of age. Chances of successful cycle are more in women lesser than 35yrs of age. In women between 35 to 40yrs egg quality and quantity can be improved using antioxidants, DHEAS, testosterone gel etc & various different stimulation protocols. There are many types of injectectable hormones available now-a-days like recombinant gonadotrophins, growth hormone etc, which help in retrieving an adequate number of good quality eggs. Similarly, different IVF protocols (Schedule of injections) have been recommended for improving egg retrieval in women with poor egg reserve. Finally, when nothing is workable then there is an option of egg donors which is widely available now a days. Many agencies provide wide range of egg donors depending upon couple's requirement. Special consideration is given to educational background, physical features (resemblance to couple), blood group and other genetic factors.

2. Abnormal Semen count and sperm quality-

There is no relation between a man's age and sperm quality, but there are many factors causing decrease in sperm count and motility. Most of the causes are treatable and can give good result with IUI ( insertion of washed sperms in uterus through a tubing). Even in couples with severe sperm abnormality IVF proves to be a boon allowing fertilization through ICSI. In males with complete absence of sperms due to obstructive azoospermia TESE( Extraction of sperms from Testes) is also very beneficial. Swim up technique, HA binding etc are very helpful in improving success rate of IVF cycle in such patients.

3. Poor Lining in Uterus -

Even a  good seed needs a fertile soil to grow. Similarly, an A grade embryo needs a receptive endometrial lining of uterus to implant and progress into a successful pregnancy. Most of the cases of repeated IVF failures have problem with uterine lining. With the advancement of technology, there are many options e.g. PRP, Gcsf, stem cells etc, for improving lining thickness and enhancing receptivity of uterus.

For couples with repeated implantation failure, there is an option of ERA (Endometrial Receptive Array) which tells us about appropriate window of implantation in uterus. This way embryos are transferred only after confirming receptivity of endometrium, which in turn enhances the chances of positive pregnancy result in that cycle.

4. Adenomyosis, Polyp, fibroids etc -

Any abnormality in uterus may cause failed IVF cycle. While polyps, fibroids are easily treatable conditions hysteroscopicaly, the problem of adenomyosis needs a balanced management. Mostly long suppression of body hormones with injections is quite helpful in minimizing adenomyosis thereby increasing success rates of IVF. Sometimes, surgery especially in localised Adenomyosis is recommended for better results.

5. Genetic Abnormalities -

In most of the cases of unexplained infertility, certain underlying genetic abnormalities are the culprit. Now a days, we have the options of PGS (Preimplantation Genetic Screening) & PGD (Preimplantation Genetic Diagnosis). These tests are done in embryos and help in selecting healthy embryos, thereby improving success rates of IVF