After a failed IVF cycle, couples should prioritize healing emotionally before deciding whether to try again, as a failed treatment reveals critical information about fertility.
A couple should take the time to heal emotionally from the disappointment of a failed IVF cycle before deciding whether or not to try again.
— Positive Parenting In vitro fertilisation has helped thousands of couples in Malaysia to conceive and complete their family. These couples often become confused and worried about their path ahead. I have always told all my patients that IVF is their final test, the results of which reveals a lot about their own fertility.
Thus, a failed IVF cycle should be viewed as a step in understanding your body better and improving your chances of conceiving in your next attempt. Theoretically, IVF should result in a pregnancy every time a good quality embryo is created. The reality is that many of the embryos created in an IVF cycle are not capable of resulting in a pregnancy.
That is the reason why women with low egg reserve tend to need more than one IVF cycle to create an embryo that can successfully implant to become a pregnancy. There are a few common reasons why IVF can fail. Not all embryos created are genetically normal or capable of implantation. Implantation problems are also a significant factor preventing IVF success.
Even though there are tests that predict endometrial readiness, they are not perfect yet and the science is still evolving. Underlying medical conditions such as endometriosis, adenomyosis and uterine fibroids tend to lower IVF success rates. This makes it difficult to find a reliable and consistent solution. Damaged sperm cells can contribute to an abnormal embryo, even after successful fertilisation.
If IVF fails, the couple will experience disappointment, frustration, and sometimes, guilt. First of all, as a couple, you should take your time and speak with each other openly about how each of you feels. Healing emotionally helps you see your path clearly, and you will be better prepared for your next step. An IVF treatment reveals more information than a typical fertility test.
The IVF laboratory will be able to assess the fertilisation capacity of the sperm. Typically, in a post-IVF review session, I will discuss with the couple about their IVF stimulation response, percentage of ovarian follicles with eggs, egg maturity, sperm quality on the egg collection day, and embryo/s grading and development. During this review session, we might be able to identify infertility factors or clues that need improvement or adjustment to help them succeed in their next IVF cycle.
Once the post-IVF cycle review is complete, further tests or remedies can be recommended for the couple’s consideration. For a couple who still have frozen embryos, the focus will be on either the remaining embryo/s or the womb. For those who may need to restart a new IVF cycle, the focus should be to improve the egg and sperm quality. Hysteroscopy is a procedure where a telescope is introduced into the uterine cavity.
This direct visual examination may provide more information about the uterine cavity, such as uterine polyps that were not detectable on an ultrasound scan. It may also provide evidence of possible uterine infection known as endometritis, which can be treated before an embryo transfer. For a couple with multiple unsuccessful embryo transfers, they can consider a blood test for Beta 2 Glycoprotein 1 antibody, which is associated with autoimmune-related miscarriage, thrombosis and infertility.
If the titre of the antibody is high, the woman may need oral and injectable medications as part of her embryo transfer plan. Endometrial receptivity tests have also been used to assess the window of implantation for the woman.
However, current studies offer mixed evidence about its effectiveness in improving live birth rates in IVF. Pre-implantation genetic testing can also be considered for couples who still have remaining frozen embryos. The aim is to choose a “genetically-normal” embryo, which may have a much higher chance of implanting.
However, couples who are considering PGT-A should also discuss with their fertility specialist about the disadvantages of PGT-A, especially false positive and false negative results. PRP is prepared using the woman’s own blood, which is centrifuged in a specially-designed tube to separate the plasma from the blood cells. By releasing growth factors, it enhances endometrial thickness and receptivity. It is a specialised hyaluronan-rich transfer media used in frozen embryo transfers.
Couples should also focus on improving their lifestyle choices. Maintain a healthy weight; avoid smoking, vaping and excessive alcohol; manage stress and sleep quality; and eat a balanced diet as much as possible. These changes can improve egg and sperm quality, especially if you are considering another IVF cycle. Medically speaking, the woman can start her next treatment cycle the following month.
However, the actual timing will depend on the woman’s psychological recovery and the remedies that have been outlined by her doctor. The subsequent embryo transfer and IVF cycle might be different from the first attempt. There could be a different regime to prepare the uterus lining for embryo transfer, on top of additional medications to support the uterus.
Furthermore, support medications to improve egg and sperm quality could also be started for few weeks before beginning the new IVF cycle. If your IVF has failed, it is understandable to be discouraged and disappointed. Look for lessons that can be learned from the failed cycle to guide your next move. All the best on your fertility journey.
Dr Agilan Arjunan is an obstetrician and gynaecologist, and fertility specialist. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice.does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column.disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
IVF Failed Cycle Healing Emotionally Guilt Disappointment
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