IVF failure – What’s next?

What are the symptoms of IVF failure? What are the reasons for IVF failure? Should I try again with donor eggs? What if I have IVF donor egg failure or a history of repeated IVF failure? How many cycles are enough? Are there any additional tests I can take? How to get pregnant after IVF failure? Can natural pregnancy happen after IVF failure? These are the questions that many fertility patients ask – find out the answers in this webinar. Watch the recording above for the presentation by Dr Ioannis Koutoulakis, a Consultant Gynaecologist at fertility clinic Serum IVF in Athens, Greece. Dr. Koutoulakis has experience with working with patients after IVF failure and is able to recommend other solutions.

What if my IVF cycle failed?

It’s an incredibly sad fact, but IVF isn’t a given; it can, and indeed does, fail, sometimes repeatedly. Unsuccessful cycles often leave patients feeling disheartened and confused, wondering what their next steps might be, in order to conceive, and fulfil their dreams of becoming a parent. It can be an overwhelming time, searching for answers and trying to find the solutions, which could lead to a healthy pregnancy and live birth. In this webinar, Dr Yannis Koutoulakis, Clinical Director of Serum IVF, in Greece, discusses the range of options available, for anyone experiencing the devastation, failure of IVF treatment brings.

In order to conceive, either naturally or with assistance, three things are required; good quality oocytes (eggs); good quality sperm and an embryo “friendly” endometrial cavity. These all need to happen in conjunction, taking place at the same time, with Dr Koutoulakis stating that, in addition to these three elements, “a matter of luck” is also required, for human reproduction.

There are, of course, many factors that play a role in achieving the optimum quality of eggs, sperm and uterine cavity; the immunological and hormonal health, of both parties, any chromosomal abnormalities and medical history, to name just a few. Fortunately, clinics can now run a whole range of tests, with screening taking place, in order to help provide answers and create a tailormade programme, for each couple, after many failed attempts. Following a cycle of IVF, Dr Koutoulakis advises that medical specialists are able to understand, with greater clarity, the condition of a woman’s eggs, by looking at the appearance of the oocytes retrieved, how many were collected and how they fertilised. This information can then be used to form a more detailed medical picture, around a woman’s fertility, and determine whether any different, or additional, protocols should be suggested, for future rounds of IVF.

Egg quality and age

If egg quality has decreased, due to, perhaps, maternal age, medical conditions or illness, it can, sometimes, be improved, with supplements, such as folic acid and / or melatonin. However, Dr Koutoulakis warns not to expect miracles, and advises that in cases, where oocyte quality is diminished, and IVF has repeatedly failed, the use of donor oocytes are an option, for a successful pregnancy.

Female’s uterine cavity

The female’s uterine cavity should be screened for macroscopic disorders, such as fibroids or polyps, which are known to cause problems with embryo implantation. If diagnosed, these are likely to be correctable, and couples may go on to conceive, with IVF. Dr Koutoulakis would also suggest an intrauterine biopsy or period bleeding test, to screen for the presence of NK (natural killer) cells, or any bacterial secrete toxins, which could also hinder implantation. Again, he advises that, if discovered, these conditions can, usually, be treated, either by medication or surgery, depending on the individual circumstances of patients. It’s also advisable for couples to undergo immunology screening.

Male factor and IVF

Currently, the usual fertility investigations do tend to focus, predominantly, on the woman. However, Dr Koutoulakis is keen to point out that male infertility does pose problems, and Serum IVF treats many couples, requiring assisted conception, due to male factors.

As sperm carries the paternal DNA, which is used in the creation of an embryo, any problems, with the seminal fluid, will have a detrimental effect on the outcome of fertility treatments.

Classic sperm tests provide medical teams with information including, the number; count, appearance; morphology, and how they move; motility. Additional sperm DNA fragmentation and oxidation tests can also offer further insights into a couple’s fertility. In cases of lower quality sperm, supplements and / or medication may be prescribed, as part of a sperm improvement protocol. If no progress is noted, then, once again, Dr Koutoulakis advises that using a donor may be presented as a viable alternative.

For some couples, unexplained fertility is, frustratingly, diagnosed, when nothing abnormal has been found, in either the male or female, following intensive fertility testing.

From the clinic’s experience, Dr Koutoulakis explains that, when IVF failure is recurrent, and there is no confirmed reason, for the infertility, Serum IVF would then recommend treatment should proceed using donor sperm. This has shown to have a positive pregnancy outcome, for clients undergoing treatment within the clinic. Once a full, comprehensive, fertility investigation has been undertaken, doctors can then work, with patients, in order to design a specific, and unique, treatment plan for each individual, be that medication, surgery or the use of donor gametes, in the hope of a successful cycle of IVF, and a healthy pregnancy to follow.