What is IVF Cycle

IVF is a procedure where we take out eggs from a woman’s ovaries and fertilize them with sperms from her husband in an IVF lab. Embryos are grown in the laboratory for 3-5 days and then good quality mature embryos are placed inside the lady’s womb. This way pregnancy can be achieved in couples who have been married for quite long and are unable to conceive a pregnancy.

Even then many of them are not able to get positive results. Then obviously we all are very much disappointed that even after undergoing such an expensive procedure the result is negative. Today we are going to discuss various reasons behind the failure of such an IVF cycle. A most important factor as we all know is the competence of the Gynaecologist and quality standards of the laboratory.

I know most of you have ensured before starting the IVF cycle. Following are the reasons behind failed IVF cycles-

Number and Quality of your Eggs

A woman’s egg quality plays a major role in determining the quality of embryos being formed. And obviously greater the number of eggs, more will the number of good quality embryos to an extent. Egg quality though depends mostly on the age of the woman. But we can improve egg quality by taking antioxidants, vitamins, etc and improving our diet, making it rich in fruits, vegetables, dry fruits, etc & avoiding alcohol, smoking (both active & passive).

Sperm count and morphology

Sperm motility issue is resolved with IVF. As nowadays we are doing ICSI for almost 100% cases. So the only requirement is a normal-looking sperm even if the number is very low. Again, our dietary habits and lifestyle play a major role in determining the quality of sperms. Antioxidant supplements along with abstinence from alcohol, tobacco & smoking can really bring drastic improvement in semen parameters.

A Number of Quality Embryos

First, we need to know how many of the eggs got fertilized and after that how many of them are able to grow into good quality embryos. We all know that the success rate of Day 5 Transfers is higher than Day 3 transfers. Day 5 embryos are known as Blastocysts. Nowadays we are doing Day 5 transfer only in almost all of the cases.

The Thickness of the Uterine lining

Uterine lining like for a good quality seed to grow we need fertile soil. Similarly, for a good quality embryo to get implanted in uterus we need a good thickness of lining inside the uterus. It is called the endometrial lining. We can measure it on ultrasound. The thickness, pattern, blood flow, etc there are many factors that determine the success rate of an IVF cycle. Many times we do hysteroscopy also in the month prior to transfer. Here we put in a camera inside the uterus and directly look at the endometrial cavity where we are going to put in the embryo. In case there is any problem like adhesions, polyps, etc we can correct those problems then and there only.

Role of PGS

This new technique helps us in identifying embryos with an abnormality in their DNA. As a result, we can select genetically normal embryos and then transferring such embryos helps us in achieving much higher success rates for IVF cycles.

Role of ERA

Many times couples come to us with multiple failed cycles. When we are assured that good quality embryos were transferred in a uterus with adequate normal thickness of the lining and even then pregnancy result is negative, then we do ERA for such patients. It is a procedure we prepare the uterus for embryo transfer as usual and on the day of transfer instead of putting in the embryo we take out few cells from inside the uterus and send it to the lab for examination. This tells us what’s wrong with the cells at the microscopic level because of which embryos are not getting implanted. Many times thickness is good but physiologically that lining is either very fast-growing or very slow-growing. As a result, when we are transferring embryos according to normal timing, the lining is actually not in that phase and embryo is not able to implant. This technique helps in determining accurate timing when we need to do the embryo transfer.

All these techniques help in achieving almost 90% success rates in IVF cycles nowadays.