N owadays, there are many patients who are undergo various IVF cycles but still are unable to conceive. These patients undergo many IVF cycles and produce the embryos , but due to some or the other reason they fail to implant. This inability of implantation is referred to as IVF failure or implantation failure. This is a frustrating problem for both the patients as well as doctors. For few females, the embryos are of good health, but still fail regularly during implantation due to unexplained reasons . Due to the irregular failures, they are referred to as repeated failure patients. This is just a black box diagnosis as doctors are not aware the adequate reasons why the implantation of embryos is not successful in cases of these females.

Am I a patient of repeated IVF Failure

If you have a problem at multiple times with the implantation of embryo, then you are considered to b e a patient of repeated IVF failure. You are also designed to be its patient if you experience no positive pregnancy test in these scenarios:

  • After at least two treatment cycles with the transfer of either fresh or thawed embryos
  • In all at least four transferred embryos
  • With good quality embryos

Reasons of Repeated IVF Failure

There are several reasons identified which explains the reasons of failed implantation. Failed implantation can be due issue in the endometrium cells, to the embryo, or to a lack of communication between the two.
The other causes identified are as mentioned below:
• Systemic maternal factors
• Endometrial receptivity problem
• Difficult embryo hatching
• Difficult embryo transfer
• Attempted pregnancy at advanced age
• Good embryo development up until cleavage stage but failure at blastocyst level
• Genetic factors of prospective parents

Diagnosis of Repeated IVF failure

Repeated IVF failure is diagnosed by the review of the medical records by the fertility specialist. Hence it is important to show the records of the medical history to the doctor, to diagnose better on embryonic development and embryo quality after IVF/ICSI.

Next level after the diagnosis of Repeated IVF failure

The treatment and the next steps depends on the reasons identified behind the failure. On the basis, the following are proposed by the doctors:

  • Monitoring of the embryo transfer to optimise implantation in the uterus
  • Application of assisted hatching to facilitate implantation of the embryo in the endometrium
  • Blastocyst culture to be performed to see the capacities of the embryos to survive until 5th days of embryonic development.
  • Performance of laparoscopic to rule endometriosis.
  • Monitoring the receptivity of the lining of the womb(endometrium)
  • Endometrial scratching to be performed in an attempt to augment endometrial activity.

In last, in extreme cases, in spite of best embryo technology being used, oocyte donation can be the option of to provide an alternative for the patients of repeated IVF Failure. Final decisions are made by the joint discussion of the doctors and the patient who are completely aware of the details of t he specific case.