What to do after a failed cycle of IVF
IVF failed - what next for success with the second IVF attempt?
Advanced
Fertility Center of Chicago
Infertility and in vitro fertilization specialists
Gurnee & Crystal Lake, Illinois
Why does IVF fail and what can the fertility
specialist clinic do to increase the chance for success on a second IVF?
A first IVF cycle is often successful at a high quality program. Unfortunately, many couples will
not have successful first cycle IVF results and will need to consider a second
cycle of in vitro fertilization. So what should be next after one failed IVF
cycle? Let a week or so pass in order to make the difficult adjustment to the
devastating news that your cycle did not succeed. When you feel ready, schedule
a consultation with your IVF specialist to go over what might have been learned
from the failed IVF attempt. A very important consideration should be whether to
change IVF doctors or switch to a different IVF clinic at that point. In vitro
fertilization programs are not all equal - some give a much higher chance for
success than others.
See our IVF success rates and links to
the US government report showing success rates for all reputable IVF programs
The first thing that should happen is for the IVF specialist physician to
review the failed cycle carefully to possibly learn something from the results
of the IVF ovarian stimulation process, or from any
issues with egg retrieval, egg quality and/or
quantity, fertilization results, embryo development,
or any problems with the embryo transfer procedure.
Often there will be an issue in one or more of these areas. The ovarian
stimulation protocol and results as well as the embryo development issues should
be discussed with the couple. Pictures of the embryos
and quality scoring issues, including cell stages, fragmentation and regularity
of the cells in day 3 transfer cases, or
blastocyst grading and expansion scoring for day 5 transfer cases - should
also be reviewed and discussed. Then a plan for a second IVF cycle can be
formulated.
Inefficiencies in the IVF process will not always be issues that are "fixable" -
but they should be studied and discussed with the couple so that they are
educated about their situation and their estimated success rates for a second
IVF attempt. Many issues seen in a failed first IVF attempt can be addressed in
some manner in order to eliminate or reduce the likelihood of the same issue
occurring in a second try with in vitro fertilization.
What is the reason that IVF fails?
If there is an embryo transfer done, the reason that IVF fails is because
of implantation failure. However, that is not very helpful at all. We know that
the embryos were transferred to the uterine cavity - particularly if
ultrasound guided embryo transfer is done. When IVF fails there was
implantation failure, but we do not know whether the failure to implant was due
to a problem with the embryos or a problem with the uterus.
Most fertility specialists believe that in more than 95% of IVF failures it is
due to arrest of the embryos. This is quite often due to chromosomal or other genetic
abnormalities in those embryos that made them too "weak" to continue normal
development and implantation. Unfortunately, these issues are mostly a "black
box" at the present time - we do not have a safe and cost-effective technology
currently that would allow us to investigate the chromosomal and/or genetic
issues in a manner that does not damage the normal embryos significantly. PGS or
PGD can be used to investigate chromosomal abnormalities in IVF embryos, but has
been shown in well-controlled studies to lower chances for pregnancy rather than
improving them. Learn more about
PGD for chromosomal
abnormalities (aneuploidy) in IVF
What is the success rate with a second cycle of IVF?
Couples often ask this very reasonable question. However, there is not a
good, short answer. Many couples will have a successful second IVF. The chances
for that happening depends on many factors, including:
In order to maximize the chances for a successful second IVF try make sure
that your doctor has carefully reviewed the issues above. You might also
consider changing doctors between IVF cycles. Some reproductive endocrinologists
(infertility and IVF specialists) are pulled in many different directions and
are not focused on IVF or on having the best possible IVF lab and clinic. Having
an outstanding IVF program requires constant diligence and consistent execution.
This is not an easy proposition - particularly in very large IVF clinic - where
thousands of couples are pushed through annually in a mass production approach.
That approach to IVF works much better for the clinic than it does for the eggs,
the embryos, or the infertile couples there.
IVF failed - what next?
Summary for a second try with IVF:
- Get an honest estimate from your IVF doctor on your chances for
success rates with a second IVF try
- If there were difficulties with the ovarian stimulation or low
numbers of eggs - consider modifications to the drug protocol
- If there were average or good looking embryos for transfer, but none
implanted, try IVF a second time at the same or a different IVF clinic
- If there were significant egg and/or embryo quality issues, it is
most likely due to an egg problem or an IVF lab quality control problem.
Therefore, consider changing the IVF clinic to a program with higher
in vitro fertilization success rates to
see if these issues were due to egg quality - or a problem with the ovarian
stimulation, or a problem in the IVF lab
- Donor sperm, donor eggs, or donor embryos could be future considerations,
but those are usually further down the road than
after one failed IVF cycle
- The uterus can be the problem, but that is rare. Implantation failure
is almost always because the transferred embryos were too weak to implant and
continue normal development. The uterus is almost always receptive for embryo
implantation.
Overall, IVF success rates are about the same on the average for second
attempts as compared to first IVF tries. Couples with the best egg quality are
more likely to get pregnant on their first try, but this is balanced out to some
extent by learning from the first failed cycle and making some adjustments to
maximize success for the second in vitro fertilization attempt. The graph below
from the US government's 2005 CDC report shows national average data on IVF
success by age and whether it is a first try or a try after previous failed IVF
(and no previous births).
Under age 43, IVF success is slightly lower if there have been previous IVF
failures and no success
Related pages:
In vitro
fertilization
IVF pricing
IVF
pricing plan with money back if no baby
IVF success rates
Embryo
quality on day 3
Embryo quality on day 5
Egg
donation
Come here
from out of town for IVF with own eggs
Come
here from out of town for donor egg IVF
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