Dealing successfully with a failed IVF cycle

The majority of couples take it for granted that they will conceive naturally when they decide to start a family.

However, conceiving is not always instant. In fact, on average, for every 100 couples trying to conceive naturally, 84 will conceive within one year, 92 will conceive within two years and 93 will conceive within three years.

For one in six couples in South Africa, however, it is not as easy as all that. Most of these couples will need some fertility treatment intervention to allow them to conceive and carry a baby to term.

In Vitro Fertilisation (IVF) is the most successful form of fertility treatment. At Medfem Fertility Clinic, we have a 52% success rate per embryo transfer for IVF and ICSI in women under the age of 36.

However, it is very important to understand that that it is common to undergo an unsuccessful IVF cycle. Although IVF success rates are improving all the time, it can often take a number of cycles before a patient will see a successful outcome.

What could cause a failed IVF cycle?

A genetically normal embryo and a receptive uterine lining are required for a successful embryo implantation that will make a healthy baby.

In more than 95% of IVF failures, the cause is the arrest of the embryos. About 95% of the final quality of an embryo is due to egg quality. Poor egg quality always leads to poor embryo quality and embryos from low-quality eggs often fail to implant. If the egg quality is poor, an IVF cycle can be unsuccessful even with good numbers of eggs and embryos.

The embryonic arrest is quite often also due to chromosomal or other genetic abnormalities in those embryos that made them too ‘weak’ to continue normal development and sustained implantation. At Medfem, we can do preimplantation genetic screening (PGS) for chromosomal status on the embryos before transfer, to ensure the embryos are likely to be competent.

The embryo(s) must also successfully implant in the endometrial layer, which must be thick and vascular to provide nutrients essential for embryonic development. Ideally, the endometrium should measure at least 9mm in thickness or more.

The endometrium is composed of cells that divide rapidly under the influence of progesterone and estrogen. Some women have a poor endometrial lining because they do not have enough progesterone to stimulate and support endometrial growth (called a luteal phase defect) or because of inflammation, invasion of the uterine muscle by endometrial glandular tissue, multiple fibroids, or back-to-back cycles of clomiphene citrate ovulation induction. Treatment with oestrogen and progesterone can alleviate this problem.

Immunologic factors are also known to be a cause of IVF treatment failure. Some of the immunologic factors include anti-phospholipid antibodies (APA), antithyroid antibodies (ATA), and most importantly activation of uterine natural killer cells (NKa). Intralipids and other drugs can be used to control these conditions.

Pinpointing the cause

A failed IVF cycle can provide crucial information for a successful next IVF treatment.

At Medfem, we analyse factors such as egg quality; sperm quality; the stimulation protocol; fertilisation results; embryo development; the embryo transfer procedure; and the endometrium to find the cause of an IVF failure.

By reviewing the cycle to understand the various results, many issues identified in a failed IVF attempt can be addressed in order to eliminate or reduce the likelihood of the same issue occurring in a next try with IVF, and to establish an estimated success rate for this next IVF attempt.

Coping with a failed IVF treatment

Dealing with a failed IVF cycle can be a frightening and hopeless time for many people. After everything you have been through it can be very difficult to accept that there will not be a baby at the end of it all.

If you have experienced a failed IVF treatment, there are things you can do to help you to cope better with everyday life.

Focus on the follow-up appointment

Understanding why an IVF cycle failed can be very helpful in dealing with the disappointment.

In fact, the first thing that should happen after a failed IVF is to meet with a fertility specialist to analyse the range of factors that could have caused the failure. As soon as you are ready, meet with your fertility specialist. Try to avoid making any decisions until then.

During your follow-up appointment, your fertility specialist at Medfem will review the cycle with you to understand the various results and establish an estimated success rate for a second IVF attempt. There may be changes that can be made to the protocols that might help your odds on a subsequent cycle. There may also be further fertility investigations that can be done or new techniques that can be tried.

Look after your relationship

As with any traumatic loss, a failed IVF cycle can take a huge toll on your relationship. Some degree of anger and anxiety can be expected after a failed IVF cycle, but it is important not to let it take over, or it can be destructive. It is also important not to blame each other.

For some couples, the relationship itself can become less important than the goal of having a baby. Remember to nurture your relationship with your partner, spend time talking and understanding each other’s grief, and continue to make time for yourselves as a couple.

Allow yourself time to grieve

For most couples, a failed IVF cycle equates to the loss of a dream which is heart-breaking. It is ok and natural to feel this way. It is also important to take the time to grieve and deal with the trauma, or the feelings won’t go away. Instead, they can grow to dominate every aspect of life. Give yourself time for your head and your heart to heal.

Counselling

A failed IVF cycle can bring a lot of stress to couples, and it is well known that excessive stress has a distinct physical effect on the body, including ovulation being disrupted or stopping altogether.

Counselling with a specialist in fertility matters can be very beneficial – not only to deal with the failed IVF cycle, but also to prepare for the next.

Feeling calm and prepared when going into the next IVF cycle not only makes the treatment more bearable but may well increase the chance of success. For further information visit https://www.medfem.co.za/treatments/counselling-support.

Implement lifestyle changes

Implementing a new fertile lifestyle tells the brain that a new and better strategy is being introduced, and it can therefore expect to have a better outcome. Lifestyle changes could include exercising regularly, managing your weight, quitting smoking, cutting down on your alcohol consumption, avoiding caffeine, and learning new stress management techniques.

The next step

If you have experienced a failed IVF cycle, your next step should be to meet with a fertility specialist.

At Medfem Fertility Clinic in Sandton, Johannesburg, you can meet some of South Africa’s leading fertility specialists. Many of our patients come to Medfem after having failed IVF cycles elsewhere.

Over the last 30 years, our team has helped bring more than 30,000 babies into the world at our accredited clinic that offers advanced facilities; technologies on par with the latest medical advancements and a range of fertility treatments to achieve great success rates.

Setting up your initial fertility consultation to determine the cause of a failed IVF cycle and preparing for a successful next cycle is as simple as clicking here or contacting us on +27 (11) 463 2244.

We look forward to meeting you at Medfem Fertility Clinic!