Five Top Reasons For Recurring IVF Failure

In a recent video, Dr Johan van Schouwenburg, one of Medfem Fertility Clinic’s fertility specialists, shared his insights regarding realistic expectations about IVF treatment, and the reasons for recurring IVF failure.

Dr van Schouwenburg, a founding member and director of Medfem Fertility Clinic, is nationally and internationally recognised as a pioneer and innovator in the field of infertility treatment. Along with Professor Kruger, Dr van Schouwenburg performed the first IVF treatment in South Africa at the Tygerberg Hospital in 1983. Since then, he has remained at the forefront of the development of infertility services in South Africa for over 30 years and personally treated many thousands of patients with infertility problems.

In this article, we look at the five top reasons for recurring IVF failure and how the team at Medfem Fertility Clinic deliver superior IVF success rates.

IVF pregnancy expectations should be realistic. While the parents-to-be should be optimistic, the reality is that it can take up to five embryo transfers before a pregnancy is achieved, and this success depends on a great many factors.

However, based on his extensive experience Dr van Schouwenburg shared the most common reasons for repetitive IVF failure. These are hormonal disorders, uterine abnormalities, hydrosalpinges, endometriosis and severe sperm abnormalities.

A brief look at each of these reasons for recurring IVF failure is provided below.

1. Hormonal disorders

Hormonal disorders such as disorders of the thyroid gland and insulin resistance are top of the list.

Autoimmune diseases like hypothyroidism can play a significant role in recurrent IVF failures. For women, the effect of hypothyroidism on fertility is evident in a lack of proper ovulation and/or a very thin or very thick lining in the uterus. Hypothyroidism also causes poor egg quality which causes problems with the ability of the sperm to bind to the egg, and to fertilize the egg naturally. This further results in poor quality embryos. In addition, a very thin or thick uterus lining is not receptive to an embryo implanting. These factors lead to infertility or recurrent miscarriages. Thyroid antibodies in a woman’s body are also associated with problems with the ability of the uterus to respond properly to estrogen, progesterone and the implantation of an embryo; and are also markers for other immune causes of recurrent implantation miscarriages and reduced live birth rates.

In men, the effect of hypothyroidism on fertility is evident in an abnormal semen analysis and problems with the sperm motility and count.

Another common autoimmune disease – hyperinsulinemia – affects both the female partner and the quality of her eggs, and the male partner and the quality of his sperm. In addition, it negatively affects the uterine environment, making successful implantation of the embryo less likely.

2. Uterine abnormalities

Uterine anomalies are anatomical problems with the uterus. Some uterine anomalies do not require any treatment, but others may cause irregular periods or no periods, recurrent miscarriage, and infertility, as well as problems delivering during pregnancy.

Fibroids are common abnormalities in the uterus and a known cause of infertility and miscarriages in women. While some women suffer no symptoms from having fibroids, unfortunately, for others, fibroids can cause a great deal physical discomfort, including heavy bleeding during a period, pelvic cramping or pain with periods.

The uterus must be free of fibroids in order for an embryo to grow and develop successfully. When there are fibroids in the uterus, and especially if there are fibroids directly below the uterine lining, they not only take up precious space in and beneath the cavity of the uterus, but they also limit the blood supply to the foetus.

3. Hydrosalpinges

Hydrosalpinges refers to infected water blocking fallopian tubes, which are crucial in achieving a pregnancy. If your fallopian tubes are damaged or blocked, the egg and the sperm are prevented from interacting; proper embryo development is impeded; the proper movement of embryos along the tube to the uterus is obstructed; and implantation in the uterus is hindered – all of which can prevent a pregnancy.

4. Endometriosis

Endometriosis occurs when the tissue that normally lines the inside of the uterus, called endometrium, grows on other parts of the body, including the bowel, bladder, rectum and intestines, as well as on the ovaries, fallopian tubes and the outside surface of the uterus.

Many women who have endometriosis experience few or no symptoms. In others, endometriosis may cause a wide range of debilitating symptoms such as pelvic, abdominal and back pain, heavy and painful periods, and infertility.

Some of the ways in which endometriosis can affect fertility include scarring and adhesions that distort the anatomy of the pelvis; inflammation of pelvic structures; scarred, blocked or damaged fallopian tubes; damaged ovaries; changes in the hormonal environment of the eggs; altered egg quality; and impaired implantation of embryos.

5. Severe sperm abnormalities

Most causes of male infertility are usually related to sperm disorders – in fact, damage to sperm production affects two thirds of men who are experiencing fertility challenges. One of the most common causes of infertility in men is damage to the production of sperm resulting in a low sperm count (oligospermia). This can also be associated with reduced sperm movement and abnormally shaped sperm. A severe case of this results in azoospermia, which means the total absence of sperm in the ejaculate.

Severe sperm abnormalities are usually associated with unhealthy social habits and stress.

How to prevent recurrent IVF failures

It is crucial that your fertility specialist should rule out any treatable causes for the failure of an IVF cycle, starting with the common reasons for recurring IVF failures discussed above. These should ideally have been addressed before IVF treatment commenced, but if this was not the case, these issues must be corrected first before any further attempt at IVF treatment.

A failed IVF procedure is an emotional and traumatic experience, it is usually necessary to allow time for healing emotionally and for the ovaries and uterus to normalise. Although it is usually advised to wait at least a month before trying again, it may be possible to proceed as soon as the menstruation starts. Your fertility specialist will guide you in this regard.
At Medfem Fertility Clinic, we minimise IVF failures by ensuring that all of the top five issues responsible for recurring IVF failure, as well as any other potential reasons for IVF failure, are addressed before IVF treatment is commenced.

Our team does this through:

* a thorough physical and sonar examination of both partners,
* blood tests on both partners,
* hysteroscopy and laparoscopy, and
* ruling out genetic abnormalities of embryos before embryo transfer.

If you are considering IVF treatment or if you have experienced a failed IVF cycle, would like to invite you to meet our fertility specialists.

Medfem Fertility Clinic’s team are committed and understanding team of medical professionals, who have the experience, knowledge and desire to provide you with the best chance of a successful outcome at the end of your treatment.

Since the 1980’s, Medfem Fertility Clinic’s team has assisted couples struggling with infertility to experience the joy of parenthood, helping to bring more than 18,000 babies into the world.
Simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244. We look forward to meeting you!

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