Recurrent IVF Failure – The Numbers and Causes

IVF or In Vitro Fertilisation – probably the fertility treatment most people have heard about – is a safe and effective assisted reproductive therapy (ART) that has helped millions of couples struggling with infertility to have the families they dreamed of.

However, not every IVF cycle is a success, and in many cases, couples require more than one cycle of IVF treatment to achieve a pregnancy. Sadly, some couples also experience recurrent IVF failures.

Speaking at the recent Fertility Show Africa 2023, Medfem’s Dr Tony Rodriques provided insight into the numbers of patients affected by recurrent IVF failures and what causes this to happen.

IVF treatment is a process of assisted reproduction therapy (ART). During this process – in very simplified terms – the egg and sperm are fertilised outside of the body to form an embryo, which is then transferred to the uterus to hopefully implant and become a pregnancy.

Over the last 30 years, IVF has helped millions of couples around the world to become parents. In fact, since 1983, IVF has been the standard treatment for infertility and more than 8 million babies have been born worldwide as a result of IVF treatment. The success rates of IVF treatment are now comparable – and even superior – to those of nature.

However, not every IVF treatment cycle is successful, and for many couples, more than one IVF treatment cycle is required. There are also cases in which patients experience recurring IVF failures.

At Medfem Fertility Clinic, we do everything in our power to prevent recurrent IVF failures with specialised protocols and this is reflected in our excellent success rates.

Speaking at the recent Fertility Show Africa 2023, Dr Antonio (Tony) Rodrigues – a reproductive medicine specialist and a founder and director of Medfem Fertility Clinic in Sandton, Johannesburg, South Africa – provided insight into the numbers of patients affected by recurrent IVF failures and what causes this to happen.

Recurrent IVF failure – in numbers

Many patients want to know what the chances are of having recurrent failure if they undergo IVF?

Dr Tony explained that if we look at the worldwide statistics, the chances of having recurrent IVF failure are around about 10%.

This is encouraging news, because among all the patients who undergo IVF each year all around the world, just one in ten will experience recurrent IVF failure. So, it is important to realise that recurrent IVF failure is not something that happens to every couple receiving IVF treatment, but only to a small group of IVF patients.

It is also important to realise that the chances of success increases – not decreases – with each IVF cycle.

The success rate for a single cycle of IVF treatment is around 20%, which is close to the rate of natural conception in couples with no fertility challenges. However, over three cycles of IVF treatment with tested embryos, the pregnancy rate increases to as high as 92.6%.

In addition, to understand the numbers, it is also crucial to understand how recurrent IVF failure is defined, who is likely to experience it and why it happens.

How is recurrent IVF failure defined?

Recurrent IVF failure is generally not well defined. At Medfem Fertility Clinic, the definition from the American Society for Reproductive Medicine (ASRM) is used: where patients have experienced three failed embryo transfers with high quality tested embryos, it is referred to as recurring implantation failure.

What causes recurrent IVF failure?

Most IVF failures are a result of abnormal embryos which results in failed implantation.

Successful implantation requires a number of factors and steps. The first is a high-quality blastocyst, which is a 5-day-old embryo (fertilised egg) that consists of an outer cell mass which creates the placenta and an inner cell mass which creates the baby.

The only way to determine if an embryo is normal is to have it tested. They can look normal under a microscope and even be graded well, but only testing can reveal if they are chromosomally normal.

The next step is that the embryo hatches and that often happens even before the transfer. And then three important things need to take place: the first is that the embryo must come close to the lining of the uterus. The second thing the embryo needs do is to attach itself to the lining. And then, the third thing that needs to happen, is that the embryo actually has to penetrate the lining to make a space for itself and to become a pregnancy.

If any of the factors or steps described above go wrong, the implantation – and therefore the IVF cycle – will fail. Only normal embryos are able to grow and implant successfully.

For this reason, at Medfem Fertility Clinic, we do extensive testing before an IVF treatment cycle, and also implement special protocols where a patient has previously had a failed IVF cycle, to limit the number of people experiencing recurrent IVF failure.
However, sometimes, patients still have to go through more than one IVF cycle before a pregnancy is achieved.

This is because even if pre-implantation genetic testing is done, and the embryo tests chromosomally normal, it doesn’t mean there is nothing wrong with it, since there are other aspects that can’t be measured, such as the genetics between the parents and micro deletions, among other things. In addition, research shows that as an egg develops in the cycle, it can become abnormal egg, depending on the environment.

So that is why, even with tested embryos, some patients will fall pregnant with the first IVF cycle, others will fall pregnant with the second IVF cycle and by the third IVF cycle, the pregnancy rate is more than 95%.

Who is likely to experience recurrent IVF failure?

It is also true that of the 10% of IVF patients who experience recurrent IVF failure, most are older women.

In fact, age is the most important determining factor of IVF success. This is because the younger the female partner is, the better the quality of her eggs. At an advanced maternal age (35+) the number of normal eggs that have normal chromosomes is significantly reduced.

Another group of patients likely to experience recurrent IVF failure are those couples in which one or both partners have poor lifestyles that affect their health negatively. This is because a healthy embyo requires both a healthy egg and healthy sperm.

All patients undergoing their first IVF cycle, but especially those who have experienced IVF failure, need to manage their general health and make the lifestyle changes that improve general health and improve the health of their eggs and sperm. This includes following a nutritious diet, taking the health supplements, avoiding smoking, drugs and alcohol, and managing stress and lifestyle diseases such as high levels of insulin (hyperinsulinemia) or prolactin (hyperprolactinemia), as well as thyroid disease (hypothyroidism) and endometriosis.

Have you experienced IVF failure?

Whether you have already experienced a failed IVF treatment cycle or if you would like to improve your chances of avoiding a failed IVF cycle, we invite you to meet one of our specialists.

Simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.

Our Fertility Specialists can also meet with You During a Virtual Consultation Via Zoom or Skype. Click here to book a virtual consultation now.

We look forward to meeting you at Medfem Fertility Clinic!


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