When you have been trying to become parents for a for a long time, IVF can come as a beacon of hope. It has been a path to parenthood for many couples across the globe. Of the couples who have undergone an IVF cycle, most would have been successful, but there would be a few who would have faced a failed treatment.

Dr Anil Chittake, Director and IVF Specialist, EmBrio IVF Centre, Baner, Pune
“In these situations, couples generally go through a roller coaster of emotions – anger, frustration, hopelessness and despair and making one unsure of what should they do next,” says Dr Anil Chittake, Director and IVF Specialist, EmBrio IVF Centre, Baner, Pune.

Let’s take a peek into the success factors of IVF before understanding the next steps of a failed IVF

How Successful Is IVF And What Is The Success Percentage?

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“The success ratio rate for IVF depends on the age of the woman, cause of infertility, years of infertility, type of embryo transfer, quality of the sperm and whether self-eggs or donor eggs were used,” informs Dr Chittake. He says that the success rate is higher when frozen embryos are used as opposed to fresh embryos. Success is higher in younger women, so even when a woman has an embryo transfer, say in her 40s with embryos that were created when she was in her 30s, her chance of success is that of a woman in her 30s. Frozen cycles tend to have a higher success rate as the embryos that survive the thawing process will be more robust, resulting in higher chances of achieving a pregnancy. Donor eggs likewise come from a younger donor who is medically fit and hence tends to give better success rates. Better the sperm quality better the success rate.

Success in IVF is measured in various parameters for audit purposes. The fertilisation rate, implantation rate, clinical pregnancy rate, take home baby rate etc. Of significance is the live birth rate as this is the chance that any couple having treatment will take a baby home.

Irrespective of the age of the patient, a live birth rate of around 30 per cent is considered as gold standard around the world.

What Really Happens When One Has A Failed IVF Cycle?

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A failed IVF cycle doesn’t mean you should not try again – there is still hope
“We have to understand that the probability of a pregnancy after one embryo transfer is only about 40 to 50 per cent, so we need to look at the cumulative pregnancy rate which is approximately 87.5 per cent after three transfers, which is a common finding,” Dr Ruhi Yasmin, Director – Metro IVF, Darbhanga, Bihar, says. 

Dr Ruhi Yasmin, Director – Metro IVF, Darbhanga, Bihar

Also, one of the most common reasons is the age of the woman. As a woman grows older, her body produces fewer eggs and the quality of her eggs deteriorates as well. This number and quality begin to decline when a woman reaches her 30s.There could be other factors at play too, like weight gain, unhealthy lifestyle, poor uterus lining, and/or abnormalities in the interaction between endometrium and embryo.

Experts advise that in such a situation, a couple should support each other while grieving over emotional as well as financial trauma. They should take a break to relax. It is critical to not lose hope as for many couples, their family and friends are involved in this process too. Everyone must understand that one failed cycle doesn’t mean that the next one won’t succeed too.

What Next?

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Have a detailed discussion with your fertility doctor to understand why your first cycle failed to begin with. It is important to know whether the causes are recurrent – and if they can be corrected – and what modifications need to be done before and during the second IVF cycle.

The specialist may either suggest trying the same cycle all over again or additional technologies or medical adjustments can be made like suggested below:
• Different medication protocols
• Genetic screening like PGD/PGS
• Immunotherapy
• Adding in ICSI
• Assisted hatching
• Testing the chromosomal make-up of the couple (karyotyping). The signs of genital TB must be looked for carefully

Apart from understanding the causes and learning how to optimise the success of your second attempt, it’s also important to discuss realistic expectations with your doctor and know how likely you are to get pregnant after your next cycle.

In The Next Attamept…

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While going in for a second IVF attempt might seem like a no-brainer one must keep these three things in mind:
1. Whether or not there are clinical indications for another IVF cycle
2. Your mental and emotional preparedness
3. Financial implications of undergoing another IVF procedure

Yes, You Have More Than Just Two Chances

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When it comes to IVF, one must also know that repetition is the key to success – so one can
really have to look at that cumulative number of 87.5% at the end of three embryo transfers,” Dr Divyashree elucidates.

That said, there are many factors that contribute to how many IVF cycles you as a couple are eligible for. “For repeated embryo transfers, we need to have a good number of embryos resulting from one egg pick-up,” she says, adding: “If we have a good number of embryos from a good number of eggs obtained from a single IVF, then even one cycle can be enough.”

So from a purely medical point of view, you can have as many IVF cycles as the number of viable embryos. There is no upper limit to this number, says Dr Divyashree, stressing that perseverance, mental fortitude, and financial conditions of the couple are the driving factors for more and more cycles.

Before You Go In For The Next Cycle, Avoid These

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There is no denying that failure with IVF can be heart-wrenching. But if you have made the brave decision of going in for another cycle, then it’s important to get things right and avoid some common mistakes, like:

1. Don’t Google too much about IVF: Delving deep into the world of the internet to research about IVF is understandable. But being obsessed with what Google says about success rates, hacks to get pregnant and so on, isn’t going to help. Says Dr Divyashree: “Google cannot replace a doctor. It can, however, give you unwanted information about your medical condition, giving rise to anxiety. And anxiety is not good if you want IVF success.”

2. Don’t take to the bed after an IVF cycle: “Taking bed rest after an IVF procedure is totally unwarranted for,” explains Dr Divyashree. You see, when you move about, you give all your organs a good blood supply. This blood supply is important for the uterus too, especially for embryo implantation. “It is very important to be physically active after an IVF cycle. In fact, contrary to popular belief complete bed rest after a cycle can lead to life-threatening complications like blood clots and embolism,” she adds.

3. Choose a doctor and clinic wisely: A failed IVF cycle might leave you doubting your doctor and clinic’s credentials, wanting a switch. And there’s nothing wrong with that, as long as you choose someone who has the desired experience. “Choose a doctor who has the specified qualifications and experience with infertility and is associated with a reputed IVF clinic with good success rates,” says Dr Divyashree. If you do decide to switch clinics and doctors, carry all your reports with you because it will have a treasure trove of information for your second IVF.

In The End, Remember…

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In the four decades that IVF has been around, science has jumped ahead by leaps and bounds. So, there is absolutely nothing that you need to be worried about. “IVF is totally safe and there is no reason to panic. Millions of babies have been born throughout the world through IVF, and they are as normal as babies born naturally. You just need to have realistic expectations and consult your doctor about the next steps for you,” Dr Divyashree concludes.