When you are struggling with infertility, your number one questions is: “How can we make sure that we have a baby?: And when you’ve decided to go ahead with IVF treatment, the very last question you want to ask yourself is: “What if IVF fails?”
For couples blessed with good fertility, babies seem to come along annoyingly frequently. At least, it feels that way when you are living with infertility and dreading every pregnancy announcement on Facebook!
Couples with problems getting pregnant need fertility treatments. It’s a simple as that. Fortunately, there are many fertility treatment options available these days.
Perhaps the best known of these options is IVF (or In-Vitro Fertilisation). It’s often the recommended treatment for women over 35, or men with low sperm counts.
Why Does IVF Fail?
IVF is a treatment that grows and collects eggs from the woman and brings the sperm and eggs together in the IVF lab to fertilise the eggs, creating embryos. The embryos grown with the IVF treatment are then placed gently back inside the womb. If an embryo latches onto the womb lining and starts growing, then you have a pregnancy.
Sounds so simple and easy, right? Surely everyone should get a baby with IVF? Well, sadly that is not the case. The truth, according to worldwide statistics, is that only one in three people who start an IVF treatment cycle will have a baby.
At times, IVF fails and you do not get pregnant. At other times the IVF gets you a pregnancy, but you lose it very early. Generally, the cause of IVF failure is one of four things. Let’s look at them one by one.
Your Eggs and IVF Success
Egg quality really affects IVF success. Not all eggs will make a baby. This is the commonest reason for not getting pregnant with IVF. When it happens it usually means you simply did not have a good egg in the eggs collected for you during that IVF cycle. This does not mean you must give up, and it does not mean that you cannot get pregnant. In fact, many couples get pregnant when they try IVF again.
An interesting fact: This is also why IVF success rates are quoted according to a woman’s age. Egg quality gets lower as a woman gets older. And it happens much earlier than you may think! Most women have no clue about how early in life egg quality drops. Eggs are generally good to make a baby about 25% of the time in your 20s and early 30s. From the late 30s there is a quick drop off in egg quality.
By the age of 40, only around one in every 11 eggs is going to be good to make a baby. This means pregnancy becomes much less likely at the age of 40. Remember, women only release one egg a month, so this means that at 40 a you’re lucky to have just one good egg a year! Sounds bad, right? Now add in the fact that the egg only lives for 12 hours. Well… you can see why having a baby at 40 or older is a real challenge and certainly not a guarantee.
What does all of this mean, readers? It means when you’re thinking about IVF you must look at the success rate that’s relevant to your age group! If you’re 40, your chances are simply not going to be as good as those of a 30 year-old woman. We’ve included a quick and easy reference table to help you out.
FIGURE 1 – How many eggs are good eggs to make a baby? Or, what is the live baby rate per egg?
Let’s Not Forget the Man! Sperm can Cause IVF Failures too! Sperm Quality and IVF Success
Just as is true for eggs, sometimes the sperm have a problem and will not make a baby. This does not seem to be linked to a man’s age in the same way as it is for women and eggs.
Fortunately, there are a few tests that can check sperm quality. A new test called sperm DNA Fragmentation Testing is now widely available. It gives a measure of how good the sperm might be to make a baby. It is not a 100% accurate test and it looks at one aspect of sperm quality only, but itn is helpful. We certainly could do with other tests to see if the sperm is the problem, but sadly those tests simply don’t exist yet.
RELATED: Men Should Get Fertility Testing Too
The Womb Might be the Reason if IVF Fails
A third cause if IVF fails may have to do with either the womb or the fallopian tubes. Sometimes there’s something in the womb or tubes that is preventing an embryo from implanting or growing. There might also be something that’s upsetting an embryo once it has started the early process of implanting and growing.
Polyps, scar tissue or infections in the womb can be the cause. Fluid–filled tubes (hydrosalpinges) can also cause problems for the embryo.
Interestingly, fibroids, those non-cancerous growths in the muscle of the womb which are often blamed for infertility, are rarely the cause. Most fertility doctors believe that only the rare type of fibroids found inside the lining of the womb affect fertility and IVF success. Most fibroids are not near the uterine lining and are not thought to affect fertility in any way.
Other Issues that can Cause IVF Failure
If IVF fails it can also be the result of other issues in the woman’s system. For example, immune issues might stop or interfere with the embryo implanting.
New research and tests have also shown that some women have an unusual timing issue. This means that their window of implantation (the time when the embryo can latch onto the womb lining and grow) happens at a completely different time than when the embryo is ready. Things are not in sync.
Biochemical pregnancy: A biochemical pregnancy is a very early pregnancy loss. Things may begin well: The embryo implants into the uterine lining and grows enough that a pregnancy blood test is positive. However, the pregnancy stops growing at a very early stage. The pregnancy blood test level is then reduced to a low (negative) level. Vaginal bleeding and pain then start and a very early miscarriage happens.
Biochemical pregnancies are actually very common. They occur in one in four pregnancies. Biochemical pregnancies usually happen because the embryo that implants does not grow normally, and would have made an abnormal baby. This is normal for humans. It is not caused by anything to do with the IVF treatment and it also does not happen because you’ve done anything wrong.
Less often, a biochemical pregnancy can happen because something in the man or woman’s body is not right. Several things can cause a biochemical pregnancy. Here are a few:
- Sperm DNA damage
- Low response to progesterone hormones
- Fluid-filled fallopian tubes (hydrosalpinges)
- Womb lining polyps or fibroids inside the uterine lining
- Chronic womb infection
- A female implantation problem (immune issues or a timing problem).
Most couples who have a biochemical pregnancy will get pregnant again in the future. In fact, couples who have had a biochemical pregnancy are more likely to have a baby than couples who have never had any pregnancy at all.
What Should You do if IVF Fails?
If IVF fails and does not get you pregnant, it is normal to feel a wide range of emotions. You need professional support at this time along with the support of your trusted friends and family. Counselling is really helpful to work through the emotions and grief that are normal when IVF fails. Your fertility clinic will have counsellors available to support you through this time. Support groups are also a place to help you through.
Knowledge is power. If IVF fails, talk to your IVF doctor. Finding out more about your failed IVF cycle will help you work through the grief of an IVF failure. It also can give you a deeper understanding of your body. Understanding where things went well, and where things perhaps did not go well, is vital. This helps you make your decision for possible future fertility treatment, including whether to do another IVF cycle
It is normal to blame yourself if IVF fails but this is never the case. Do not fall into this trap! You cannot cause an IVF failure by doing something wrong.
Patients worry about eating the wrong thing, falling over, or having sex. Could any of these every day, normal things have caused me not to get pregnant with my IVF treatment? The answer is always no. It wasn’t you. Talking through the cycle with your doctor and counsellors will help you avoid this trap and find a way to move forward. There are many ways to have a baby and there are always options!
Wondering why IVF did not get you pregnant? Email us at INFO@TrinidadIVF.com if you would like a second opinion from our expert IVF doctors.