An in vitro fertilization (IVF) cycle fails when it does not result in a successful pregnancy. The failure can occur at any stage as an unsuccessful ovarian response, fertilization issue, or embryonic arrest. Here are a few common reasons behind IVF failure and how to address them:
Endometriosis
Endometriosis is a contributor to IVF failure due to inflammation caused by endometrial-like tissue growing outside the uterus. While endometriosis is showcased by pelvic pain and heavy menstrual bleeding, a silent form can exist with no obvious symptoms. This inflammation is associated with elevated BCL6 protein levels and negatively impacts embryo implantation. It blocks the ovaries and fallopian tubes, causes scar tissue, and compromises the uterine environment.
When endometriosis is confirmed as a cause of IVF failure, doctors perform hormone suppression therapy or surgical laparoscopy. Hormone suppression therapy pauses the menstrual cycle to allow for implantation. The treatment suppresses estrogen and progesterone to reduce inflammation in the uterine lining. Surgical laparoscopy allows a doctor to see and remove endometrial tissue as well as endometriomas growing outside the uterus.
Poor Egg Quality
Genetics, advanced age, and lifestyle choices can negatively affect a woman’s egg quality, leading to IVF failure. As a woman ages, the quantity and quality of her eggs may decline, increasing the risk of chromosomal abnormalities. In IVF, these abnormalities can lead to a failed cycle by preventing the embryo from developing. If an abnormal egg is successfully fertilized, the embryo may fail to implant in the uterine lining, resulting in an early miscarriage. When poor egg quality is a suspected cause of IVF failure, fertility specialists may explore preimplantation genetic testing or use donor eggs from a suitable candidate.
Poor Sperm Quality
Problems like sperm count, poor sperm motility, and abnormal morphology impact sperm quality, influencing IVF outcomes. Fragmented DNA also affects fertility. Increased sperm DNA fragmentation may be caused by the following:
- Oxidative stress
- Poor diet
- High testicular temperature
- Urogenital tract infections
- Advanced paternal age
Oxidative stress refers to a state in which reactive molecules can accumulate in the body. Sperm cells are particularly sensitive because they have a limited ability to repair certain types of cellular damage. Lifestyle factors, such as smoking, may contribute to changes in sperm health. Elevated DNA fragmentation in sperm can be associated with challenges in fertilization and embryo development during IVF.
Making lifestyle adjustments, such as reducing or eliminating smoking and alcohol use, may support overall sperm health. Some doctors recommend nutritional supplements that include antioxidants, like vitamins C and E, to support cellular function. In certain IVF procedures, techniques such as Intracytoplasmic Sperm Injection (ICSI) can be used to directly place a sperm into an egg, which is one method fertility specialists may employ during treatment.
Embryo Chromosomal Abnormalities
An embryo with a chromosomal abnormality contains an incorrect number or structure of chromosomes, which can prevent a successful IVF cycle. Chromosomal errors may occur during the formation of the egg or sperm, fertilization, or early cell division. The body rejects the embryo and fails to implant, leading to a miscarriage.
Doctors opt for Preimplanted Genetic Testing (PGT) to uncover embryo abnormalities by screening them during an IVF cycle. The PGT steps involve an embryo biopsy, genetic testing, and embryo selection. With an embryo biopsy, doctors remove a small sample of cells from the outer layer that becomes the placenta for testing. Based on the test results, doctors select chromosomally normal embryos for transfer.
Uterine Lining Receptivity
A receptive uterine lining offers favourable conditions that allow an embryo to attach and implant successfully. If the uterine lining is not receptive, even a high-quality embryo will not successfully implant. Anatomic abnormalities like fibroids and inflammation of the uterine lining caused by silent endometriosis can disrupt receptivity. Hormonal imbalances, or conditions like progesterone resistance, may also compromise a receptive uterine environment. This means that the endometrium fails to develop correctly in preparation for implantation, leading to IVF failure even with standard hormonal protocols. Issues with the uterine lining receptivity can be addressed through solutions, such as antibiotics for chronic bacterial infection, lifestyle changes, and fertility medication.
Learn More About IVF Failure
Fertility specialists perform tests to evaluate the uterine environment by analyzing an endometrial biopsy for markers like BCL6. Elevated BCL6 levels indicate underlying endometriosis that may interfere with embryo implantation, causing IVF failure. Contact a reputable specialist to find out more about their fertility treatment solutions.
