Behind the IVF treatment.

In-Vitro Fertilization (IVF) is a technique, which can help women become pregnant in certain types of fertility issues. The technique involves extracting mature eggs from the female ovary, laboratory fertilization of the extracted eggs with sperms, and implantation of the fertilized embryo back in the female uterus. Although the steps of IVF seem simple, it is a complex procedure needing immaculate technical competence to achieve a successful outcome.



What is IVF failure?

There are many definitions explaining what IVF failure is although none seems to agree on a common explanation. Some argue that, inability to become pregnant even after undertaking a single IVF procedure is ‘IVF failure’ whereas some bring in the fact that, several attempts at IVF would be required in determining a person’s unresponsiveness to IVF. In certain instances, experts are divided on whether to consider tubal pregnancies as IVF failures or can a mother having a previous successful pregnancy be considered an implantation failure following IVF. It emphasizes the fact that, the term ‘IVF failure’ would depend on many factors including institutional beliefs although the ultimate result would be the inability to bear a pregnancy.

What are the reasons for IVF failure?

IVF is a procedure, which needs to be done in several technically complex steps. Each of these steps or procedures would require meticulous timing, proper instruments, high tech laboratory facilities, skilled professionals as well as a suitable candidate and a partner. Unless all these fit in together, the ultimate result of an IVF may not be fruitful.

However, the literature regarding reasons for IVF failure is not significantly conclusive in order to arrive at a definite diagnosis on what went wrong. Therefore, clinicians and the professionals involved in such procedures have to rely on evolving scientific research to derive their conclusions.

Among many reasons for IVF failure, timing of the transfer and the location of the implant would play a major role and with mounting research evidence, practices related to implantation have also evolved. In the early days, transferring the embryo at 3 days after culture was the norm although CDC and other experts agree on the higher success rate when it is transferred at day 5 or day 6. Similarly, the widely accepted method of implanting the embryo within the fallopian tube changed to the practice of intra-uterine implantation in recent times with the growing research evidence.

Another possible cause for IVF failure is thought to be infections. Although sterile procedures are undertaken during the process of implantation, toxins present in the uterus from previous infections have been linked with implant failures by some researchers. However, the evidence pertaining to infections leading to implant failure still needs more research to claim its case.

Immune mediated IVF failures could be another reason in some women for failing to conceive after IVF and similar failures may result from antiphospholipid syndrome, in the presence of Anti-Nuclear Antibodies, as well as in the presence of anti-thyroid antibodies…etc. As with other research, these assumptions should also substantiate their claims through well-performed research evidence.

Apart from the above factors, clotting defects of the mother can also lead to IVF failures and this has prompted some experts to anticoagulate such mothers during the IVF procedure.

Reference:

Society for Assisted Reproductive Technologists. Clinic Summary Report: All SART Member Clinics. 2005.

Center for Disease Control

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