What to do After a Failed IVF Cycle
A common question for women/couples who have undergone a cycle of in-vitro fertilization (IVF) and didn't become pregnant is "what went wrong and why didn't it work?". The job of the Fertility Specialist is to look in detail at the IVF cycle, evaluate the whole situation and work out if there is any aspect of fertility care and IVF treatment that can be improved in order to optimize the success rate of future treatment. This is also a time to give detailed and candid feedback as most people want to have a good understanding of their situation and their future chances of success.
The first thing to remember is that nothing may have gone wrong, and that there is only a certain chance of conceiving with each treatment. A good analogy here is that when couples start to have unprotected intercourse and want to conceive it takes twelve months for 85% of couples to conceive where there are no apparent fertility problems (i.e. 12 natural cycles at an average of 7% per cycle). The IVF pregnancy rate per treatment is usually much higher than the natural monthly pregnancy rate, but for many couples it takes more than one cycle to achieve a pregnancy even if every aspect of treatment goes well.
At Bubtree we don't assume that past approaches to treatment were optimal, and we undertake a thorough and careful evaluation to find out if there is anything that we can do differently to increase the chance of success in a future treatment cycle. If previous IVF treatment took place at another clinic then our first step is to gather all of the information from the specialist(s) and IVF clinics including investigations undertaken before IVF, what type of treatment cycle(s) were used (dose and type(s) of medicines), blood test results and ultrasound examinations during treatment. We also gather information from the IVF laboratory including approach to fertilization, fertilization rates, embryo development, and the quality of embryos that were transferred and/or cryopreserved (frozen) during treatment. This information is extremely important as it will let us know whether there are any areas of fertility care that we could aim to improve on. We may recommend varying the dose and type of medicines or focusing on laboratory aspects of care such as culturing embryos through to the day 5 (blastocyst) stage.
At Bubtree we will carefully examine past investigations to make sure that factors that can reduce the success rate of treatment have been excluded such as endometriosis, a fluid filled fallopian tube (hydrosalpinx) or an abnormality in the cavity of the uterus such as a fibroid or a polyp. Women who are found to have these conditions may benefit from having them treated before a further attempt at IVF.
Some women undergoing treatment have polycyctic ovaries (PCO) or polycystic ovary syndrome (PCOS) and the diagnosis of these conditions hasn't yet been made. Treating women who have PCO/PCOS can sometimes be complex as they can respond differently to medication and managing an IVF treatment cycle in such women is best done by Fertility Specialists who have a great deal of experience in this area. For some women with PCO/PCOS the outcome may be improved by carefully selecting the best dose of medicine(s) and monitoring treatment closely. For other women with PCOS they may benefit from further treatment(s) before embarking on another cycle of IVF, such as metformin and/or ovarian diathermy.
In conclusion, for some women/couples prior IVF treatment may have been conducted optimally and it may simply be that pregnancy didn't happen because of the chances of success (odds) with each treatment. However, for others there may be one or more areas of treatment that can be improved on, and this kind of assessment is best undertaken by a highly experienced Fertility Specialist.
A copy of our Fact Sheet can be downloaded from the bottom of this page.