Although IVF has a high chance of success, not all couples conceive with their first IVF cycle. Patients who don’t conceive with IVF often ask, “What happened? Why weren’t we successful?” These can be difficult questions to answer, but after an unsuccessful cycle, it’s important for both the patients and the physician to review how the cycle went. For patients, knowing the right questions to ask may help them have success in the future. One way to approach the conversation with your physician is to review every aspect of the failed IVF cycle and to think about all of the contributing parts:
- Ovaries: Reviewing how many eggs were retrieved in the IVF cycle and their quality is very important. For instance, if few eggs were retrieved, I discuss with my patients whether or not adding more stimulation medication would help. If the quality appeared poor, we sometimes talk about considering adjunct medications, such as growth hormone, to improve quality and/or changing the other IVF medications. If preimplantation genetic screening (PGS) was not performed in the IVF cycle, this is also a time to consider if PGS would be helpful in another cycle.
- Uterus: It’s important to know if the uterus has any barriers to implantation. For instance, your physician may want to consider performing a diagnostic hysteroscopy to look at your uterine cavity. A diagnostic hysteroscopy provides the most clear view of the uterine cavity and can look for polyps and fibroids in the uterine lining that would impair an embryo’s ability to implant. This procedure can often be done in the office without the need for general anesthesia. Most patients feel very little pain or discomfort from it. In addition to looking for physical barriers to implantation, your physician may want to consider testing for uterine “receptivity”. At Reproductive Partners, we have been utilizing a test called, “Endometrial Receptivity Assay”, to determine if patients have a displaced window of implantation. Not all uteri are the same, so some women are found to have a narrow or displaced implantation window. Knowing this allows us to find the best timing for embryo transfer.
- Fallopian Tubes: If you have risk factors for having a tubal blockage, such as a history of having had a sexually transmitted infection in the past, you may want to consider having a hysterosalpingogram performed. Some women with tubal blockage can have fluid collect within the fallopian tubes, called a hydrosalpinx, that can be toxic to embryos. If that’s the case, you may need a surgery to correct this to improve your odds of having a successful IVF cycle in the future.
- Sperm: Good sperm quality is necessary for successful fertilization, so it’s important for men to get themselves and their sperm in the best shape possible for an IVF cycle. There are several supplements that can aid in improving sperm quality and may want to be considered for men undergoing IVF.
- General Health: A healthy diet and lifestyle for both men and women play an important role in IVF success. It’s important to optimize your health prior to IVF, so you get the best results possible. For information on how diet and lifestyle plays a role in fertility, visit our lifestyle and fertility page.
If you’ve had a failed IVF cycle or you’re planning an IVF cycle in the future, it’s important to consider all of these factors, so you get the best result from your fertility treatment. Always feel free to reach out to your physician to make sure no stone has been left unturned.