Tuesday 15 December 2015

My first IVF cycle was unsuccessful. Should I try again?




In vitro fertilization or IVF has become one of the most widely practiced fertility treatments effective for a host of infertility issues. As IVF is all about precision and timing, it involves a synchronized cycle, starting with the stimulation of the female’s ovaries to develop multiple oocytes, followed by their retrievaland subsequent fertilization by sperm in controlled lab conditions. The resulting embryo is then planted in the uterus for pregnancy to occur.
A couple enters an IVF cycle with great hope and a failed IVF cycle can cause tremendous emotional trauma as the patient invests a great deal of time, effort and money in the hope of having a baby of their own. Here the big question every such patient faces is whether they should give IVF a second try.
When making this decision, it is crucial for you to understand the reason of failure of the first IVF cycle and whether the second attempt is likely to bring a positive outcome. At Shantah IVF Clinic, we aim to assist the patients with all these answers so that they can be well informed to make the right decision.

Why could have my first IVF attempt failed?

While your doctor’s earnest intention is to have a successful outcome in the first attempt itself, unfortunately some patients do experience IVF failure. This is the reason why no IVF clinic would report or claim a 100% success rate.
Even if everything was done right, an IVF cycle can fail due to a number of reasons.Here are the possible reasons for a failed IVF attempt:

  • A majority of failed IVF attempts are linked with poor quality of the embryo, which is measured in terms of the embryo’s ability to implant itself onto the uterine wall and continue growing there. At the same time, embryo quality is not the onlydefinitive criteria for success or failure of IVF because even the best quality embryo may fail to implant.
         In fact, embryo quality is highly dependent upon the quality of the woman’s eggs. Here is where the    age factor of the intended mother comes in as a primary concern. With advancing age, the number and quality of a woman’s eggs tends to decline.
  •  The expertise of the IVF specialist is another factor which has a bearing on the result of the IVF cycle. This includes the process of embryo culture in the lab, the doctor’s experience, laboratory infrastructure, the embryologist’s expertise, as well as the embryo transfer procedure. Right from the beginning to the end of an IVF cycle, timing of the procedures involved and the expertise of your doctor are of immense importance.
  • Uterine receptivity, that is, the ability of the uterus to receive the embryo and have it implanted for further growth, also influences the success rate of IVF. Poor uterine receptivity can be improved with treatment provided your doctor has been able to diagnose it in time.
  •    Like the quality of eggs, the quality of sperm is another important determinant of the success of IVF. Your doctor should be able to retrieve enough numbers of motile (viable) sperm in order to obtain 6-10 good quality embryos. In case of severe male infertility, the doctor may suggest the use of donor sperm.
  • Ideally, a clinic that follows ethical and transparent practice should be able to explain to the patient why a particular cycle failed and what are the possible recourses available to the patient.


Should I take a second or subsequent chance at IVF?

After studying the likely cause of a failed IVF attempt, the next and most crucial step is to decide whether a repeat attempt is worth the effort and when it should be undertaken.
For this, you need to sit down with your fertility specialist and appraise the situation to pinpoint the cause of the failure of the procedure. Aspects such as the response of the woman to the ovarian stimulation as well as the timing of egg retrieval have to be evaluated carefully to ensure that the same mistakes are not repeated the next time around.
Certain measures can be taken to maximize the chances of success of the subsequent IVF cycle(s), for instance:

  • If there have been problems related with ovarian stimulation, the protocol may be altered by the specialist in the next cycle. 
  •  In case the eggs had been immature at the time of retrieval, the harvesting of the eggs in next cycle can be carried out when they have reached a larger diameter.
  • In case of failure of IVF due to poor fertilization caused by poor sperm quality, ICSI could be used instead of IVF. It is so because in ICSI, a single high quality sperm is directly injected into the woman’s egg to maximize the chances of formation of a viable embryo.

If IVF is the only option for a woman to conceive -- for instance in the case of absence or blockage of fallopian tubes, or poor quality sperm --a second IVF attempt may be the only choice. If the patient feels that the quality of services and expertise of the fertility clinic are compromising with the IVF results, they might seek to switch clinics in the subsequent attempts.
Depending on the reasons of IVF failure and the doctor’s assessment of the case, the patient must be advised of the following options:

  •   IVF with donor sperm/donor egg
  •   IVF with frozen embryo
  •     ICSI
  •    Surrogacy
  •    Adoption

A couple whohas failed in the first IVF attempt need not despair as they still have a chance to experience the joy of parenthood, provided that there are lessons learnt from the unsuccessful attempt. 

Shantah IVF is a renowned fertility clinic which endeavors to help patients find answers to all their fertility related queries. To get the trusted opinion of qualified fertility specialists, please contact us here.

Tuesday 1 December 2015

Donor-egg IVF: What is it and who would need it?

As a fertility techniquein vitro fertilizationhas become so popular that it has become almost synonymous with fertility treatment.
As you may be aware, in an IVF cycle eggs and sperm from the intended parents are combined for fertilization in a lab dish. The quality of eggs is the most crucial factors in the success of any fertility treatment; therefore your fertility doctor needs to do appropriate preliminary investigations to ensure the patient can provide healthy eggs for use in an IVF cycle.
In cases where the woman is not ovulating (releasing an egg each monthly cycle) or if the eggs are not viable enough to yield a healthy pregnancy, donor egg IVF may be seen as the only plausible alternative.If you are considering donor egg IVF, the following information will help you understand what it entails and what to expect during the procedure.

What is donor egg IVF?

As the name suggests, donor egg IVF is a combination of two procedures:egg donation and in- vitro fertilization.
While in a typical IVF cycle eggs from the intended mother are fertilized using sperm from the male partner, in donor egg IVF, eggs from a donor are used.
When a relative or a woman known to the couple is the egg donor, she may need to undergo ovulation induction wherein her ovaries are stimulated to develop and release multiple eggs in one cycle. Your doctor would monitor her oocyte development through blood tests and ultrasound, and retrieve the eggs when it’s time. The egg retrieval procedure is usually done on the same day as sperm collection.The eggs so obtained are combined with sperm to form embryos which are then placed in the uterus of the intended mother for pregnancy to occur.

If the couple is unable to arrange a donor, or if they prefer an anonymous donor, eggs from a donor bank can be used for the procedure. In this case, the desired donor profile is shortlisted and shared with the patient so that they can make an informed choice.

Donor egg IVF is a highly sophisticated procedure, and should only be handled by askilled and experienced fertility specialist in a well-equipped clinic.


When is donor egg IVF recommended?

Your doctor may recommend using donor eggs for IVFunder the following conditions:
·     
            POF or premature Ovarian Failure

A medical condition when the woman has undergone menopause earlier than expected but wants to have a child of her own, donor eggs can be utilized for the same.
·         
     Diminished Ovarian Reserve

A woman’s ovarian reserve(the number of eggs left in her ovaries) diminishes with age. In fact a woman loses about 300 eggs every day, and by the time she turns 35, the number and quality of her eggs has declined considerably. This is when she may have to rely upon donated eggs to conceive.
·         
     Genetic Disorder

If a woman is suffering from a genetically transmitted disease, which may pass on to her baby, using donor eggswould ensure a safer and healthier pregnancy with higher chances of IVF success.
·      
            Failed IVF Attempts

In some couples who have come across repeated failure in IVF attempts, the doctors may attribute it to the lack of viability of eggs and may recommend the use of donor eggs for the next IVF cycle.
Currently, donor egg IVF is gaining acceptance and has proved to be a boon for women who cannot conceive using their own eggs.

What tests are done on the recipient and the donor before the procedure?

When a couple is recommended to go for donor egg IVF, they need to consider a credible clinic where they can receive quality treatment from skilled doctors in a safe and relaxed environment.Here, the clinic mustnot only handle the actual procedure with expertise, but also needs to be well equipped to make sure that both the recipient as well as the donor qualify for the procedure.

Recipient Testing

A good IVF clinic would take no chances with the success of donor egg IVF and perform all the required tests on the recipient to ensure that she would be able to go through the pregnancy safely and successfully. A complete health check-up is done, including tests todetermine any abnormalities, physical or genetic, in the recipient. These tests may include cervical cultures, uterine sonogram, semen analysis and Rh factor tests, along with comprehensive blood tests.
Couples should look for a clinic which also offers counseling to help them cope with the pressures of fertility treatment, understandthe details of the procedure, its chances of success and the risk factors involved.

Donor Testing

Whether the donor is anonymous or known to the couple, she must be tested for any genetic disorder, infectious diseases, and her complete medical and family history must be obtained. Preferably, a healthy woman under 35 years is chosen for egg donation, and some couples also consider factors such as ethical background and family history of the donor.
Since the procedure of donor egg IVF is a complex one and comes with its own risk factors, couples should rely only on a reputed clinic for taking up the procedure.

Shantah Fertility Centre provides end-to-end egg and sperm donation services to couples who are unable to conceive using their own eggs/sperm.

If you have further questions pertaining to the procedure, or need an impartial second opinion, please contact us for a free consultation with Dr. Anubha Singh, leading Fertility Superspecialist and Medical Director, Shantah Fertility Centre.