IVF Failure....Now what?

Because of our longstanding history of excellent success rates, we at the Center for Fertility and Gynecology in Los Angeles are accustomed to seeing patients who have failed IVF at other centers.  From clearly botched cycles to unexplained failures, we have seen it all and we are happy to put our expertise to work for you.

This blog will review our approach to IVF failures and the steps, both conventional and non-conventional; we take to succeed with the next attempt.

IVF requires a huge investment, not only in terms of money, but also in time, effort, emotion and energy.  When that investment doesn’t pay off, most people are understandably upset and a failed IVF consult can help people cope .  The approach to dissecting an IVF failure is different for each doctor, but should include the following steps:

1.       Review of all medical records:

an organized, focused review of all pertinent medical records is a critical part of this process.  Even if a test result has been reviewed by several people, it is possible that an important piece of information has been missed.  In addition, as time and events change, one never knows what previously insignificant result may become important. 

Personally, I like to place all records in chronological order then document their finding s on a separate sheet.  This allows for an organized database that can grow as time goes on.

2.       Review of the most recent cycle:

While all IVF cycles are unique, there are certain characteristics that they all share.  By quantifying these characteristics, one can decide which parts of the cycle to keep the same, and which to change.  Some of the specific characteristics include: medication type/ dose, days of medication, number of follicles, number of eggs per follicles, estradiol levels, number of mature eggs, number of abnormal eggs, fertilization percentage, embryo quality on days 1-5, endometrial lining thickness and pattern and more.

3.      Further evaluation:

Armed with the information from the reviews, the doctor can begin to see where the cycle went wrong and if further evaluation is required.  For example, maybe the sperm was an issue and a test of the sperm DNA is warranted.  Alternatively, maybe the endometrial cavity was problematic and a hysteroscopy is needed. In general, follow-up testing is designed to answer a specific question about a deficiency in the cycle.

4.       Formulate a plan:

With the testing in mind, the doctor can formulate a plan for the next cycle.  The plan could be as simple as slight increase in medication or as complex as surgery, acupuncture, sperm donation and a new surrogate!  The plan will change with every unique situation.

Regardless of any specific situation, a failed cycle should be treated with respect, compassion and honesty.  And while patients should not expect that every question will have a definitive answer, they should expect that every question is addressed and considered to the fullest extent possible.

If you have questions about IVF or fertility in general, feel free to contact us, we’d be happy to speak with you.