Why does IVF fail and how do I increase my chances of success?
Repeated failed IVF cycles are distressing events for couples hoping to start a family. Here Mr Rehan Salim, a consultant gynaecologist and accredited sub-specialist in reproductive medicine at Imperial Private Healthcare’s Wolfson Fertility Centre, explains why they happen and what can be done.
“The most common reason that IVF fails across all ages is poor embryo quality due to poor egg quality. Around 70 per cent of embryos in younger patients will have some sort of genetic abnormality and this figure increases as a woman gets older and her egg quality decreases, which makes it more difficult to achieve a pregnancy.
Sperm quality can be an influencing factor although this is less significant as men make new sperm constantly. Physical problems such as fibroids (growths in the womb) or blocked fallopian tubes can also affect IVF success. There is speculation that blood clotting or immune system problems in women could also be a factor although there is no clinical research evidence for this.
Reducing the risk of IVF failure
At Hammersmith Hospital, the Wolfson Fertility Centre’s highly experienced fertility consultants can advise patients on the most suitable options to reduce IVF failure risk, explaining the techniques in the most transparent way and providing patients with as much information as possible so that they can make the best choice for them.
Possible causes for failed cycles can be investigated and potentially treated at the centre which has a highly expert team of five fertility consultants who are also specialists in gynaecological surgery and endocrinology (hormone disorders) and who all hold the UK’s highest qualification in fertility medicine.
Their expertise means they can treat patients for problems such as fibroids before overseeing their IVF cycle during a patient journey that involves seeing one consultant at one location without having to attend different centres to see different specialists. In this way, the consultant can see the whole picture that might be affecting a patient’s fertility, rather than one small part of the problem.
“Add on” treatment options
If a patient is experiencing repeated failed IVF cycles, it is possible to try so-called ‘add-ons’, to traditional IVF treatment.
These add-ons include a laser technique to break the shell around the embryo to aid the implantation process and ‘time lapse’ which involves taking photographs of the developing embryo every 20 minutes to help the embryologist select the best embryo to put back into the woman. Pre-implantation genetic screening (PGS) involves removing a few cells from the embryo to analyse them for abnormalities.
At this stage in their development, more evidence is needed to demonstrate whether these extras really do make a difference to the outcome of an IVF cycle. The Wolfson Fertility Centre allows patients to try these add-ons at no extra cost, to see whether it makes a difference to their chances of success.
Outstanding IVF success rates
The Wolfson Fertility Centre has some of the best IVF pregnancy rates in London including a pregnancy rate involving frozen embryos which is significantly higher than the national average and a pregnancy rate for the over 40s, who tend to have complex fertility issues, at a very high level of one in four.
Care continues after a woman undergoing IVF falls pregnant, as St Mary’s Hospital has an antenatal clinic specifically for fertility patients. Here, staff have expertise around the medication that some women may be taking, and also understand the anxiety and stress that patients can experience having gone through IVF treatment.
A scientific approach to success
Patients who experience repeated failed IVF cycles should try to understand, in conjunction with their consultant, why this is happening using a clear scientific approach to find a solution based on the most likely cause. The key thing is not to give up, within reason, as IVF is a treatment with cumulative chances. It is not 100 per cent guaranteed every time and it sometimes takes a few attempts to achieve the desired result.”