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IVF
Published at
4 May 2025
What is IVF?
IVF (In Vitro Fertilization) is an assisted reproductive technique that involves retrieving eggs from a woman’s ovaries and fertilizing them with sperm in a laboratory. The fertilized eggs (embryos) are then transferred into the woman’s uterus. IVF can be an effective method for treating infertility, but it is not always successful.
Some possible causes of IVF failure include:
Woman’s age: The chances of IVF success decrease as a woman gets older. This is because egg quality declines with age.
Egg problems: Some women may have issues with their eggs that prevent fertilization or implantation in the uterus.
Sperm problems: Some men may have sperm issues that hinder fertilization of the eggs.
Uterine problems: Some women may have uterine conditions that prevent embryo implantation.
Genetic problems: Some embryos may have genetic abnormalities that prevent normal development.
Unknown factors: In some cases, the reason for IVF failure is not clear.
If you’ve experienced multiple failed IVF attempts, it’s important to consult a gynecologist to explore possible causes and other treatment options. Alternative treatments may include:
IVF using donor eggs or sperm: In this approach, donor eggs or sperm are used for fertilization.
IVF with a surrogate uterus: In this method, embryos are transferred to another woman’s uterus, who carries the pregnancy as a surrogate.
Other assisted reproductive techniques: There are additional fertility treatments that might be suitable for you.
It’s important to remember that IVF is a challenging and stressful process.
Causes of IVF failure
Regarding the potential role of immunological problems in IVF failure, it must be said that this issue is still a subject of debate and research, and there is no complete certainty about it. However, some studies have shown that immune system problems may play a role in some cases of IVF failure.
Some immunological problems associated with IVF failure:
♦ Antiphospholipid antibodies: These antibodies can cause disruption in placental blood flow and consequently, miscarriage.
♦ Antinuclear antibodies: These antibodies can also lead to IVF failure by affecting embryo development.
♦ Disorder in natural killer (NK) cells: These cells play a role in the immune system, and some research has shown that their overactivity can cause embryo rejection.
♦ Imbalance in cytokines: Cytokines are signaling molecules in the immune system, and an imbalance in them can lead to fertility problems.
How to diagnose immunological problems:
Diagnosis of immunological problems related to IVF is usually done through blood tests. Some of the tests used include:
♦ Antiphospholipid antibodies test
♦ Antinuclear antibodies test
♦ Natural killer (NK) cells test
♦ Cytokines test
Treatment of immunological problems:
If immunological problems are diagnosed, various treatments may be prescribed by a doctor. Some of these treatments include:
♦ Immunosuppressant drugs: These drugs can help reduce the activity of the immune system and prevent attack on the embryo.
♦ Intravenous immunoglobulin (IVIG) infusion: This method can help strengthen the immune system and reduce the risk of miscarriage.
♦ Anticoagulant drugs: These drugs can prevent the formation of blood clots in the placenta and consequently, miscarriage.
Important points:
♦ Immunological tests and starting treatment should be done under the supervision of a specialist physician.
♦ The results of the tests and the type of treatment vary depending on the individual’s condition.
♦ More research is still needed regarding the exact role of immunological problems in IVF failure.
If you are also concerned about the potential role of immunological problems in your IVF failure, be sure to talk to your gynecologist and obstetrician about it.
Genetic reasons effective in unsuccessful implantation in IVF
Genetic reasons effective in unsuccessful implantation in IVF
Embryonic and genetic problems can also be a major reason for IVF failure. In fact, the quality of the embryo and its genetic health are very important factors in the success of implantation and continuation of pregnancy.
Embryonic problems:
♦ Low embryo quality: IVF embryos are graded based on their cellular and developmental quality. Lower quality embryos are less likely to implant and develop into a healthy pregnancy. Low embryo quality can be due to various factors such as egg and sperm quality, parental age, and laboratory conditions.
♦ Chromosomal abnormalities: Embryos may have chromosomal abnormalities (abnormal number or structure of chromosomes). These abnormalities can lead to failure of implantation, miscarriage, or the birth of a baby with genetic problems.
Genetic problems:
♦ Genetic diseases: If one or both parents carry a genetic disease, there is a possibility of it being passed on to the embryo. Some of these diseases can lead to IVF failure or the birth of an affected child.
♦ Advanced maternal age: With increasing maternal age, the likelihood of chromosomal abnormalities in the eggs increases, which can lead to embryonic problems and IVF failure.
Diagnosis of embryonic and genetic problems:
♦ PGD/PGS: Preimplantation Genetic Diagnosis (PGD) and Preimplantation Genetic Screening (PGS) methods can be used to examine the genetic health of embryos before transfer to the uterus. These methods are especially recommended for couples who are at risk of genetic diseases or have a history of recurrent miscarriages.
♦ Genetic tests: If there is a family history of genetic diseases, genetic testing for parents and the embryo can help diagnose potential problems.
Treatment of embryonic and genetic problems:
In some cases, healthy embryos can be selected and transferred to the uterus using PGD/PGS methods. In other cases, the use of donor eggs or sperm may be necessary. Also, in the presence of specific genetic diseases, genetic therapies may be needed before or after the birth of the child.
Important points:
♦ Genetic counseling: Before starting IVF, especially if there is a family history of genetic diseases, genetic counseling can be very helpful.
♦ Choosing the right center: Choosing an IVF center with experience and equipped with advanced equipment can be effective in diagnosing and treating embryonic and genetic problems.
Finally, it should be noted that embryonic and genetic problems are only one of the factors affecting IVF failure, and other factors such as maternal age, egg and sperm quality, uterine problems, etc., can also play a role.
Treatment in cases of IVF failure
Treatment depends on the underlying cause of the failure and the specific circumstances of each individual. In fact, after each unsuccessful IVF attempt, the doctor and the couple should carefully examine the potential causes and make the necessary decisions to continue the journey.
Some treatment approaches and potential strategies after unsuccessful IVF include:
♦ Review and re-evaluation:
♦ More detailed review of medical history: A more detailed review of the couple’s medical history, including age, pregnancy history, underlying diseases, and the results of tests and ultrasounds.
♦ Supplementary tests: Performing additional tests to assess egg and sperm quality, uterine condition, and other factors related to fertility.
♦ Lifestyle review: Reviewing and modifying lifestyle, including diet, weight, exercise, smoking, and alcohol consumption.
♦ Changing the ovarian stimulation protocol:
♦ Changing medications and dosages: If there was an inadequate response to the medications in the previous cycle, the doctor may change the medications and their dosages.
♦ Using different protocols: Using different ovarian stimulation protocols, such as short, long, or antagonist protocols.
♦ Using advanced assisted reproductive techniques:
♦ ICSI: Intracytoplasmic sperm injection (ICSI) can be helpful in cases where there is a problem with sperm quality.
♦ IMSI: Selecting the best sperm for injection into the egg using more powerful microscopes (IMSI).
♦ PGD/PGS: Preimplantation Genetic Diagnosis (PGD) or Preimplantation Genetic Screening (PGS) to check the genetic health of embryos before transfer to the uterus.
♦ Hatching: Creating a breach in the embryo’s outer shell to help it emerge and implant in the uterus.
♦ Treating underlying problems:
♦ Surgery: If there are problems such as uterine fibroids, polyps, or intrauterine adhesions, surgery may be necessary to correct them.
♦ Drug treatment: If there are problems such as hormonal disorders, thyroid problems, or autoimmune diseases, appropriate drug treatment can help improve the conditions.
♦ Using donor eggs or sperm:
♦ Egg donation: In cases where egg quality is low or the woman has gone through menopause, donor eggs can be used.
♦ Sperm donation: In cases where there is a problem with sperm quality or the man has azoospermia, donor sperm can be used.
♦ Using a surrogate uterus:
♦ Surrogacy: In cases where a woman has uterine problems that prevent pregnancy, a surrogate uterus can be used.
♦ Investigating immunological causes:
♦ Immunological tests: If there is a history of recurrent miscarriages or suspicion of immunological problems, performing immunological tests can be helpful.
♦ Immunological treatments: If immunological problems are diagnosed, various treatments such as immunosuppressant drugs, IVIG, and anticoagulant drugs may be prescribed.
♦ Repeating IVF:
♦ Repeating the IVF cycle: If there is no specific problem and the couple wishes, the IVF cycle can be repeated.
♦ Other assisted reproductive methods:
♦ IUI: In cases where the infertility problem is mild, IUI (intrauterine insemination) can be used.
♦ ZIFT/GIFT: Zygote intrafallopian transfer (ZIFT) and Gamete intrafallopian transfer (GIFT) may also be used in some cases.
♦ Acceptance and decision-making:
♦ Counseling: Throughout this journey, counseling with a doctor, psychologist, and fertility counselors can help couples make decisions and manage the stress and emotions associated with infertility.
♦ Decision-making: Ultimately, couples must decide on continuing treatment or choosing other methods based on their circumstances and with full awareness of the available options.
Important points:
♦ Follow-up and patience: Infertility treatment and IVF are a long and complex process and require follow-up and patience.
♦ Support: Receiving support from family, friends, and support groups can be very helpful throughout this journey.
Finally, remember that each individual and each situation is unique, and decisions about how to continue treatment should be made based on your specific circumstances and in consultation with a specialist physician.
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