Causes of unsuccessful IVF, how to survive and when you can try again?

IVF infertile couples usually refer to at least. Naturally, great hopes are placed on assisted reproductive medicine, and an unsuccessful IVF attempt may permanently remove the spouses from a state of equilibrium. Why in vitro fertilization is not always successful, how to cope with it and what to do next, we will tell in this article.

Despite the level of development of modern reproductive medicine, no one can guarantee the success of the attempt made. This should be well understood even at the preparatory stage for the first protocol. Failure is likely and this should be recognized and understood from the very beginning, so that later it does not turn into a serious psychological problem.

The percentage of the likelihood of a successful pregnancy depends on the health of the spouses, their age, the quality of the biological material, and the mass of related factors, not all of which are now obvious to scientists and doctors. According to the most optimistic forecasts, no more than 45-50% of women under the age of 35 manage to become pregnant with the first attempt at IVF. If a woman is 37-38 years old, the probability of success of an attempt is no more than 35%, and if a woman decided to become a mother at 40, the success rate of IVF is reduced to 19%. At 42, only 8% of women become pregnant after the first IVF attempt.

The probability of conceiving a baby in the second or third protocol is significantly increased, but after the fourth attempt, the chances of pregnancy decrease to basic 10-12% instead of 45%.

Every woman who has gone through an unsuccessful IVF knows how hard it is to accept a fact and realize its true causes. However, this must be done in order to clearly understand what is happening and whether it is possible to influence it. Most likely, doctors will not be able to answer the woman’s question why this happened. The reasons for the failure of IVF are many.

• The age of the woman (the older she is, the less likely the success of implantation).
• Elevated levels of the hormone FSH (this hormone is used at the stage of preparing the ovaries for puncture and egg collection). Before ovulation, a woman receives exactly follicle-stimulating hormonal support. If there is a malfunction in the body, the level of FSH can be significantly higher than necessary.
• Insufficient number of eggs (if the doctors managed to get few oocytes, the probability of a successful outcome of the protocol is significantly reduced).
• An insufficient number of embryos that were obtained by artificial insemination and underwent a qualitative “selection”.
• The quality of embryos turned out to be low (even after the “selection”, not all remaining zygotes can “boast” of high viability and persistence).

Even if the doctors managed to get a sufficient number of eggs and normal embryos, there are no guarantees that they will take root, because it also depends on the health of the future mother. Among the diseases and conditions that most often hinder the success of IVF attempts, the following can be noted:

• endometriosis and chronic endometritis;
• subtle functional resistance of the uterus epithelium due to the large number of previously performed abortions or curements of a diagnostic or therapeutic type;
• hydrosalpinx;
• genetic incompatibility of partners;
• aggravation under the influence of preparatory hormonal therapy of diseases such as diabetes, toxic goiter, chronic pathologies of the kidneys and liver;
• overweight in a man or a woman;
• low quality sperm in men.

Also, a special place in the list of possible reasons for a failed IVF attempt is assigned to idiopathic reasons that cannot be established. They are called inexplicable, and with the correction of protocols in the next attempts for such reasons, many difficulties arise because it is not clear what exactly and how to adjust.

A woman should be aware that the probability of successful IVF is reduced if, after embryo transfer, a woman continues to smoke or takes alcohol even in small doses. In this case, the fragile and narrowed vessels in her body, including reproductive organs, do not allow the normal blood supply to the functional layer of the uterine epithelium, which reduces the possibility of successful implantation of the transplanted embryos into the uterine wall tenfold.

If the scarce brown discharge does not stop after embryo replanting, this may well be a sign of a successful attempt. Up to 14 days of normal excretion may be present. But if after this period painful sensations appear, excretions intensify, they pass into abundant, with a high degree of probability the pregnancy did not take place in this cycle, the fertilized egg did not stick.

What sensations does a woman experience? Yes, in fact, the same as during normal menstruation, only slightly more painful. The woman complains that the lower abdomen hurts, pulls the lower back, because of the hormonal support that the patient had in the second half of the cycle, the chest could hurt. On ultrasound, it becomes obvious that the embryos inserted into the uterus could not be implanted or died some time after implantation.

So, you have passed the embryo replanting stage. From this point on, a woman needs to be extremely attentive to her own well-being. In addition, the doctor will recommend every two days to donate blood for hCG. If implantation takes place, after about 48 hours, a first rise in the level of this hormone produced by the chorion shells will be observed. If the days go by and the level of hCG does not increase, this may be the first sign of failure.

Women who have gone through IVF know that the growth of hCG by itself is not a guarantee of pregnancy, because the fertilized egg can attach, but then die, and then the first tests will show the growth of the hormone, and the following - a decrease in its level. That is why it is important within 2-3 weeks after transplantation to fulfill all the recommendations of the doctor and take all the necessary tests.

There is no definite answer to this question. Much depends on the woman herself, the reasons that caused the failure in the first protocol, as well as the morale of the spouses: in a depressed and pessimistic mood you should not start the second attempt.

According to the established medical practice, about 3 months are usually given for restoration. These cycles, free from hormone therapy, are given to a woman to prepare for a new attempt, to pass the necessary tests and to put her emotional state in order.In the next month after the end of menstruation, it will definitely not be possible to repeat the attempt.

If in the first protocol not all of the eggs obtained are used and the rest are frozen for a while, then the second IVF after the unsuccessful first takes much less time: there will be no follicle-stimulating therapy and oocyte puncture. Oocytes will be thawed in accordance with strict technological requirements and fertilized with husband's sperm.

After an unsuccessful IVF, it is important for a woman to cope with her negative emotions as early as possible and begin to cooperate with her doctor. Not to communicate, not to argue, but to cooperate. Such cooperation will enable the doctor to find out the true reason for the failure, make adjustments to the protocol and increase the chances of getting pregnant on the next attempt. Sometimes it is enough just 1-2 new drugs added to the treatment regimen, and the problem that prevented the implantation of embryos and their development will be eliminated.

After the monthly period ends, the woman needs to be tested for blood, urine, hormone profile tests, ultrasound. After that, together with the doctor, the previous protocol is being analyzed - the dosages of the preparations are revised, the data from the laboratory are evaluated (how fast the eggs were fertilized, how the embryos developed, whether they were cryopreserved).

The doctor will pay special attention to the health of the uterus and ovaries. A woman is assigned a hysteroscopy - a study of the inner walls of the uterus with a special device - a hysteroscope. It is administered under anesthesia. The results of hysteroscopy are fundamental in planning the next attempt.

If there are no pathologies of the uterus, the next attempt can be planned earlier. If anomalies are revealed, then the woman must first prepare and undergo the necessary treatment, recover from it and mentally “mature” to the new protocol.

For many women, after an unsuccessful attempt, the question of how to survive the internal crisis and relationship crisis, which inevitably, in almost 95% of couples, arises after the long-awaited IVF failed, comes first. Often life is divided into “before ECO” and “after it”. Women compare their feelings with the conquest of the mountain peak - in one step from it the climber fell down. The feeling of hopelessness, hopelessness, confusion, resentment can turn into a prolonged severe depression. That is why women are strongly advised to help a psychologist, such specialists take for free at any antenatal clinic and reproductive centers where IVF is performed.

The reluctance of a woman to go to a psychologist after the "failure" is also completely understandable. It is difficult for her to relive her hopes and the moment when they collapsed. But a woman who really wants a child should understand that without a normalization of her emotional state, she will not be able to count on a successful next attempt.

Psychologists say that the spectrum of feelings that a woman experiences after an unsuccessful attempt is similar to the spectrum characteristic of the loss of a loved one, the death of a dear person. To facilitate the state, experts advise to adopt the method of “shifting responsibility”.While the woman is undergoing the IVF procedure, it seems to her that everything is controlled by her and the doctor - tests have been passed, stimulation has taken place, eggs have been taken. There is an illusion that the whole process is under control.

In fact, in matters of pregnancy, not everything is decided by doctors and tests, much depends on luck, and on the “higher powers”. Psychologists advise to shift the responsibility for failure to them, these forces. Then the feeling of your own fiasco will change to the perception of yourself as being dependent, which in this situation will help to come to terms and find faith in the “miracle”, tune in to a new attempt, but no longer from the position of “master of the situation.”

To keep emotions in yourself at the initial stage is a big mistake. If you want to cry, you can cry, if you want to shout and complain, you can afford it. But after acknowledging one's own powerlessness and responsibility of the “higher powers” ​​for the sacrament of fetal development, one should calm down and take action.

A woman should paint her every day tightly, be sure to include in her plan for meeting with relatives and friends, going to the cinema, theater, shop, to visit. Communication and new experiences will help not to “fix” on the problem. The more a woman wants pregnancy, the less likely it is to occur. Some philosophies recommend that you let go of desire, stop wanting to finally get what you want. With regard to the planning of pregnancy, this idea sounds more sensible. There are cases when, after an unsuccessful IVF, a woman worked so successfully on her psychological mistakes that she managed to get pregnant on her own.

Another well-known psychological method of exit from the state of loss and collapse is to help other people. It is enough to look around, as soon as there are those who live even harder and worse, who need help and support. A woman, in anticipation of the next attempt, can take up volunteering, visit disabled homes and orphanages, help sick babies, play and draw with them, change their diapers, feed them with a spoon.

You can help your friends and neighbors in a difficult situation, if not finances, so at least a kind word, self-baked pies, an inexpensive toy for a neighbor's disabled boy. Such actions heal not only the soul, but also the body.

Psychologists recommend that special attention be paid to normalizing relations with a husband. After the tears are cried out, and the emotions are reprimanded, it is worth thinking about returning to normal, interesting sex, with experiments and intimacy. You can start repairing the kitchen together or go somewhere for a couple of weeks, of course, after all the tests and examinations have been completed.

Unsuccessful IVF should not be taken as drama. This, according to medical statistics, is the norm. And in order to calm oneself, one should remember that couples who are planning pregnancy in a natural way risk even more, because the probability of conceiving a baby not in a test tube, but in bed from the first cycle is no more than 7%.

Women do not hesitate and do not hold back emotions, leaving feedback on their sad experience of unsuccessful IVF. By themselves, these reviews are an excellent psychotherapy for the one that seeks answers to numerous questions after the hope of pregnancy has collapsed. Please note, some have made 2-3 attempts, while others are going for 8 or 9 IVF and are full of optimism.

Women's reviews vary. Some get pregnant after the second attempt, while others - with the fourth or seventh. According to women, doctors do not in all cases establish the true reason for a negative result of the protocol.

A lot of good reviews about the so-called "marathon" protocol, in which a woman artificially suppresses ovulation by hormones for several months, she has no periods, practically she is in climax. And then the drugs are canceled and conduct a quick protocol. Typically, this method is used after several unsuccessful attempts.

What if there were unsuccessful IVF attempts? See this in the next video.