IVF Failure After Successful Pregnancy: Why It Happens and What To Do Next
In vitro fertilization (IVF) is an assisted reproductive technology (ART) where fertility doctors fertilize an egg with a sperm in a test tube, then transfer the embryo that forms after fertilization into the uterus. Many couples who struggled with fertility have tried to become pregnant via IVF. But your IVF may fail even when it succeeded previously. Here is why this happens and your options after IVF failure:
Reasons for IVF Failure
Identifying what went wrong during IVF helps fertility doctors decide whether to do another round of IVF or try other fertility treatments. Your doctor may undertake additional fertility testing to check for new fertility issues or issues that went unnoticed during your previous IVF. Tests may reveal the following causes of IVF failure:
Embryo Quality
When combining the woman’s egg and the man’s sperm, the resulting embryo may appear healthy but have an undetectable flaw that prevents it from implanting once transferred into the womb. Embryos with chromosomal abnormalities may implant but end in a miscarriage as the woman’s body rejects them.
Preimplantation genetic testing helps identify chromosomal and genetic anomalies that may affect embryo development. This test helps doctors pick the healthiest embryo to transfer into the uterus, potentially increasing your chances of success in IVF.
Asymptomatic Endometriosis
Endometriosis is characterized by the growth of the uterine lining outside the uterus into areas like your ovaries and fallopian tubes. Even when it grows outside the uterus, the endometrium behaves like it does in the uterus. It grows and bleeds during your menstrual cycle. The changes to the endometrium can cause inflammation and the formation of lesions and scar tissue in the uterus. The scar tissue in your uterus can make it harder for an embryo to implant after transfer during IVF.
According to research, 25-50% of women who experience fertility challenges have endometriosis. Endometriosis may sometimes be asymptomatic, so you might not know you have it. Your first IVF may have been successful because you did not have a lot of scar tissue in your uterus. If your endometriosis progressed between your first and second IVF, you may experience implantation failure.
Some fertility centers offer an endometrial test that checks for the presence of BCL6, a protein that indicates inflammation in the uterus, which is characteristic of endometriosis. If your BCL6 test is positive, your doctor can prescribe medication to suppress endometriosis. They may also perform laparoscopic surgery to treat the endometriosis before you begin your next round of IVF.
What To Do After a Failed IVF
The first thing to do when experiencing IVF failure after a successful pregnancy is to undergo comprehensive testing with a fertility specialist. Redo the tests you took before your first IVF and check for silent endometriosis. This evaluation may help identify new fertility issues that may have emerged after your first pregnancy. An assessment of your medical history and lifestyle factors can also help identify the causes of failed IVF.
Reducing or quitting alcohol and smoking, losing weight, and managing stressors can positively impact your reproductive health. You may also want to consider other ARTs, like intrauterine insemination. If you have sperm or egg quality issues, consider using a donor egg or sperm during your next round of IVF. Surrogacy is also a good option for failed IVF caused by embryo implantation failure.
Get Comprehensive Fertility Testing
An IVF failure after successful pregnancy does not mean you have lost your chance at having another baby. You can identify and treat previously undiagnosed and emerging fertility issues, potentially improving your chances of IVF success. Consult with your fertility specialist for recommendations on tests and treatments to improve your fertility prospects.
