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Coping with failure of first IVF cycle attempt, Coping with infertility, Failure in achieving proper baseline, Quality of Egg

Knowing that you cannot become a parent, is one of the biggest pain that life can inflict upon you. All your dreams and hopes of having a happy beautiful family come crashing down and you feel as if you have lost all belief and hope but then owing to the technological advances in the medical field you come to know of IVF (In Vitro Fertilization) and all the shattered hopes start to build again.

You consult your fertility specialist and connect with a fertility clinic to start the process of your first IVF cycle. The fact that it is finally happening leaves you immensely positive, excited and hopeful. But you are again thrown back to the same space and this time in a more pathetic way when you realize that your first IVF cycle failed.

Infertility in today’s world has become a rapid area of concern because of the shifted priorities and lifestyle of the human population. Whether it is natural infertility or primary or secondary infertility due to health issues, unsuccessful relationships (married life), intake of drugs, age or unhealthy lifestyle, it has affected the couples throughout the world.

Hopefully to cater this situation, the field of medicine has evolved technologically enough to provide couples with various options to conceive and extend their families such as usage of various oral and injectable medications, artificial insemination, intrauterine transfers and In vitro fertilization etc.

In-vitro fertilization is an ultimate solution for an infertile couple to conceive. It is a process in which the egg is retrieved from the female and fused with the sperm of the male counterpart in the lab, left to divide under the surveillance of medical experts and further transferred into the uterus leading to pregnancy. Before knowing how to coping with a failed first IVF cycle and knowing how to deal with it, it is important to know why it actually failed and to understand that, it is important to know how an IVF cycle works.

IVF cycle starts with preparing a suitable “baseline” with the help of hormonal supplements. Baseline preparation includes healthy ovaries, low estrogen progesterone and LH level as well as thin uterine lining. After the desired baseline is achieved, the female is injected with FSH or other stimulating hormones to stimulate the ovary to produce multiple follicles.

Further to facilitate the egg retrieval process the female is injected with HCG or Lupron which works similar to LH surge in the natural cycle and then the egg is retrieved within 34-36 hours. The reason to stimulate multiple follicle production is to ensure that, there are sufficient numbers of eggs to choose from, as not all the follicles have egg and not all the eggs retrieved are alive, mature, capable to fertilize or sustain long after fertilization to carry implantation. The live eggs are then fertilized with the sperm from the male counterpart or donor in the lab and further transferred in the uterus after 3rd or 5th day of fertilization to induce implantation.

The number of fertilized eggs to be transferred on the 3rd day is generally 3 to 4. However, if the transfer is to happen on the 5th day it is done using 1 or 2 fertilized eggs in their blastocyst stage which increases the chances of successful implantation and decreases the chance of high order multiple pregnancies. Nonetheless, the 5th-day transfer depends on the capability of a fertilized egg to sustain that long. After successful implantation, the female is kept under observation to see whether the body is responding well to the induced pregnancy with a suitable environment for the development of the foetus.

By understanding the process of IVF, we can observe the complexity and the chances of failure that it withholds. Almost every step in an IVF cycle holds a chance of failure if not carried out or responded to properly. There are a lot of reasons behind a failed first IVF cycle but some of the major ones can be as follows:-

  1. Failure in achieving proper baseline – IVF failure can happen if the basic requirements to start the cycle aren’t fulfilled. Sometimes even after usage of pills and hormonal supplements, the female reproductive organ isn’t able to reach the required form.
  2. Failure in producing enough number of eggs – in some cases even after use of FSH and another stimulating hormone the ovary isn’t able to produce multiple follicles or even if multiple follicles are produced not all of them contain eggs.
  3. Quality of Egg – the reason to produce multiple follicles is to produce multiple eggs that can increase the chance of a healthy fertilized egg to be transferred. Not every egg retrieved is alive and even if all of them are alive, they aren’t mature enough or are fertilized to become embryo.
  4. Implantation failure – even if the experts are successful in producing fertilized eggs and are able to keep them safe until they multiply and reach the stage to be transferred into the uterus, the process of implantation is still risky. The failure of implantation mainly occurs due to fertilized egg having any chromosomal disorder or unhealthy endometrium lining.
  5. The other major factors leading to a failed attempt at IVF are the ones associated with the lifestyle of the patients. Among these factors, age of the female partner matters the most. The females under 35 years of age have more chances of successful IVF than the ones above 35 years. Patients involved in smoking have higher chances of a failed IVF cycle. The weight (overweight/underweight) of the female patient also influences the success of an IVF cycle.

Any of the above-mentioned reasons or reasons specific to a particular couple can lead to failure of a first IVF cycle. It has to be accepted that an IVF cycle has as much of a chance of failure as of success and that the 1st IVF cycle always has higher chances of failure than the following attempts. The question that arises now is how to cope with this failure?

The first and foremost thing to do after your first failed IVF cycle is to give yourself and your partner some time to sit back, accept it and deal with it rather than denying its emotional and psychological effects and rushing into another process. Even your body requires time to deal with it and rushing into another process without a break would increase the chances of its failure.

The second most important step is to talk with your doctor and find out where the process failed. You need to question the process and understand it and know that it wasn’t because of you so that you don’t enter into the zone of self-blame and self-loathe. Understanding the cycle and the reason behind the failure will help you cope with the failure well, at least more than locking yourself up and pitying yourself, plus, it would help you to be more cautious and careful in further attempts.

One needs to realize that the failure of the first IVF cycle isn’t the end of your dreams even though it seems like. While thinking of what one must do after a failed IVF attempt, the most feasible and appropriate solution that appears is to try again. Once indulging in the process of IVF requires multiple attempts to lead to a successful cycle. Although it is draining in both emotional and financial ways then that is how it works. One needs to trust the process and the experts involved in it.

In case of a failed IVF cycle, the doctors examine the entire process and conclude where it went wrong and find solutions so that it can be corrected in the later attempt. For example in case of failed ovarian stimulation a better combination and dose of drugs can be used, whereas for failed implantation, techniques like PGS (preimplantation genetic screening- a process that screens the embryo before implantation to check the presence of any genetic disorders) can be used or the uterine lining can be prepared better.

Apart from this one can always look for second opinion. You can refer to different experts and even change clinic if it doesn’t feel satisfactory to you. Moreover, people need to realize that feeling exhausted from the process is okay. Adopting a child or deciding to have a child-free life isn’t being a failure and is completely okay irrespective of the social constructs that we have grown in.

However, in the entire process, people tend to ignore their mental and emotional health which turns out to be one of the biggest mistakes one could do. This process is undoubtedly exhausting, not just physically and financially but emotionally, mentally and psychologically as well. Thus, it requires proper care and support. The couple needs to stand together and be supported by the near and dear ones.

In addition to that, remember that seeking professional help doesn’t make you weak rather it helps you cope with the process in a far better way. The most important thing to cope with during this failure is your emotional and mental health and the best way to cope it is to let yourself be loved and be under proper care and definitely professional care if needed.





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