ByZarafshan Shiraz, New Delhi

Couples present process IVF therapy are of various age teams therefore, the success charges will differ when in comparison with a younger couple relatively than an older couple and the components that have an effect on IVF success charges are diverse. Doctors talk about the success fee in response to the affected person’s historical past, age and issues.

Causes:

In an interview with HT Lifestyle, Dr Asha Vijay, Gynaecologist and Medical Director at GarbhaGudi IVF, listed the components for repeated IVF failure as -

1. Age: As the girl ages, the performance of ovaries deteriorates and the standard/amount of eggs come down.. The embryo high quality and the implantation potential turns into very much less. In males, sperm injury turns into extra as they age and the embryo injury turns into extra as soon as the person crosses 40-45 years of age. If the girl is alleged to be 35 years of age and the person greater than 40, there's a likelihood of implantation failure resulting from embryo points induced resulting from age.
2. In addition, the infrastructure, embryology companies and state-of-the-art services obtainable at a specific IVF Centre additionally performs a task. So {couples} ought to fastidiously think about these components earlier than deciding on a sure IVF centre.
3. History of the affected person: If the girl has underlying or a historical past of repeated surgical procedures, she is liable to IVF failures. Doctors should analyze the issue and deal with the trigger.
4. Below are a couple of different components -

• Repeated fibroid elimination surgical procedure on the uterus
• Repeated endometriosis
• Repeated surgical procedures on the ovaries
• Congenital anomalies within the uterus like septum.
• If the endometrium doesn't develop, it may very well be due to a earlier TB an infection or pelvic inflammatory illness, regardless of how good the embryo is, it can't be implanted.

According to Dr B Ramesh, Medical Director and Chief Gynaec Laparoscopic Surgeon - Infertility, IVF Specialist and Urogynaecologist at Altius Hospital, the recurrent implantation failure causes are grouped into 3 classes :-

• Decreased endometrial receptivity – may very well be resulting from myomas, endometrial polyp, skinny endometrium, endometritis, adenomyosis, PCOS, thrombophilia.
• Defective embryo growth - may very well be resulting from zonal hardening, suboptimal tradition situation, poor high quality embryos, and genetic abnormalities.
• Multifactorial components - like hydrosalpinges(issues with fallopian tubes), previous age, diabetes mellitus, elevated sperm DNA fragmentation.

How many occasions can a pair go for IVF?

Dr B Ramesh defined, “RIF (Repeated Implantation failure) definition – failure to become clinically pregnant after the transfer of atleast 3 good quality embryos in 3 fresh or frozen cycles in women under 40 yrs of age.”

Dr Asha Vijay elaborated, “If the woman has good reserves, doctors can try for 3 cycles. If there are enough embryos after the first IVF, then 3-4 embryo transfers can be performed. Few patients would have undergone 6 transfers but it is advised not more than 3 stimulations. Mainly if the patient has had repeated failures. The recent advancements can help detect the exact time for embryo transfer. Usually the transfer of embryo happens at 120 hours of progesterone. The endometrial receptivity assay (ERA) can not only detect when the embryos should be transferred, it can also suspect if the patient is failing because of the displaced window.”

Solutions

Dr Asha Vijay steered -

• Opt for centres with good services, embryo companies, and infrastructure.
• Choose technologically and scientifically superior centres
• Do not merely go as per the charges, reductions and packages which can be provided. Spend sufficient time researching concerning the centre and speak to different {couples} who've used the companies at a specific centre
• Talk to different {couples} who've undergone profitable IVF remedies
• Read concerning the physician and the extent of experience the centre gives.

Dr B Ramesh concluded, “Couple should visit the fertility specialist. We will start investigating the cause for RIF and the majority of RIF cases are idiopathic with no identifiable cause in either partner. Other investigations like hysteroscopy to rule out uterine cavity abnormality, thrombophilia profile, karyotyping of parents, evaluation of sperm DNA fragmentation index, EB for culture of tuberculosis, ovarian reserve assessment.”