The first protocol of in vitro fertilization is often unsuccessful. Pregnancy does not occur in about half of the cases. There is also a high probability of a missed pregnancy or early miscarriage. After that, a reasonable question arises, when can you try again. We will talk about this in our article.
Why do attempts fail?
If an IVF attempt is unsuccessful, it is important to establish the true reason why the pregnancy did not take place. It depends on which factor or combination of causes influenced whether the chances of pregnancy will increase during the subsequent protocol. The reasons for failure can be very different.
Often, embryos obtained by fertilizing mother's eggs with sperm from a husband or donor do not meet strict quality requirements. They do not show high vitality, in fact, they are not strong and healthy. Such embryos have almost no chance of successfully implanting.
Embryos can be injured during transfer, for example if transferring too quickly. They also die, pregnancy does not occur. The reasons may lie in the insufficient quality of biological materials - oocytes and sperm.
Often the protocol ends unsuccessfully due to too aggressive hormonal stimulation of the ovaries in the first phase of the menstrual cycle in the first protocol. At the same time, an excess of estrogens, FSH occurs in a woman's body, ovarian hyperstimulation syndrome may develop, which significantly reduces the already far from one hundred percent probability of a successful completion of the protocol.
A woman can get flu or SARS after the transfer of fertilized eggs into the uterine cavity. Her long-standing chronic diseases may be exacerbated by aggressive hormonal therapy. Sometimes the reason for the absence of pregnancy after an IVF attempt is autoimmune processes, as well as the genetic incompatibility of partners. Sometimes doctors fail to obtain a sufficient number of eggs, and sometimes a large number of fertilized eggs do not pass selection for suitability for transfer.
Quite often, implantation is hampered by the patient's burdened obstetric history - endometriosis, uterine and cervical pathologies can be a significant obstacle to the cherished motherhood.
Previous abortions, curettage (including diagnostic) can make the endometrium heterogeneous and too thin for a fertilized egg to successfully attach to it and begin to develop further.
Even if pregnancy has occurred, and this was confirmed by ultrasound and hCG tests, after IVF, the likelihood of pregnancy fading or early miscarriage is quite high. This, again, can be a consequence of hormone therapy, and is also caused by a variety of reasons.
Pregnancy after IVF is special, more careful monitoring is required for such expectant mothers. But even the best doctors, alas, cannot always prevent the death and detachment of the ovum.
Unsuccessful IVF, whatever it may end, may be a consequence of the woman's age. The optimal age, when the success rate is the highest, is considered to be the age of 35 years, then every year the probability of a successful pregnancy decreases.
After an unsuccessful attempt, it is important to gather the will into a fist, and no matter how much you want to drop everything and cry, you must definitely go for an examination, which will help you understand what really happened and when you can start the next attempt.
What examinations do you need to undergo?
After the end of the next menstruation, which completed the unsuccessful protocol, the woman must do an ultrasound of the pelvic organs, as well as hysteroscopy, which will show all the features of the uterus and endometrium. It is imperative to donate blood for hormones, general and extended blood tests, urine tests.
Couples over 35 years old, as well as couples who have undergone three or more unsuccessful replantings, need to visit genetics and do the necessary tests for compatibility and karyotyping. And an immunogram made in the clinic will help to identify possible immune factors in which a woman's body rejects pregnancy as something foreign.
If a miscarriage or miscarriage has occurred, the woman will have to do all the same tests, and in addition to them, it is desirable to get a conclusion from the genetic laboratory, which examined the embryonic tissue after the pregnancy fading or spontaneous miscarriage. With a high degree of probability, such a study will show whether the baby had genetic pathologies or other reasons became the cause of his death.
After passing the examination, you should immediately go to the doctor who did the IVF so that he could review the previous protocol and make adjustments to it. Sometimes it is just enough to change the protocol from long to short, or replace one hormonal drug with another, or change the dosage so that the second attempt is more successful.
When can I try again?
The question of how many days a second IVF can be done is not entirely correct. In each case, individual terms are established, which depend on the well-being, state of health of the woman and the reasons why the first protocol was unsuccessful.
The most common time a woman is given to recover is three months. During this time, a woman usually has time to calm down after a previous defeat, gain hope and do all the necessary tests and examinations.
However, if the previous attempt was carried out without hormonal stimulation of the ovaries, in the natural cycle, you can try again in the next menstrual cycle, that is, after two weeks.
After a miscarriage and a frozen pregnancy, a woman usually needs more time to recover, since in most cases such situations require curettage of the uterine cavity. First, she must undergo treatment with antibiotics and anti-inflammatory drugs, then proceed to rehabilitation and, finally, to preparation. The recommended pause in this case is six months.
Probability of a successful protocol
A repeated protocol is almost always more likely to succeed than the very first. This is because ovarian stimulation is often unnecessary on repeated attempts. If during the first stimulation a sufficient number of oocytes is obtained and several oocytes are left frozen in the cryobank, then a cryoprotocol is prescribed. The transfer of embryos into the uterus of a woman who is rested from the aggressive hormonal effects significantly increases the likelihood of a successful pregnancy.
Even a stimulated second or third protocol is considered more successful than the first. So, with the first protocol, the probability of pregnancy after IVF is about 45%. In the second protocol, the probability of pregnancy reaches 60%. However, after the third attempt, the chances are significantly reduced and are no more than 15-20%.
The age of a woman influences the forecast - if she is under 35, then the chances are high. At 38 years old, they do not exceed 35%, at 40-42 years, the probability of pregnancy is 15-19%, and after 45 years - no more than 8%.
Any aggravating factors - ovarian hyperstimulation, tumors in the uterus, exhausted endometrium, chronic diseases reduce the success rate by about 5% for each factor. However, everyone always has a chance to get pregnant. Gynecologists are aware of cases when IVF ends with a successful pregnancy in women aged 50 and older, as well as in women with severe forms of infertility.
The following information is useful as a "bonus": the first or second attempts at IVF, if they were carried out with hormonal support, significantly increase the likelihood that the woman's reproductive system will start working more actively after the hormonal "shock". Therefore, in 25% of couples, after an unsuccessful attempt or two, pregnancy from natural conception is quite likely.
This usually happens during the period of recovery and preparation for the next attempt at in vitro fertilization. Naturally, such an outcome is likely only in women who have preserved the ovulatory function of the ovaries and the ovaries themselves, and also there is no obstruction of the fallopian tubes.
To all of the above, it remains to add only that it is also not worth delaying with the next attempt. A long break, as well as an excessive rush, can badly affect the outcome of the next attempt. Obey the doctor, follow his recommendations and everything will definitely work out.
Reviews
According to women's reviews, which exist in large numbers on thematic forums on the Internet, one of the most important is the psychological attitude before the next attempt. So, women who worked with a psychologist, attended IVF preparation seminars, used the services of a psychotherapist, are more likely to get pregnant than women who are simply fixated on a possible failure and limit themselves in communicating with someone on this topic.
Most often, women note that the second or third protocol was successful. Less often - 5-6. Cases when women went "to victory" are rare, but they are there - 8 and even 9 IVF and finally the first positive result. That is why it is important not to lose hope and try not to worry.
The importance of support is not even worth talking about. That is why there are many forums where women who find themselves in similar situations can share their experiences.
In the next video, a doctor at the FertiMed Center for Reproduction and Genetics answers frequently asked questions.
