Despite several years of research and technological advances, assisted reproductive therapies are not an exact science. Women and couples attempting to become pregnant are usually advised to manage their expectations for success, since every infertile patient has unique challenges to face.
Many couples undergoing in-vitro fertilization will not have a successful cycle the first time around, and are faced with a difficult decision: whether to consider a second cycle.
After a failed IVF attempt, the reproductive specialist physician reviews the details of the cycle to determine which step in the process was the most likely reason for failure. Any of the following steps may have been problematic:
• Ovarian stimulation via hormone administration
• Egg retrieval
• Egg quantity and quality
• Fertilization results
• Transfer of fertilized embryo
• Embryo development in utero
In many cases, the problem can be localized to one or more of these areas, and the protocol for ovarian stimulation as well as development issues need to be discussed openly and candidly. If there are any pictures of the embryos or documentation of the embryo quality at every stage of development, they also require discussion and review before a plan for a second IVF cycle can be considered. Thus, it is important that the rapport be strong between doctor and patient.
Not every issue in any failed IVF cycle will be reparable. Despite this, many issues that are identified in a failed first IVF cycle can be treated so that they will not happen again, or at least have a lower likelihood of recurrence. Nonetheless, the couple should discuss these with their reproductive specialist so that they have as full an understanding as possible about their situation, and that they have an accurate estimate of the success rates for the second attempt at IVF.
Couples who have endured a failed IVF cycle often ask one very common question: what is the success rate for the next cycle? Some of the factors to consider are the following:
• Female partner’s age
• Sperm and egg quality and quantity
• Skill of reproductive specialist in administering ovarian stimulation
• IVF lab quality
• Egg retrieval and embryo transfer skills of reproductive specialist and staff
• Number of eggs retrieved
• Underlying cause of infertility
• Presence of uterine pathology
• Rates of embryo development or embryonic arrest
• Genetic and chromosomal viability of embryos
Overall, the success rates for a second attempt at IVF are about the same on average for the first. Learning from the first failed IVF cycle and making adjustments to maximize success for the second in-vitro fertilization attempt can increase the chance for a successful second attempt at IVF.