When an IVF cycle fails , it causes a lot of frustration and anguish; not just for the patient, but for the doctor too. The first thing the patient asks her doctor is – “Why did my cycle fail?” and understandably, doctors are also under a great deal of stress when they are answering this question. This is also why they end up ordering a wide range of tests, in an attempt to pinpoint exactly why the embryos didn’t implant.
Unfortunately, the fact is that the available tests are of almost no use in this particular setting. We do know that the most common reason for an embryo failing to implant is because it has genetic defects and this causes them to arrest. It is nature’s defense mechanism to prevent an abnormal baby from coming into the world.
Sadly, the genetic tests that are currently available are extremely crude. The tests such as PGS/CCS/NGS don’t do much more than give us the chromosome count. We can’t really analyze the defects at the gene level yet. Asking patients to do these unnecessary tests only harms the patients as most of these genetic tests tend to produce false positives.
For example, doctors do a test for TB PCR, and then they "treat" completely normal patients with 9 months of various toxic drugs. Some doctors check for "NK cell activity" and then they treat patients with very expensive IV immunoglobulins; its important to note here that these drugs have unproven efficacy.
Our first sacred oath as physicians is to “do no harm,” and ideally, such therapies should be approached with skepticism. A "pseudodiagnosis" can end up being an expensive exercise for the patient- in terms of time and money!
Some sound advice
I have a very simple suggestion for patients who have failed an IVF cycle. After their IVF specialist asks them to do a complete workup and they still have no answers about what caused the failure, they should just accept the fact that their doctors just may not be able to provide them the answers. Instead of getting frustrated and anxious, they should rejoice in the fact that everything is normal. They should count their blessings that no problems have surfaced.
Though the technology to identify problems isn’t very good, IVF treatment has most of the answers and can find solutions by bypassing those problems. Keep in mind that just because one or more of your cycles has failed, that isn’t an indication that a future one will. You only need to be motivated, patient and resilient- you will find that the rewards are well worth all the trouble.
Not happy with the attention you are getting from your IVF clinic? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!