While the chances of poor quality embryos implanting are almost nil, most good quality embryos also don’t implant even when they are transferred into a receptive uterus. It means, that in addition to the uterus and the embryo, there is an X-factor in the picture too.  There is no doubt about the fact that it’s frustrating when an IVF cycle fails. However, the unfortunate truth is that regardless of how good the doctor, the success rate on an IVF cycle can never be 100%.

The variables

When an IVF cycle fails, there are a number of thoughts that whirl through patient’s heads, such as- Why did the IVF cycle fail? Should I change the clinic? It’s important to look at the entire situation very logically; there are basically just two variables that determine if a pregnancy will occur or not after an embryo transfer:

  • The embryo, that  the doctor creates in the IVF lab
  • The uterus

The X-factor

But since we know that even top quality embryos won’t always implant, we know that apart from these 2 , there is a third factor at play, which could be:

  • The clinical skill of the physician
  • The maternal environment
  • Immune system in the endometrium
  • Plain luck ( for lack of a more scientific term)

It can be extremely hard to determine this and it’s also why I’m labeling it as the X-factor. I’m just not sure what exactly it is.

  • Certain doctors believe that in case top quality embryos fail to implant, the problem lies with the immune system of the woman (such as problems with their NK), it causes them  to reject the embryos. If this is what they believe, they begin treating the patient with various  immune therapy options including:
  • Intravenous intralipids
  • Lymphocyte immunization therapy
  • Intravenous immunoglobulins
  • Some patients believe that their embryos do not implant is because someone has put a curse on them. In this case, the X-factor then becomes that curse. They may also get the help of a witch doctor to exorcise this.  
  • Other patients believe that excessive stress prevents their embryos from implanting. They trust that using Mind-Body Techniques to manage their stress will help overcome Factor X.

The main reason why this list is such a long one is because we don’t really have any clear way to define the problem. Since we are unable to identify it, we can’t really solve it.  Of course, with time, as our understanding about embryo implantation improves, we will also be able to progressively decode this X-factor in a much better way. That’s when we will be able to improve IVF pregnancy success rates.

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!

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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