A failed IVF cycle causes a lot of heartburn . It's not just
patients who get disheartened and disappointed, and doctors also wonder about
what they can do differently the next time to improve the chances of success.
We need to differentiate between repeated IVF failure versus recurrent implantation
failure. Recurrent implantation failure means good quality embryos ( usually, a
total of 4 top quality blastocysts) have been transferred in the uterus over 3
cycles and yet have failed to implant.
There are many other reason for IVF failure - for example,
because the embryos were of poor quality. If we know what the reason is, then
this is something we can focus on and try to correct. Thus, if the reason for
poor quality embryos is poor quality eggs because of advanced age, we can
address this issue by suggesting the use of donor eggs.
However, for patients where we have transferred top quality
embryos into a receptive endometrium, but the embryos stubbornly fail to
implant, then it becomes a much more complicated issue , because we cannot
determine why they are not implanting.
The reality is that we will have to call these unexplained implantation
failures, because implantation is still a biological black box which we cannot
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We need to understand our limitations , and this is why documenting the quality
of embryos ( by sharing photographs with patients) is so important for
determining what the next steps should be !