The 3 kinds of IVF Failure – and what you can do about them ?
Most patients who fail IVF feel very sorry for themselves. Though they spent all that time, money, and energy, the cycle failed and all their efforts went down the drain, and they didn't end up getting the baby that they wanted.
It’s important not to get depressed, but to logically analyze the failure, by looking at the medical details of the IVF cycle in greater detail. It’s helpful to classify IVF failures into three kinds because this gives us useful actionable information which we can use to increase the chance of success for the next IVF cycle.
The first kind of IVF failure is unavoidable IVF failure. The IVF cycle was medically and technically perfect; the embryo was a top-quality blastocyst, as documented with embryo photos; the endometrium was receptive; the transfer was smooth, and yet the embryo didn't implant. This failure is unavoidable, because embryo implantation is still a black box area, and there's very little that we can do to control the biological process of embryo implantation.
The trouble is that when the cycle fails, especially when it is perfect, patients demand answers - and when patients demand something, doctors tend to give it to them. Unfortunately, they're not willing to tell patients the truth that we cannot determine the reason for the failure after transferring a perfectly good embryo into a perfectly good endometrium. The reality is that sometimes it's just luck or bad luck. This is random, and we don't have the tools for being able to determine the underlying cause, except for reminding patients that human reproduction is inefficient – both in vitro ( in the IVF lab), and in vivo ( in the bedroom).
However, doctors want to pretend to be omniscient. They are worried that if they tell patients the truth that this is outside their control, patients will think they're incompetent, or not knowledgeable, and will go to another clinic to get a second opinion and look for a doctor who will give them the answer that they're looking for. This is why doctors will make up an answer, and it's very easy to make up glib answers and fool patients, because patients don't understand technical minutiae, and pretty much believe whatever the doctor says. This is why the doctor will then advise more tests – including genetic tests; immunological tests; and embryo biopsy, all of which are entirely useless, because they don't increase the chances of implantation in the next cycle, but both patients and doctor are happy because at least the doctor is doing something different in the next cycle!
The fact that the doctor has explored cool new technological options gives the patient peace of mind that the doctor is doing his best, even though this is purely illusory! This over-testing does not add value to the patient, but definitely adds value to the clinic, because the doctor can now charge for all this additional stuff , and posture that they have done everything humanly possible, and left no stone unturned – even though these were stones which actually didn't need to be turned in the first place, but the poor patient doesn't understand that.
The second group of IVF failures are the avoidable IVF failures, and these are distressingly common in Indian IVF clinics. Here, the IVF cycle fails because the embryos are of poor quality ( they have been arrested or are dead ), and yet the doctor goes ahead and does the transfer, to cover up his incompetence. This seems like a travesty of medical care but is surprisingly common because a lot of IVF clinics will take advantage of their patients' ignorance and hide information from them. They will not share embryo photos and ruthlessly put dead embryos back into the uterus, even though they know that the embryo cannot possibly become a baby. To hide the truth, they don't provide photographs, and label the embryo as a “ top quality “ grade 3AA blastocyst on a computer printout, even though this is a lie, because they know they can get away with it!
One way of differentiating between avoidable IVF failure and unavoidable IVF failure is to analyze all your medical records yourself and make sure that you have images of your embryos, as well as the ultrasound scan images of your endometrium lining. This can be analyzed independently by another specialist, who can confirm that everything went the way it was supposed to.
One way of differentiating between avoidable IVF failure and unavoidable IVF failure is to analyze all your medical records yourself and make sure that you have images of your embryos, as well as the ultrasound scan images of your endometrium lining. This can be analyzed independently by another specialist, who can confirm that everything went the way it was supposed to.
Indian patients are very easy to take for a ride because they are so poorly informed. Ironically, it's often the brand name clinics that do this and are able to get away with it, because of their brand name, and because patients aren't intelligent enough to push back, demand information, or ask the right questions!
Yes, IVF failure can be heartbreaking, but if it’s avoidable IVF failure or iatrogenic IVF failure, that's good news, because all you need to do is find a better IVF clinic. It’s hard if it's unavoidable IVF failure, but you need to come to terms with the fact that science doesn't have all the answers, and sometimes you just need to be patient until your cycle works. And even though your earlier cycle failed, at least you have peace of mind the process was done properly, which means you have a good chance of success for the next attempt! This analysis will ensure you don't have any regrets in the future!