How to Increase IVF Success Rates?
Avoid excessive physical activities such as jogging or lifting heavy things. Practising yoga can relieve the mind and improve the body’s blood circulation. Make sure to get enough rest.
- Do not take any medication or drugs without consulting your doctor. This may harm the implantation process and development of your embryo during the first 3 months of pregnancy. Avoid herbal or traditional Chinese medication.
- Remember to take your progesterone medication daily and on time. This medication is inserted vaginally or via injection. Progesterone is essential for the early implantation of your embryo
Stop consuming alcohol and smoking during your IVF cycle and pregnancy. Smoking and alcohol both contain substances that may increase the risk of failed implantation, miscarriage, or birth defects.
- Drink plenty of water to improve hydration, boost blood circulation, and maintain cell integrity.
- If your work involves a lot of travelling, stress, and rigorous physical activities, it is advised to take one week’s leave after the embryo transfer.
- Store the vaginal pessary in a cool place (below 20°C) to prevent deterioration of its efficacy.
- Avoid intercourse for at least 3 weeks after the embryo transfer. Semen contains prostaglandin, which causes the uterus to contract and disturb the implantation of the embryo.
- Choose a fertility centre that is close by to reduce the stress of repeated travelling between your home and the centre as it will affect success rates. For instance, those staying in Selangor should choose a centre within the Klang Valley rather than travel to Johor Bahru.
- Consider pursuing infertility treatment promptly, as advancing age may lead to diminished egg quality and reduced IVF success rates.
- After the OPU procedure, look out for the following:
- Vaginal bleeding is usually spotty and should not be more than 1/4 of the pad. If it is more than 1/4 of the pad, please consult our doctor.
- Abdominal or tummy pain, often caused by the leakage of blood from the ovaries after OPU, can be alleviated by taking 650mg of paracetamol. If the pain persists, please consult with our doctor.
If you follow the IVF treatment cycle and precautions above, it will increase your IVF success rates.
Why IVF Cycle Failed?
The first IVF baby, Louise Brown was born on July 25, 1978, until today over 3 million babies have been born using IVF. The IVF success rate increased dramatically compared to the past. Today patients who undergo IVF cycle treatment are more likely to get pregnant than not.
However, there are still patients who required 2nd or 3rd IVF cycle. After this initial IVF cycle, every measure needs to be taken to improve the outcome of the next cycle. Identification of factors that link to the IVF cycle will help.
For normal endometrium to grow and be ready for implantation requires adequate blood flow to the underlying spiral vessel, adequate estrogen level, and no abnormalities of the uterus such as fibroid and congenital abnormalities. If the endometrium growth is poor then the patient can be treated using exogenous estrogen.
Sometimes the endometrium can be damaged due to previous infection or traumatic D & C. There will be fibrous adhesion between the uterine walls. This area would have an absence of endometrium to prevent implantation. This uterine adhesion and Ashermann syndrome can be easily diagnosed via a hysterosalpingogram (HSG) or hysteroscopy.
The adhesion can be removed surgically followed by IUCD insertion to prevent re-adhesion. However, there are still some patients who have a normal uterus, normal uterine blood flow, and good estrogen level & yet the endometrium remains persistently. This is because the end-organ damage and the endometrium do not respond to estrogen in the normal way.
For many years it was believed that the best time for embryo transfer is on the 2nd day after egg retrieval. The aim of the embryologist during the embryo transfer is to select the best embryo that has the best chance to implant and develop into the fetus. May of the failed implantation is due to chromosomal or genetic abnormalities of the embryos (some said it is as high as 50%).
The criteria used by the embryologist to select the most viable embryo are 4 cell embryo, equal size blastomere, absence of fragmentation, and mono-nucleusity.
Preimplantation genetic diagnosis (PGD) has been suggested to determine the normality of the embryo before transfer. However, many studies have shown that PGD causes embryo damage & does not help to increase IVF success rate. PGD is used in cases where the patient suffers recurrent miscarriages or the couples have a high risk of genetically inherited diseases that can be diagnosed through PGD.
Another reason for failed implantation is failed hatching. Normally the embryo will hatch through the zona pellucida on day 5. There is thinning followed by the opening of a tiny hole on the zona pellucida which enables it to be extruded and implanted in the endometrium. AH will help these patients who have failed.
It is estimated that 30% of female infertility is caused by a hormone imbalance of some sort. These patients with hormone imbalance were having irregular ovulation and irregular menses. We can determine your hormone profile by measuring your FSH level, LH level, progesterone on day 21, and prolactin level at any time.
During the IVF cycle, these hormone imbalances can be corrected by exogenous hormones (oral, injection, or vaginal route). The most common hormonal imbalance that causes fail IVF cycle is a luteal deficiency.
During the luteal phase, an adequate amount of progesterone is essential for successful implantation. The progesterone will increase the blood flow to the endometrium, increase the glycogen for improving the embryo, decrease uterine muscle contraction, and decrease uterus mobility. The endometrium needs to be quiescence. That’s why all IVF cycles requires progesterone support either in oral tablets, injections and vaginal pessaries.
The immune system or antibodies in the body is designed to protect women from infection by microorganisms. The microorganisms that enter the body will be attacked and neutralized by the lymphocyte or the antibodies that are produced by the immune system.
The immune system is necessary to control infection. Normally this immune system should not interact with the embryo which is implanted in the endometrium.
In some cases complex immunological interactions take place between the women’s immune cells called NK cells and the embryo, resulting in the destruction of the blastomere and failed implantation. There are also antibodies that produce from B lymphocyte that circulates in the body tissue and act on this embryo and her own endometrium leading to an IVF cycle & recurrent miscarriage.
IVF cycle itself is stressful and if there are other events in your life that further add to this stress then it may affect your immune system, causes an imbalance of hormone, and increase uterine contraction and endometrium mobility. All these will add up and can lead to failed IVF cycle. A good understanding of the IVF cycle, what to expect in the IVF cycle, and a good supporting partner will help to decrease your stress level.
Any routine that you have been doing physically stressful such as aerobics, mountain climbing, and long journey traveling should be prevented during IVF because these activities will stress your body system and increase uterine mobility.
Being overweight, smoking and alcohol also affect IVF outcomes of the IVF process. Many studies have shown women with a body mass index (BMI) of more than 25 have an increased risk of miscarriage and failed IVF cycle compared with normal-weight women.
Smoking and alcohol also affect the implantation of the endometrium by decreasing the uterine blood flow. If you are going through IVF treatment you should stop smoking, take alcohol and control your body weight if you are obese.
Why Do IVF Cycles Fail?
The first IVF baby, Louise Brown was born on July 25, 1978, until today over 3 million babies have been born using IVF. The IVF success rate increased dramatically compared to the past. Today patients who undergo IVF cycle treatment are more likely to get pregnant than not.
However, there are still patients who required 2nd or 3rd IVF cycle. After this initial IVF cycle, every measure needs to be taken to improve the outcome of the next cycle. Identification of factors that link to the IVF cycle will help.
For normal endometrium to grow and be ready for implantation, it requires adequate blood flow to the underlying spiral vessel, adequate oestrogen levels, and no abnormalities of the uterus such as fibroid and congenital abnormalities. If the endometrium growth is poor, the patient can be treated with exogenous oestrogen.
Sometimes, the endometrium can be damaged due to a previous infection or traumatic D&C. There will be fibrous adhesion between the uterine walls. This area would have an absence of endometrium to prevent implantation. This uterine adhesion and Ashermann syndrome can be easily diagnosed via a hysterosalpingogram (HSG) or hysteroscopy.
The adhesion can be removed surgically before an IUCD insertion to prevent re-adhesion. However, there are still some patients who have a normal uterus, normal uterine blood flow, and good oestrogen levels. Yet, endometrium issues remain persistent. This is because end-organ damage and the endometrium do not respond to oestrogen conventionally.
For many years, it was believed that the best time for embryo transfer was on the second day after egg retrieval. The aim of the embryologist during the embryo transfer is to select the best embryo that has the best chance of implanting and developing into a foetus. Many failed implantations are due to chromosomal or genetic abnormalities of the embryos (which may be as high as 50%).
The criteria used by embryologists to select the most viable embryos are four-cell embryos, equal-sized blastomeres, the absence of fragmentation, and mono-nucleusity.
Preimplantation Genetic Diagnosis (PGD) has been suggested to determine the normality of the embryo before transfer. However, many studies have shown that PGD causes embryo damage and does not help increase IVF success rates. PGD is used in cases where the patient suffers from recurrent miscarriages or if couples have a high risk of genetically inherited diseases that can be diagnosed through PGD.
Another reason for failed implantation is failed hatching. Typically, the embryo will hatch through the zona pellucida on day 5. There is thinning followed by the opening of a tiny hole in the zona pellucida, which enables it to be extruded and implanted in the endometrium. Assisted hatching will help these patients who have failed.
It is estimated that 30% of female infertility is caused by a hormonal imbalance of some sort. These patients with hormone imbalance experience irregular ovulation and menses. We can determine your hormone profile by measuring your FSH levels, LH levels, progesterone on day 21, and prolactin levels at any time.
During the IVF cycle, these hormone imbalances can be corrected through exogenous hormones (oral, injection, or vaginal route). Luteal deficiency is the most common hormonal imbalance that leads to a failed IVF cycle.
During the luteal phase, an adequate amount of progesterone is essential for successful implantation. The progesterone will increase the blood flow to the endometrium, increase the glycogen for improving the embryo, decrease uterine muscle contraction, and decrease uterus mobility. The endometrium needs to be quiescent. That’s why all IVF cycles require progesterone support either in oral tablets, injections, and vaginal pessaries.
The immune system or antibodies in the body are designed to protect women from infection by microorganisms. The microorganisms that enter the body will be attacked and neutralised by the lymphocyte or the antibodies produced by the immune system.
The immune system is necessary to control infection. Normally, this immune system should not interact with the embryo implanted in the endometrium.
In some cases, complex immunological interactions take place between the women’s immune cells (NK cells) and the embryo, resulting in the destruction of the blastomere and failed implantation. Some antibodies produced from the B lymphocyte circulate in the body tissue and act on this embryo and the woman’s endometrium, leading to a failed IVF cycle or recurrent miscarriage.
Going through IVF itself is stressful, and if other events in life add to this stress further, it may affect your immune system, cause hormonal imbalance, and increase both uterine contraction and endometrium mobility. All these will add up and lead to a failed IVF cycle. A good understanding of the IVF cycle, what to expect, and a good supporting partner will help to decrease your stress levels.
Any physically taxing routines such as aerobics, mountain climbing, and long journey travelling should be avoided during IVF treatment. These activities will bring stress to the body and increase uterine mobility.
Being overweight, smoking, and drinking alcohol will also affect IVF outcomes. Many studies have shown that women with a body mass index (BMI) of more than 25 have an increased risk of miscarriages and failed IVF cycles compared to women with a normal body weight.
Smoking and alcohol can also affect the implantation by decreasing the uterine blood flow. Anyone going through IVF treatment should stop smoking, alcohol, and manage their weight if obese.
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