Multiple IVF failures can be devastating and disheartening for couples, who hope for a child with infertility treatment. Many women think that their uterus might have some issues, or their body is not accepting the embryo. There can be multiple causes of embryo implantation failure. Several tests can help to evaluate the exact causes behind the failure as well as help in increasing the chances of pregnancy.
What tests should I get done to know the cause of implantation failure? Dr Preeti Mahawar, Fertility Consultant, Nova IVF Fertility East, Kolkata, answers:
Sperm DNA fragmentation test
The Sperm DNA Fragmentation assay is a test that measures the quality of sperm to carry DNA. If the DNA fragmentation levels are higher, the fertilization rate will be much lower. Also, there might be chances of implantation failures and a higher risk of miscarriages due to abnormal genetic material in the sperm. Sperm DNA cannot be assessed through semen analysis. The test has gained importance in the field as knowing the integrity of genetic material in the sperm is essential for the normal development of the embryo.
Uterine evaluation/USG (TVS)
USG is done to evaluate the uterus ovaries and adnexa. This simple test helps us to know endometrium thickness, blood flow and pattern. We can also get information about any polyp or fibroids on cavity . Bulky uterus like adenomyosis candecrease the embryo chances to implant and therefore needs treatment. If tubes are filled with fluid / blood they appear dialateted in USG (hydrosalpinx) and need to be separated from uterus, this will improve the embryos potential to implant.
Endometrial Receptivity Assay (ERA)
ERA biopsy is recommended to women going through infertility treatment with a history of IVF implantation failures. It is a procedure that evaluates the endometrial cavity for implantation. A sample of the uterus lining or endometrium is sent for biopsy. If the sample test is receptive, it means that the endometrium is ready for embryo implantation. If the results show pre-receptive, it means that the lining of the uterus is not ready to receive the embryo and the chances of implantation will be less.
Sometimes the immune system may cause implantation failure. These tests help identify what is causing failure in IVF or a miscarriage. Many immunological alterations occur in a woman’s body to protect the developing embryo. Any immune system disorder can cause miscarriages and failure of IVF.
Preimplantation Genetic Testing for aneuploidy
Many times, abnormal embryos can be a major reason behind implantation failure. This happens because embryos may have an abnormal number of chromosomes, leading to abnormal births or failure in conceiving. PGT-A is a procedure in which cells from a developing embryo are tested. Out of these embryos, only the normal ones are transferred into the woman’s uterus. PGT-A is also effective in improving the chances of a pregnancy with a single embryo, reducing the risks of multiple pregnancies.
“Frequent IVF failure can be challenging for both doctors and patients. Sometimes genetic and chromosomal issues can also lead to failure of embryo implantation. Chromosomal abnormalities increase as a woman’s eggs grow older with her age. The advancing female age can lead to a high rate of chromosomally abnormal human embryos, especially when the woman is in her mid-40s. This is not the case with sperms, as the chances are low. Therefore, female age plays a major role in IVF procedures,” says Dr Preeti.
You have a right to ask questions to your fertility experts about why your IVF failed and what can be done to improve the chances of a pregnancy.