Management of Recurrent IVF failures
Management of Recurrent IVF failures, pregnancy failures, and miscarriages
Recurrent miscarriage is also known as recurrent pregnancy loss. It is an extremely distressing condition that can affect some couples who are trying to conceive. There are many reasons for miscarriage. Sometimes the couples get so disheartened that they lose hope, but there are solutions to every problem and hence, a miscarriage should not stop any woman or couple from trying for a child again.
In cases where a woman goes through more than one miscarriage can be disheartening. It should be kept in mind that miscarriages are often a natural process. As much as two-thirds of women who go through recurrent pregnancy loss can eventually have a healthy baby with the right help.
Recurrent IVF Failures
Recurrent Implantation Failures stands for the inability to achieve a clinical pregnancy despite transfers of four or more good quality embryos in at least three fresh/frozen cycles for women under 40 years of age. The reasons for failure to the implant can be due to the embryo or uterine factors. The reason for failure to the implant can also be due to contributory factors such as poor egg quality, poor sperm quality, or increased sperm DNA fragmentation. Recurrent implantation failure can lead to repeated IVF failure.
What factors influence recurrent pregnancy loss and miscarriages?
- Age: The risk of miscarriage is higher as women get older beyond 40.
- Genetic factors: Many women or their partners may have a chromosomal abnormality that can cause a problem if passed on to the newborn.
- Structure of the womb: Women with serious anatomical abnormalities of the womb such as the uterine septum, bicornuate uterus, unicornuate uterus are more likely to have a miscarriage or give an early birth. Minor structural variations do not cause miscarriages.
- Autoimmune factors: About 15% of women who have had a recurrent miscarriage are those with antibodies called antiphospholipid (aPL) in their blood. For a woman with a history of recurrent pregnancy loss and the presence of aPL antibodies, the chances of a successful outcome are bleak without treatment.
- Abnormalities in the embryo: Abnormalities in the embryo due to chromosome are high in women age more than 37 years and are a common reason for a miscarriage.
- Blood conditions: Inherited conditions such as thrombophilia can play a part in miscarriage. Thrombophilia is a condition where blood is more likely to clot than usual.
- Infections: Infections such as bacterial vaginosis early in pregnancy can increase the risk of miscarriage or premature birth.
- Weak cervix: In several women, the cervix or the entrance of the womb opens too early during pregnancy causing a miscarriage in the third or fourth month.
How can you prevent recurrent miscarriages?
- Screening for genetic problems: Either of the partners can have a chromosomal abnormality. A blood test called karyotyping can be done to check for any abnormalities and risks associated with it.
- Screening for abnormalities of the womb: An ultrasound scan of the pelvic region should be done to check for any abnormalities in the structure of the womb and if found should be corrected by hysteroscopy and laparoscopy.
- Screening for infection: Women who have had miscarriages in their fourth to sixth month or premature labour should be screened for bacterial vaginosis. Antibiotics treatment can reduce the risk of miscarriage considerably.
- Treatment for hormone imbalance: Women with hormonal imbalance should take progesterone or human chorionic gonadotropin hormones early in their pregnancy after a suggestion from their doctor. This can help to prevent miscarriage.
- Treatment for weak cervix: With a weak cervix, miscarriage is likely. An ultrasound scan can help to indicate that. A stitch in the cervix can be put to ensure it stays closed.
- Treatment for aPL antibodies: Treatment for women with aPL antibodies can be done with low dose aspirin and heparin injections after a suggestion from your doctor. This can improve changes for birthing women with a history of recurrent miscarriages.
- Treatment for thrombophilia: Even though Thrombophilia increases the risk of miscarriage, treatments can help to reduce the risk of a blood clot.
Dr. Richa Singh is a well known IVF specialist from Max Hospital, Delhi who has been awarded for her exemplary work in the field of infertility, and now she is available in Lucknow. She has a proven track record of high success rates and has been helping numerous families to conceive through various procedures of ART. She has expertise in treating complicated cases of infertility with a history of recurrent pregnancy loss and implantation failures. Patients all across the nation and abroad have been seeking her help for conception in such cases. She has managed to give pregnancies to previous 6-7 cycle IVF failure patients and thus gained their trust. Her patients can vouch for her exceptional services.