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Failed IVF Cycle

 In Assisted Reproductive Techniques

Our Center specializes in treating couples who have had failed IVF cycles. A failed IVF cycle can be because of poor egg quality, sperm quality or uterine lining. It is assumed that all the stimulation egg pick up, laboratory procedures and embryo transfers have been done meticulously in previous attempts. We offer certain modifications in an IVF cycles for optimizing outcome in couples suffering from failed IVF attempts-

  • Optimized stimulation protocol:The short antagonist protocol offers the best results in terms of selection of the best oocytes(eggs) in most cases
  • Selection of Sperm: In many cases, Intra Cytoplasmic Sperm Injection (ICSI) is offered as it has been suggested that it may improve fertilization rates and hence, overall pregnancy outcome. Our embryologist takes special care to select the best sperms for doing ICSI.
  • Hysteroscopy:The hysteroscope aids us in picking up uterine abnormalities which are sometimes missed at routine ultrasound e.g., small polyps. It is also useful in washing and cleaning the uterus which sometimes may help in improving the outcomes. Endometrial scratching is also done at the same setting to improve the uterine receptivity.
  • Intravenous Immunoglobulin (IVIg):IVIg seems to directly affect NK cell level and activity, by reducing their absolute numbers and increasing the expression of inhibitory receptors CD94 which potentially can improve pregnancy outcome.
  • Atosiban:This is a uterine relaxant which is given during the embryo transfer. It helps in relaxing the uterus and therefore, improving the endometrial receptivity.
  • Vitamins and Antioxidants:DHEA, L Arginine, Zinc, selenium etc. are given to women and men as indicated to improve the egg and sperm quality.
  • Day of Transfer:Not all women will be benefitted by Blastocyst (Day 5 ) transfer as many seem to believe by studying the internet. The day of transfer should be individualized for each patient.

The internet is flooded with various treatment options for failed IVF cycles, amongst these are ERA (Endometrial Receptivity Assay), PGS (Preimplantation Genetic Screening) and laser hatching. ERA presumably detects the phase of the endometrium in which the embryo best implant. However, there is controversy regarding the actual benefit of this in improving the live birth rate.

PGS is a way of detecting abnormal embryos but many studies have failed to prove the beneficial effects of PGS in improving the pregnancy rates.
(Please read: http://www.ncbi.nlm.nih.gov/pubmed/19079970, http://www.ncbi.nlm.nih.gov/pubmed/16437524)

Laser hatching is only useful in older eggs which have a thick shell.
(http://www.ncbi.nlm.nih.gov/pubmed/16437437, http://www.ncbi.nlm.nih.gov/pubmed/27071963)

Dr. Banerjee studies each case individually and decides which treatment will be the most beneficial for that particular patient. She does not believe in increasing the cost of treatment by using technology whose role is yet to be established. Many couples have been blessed this way who earlier were struggling to fulfill their dreams of parenthood.

 
 

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