Previous ART Failures
What If I’ve already tried without Success?
Aaradhya team of specialists produces one of the highest success rates in Visakhapatnam. Aaradhya has helped thousands of couples achieve their dream of having a child. Many of our patients have undergone unsuccessful IVF cycles in other centers.
Aaradhya incorporates innovative procedures in its treatment plans for the more “complex” patients including:
- Highly individualized medication schedules for ovarian stimulation of women over 37, patients with slightly elevated FSH, and patients who are poor responders to fertility drugs.
- Intracytoplasmic sperm injection (ICSI) for patients with significant male factor infertility or those who previously had low fertilization rates or fertilization failure. Assisted hatching is offered in IVF procedures to assist with uterine implantation issues.
- Donor egg IVF program. Altruistic donation may be from a family member or friend of the woman desiring a pregnancy or an anonymous donor to the clinic.
- Assisting with gestational carrier IVF, when the woman desiring children has a uterine abnormality or a history of an inability to carry a developing fetus to term.
There are many interventions that can increase your chances of conceiving and delivering a baby. You are encouraged to see the doctor for consultation to discuss your options.
Recurrent implantation failure
Recurrent implantation failure is usually defined as more than 3 transfers of embryos without implantation (no positive pregnancy test).
What we do know: It is difficult to understand why implantation does not occur but age, embryo quality and submucosal fibroids are known to affect implantation.
Age of the woman: As a woman gets older, the chance of conception from IVF treatment declines. This is a well established fact and is most likely secondary to the increasing number of abnormal (aneuploidic) embryos created as a woman gets older. Unfortunately there is no treatment for this.
Embryo quality: There is a reduced chance of conception if the embryo quality is poor. Although embryo quality is a purely subjective analysis made on the appearance of the embryos, there is good evidence to suggest that poorer quality embryos are less likely to implant with overall pregnancy rates being less.
Submucosal fibroids: Fibroids located within the uterine cavity are known to· cause implantation failure and should be removed prior to commencing treatment. They are diagnosed by ultrasound scan with saline instillation sonography and treated by means of a hysteroscopy and transcervical resection under general anaesthetic. What we don’t know or is not established currently in the literature: Immunological Causes and Blood Flow.
What we don’t know or is not established currently in the literature: Immunological Causes Aberrant immune responses may be related to infertility, implantation failure and recurrent pregnancy loss. The regulation of uterine and circulating peripheral blood natural killer (NK) cells has been associated with reproductive failure with NK cells reacting abnormally to an implanting embryo, treating it as an invading cell and signalling for the body to attack it. The prognostic value of measuring peripheral or uterine NK cells however remains uncertain. The value/role of NK cell assessment as a predictive test for screening women who may benefit from immunotherapy has not been proven with most studies being insufficiently large enough to make a proper assessment.
Treatment: Intralipid has been shown to suppress Natural Killer Cell toxicity as evidenced by both animal and human studies. Studies have found that intralipids can help to regulate NK cells, allowing the embryo to implant on the uterine wall and grow normally. Research has suggested that women who have experienced recurrent implantation failure or multiple failed IUI or IVF cycles as a result of NK cell activation may benefit from the use of intralipids. Intralipid is the name of a fat emulsion used to provide essential fatty acids for intravenous nutrition. Intralipid also contains soya oil, glycerol, purified egg phospholipids and phosphate. Intralipds are given via a drip and have few side effects with excellent patient tolerance. Immunoglobulin (IVIg) has also been shown to supress Natural Killer Cell toxicity. The benefit from the use of intravenous immunoglobulin has yet to be proven.
Thyroid Peroxidase Antibodies: Have been associated with an increased prevalence of recurrent implantation failure. Studies are being performed to investigate the efficacy of giving Thyroxine to women to assist implantation.
Treatment: Thyroxine, Prednisolone Antiphospholipid syndrome.
A diagnosis of antiphospholipid syndrome should only be Antiphospholipid syndrome: A diagnosis of antiphospholipid syndrome should only be made if the antibodies (anticardiolipin antibodies and/or lupus anticoagulant) are persistently positive in tests done at least 12 weeks apart. Although many studies have shown an increased prevalence of antiphospholipid antibodies among women undertaking IVF, prospective studies have shown that the presence of these antibodies does not affect either the implantation or ongoing pregnancy rate.
Treatment: Subcutaneous Heparin; although there is little evidence to support the use of Heparin with no substantial evidence of improvement in pregnancy rates.
Inherited thrombophilias: Activated protein C resistance, deficiency in protein C/S, deficiency in anti-thrombin III, Hyperhomocysteinemia and prothrombin gene mutations have been associated with recurrent implantation failure.
Treatment: Heparin. Heparin has been shown to be of benefit in improving implantation rates in women with thrombophilia.