What happens if an embryo fails to implant

Actresses and entertainers over 40 have success after success, seemingly. But, remember, those magazines, and TV tabloid shows, are in it to make money and you see very little, if any, of the real story behind their fertility experience. When IVF fails there can be myriad reasons. Depending on the reason for your failed IVF, there are several solutions, ranging from trying another cycle of IVF, to third party fertility assistance, to adoption. For all of the success in fertility treatment, specifically IVF, it is a fragile and precise science.

Eggs, and sperm, must be viable and fertilize successfully. That fertilization must result in a healthy embryo. That embryo must implant accordingly in the uterus. Once implanted, the embryo must continue to develop. Here are some of the more common possibilities why your IVF failed. You, and your partner, should seek support before moving forward in your treatment. Numerous sperm — at high magnification on a counting chamber.

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Your fertility specialist will explain what may have happened and what you can do next. Here are some common reasons why an IVF cycle fails. The major reason why an IVF cycle is not successful is embryo quality. Many embryos are not able to implant after transfer to the uterus because they are flawed in some way. Even embryos that look good in the lab may have defects that cause them to die instead of growing. This affects her chances of success with IVF as well.

On average, only about 25 percent of transferred embryos go on to result in live births of babies. Women under 35 using their own eggs for IVF have an implantation rate of about 45 percent. Women 40 to 42 years old using their own eggs have only about a 15 percent chance of implantation.

Embryos end up with an abnormal number of chromosomes because the egg has abnormal chromosomes, or the sperm has abnormal chromosomes or during the first cell division after fertilization, the chromosomes are inappropriately separated. Despite our ever-improving approaches to care, embryonic issues still create inefficiency in all of our treatments. Over the last two decades, various approaches to try and address this problem have been developed. All of these approaches have utilized in vitro fertilization with the embryos being tested.

For many patients, the testing allows us to accurately address the problem of embryos having abnormal chromosome numbers. How can this be?

Today, we are going to explore why chromosomally normal embryos may not implant and how we try to address the problems when we can. Failure to achieve a successful pregnancy with euploid embryos can be generally grouped into three major areas: embryonic, uterine, and systemic.

The development of an early embryo is a complex and highly synchronized series of events to prepare it for attaching to and invading the lining of the uterus. The process starts at fertilization with single cell called a zygote, which develops over 5 days into a cell hollow ball, called a blastocyst.

It is a blastocyst that will attach to and implant in the lining of the uterus. Our 46 chromosomes contain about 25, genes that have to function properly to have the embryo develop successfully. I think of it like a symphony of the genes being turned on and off at specific times. If the timing of this is off, just like an orchestra, things will go badly.

Basic science studies suggest that energy function metabolism of the embryo is also a likely cause of failure, but this too cannot be practically measured in the clinical lab.

Basic science studies and our clinical experience suggest that early embryo development can be altered by our clinical and laboratory environment. It is clear that the type of follicular stimulation in an IVF cycle will impact the oocyte and embryo. The correct use of supporting medications LH or low dose-hCG, growth hormone, androgens may be beneficial to development of the growing follicle and egg for some individuals.

However, incorrect use of these medications can be detrimental. The type of trigger shot used to prepare for egg retrieval hCG or GnRH agonist may have an impact on egg quality also, but who may benefit from which drug and to what degree there is an advantage remain unclear. As you can imagine, the laboratory environment plays a huge role in how the embryos will perform. Culture media has evolved tremendously over the last 30 years, starting from simple media adequate for most cells to the variety of high quality embryo-specific, commercially made media that we currently use.

There are several high quality culture media available that work well however, constant quality testing is essential to make sure a chosen media performs optimally. The incubators that the embryos grow in and their function are clearly a major factor. Most high quality practices are using the small bench top incubators which do a better job of maintaining the chemical environment and temperature stability for the embryos to grow in.