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After a failed IVF cycle - what next ?

Posted Nov 18 2008 12:17am

Every patient does an IVF cycle with the hope that it's going to work. When the IVF cycle fails ( as it does for the majority of patients), then it's important to analyse what you've learnt from it , so that you can pick up the pieces of your broken heart and move on.
The question we would all like an answer to is - why did it fail ? Unfortunately, most of the time we cannot answer this question. Embryo implantation is a "black box" we still cannot probe or dissect. Even though we expect that all good embryos should implant, the fact remains that the majority don't - and we still don't know whay certain embryos implant - and why others don't.
In nay case , the question should not be - why did the cycle fail ? The question should be - what do we do next ?
Remember that there are only 5 variable to analyze - eggs; sperm; embryos; the uterus ; and the IVF lab. Go through these one by one, so you can formulate your next step.
If you had good quality embryos which did not implant, it's reasonable to repeat the cycle again without making any changes.
If the egg quality was poor, you may need to consider changing the superovulation regime ( and this may involve changing the clinic); or using donor eggs.
If the sperm did not fertilise the egg, then you should consider doing ICSI.
If the embryos were poor quality, then it could either be a lab problem; or an egg problem.
If the uterus lining was poor or abnormal, then the option would be to consider surrogacy.
Of the 5 variable, you need to decide which ones performed well - and which did not; and then you need to think about which ones you are willing to substitute. Are you willing to change the clinic ? use donor sperm ? use donor embryos ? use a surrogate.
Use the McKinsey MECE formula ( make a list of mutually exhaustive and completely exhaustive options) and then work through these. Some will have a higher success rate, but if you are not psychologically prepared to use these, just consider them, and put them away as Plan B.
This sort of systematic planning will give you peace of mind you gve your IVF treatment your best shot !

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