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Why Surrogacy is usually not Helpful in older women with Repetitive Implantation Failure

Posted Feb 11 2014 8:32pm

A successful In Vitro Fertilization cycle requires many factors to work harmoniously. These include a few good sperm, good eggs, and a smooth transfer of good quality embryos into a receptive uterus. After the transfer of the embryo into the uterus, the process of in vivo implantation may or may not occur. Many aspects like hormonal levels, genetic predisposition plays a role in this. Unfortunately, in the case of some couples the embryo fails to implant. It is tough for the couple to accept the failure and move on.
Many women start fantasizing about the baby after the embryo transfer. Some even start referring to their embryos as their babies or embies . When the doctor is happy with the transfer and the uterine lining, and describes the embryos as being Grade A, they start assuming that their cycle is bound to succeed, and start planning for their birth. However, when the embryos do not implant, it is difficult for the couple to come to terms with the failure . 

Some of these patients change clinics in search of a better doctor, because their IVF specialist fails to explain the possible reasons for the IVF failure and the next course of action. Some doctors start ignoring these patients. They are understandably confused about what to do next .

Many couples start believing that surrogacy is their best option. The logic is that if the embryo is of good quality and yet the procedure failed , then this means the uterus is at fault. The woman blames her uterus for rejecting the embryo. They come to a conclusion that using some other woman’s uterus would ensure implantation and continued pregnancy.

This logic is completely wrong. The assumption of a faulty uterus is baseless. The uterus cannot immunologically reject the embryo. If the embryo fails to implant after in vitro fertilization then it is far more likely that it is the embryo which is problematic , rather than the uterus. The uterus is usually just a passive recipient. Many times, it is a genetic defect which stops the embryo from implanting. This defect is mostly undetectable , even with today’s technology. Surrogacy would not help in these cases.  For older women, the problem is far more likely to be a result of poor egg quality; and donor egg IVF would give them a far higher chance of success.

Confused as to whether you should explore surrogacy or donor egg IVF ? Please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !




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