How to usher in a good pregnancy after repeated IVF transfer failures?
In the difficult journey of IVF, unexplained repeated transfer failures are like a fog that hangs over every couple who yearns for a new life, bringing tremendous physical and mental stress. But don’t be discouraged, together we can lift the fog and look for ways to pick up a good pregnancy!
I. Comprehensive screening of potential factors
In-depth examination of the reproductive system: Even if routine examinations have been done before, in the face of repeated failures, a more in-depth assessment of the reproductive system is still needed. For example, the inside of the uterus is examined through hysteroscopy to see if there are problems such as tiny polyps, adhesions or inflammation of the lining. These subtle lesions may be overlooked during a routine examination, but can affect embryo implantation. Statistics show that about 20% – 30% of patients with repeated failed transfers have previously undetected endometrial problems discovered by hysteroscopy. In addition, more precise imaging of the fallopian tubes is performed to ensure that they are free of fluid backing up into the uterine cavity and interfering with embryo implantation.
Detailed screening of the immune system: Abnormalities in the immune system may lead to an immune attack on the embryo by the mother. Tests include antiphospholipid antibodies, antinuclear antibodies, and closed antibodies. About 10% – 15% of recurrent transfer failures are related to immune factors. For example, patients with positive antiphospholipid antibodies are prone to hypercoagulable blood, which affects the blood supply to the embryo and leads to failure of implantation. For such patients, anticoagulation therapy with drugs such as aspirin and heparin may be needed to regulate the immune status before the next transfer.
In-depth analysis of genetic factors: Chromosome examination of both the couple and the embryo is crucial. It is important to check not only for normal chromosome numbers, but also for abnormalities in chromosome structure such as translocations and inversions. Studies have shown that about 3% – 5% of repeated transfer failures are associated with chromosomal abnormalities in embryos. In addition, some single-gene genetic diseases may also affect embryo development. Genetic testing technology, such as Next Generation Sequencing (NGS), can be used to more comprehensively screen for these potential genetic problems.
Optimising lifestyle and physical and mental state
Adoption of a healthy lifestyle: A regular routine is essential for reproductive health. Ensuring 7-8 hours of quality sleep every day can regulate endocrine secretion and create a favourable hormonal environment for embryo implantation. Eating a proper diet is also essential. Increase the intake of foods rich in protein, vitamins and minerals, such as lean meat, fish, fresh fruits and vegetables. At the same time, reduce the intake of caffeine, alcohol and cigarettes, which may have adverse effects on germ cells and embryo development. For example, prolonged and heavy alcohol consumption may lead to reduced egg and sperm quality, increasing the risk of abnormal embryo development. Moderate exercise is also important. At least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking and swimming, can help improve blood circulation, enhance physical fitness and improve the chances of conception.
Effective regulation of psychological stress: Psychological stress brought about by repeated failed transplants may affect conception through the neuroendocrine system. Learn to relax your mind and try stress reduction methods such as meditation and yoga. Meditation can help relax the body and mind and reduce anxiety. Spending 15 – 20 minutes a day on meditation practice can help regulate the endocrine system. Meanwhile, seeking emotional support from family and friends, or joining a pregnancy preparation support group to share experiences and encourage each other can also effectively relieve psychological stress. According to research, patients with good psychological state have relatively higher IVF success rate.
III. Adjustment of treatment programme
Optimisation of the ovulation induction programme: Review the previous ovulation induction process and adjust the type, dosage and duration of use of ovulation induction drugs according to the patient’s age, ovarian reserve function and other factors. For example, in patients with decreased ovarian reserve, a microstimulation or mild stimulation protocol may be more conducive to obtaining high-quality eggs. These regimens use lower doses of ovulation stimulating drugs, and although the number of eggs obtained may be relatively low, the quality of the eggs may be better, contributing to improved embryo quality and implantation rates.
Adaptation of embryo transfer strategy: consider changing the timing and manner of embryo transfer. For example, patients who have previously failed to transfer cleavage stage embryos may try blastocyst transfer. Blastocysts are closer to the stage at which the embryo enters the uterus during natural conception, with better synchronisation with the endometrium and a relatively high rate of implantation. In addition, the use of assisted hatching technology, which punches holes in the zona pellucida to help the embryo hatch out, may increase the chance of embryo implantation, especially for patients of advanced age or those with thicker zona pellucida.
IV. Successful Case Sharing
ximi and kivem experienced three failed IVF transfers and were devastated each time. On the advice of their doctor, they underwent a comprehensive examination. Through hysteroscopy, Xiaoyan’s endometrium was found to have slight inflammation, which was improved after targeted treatment. At the same time, a more detailed chromosome test was performed on the embryos, and it was found that there were chromosomal microdeletions in the previously transferred embryos. The doctor then adjusted the ovulation programme, using a gentler stimulation method to obtain better-quality eggs, and performed a three-generation IVF technique (PGT) screening to select chromosomally normal embryos. Before the transfer, Xiaoyan adjusted her mindset through meditation and yoga to maintain a good physical and mental state. For the fourth transfer, the doctor chose a blastocyst transfer with assisted hatching technology. In the end, Xiaoyan was able to conceive and has now given birth to a healthy baby.
In addition, some single-gene genetic diseases may also affect embryo development. Genetic testing technology, such as Next Generation Sequencing (NGS), can be used to more comprehensively screen for these potential genetic problems. Optimising lifestyle and physical and mental state