Failed implantation is one of the most frustrating
outcomes of an IVF cycle.
Failed implantation is one of the most frustrating
outcomes of an IVF cycle. For most patients, the actual IVF treatment itself
usually goes well . The quality of the embryo is good, the transfer goes
smoothly and the thickness of the endometrial lining is also fine. Many couples
even start referring to their embryos as
their babies
( “ embies”) . Transferring the embryo to the uterus is the last
stage of the IVF cycle. And when their embies fail to implant and don’t become
babies, coping with this failure is emotionally taxing, because they have
already started bonding with their embryos.
When the cycle fails, all their hopes come crashing
down, and patients have complaints and want answers. Most doctors label this as
implantation failure , and order multiple tests in order to determine the
reason. They also offer lots of suggestions regarding what can be done
differently next time to better the odds.
Most patients understand the fact that there is a
50% success rate for a perfect IVF cycle. However , with repeated failures , they
want to fall back to an alternative plan. Many would change the clinic, but in
case the same story is repeated , they begin to believe that something is wrong
with their uterus. They start to consider surrogacy as their sole option.
Dr.Malpani believes this reasoning is flawed , even
though it seems quite logical . After all, women believe that if even after
transferring the best quality embryos into their uterus , they experience
failure, this proves that the embryo has been rejected by the uterus, which leaves
surrogacy as their last resort. She logically concludes that a surrogate has
proven her fertility, and if she transfers her perfect embryo into her perfect
uterus , this would result in a pregnancy and give her the baby which she has always
longed for.
The reason this thinking is flawed is that in most
cases , even the best looking embryos might have genetic problems which remain
unidentifiable , and result in a failed implantation. These very reasons make
the process of human reproduction very inefficient, and possibly delay the
process of having a baby even for fertile couples.
If a perfect looking uterus fails to sustain a
perfect looking embryo, then 90% of the time the problem lies with the embryo
rather than the uterus. The
field of medicine works on a very
simple rule i.e. when you hear the sound of hoofs, you must think of horses
rather than zebras – common things occur commonly !
This is why surrogacy might not be the best
possible option for those who have gone through multiple failures in IVF cycles. It has been found that the majority of these women have a completely
normal uterus , and can carry a pregnancy. Their chances of having a successful
implantation are considerably higher if the transferred embryo is developed
using donor eggs from a healthy young woman. Remember that uterus cannot reject
embryos, no matter what their source is , since it is an immuno logically privileged
site.
POSTED BY DR.MALPANI
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