in vitro fertilisation (ivf)

Cancelled IVF Cycle - Implantation Failure and Factors affecting IVF Success

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  • 4.7   (6 Votes)
Medically Reviewed by Dr. Deepika Tiwari - MBBS on 24 Dec 2018 - Written by Dr. Meenakshi Sauhta - MBBS - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MBBS

Cancelled IVF cycle is caused due to a low number of developed follicles in the ovaries during the stimulation phase of treatment. The steps of IVF process starts from ovary stimulation to embryo implantation. Causes behind IVF cancellation include ovarian cyst, low estrogen levels, and high progesterone levels.

Let’s Discuss in More Detail ICSI IVF:

  1. What are the Steps of the IVF Process?
  2. What Factors Affecting Success of an IVF Cycle?
  3. Why Does Implantation Fail In IVF?
  4. Reasons Behind IVF Cancellation?
  5. Cancelled IVF Cycle Now What is Next?

In Vitro Fertilization or IVF is a procedure of infertility treatment where the doctor takes the egg from the ovaries and fertilizes them with treated sperms outside the uterus. It is conducted inside a specialized lab with extreme care and precision. After fertilization, when the egg begins to develop into an embryo, the specialist implants the embryo back into the uterus. 

Common procedures performed during IVF Cycle:

  • Egg Retrieval: An IVF specialist removes the eggs from the follicles inside ovaries with a small surgical procedure.
  • Sperm Freezing: The sperms of the male partner or donor are obtained for examination. The toxic impurities and unhealthy sperms are removed from the sample and kept in a contained environment. Only high quality and motile sperms are preserved for later use in insemination. 
  • Intra-Cytoplasmic Sperm Injection (ICSI): In this procedure, a single healthy sperm is injected to an egg to trigger fertilization. This is done by an IVF specialist with advanced equipment in the embryology laboratory.
  • Embryo Development: If the sperm successfully fertilizes the egg, an embryo begins to form and grow. The fertilized eggs are kept in the lab for 5 to 6 days until it reached the ‘blastocyst’ phase. This is when the egg begins to show signs of fertility. 
  • Assisted Hatching: After a few days of development, a laser and chemical solution is applied to the embryo so that it can be firmly implanted in the lining of the uterus. 
  • Embryo Transfer: The fertilized eggs are placed back into the woman’s uterus or fallopian tube through the cervix.
  • Embryo Cryopreservation: The unfertilized eggs, which are not required at the moment, are stored and frozen in the lab at very cold temperatures. These preserved embryos can be used for future use.

Factors Affecting Success of an IVF Cycle

IVF procedure may be one of the effective treatments for fertility, but the procedure also requires a lot of analysis, trials, and attempts. The success of IVF treatment depends on:

  • Age: The most important factor in predicting IVF success is the age of the female partner. As women get older, the production of eggs begins to decrease gradually. The egg production begins to slow down in the thirties and the decline accelerates once she reaches the age of 37 years. The chance that an IVF cycle using fresh self-eggs will result in a live birth is, on an average, almost 32 percent for a 35-year-old woman, but only 12 percent for women above 40. 
  • Embryo Quality: IVF cycles also tend to fail due to poor embryo quality. In this case, the embryos fail to implant and grow because they have chromosomal or genetic defects. Older eggs are more likely to result in poor embryo quality.
  • Ovarian Response: To increase the chances of conceiving with IVF, medications are provided to assist in the production of multiple eggs in the ovary. Some women produce very fewer eggs, which interfere with the IVF treatment. This is usually observed when the woman is over 37 or has high FSH (follicle stimulating hormone) or low AMH (antimullerian hormone) levels.

Cancellation of IVF Cycle

IVF cycle is canceled when there are a low number of follicles in the ovaries during the stimulation phase of treatment, and the egg cannot be retrieved.

There are three reasons for canceling IVF procedure and they are as follows:

  • Poor Responders: Women whose ovaries are not able to produce enough eggs during IVF treatment are called “poor responders”. 5 to 35 percent of IVF procedures are canceled due to women being poor responders. 
  • Canceled Egg Retrieval: The egg retrieval is sometimes canceled due to underdeveloped follicles. If the eggs are not healthy or mature enough, the IVF process may be canceled. 
  • Delayed Embryo Transfer: In case the sperm is not healthy or the embryo is not fertilized, the IVF specialist will delay embryo transfer. Sometimes, even after the embryo is fertilized there may be certain complications that delay embryo transfer. 

Reasons Behind IVF Cancellation

The above-mentioned three IVF cancellations or delays can be caused by: 

  • Ovarian cyst: At the beginning of an IVF cycle, a baseline ultrasound is performed and reported to the specialist. Blood tests are also taken to confirm good health, the balance of hormones and to make sure there are no cysts on the ovaries. If a cyst is found in the ovary, treatment may need to be delayed. These cysts are common and cured without additional intervention. Once the issue is resolved, the gynecologist may start the IVF cycle after some days. 
  • Low estrogen levels: If estrogen levels are lower than expected during the ovulatory stimulation part of the cycle, the follicles may not have development. Usually, the cycle is not canceled due to low estrogen levels but due to low volume of follicles. 
  • Unexpected drop of estrogen levels: Some IVF cycles are canceled due to immediate drop of estrogen levels. This is not usually considered a problem but it may affect the egg retrieval process. The doctor may recommend stopping the cycle, which is not likely to succeed. 
  • High estrogen levels:The cycle may also be halted due to high estrogen levels. The fertility drugs, which are taken as medication for IVF treatment, can overreact causing the rise in estrogen levels. This can lead to ovarian hyperstimulation syndrome (OHSS), a condition that if left untreated can become dangerous. In severe cases, it can result in complete loss of fertility.
  • Not taking hCG at the right time: hCG is a fertility drug taken via injection approximately 36 hours before egg retrieval. The timing of this drug injection is very important as the eggs may ovulate before the commencement of the procedure. The eggs cannot be retrieved for IVF once it is released in the pelvic cavity. 
  • High progesterone levels: Progesterone is a hormone that rises after ovulation. It helps prepare the endometrial lining, where the embryo is expected to implant, and it helps maintain a pregnancy. If the embryo is transferred during high levels of progesterone cycles, it is less likely to lead to pregnancy success.
  • No embryos to transfer:Sometimes, fertilization does not occur even after insemination. The eggs are not fertilized to form an embryo even when the process is done correctly. The IVF cycle is canceled in such cases. 
  • Illness unrelated to IVF: An illness unrelated to IVF means the one that has no direct role in IVF cancelation. If any of the partners is suffering from serious illnesses in the midst of treatment, the cycle may be either canceled or delayed. High fever or weakness can negatively affect sperm counts. 

The cancellation of IVF cycle can be distressing and emotionally painful. The process of IVF treatment requires a lot of time, a considerable amount of funds and energy, therefore knowing that the embryo could not be transferred to the uterus can be heartbreaking. However, cancellation of IVF cycle does not mean the next IVF cycle will result as the same. The next cycle may have a positive outcome without any risk of complications.

What is Next?

The best thing to do after an IVF cycle cancels is to have patience and start planning for the next IVF cycle. If you need help finding a right fertility clinic or a reputed IVF specialist, Elawoman can help you in finding the best hospitals and doctors in your area. Surrogacy and IUI doctors are also available through us. We also provide you with appropriate IVF treatment costs along with unconditional emotional support on the road to parenthood. Call +91-7899912611 for more information. 

Dr. Meenakshi Sauhta

Written by

Laparoscopic Surgeon, Gynecologic Surgeon
Gurgaon

Dr. Meenakshi Sauhta is an infertility specialist and laparoscopy surgeon has rich years of experience in the field of Gynecology and Infertility Evaluation. She did MBBS from Nagpur University in 1988, pursued MD in Obstetrics and Gynecology from Nagpur University in 1990 and MGIMS in 1994. She is a member of the Maharashtra Medical Council, Haryana Medical Council, and Indian Medical Association. Her specialization includes Tubectomy, Hysterectomy, Fibroid as well as Cyst Removal. She is working with Max Hospital in Gurgaon. You can get the contact details of Dr. Meenakshi Sauhta at elawoman.com

6 Comments

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Priyanaka Sambhavi

IVF has helped me in becoming a mother. It is one of the best infertility treatments. My doctor said that there might be some complications but eventually, it was successful.

Nov. 26, 2018, 6:11 p.m. 4.5

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Prachi Sharma

I got my IVF cycle canceled due to high estrogen levels. The doctor said that it will lead to a failed IVF cycle so it is better to cancel it now.

Nov. 25, 2018, 9 p.m. 5.0

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Raunak R Bhargav

My wife's IVF cycle was canceled because of the low volume of follicles. Now she is being treated for this problem. We just pray that after this we will get a successful treatment.

Nov. 22, 2018, 12:20 a.m. 4.5

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Fatima Sultana

After three failed IVF cycles I got success in the fourth attempt. There were some complications because of which every time the results were negative. I am happy that finally, it was successful. Now I am pregnant and hope to see my baby soon.

Nov. 21, 2018, 10:21 p.m. 5.0

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Riddhima Gahlot

The most important factors that affect the success of an IVF cycle are age, quality of the embryo and ovarian response.

Nov. 20, 2018, 3:56 p.m. 4.5

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Surabhi Devi

My IVF cycle got canceled because of very thin endometrium lining. I am on medication to improve my lining.

Nov. 19, 2018, 8:22 p.m. 4.5

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