In vitro fertilization (IVF) is a sophisticated series of procedures designed to assist with fertility, prevent hereditary genetic issues, and aid in conception. While modern technology has made IVF in Delhi NCR more successful than ever, it is a biological reality that the process does not always result in pregnancy on the first attempt.

Younger women generally see higher success rates—approximately 40% for those under 35. However, when a cycle fails, it is often due to factors beyond the patient’s control. Understanding these medical hurdles is essential for planning a more successful subsequent path.

1. Chromosomal & Egg Abnormalities

The health of a human egg (oocyte) is susceptible to damage from free radicals and metabolic byproducts, especially as a woman ages. Studies indicate that 25% to 40% of all oocytes can be chromosomally anomalous. This percentage increases significantly after the age of 37, often leading to embryos that fail to implant or result in early miscarriage.

2. Embryo Quality and Selection

In our lab, embryologists evaluate embryos based on three primary standards: cell stage, embryo grade, and the rate of cell division. For instance, a Day 3 embryo should ideally reach at least the 6-cell stage. Embryos that divide too slowly or show poor grading have a significantly lower chance of successful implantation.

3. Poor Ovarian Response

Sometimes, the ovaries do not respond adequately to fertility medications. This is more common in women with a diminished ovarian reserve or high FSH levels. If the cycle produces too few eggs, there may not be enough viable embryos for screening or transfer, increasing the likelihood of failure.

4. The Role of Sperm Quality

While sperm issues are less likely to cause IVF failure—thanks to techniques like ICSI (Intracytoplasmic Sperm Injection)—healthy, motile sperm remain crucial. If the sperm lacks the necessary enzymes to penetrate the egg’s outer membrane, fertilization failure can occur, even in a lab environment.

5. Lifestyle Factors: The Controllables

While many factors are genetic, certain lifestyle choices significantly impact outcomes:

• Smoking: Women who smoke often require twice as many IVF cycles and face a higher risk of miscarriage.
• BMI: Being significantly over or underweight can disrupt hormonal balance. Losing just 10% of body weight can markedly improve pregnancy odds.

How We Mitigate IVF Failure

Understanding the “why” is the first step toward the “how.” At our Gurugram fertility clinic, we utilize advanced protocols to mitigate failure, including:

• PGT (Pre-implantation Genetic Testing): Screening embryos for chromosomal health before transfer.
• Individualized Protocols: Adjusting medication types and dosages based on previous ovarian response.
• Advanced Lab Techniques: Using ICSI or donor eggs/sperm when qualitative issues are identified.

Endometrial polyps are localized overgrowths of the uterine lining. While usually benign, they act like a “natural copper-T” or contraceptive device inside the uterus. If you are struggling to conceive or facing repeated IVF failures, a small polyp might be the hidden cause.

Sonographic Appearance of Polyps

On a standard Transvaginal Ultrasound (TVS), a polyp appears as a well-defined, echogenic (bright) mass within the endometrial cavity. To confirm the diagnosis, we look for two specific markers:

• The Feeding Vessel (Pedicle Artery Sign): Using Color Doppler, we can often see a single artery supplying blood to the polyp. This distinguishes it from a fibroid, which usually has a circular blood supply.
• Intracavitary Fluid: Sometimes, natural fluid in the uterus helps outline the polyp, making it easier to see.

Saline Infusion Sonography (SIS)

When a standard scan is inconclusive, we perform an SIS (Water Scan). We gently infuse sterile saline into the uterine cavity during the ultrasound. The water “inflates” the cavity, allowing us to see exactly where the polyp is attached and how much space it is occupying.

Management: Hysteroscopic Polypectomy

At Talwar Fertility & Child Health Centre, we recommend removing polyps larger than 10mm or any polyp found in a patient with unexplained infertility. This is done via Hysteroscopy—a “no-cut” procedure where we use a tiny camera to enter the uterus and remove the polyp under direct vision. This significantly boosts natural and IVF pregnancy rates.