World IVF Day: What to test for when IVF fails repeatedly

Failed IVF is heartbreaking, but it's not the end of the road. With specific tests, genetic testing, avoiding infection, and cutting-edge fertility care, a lot of couples still manage to achieve their dream of having a child (Image: Pexels)

IVF has provided numerous couples with a second great gift. Although with hope comes frustration because every failed cycle is equivalent to a loss. However, Failure of IVF again doesn't indicate that the journey is complete and with a proper diagnostic plan and expert guidance, conception isn't impossible.

Dr Pooja Trehan, Consultant pathologist and zonal chief of labs - Uttar Pradesh and Uttarakhand, Metropolis Healthcare Ltd discusses a step-by-step discussion of some significant investigations and issues to be evaluated after repeated failure of IVF is as follows:
1. Genetic Testing: Required for both partners

• Karyotyping or Chromosomal Microarray: Facilitates the identification of chromosomal abnormalities in either of the partners.
• PGT-A (Preimplantation Genetic Testing for Aneuploidy): Tests embryos prior to implantation for genetic disorders, raising the probability of a successful pregnancy.
• Genetic Counseling: Comes in handy in recurrent pregnancy loss or implantation failure to find out the way forward.

2. Autoimmune testing

Some autoimmune conditions might hinder successful embryo implantation.

• Lupus Anticoagulant
• ANA (Antinuclear Antibody)
• Cardiolipin Antibody
• Thrombophilia Panel: Identifies blood clotting disorders which might interfere with implantation.

Besides regular semen testing, further tests can identify causes of male infertility:

• Sperm DNA Fragmentation Test
• Sperm Aneuploidy Testing
• Sperm Antibody Test

Certain infections cause embryo implantation failure and IVF failure. Infections to screen for:

• Chlamydia
• Gonorrhoea
• Herpes
• Tuberculosis
• Toxoplasmosis
• CMV (Cytomegalovirus)
• Rubella

The first blood tests are required to prepare the body for successful implantation.

• Thyroid Function Tests (T3, T4, TSH)
• AMH (Anti-Müllerian Hormone)
• Estrogen, Progesterone, FSH, LH
• Prolactin, Testosterone
• Blood Sugar Levels (Fasting/PP/HbA1c)

6. Uterine evaluation

Problems with the uterus may have a great influence on implantation success.

• Ultrasound: To detect fibroids, polyps, or adhesions.
• Hysteroscopy: Provides direct visual inspection of the uterine cavity for disease.

IVF takes more than science; it's emotional, economic, and physical. But:

• Each cycle is another chance.
• Advanced technologies can reveal concealed causes.
• Identifying the right physician and individualized plan can be the breakthrough.