Is Sperm DNA to be blamed for repeated IVF failure (RIF)?
Nova IVF Fertility highlights the reasons for RIF and measures which can prevent it
4 – 17% of Indian couples are diagnosed as infertile. Infertility is a condition characterised by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse. However, only 1% of the affected couples have opted for IVF (in-vitro fertilization) or other treatments that can help conceive. The uptake of Assisted Reproductive Technology (ART) for conceiving is on the rise. In fact, 40 years since the world’s first IVF baby was born, over 8 million IVF babies have been born worldwide.
IVF is the most commonly used ART technique. In Vitro Fertilization (IVF) is a technique where a woman’s eggs and man’s sperm are combined to create an embryo(s). Depending on the diagnosis and age of the woman, an embryo or embryos are transferred to the woman’s uterus through her cervix to enhance the chances of pregnancy. However, there are instances when IVF cycles could repeatedly fail.
Repeated IVF Failure (RIF) refers to cases in which women had three failed in vitro fertilization (IVF) attempts with good quality embryos. There are multiple risk factors for recurrent IVF failure including advanced maternal age, smoking status of parents, elevated body mass index, and stress levels.
Discussing the reasons and implications of RIF at a press meet held today, Dr Chandana Lakkireddi, Fertility Consultant, Nova IVF Fertility, Hyderabad commented, “Implantation dysfunction is a common cause of repeated “unexplained” IVF failure with good embryos. This is especially the case in young ovulating women who have normal ovarian reserve and have fertile partners. Successful embryo implantation depends on a well-functioning endometrium as well as a normal healthy embryo. For IVF procedures, it is critical to ensure the adequacy of the embryo and endometrium individually. This process might be hampered if either of these variables is defective”.
Reasons for Repeated IVF Failure:
With an average success rate of 50%, there are several couples who experience failed IVF treatment. The most common causes of RIF are generally classified as maternal and/or embryological factors. Some of the most common reasons for IVF failure are:
Implantation failure is commonly caused due to uterine health. If the endometrium (lining of the uterus) is not thick enough for the embryo to be attached or if it does not provide the necessary nutrients for the embryo to develop in the first few days, the embryo fails to implant to the uterine wall. A weak endometrium is often a result of conditions like fibroids, endometrial polyps, congenital anomalies, intrauterine adhesions, hydrosalpinges. Most health care professionals are looking for a uterine lining to be greater than 8mm when a patient is having fertility treatment, however optimal would be considered 11-12 millimetres
Maternal age is the most important variable in predicting implantation. The ovarian reserve of a woman tends to decline sharply after her mid-30s. Advanced maternal age is not only associated with increase in embryo anueploidy but also there is a parallel decline in ovarian reserve and response to gonadotropin stimulation.
The health of the embryo depends on the quality of the gametes; i.e the oocyte and sperm quality, in cases with advanced maternal age the oocyte quality can be compromised affecting implantation and success of IVF. If the quality of the Embryo is compromised due to alterations in the number of chromosomes or if the shell surrounding the embryo is thin, of in instances where the cells that are developing in the embryo itself are irregular or when there is a significant degree of cell debris around the embryo (known as fragmentation) it is thought that implantation could be compromised
Sperm DNA integrity is vital for successful fertilization, embryo development, pregnancy, and transmission of genetic material to the offspring. DNA fragmentation is the most frequent DNA anomaly present in the male gamete that has been associated to poor semen quality, low fertilization rates, impaired embryo quality, and pre-implantation development and reduced clinical outcomes in assisted reproduction procedures.
Advanced technologies that improve success rate of IVF
Blastocyst Culture is a technique in which an embryo is developed in the laboratory for 5-6 days after fertilization before being placed in womb. The embryo gains many cells as a result of being developed for so many days. The embryos developed for 5-6 days are much more advanced than the ones developed for just three days. This enables embryologists to select from the more advanced embryos with better potential for implantation. The biggest advantage of Blastocyst Culture method is that it significantly reduces the risk of multiple pregnancies.
“Over the years, Advanced Reproductive Techniques have witnessed some major developments giving rise to the trend of personalized medical attention. Advanced Reproductive Techniques such as Blastocyst, PGD & PGS, ERA and Magnetic Activated Cell Sorting help in solving abnormalities due to genetic issues in the fertile couples.” added Dr Chandana Lakkireddi.
About Nova IVF Fertility
Nova IVF Fertility (NIF) is the among the largest service providers in the fertility space. NIF aims to bring advanced Assisted Reproductive Technology (ART) to India in partnership with IVF of Spain. The partnership has resulted in a substantial addition to Nova's IVF services and technology, including proprietary software, training, and quality management. With IVF's know-how and vast international expertise, NIF brings the same exceptional standard of processes, protocols, and policies to India.
In addition to providing core procedures such as IUI, IVF, and Andrology services, NIF offers several state-of-the-art technologies such as Vitrification for preserving embryos and eggs, ERA to find out the timing of the uterus' capacity to accept embryos, PGS and PGD for the transfer of genetically normal embryos – all procedures that significantly improve the chances of a pregnancy following IVF-ICSI, even in patients with multiple previous failures. NIF currently operates 20 fertility centres in India (Ahmedabad (2), Bengaluru (3), Chennai, Coimbatore, Hisar, Hyderabad, Indore, Jalandhar, Kolkata, Lucknow, Mumbai (2), New Delhi (2), Pune, Surat, and Vijayawada).
For further information, visit www.novaivifertility.com
Manager – PR, Nova IVF Fertility
Phone: +91 76194 62888