1. Blockade.
Day 21-25 of the cycle, its duration is from 12 to 22 days.

2. Stimulation of the ovaries.
Day 3-5 of the cycle, its duration is 12-17 days

3. Puncture.
12-22 days from the start of ovarian stimulation.

4. Embryo transfer.
3rd-5th day after puncture.

5. Support.
It is carried out after the puncture and ends after the control hCG is done, usually 12-20 days after the transfer.

6. Pregnancy control.
12-21 days after embryo transfer.

The total duration of the protocol is approximately 40-50 days.

List of drugs:

1) For blockade, agonists, metipred (dexamethasone) are used.
2) For ovarian stimulation - HMG (Metrodin, Menogon, Humegon), as well as recombinant MG (Gonal-f, Puregon)
3) For ovulation trigger - prophasia, choragon
4) For anesthesia when performing a puncture - diprivan
5) For support corpus luteum Infertility clinic specialists use progesterone, duphaston, utrozhestan, choragon

Disadvantages of this protocol, are:

The blockade leads to delays and cycle failures;

As a side effect, menopausal symptoms appear - fever, hot flashes;

Waiting for ovarian stimulation to begin causes serious emotional stress;

A long-lasting aftereffect caused by blockade of the pituitary gland. Sometimes it lasts up to six months;

Sometimes the implantation process is affected.

The protocol has certain distinctive features:

Considered the “gold standard of Russian reproductive specialists” of the late 20th – early 21st centuries;

Only possible option for complications of endometriosis. ;

Absolute hormonal control during initial stage ovarian stimulation. This means that the infertility patient's hormones are turned off;

Can only be used in women diagnosed with infertility and whose age limit is 30 years.

The long protocol is very long, it also takes up the second phase of the cycle that precedes the procedure in vitro fertilization. Ovarian stimulation can last from 12 to 17 days, its duration depends on both the drug used and the response of the ovaries.

From 21-25 days from the beginning menstrual cycle blockade of gonadotropic function is prescribed. A patient who is being prepared for IVF is artificially brought to a menopausal state using special drugs - blockers. As a result, by the beginning of the next menstrual cycle, the content of your own hormones is sharply reduced. It's time for the next stage. Due to the blockade of the pituitary gland, the ovaries are prepared to perform superovulation, which is carried out with the help of HMG drugs.

The duration of the blockade is from 10 to 22 days. Each case is individual. If, after you have been administered agonist drugs, you do not have menstruation, you should consult your doctor, since the onset of pregnancy naturally cannot be completely ruled out.

At the first stage, drugs of human menopausal gonadotropins (HMG), GnRH agonists, and also drugs of human chorionic gonadotropin (hCG) are most often used.

GnRH agonists

Some medications are intended for daily injections, while others are administered only once every few days (such medications include so-called depot medications). Most of the drugs are administered subcutaneously, the rest - intramuscularly. They are usually sold in syringes. Very detailed instructions, which is attached to each drug, allows patients preparing for in vitro fertilization to carry out injections themselves. But, since the administration of these drugs still has some peculiarities, it is advisable that the first injection be given to a woman who is being treated for infertility by a nurse, focusing on the special nuances of performing the injection.

Agonists contribute to ovarian suppression, and accordingly the concentration of estradiol sharply decreases. The achievement of the required phase is indicated by a characteristic ultrasound picture. After this, the doctor prescribes HMG drugs to stimulate the ovaries for a woman suffering from infertility, and reduces the dosage of agonists by half.

Let's look at how one of the agonists, Decapeptyl-Daily, acts on the body.

Main active substance the drug is synthetic analogue GnRH - triptorelin. It promotes the release of gonadotropic hormones, which affect the maturation of eggs, the production of female sex hormones, as well as the growth of follicles.

Decapeptyl-Daily has the form of a syringe, convenient for self-injection. The drug comes in two types:

1. Decapeptyl - daily 0.5 mg (each syringe contains 1 ml of solution containing 525 mcg of triptorelin acetate or 478.1 mcg of triptorelin);

2. Decapeptyl - daily 0.1 mg (each syringe contains 1 ml of solution containing 105 μg of triptorelin acetate or 95.6 μg of triptorelin).

The syringe with this drug looks like a regular one insulin syringe– a very thin needle, like a hair, which allows you to make subcutaneous injection almost painless. Injections of this drug are usually performed daily.

The packages of the drug are different - 7 or 28 syringes. It is recommended to store Decapeptyl-Daily in the refrigerator; the shelf life is 3 years.
One syringe - one injection. In a couple of weeks daily dosage usually reduced because the fertility center doctor prescribes additional HMG drugs, only half the contents of the syringe should be injected daily. The remaining drug must be removed, protecting the needle with a cap.

Distinctive feature this drug is that Decapeptyl-Daily, taken from the refrigerator, does not need to be heated before injection. The drug rarely causes side effects that are a consequence of a reduction in sex hormones in the blood. Sometimes patients undergoing infertility treatment note sharp changes moods, depressive state, hot flashes. These symptoms do not last long, indicating that the drug is effective, that is, it temporarily reduces the level of estradiol, due to which such sensations arise. Any side effects that occur after taking Decapeptyl-Daily then disappear without a trace.

Very rarely, where the needle was inserted, local allergic reactions- weak painful sensations, slight inflammation or itching. There is no need to discontinue the drug, but you should definitely inform the doctor at the infertility clinic about the symptoms.

Decapeptyl-Daily injections must be done daily, according to the exact time, most optimally in the evening. If you decide to change the time, please discuss this situation with your doctor first.

Stimulation of superovulation

Ovarian stimulation is prescribed on days 2-5 from the start of the menstrual cycle, which occurs after the administration of GnRH agonists to a patient suffering from infertility. Stimulation of ovulation lasts from 12 to 17 days. For these purposes they are used special drugs, which contribute to the maturation of several follicles in a woman’s ovaries at once - up to 30-40 at a time.

From the middle of the cycle, the patient, who is being prepared for in vitro fertilization, is prescribed a third drug - hCG, due to which most of the follicles ovulate. It is this complex of drugs – HMG + agonist – that contributes to a significant increase in the number of maturing follicles. The same factor makes it possible to improve the quality of embryos and their quantity, which helps to take into account the patient’s wishes when planning a treatment cycle. For example, you can undergo the follicle puncture procedure without any fear; this will not affect the results of infertility treatment.

With the introduction of gonadotropins, the IVF/ICSI cycle begins, which differs from other stimulated cycles, which can also be used as assisted reproductive technologies, such as insemination, including the use of donor sperm. In such cycles (not in vitro fertilization), ovulation stimulation is carried out, as a rule, without the use of agonists from the 3rd-5th day of the menstrual cycle.

Drugs such as Humegon, Menogon, Pergonal, Metrodin, Neo-Pergonal are classified as human menopausal gonadotropins (HMG). They act directly on the ovaries, promoting more active maturation of follicles. The drugs are in powder form and come with a special solvent. 3-4 servings of dry substance - 1 ampoule of solvent.

The doctor at the infertility treatment center selects the dosage based on the patient’s age, her weight, as well as the condition of her ovaries by at this moment. The dose of the drug can be adjusted, it all depends on the response of the ovaries. The reaction of the ovaries is determined based on the level of sex hormones (estradiol), as well as according to ultrasound data, which makes it possible to determine the thickness of the endometrium, the number and size of maturing follicles. The last procedure is called ultrasound monitoring.

A blood test that determines the content of estradiol is performed at a diagnostic laboratory in the direction prescribed by a doctor treating infertility. Ultrasound monitoring is carried out by the attending physician himself, and no additional payment is required. The doctor decides how often to perform this procedure; it usually depends on what ultrasound results were obtained. The appointment sheet should be kept with the patient preparing for in vitro fertilization. The doctor enters the date and time of the next visit there. Maximum quantity visits for ultrasound monitoring – four or five.

The first time an ultrasound is prescribed after 4-5 days of treatment, in order to determine the reaction of the ovaries and find out at what speed the follicles are growing. In addition, the thickness of the endometrium is determined during the procedure. The combination of these signs can affect when changing the dosage of drugs. Until the follicles reach a size of 10 mm and are actively growing, ultrasound is performed no more than once every 4-5 days. Then the procedure is done 8-10 times, and when the leading follicle increases to 15-16 mm, the ovaries are examined every day. Blood tests for estradiol levels are usually carried out with the same regularity, sometimes a little less frequently. A follicle is considered mature if its size is at least 18-20 mm.

The time for follicle puncture is determined by the doctor at the infertility treatment center, based on objective signs. Previously (1.5 days before), the patient who is being prepared for in vitro fertilization is given an injection of hCG so that the oocytes finally mature. Ovulation occurs 36-38 hours after the hCG injection was performed.

Administration of the drug may cause slight discomfort belly. The reason for this is the enlargement of the ovaries. It is not worth it that ovulation will occur ahead of time, this is almost impossible. This is facilitated by the control exercised by the doctor at the infertility treatment clinic during treatment, as well as hormonal drugs.

HCG drugs are prescribed only when at least three follicles have reached a certain stage of development - 18 mm, and the level of estradiol has reached the required value.

Sperm quality can be negatively affected by: sexual abstinence(from 5 days), so sexual intercourse performed one day before the puncture. Doctors at the infertility treatment center recommend refraining from intimate life 4-5 days before the puncture, but this is decided individually for each specific case, which should be discussed with a specialist before starting infertility treatment.

HCG - Human chorionic gonadotropin is a hormone that is similar to luteinizing hormone (LH). This drug promotes ovulation of the leading follicle, which usually occurs in the middle of the menstrual cycle. The ovulatory dose is considered to be 5000 IU of hCG, which causes changes in the follicles, due to which ovulation occurs after about two days.

If the puncture is performed before ovulation, the follicles will be empty. For this reason, hCG should be used 1.5 days before the puncture. For example, if the puncture is scheduled at 9-00 on May 20, then the hCG injection must be done on May 18 at 22-00.

HCG preparations are a dry powder that is diluted with a solvent immediately before injection. The drug must be administered intramuscularly. Side effects symptoms that occur after the administration of hCG are identical to those that appear after HMG injections. HCG drugs are produced under different names, it all depends on the company, the most common are Profasi, Horagon, Pregnil.

HCG drugs are administered once during the entire cycle, the injection is absolutely painless, and is often performed by a woman suffering from infertility on her own. Next, the patient comes for an appointment only to perform the puncture procedure.

Embryo transfer

This day is prescribed by the doctor individually. A woman can come alone or with her husband, if she wishes. Before going for a puncture, a woman can have a light breakfast, but fluid intake must be limited, otherwise it will cause serious discomfort. bladder.
The procedure itself is not complicated. After the woman lies down in the gynecological chair, the doctor exposes the cervix, then inserts a catheter and guidewire. Embryos are transferred through it using a special syringe. At the end of the procedure, the doctor carefully examines the catheter to find out whether some of the embryos remain there. The procedure goes quite quickly.

There is usually no pain during the procedure; sometimes a woman may feel only slight discomfort, as with normal gynecological examination. After the embryo transfer has been carried out, the patient should lie down for another 20-30 minutes. Then the woman can go home, it is better if someone accompanies her.

It is better to free the day of embryo transfer from physical activity, rest while lying down. We must not forget that until the results of the pregnancy test are received, it is necessary to continue progesterone injections (if the support was prescribed by the doctor at the infertility treatment center).

Small spotting from the genital tract, or the release of air bubbles from them is not a cause for concern. This does not mean that the embryos did not take root and decided to leave the uterine cavity. Already since next day after the transfer, a woman who has undergone IVF can pursue her everyday affairs, until the day when the pregnancy test is performed.

There are only small exceptions that should be remembered to avoid these violations. It is forbidden:

Swim or wash one day before and after embryo transfer;

Take a shower or douse yourself with water;

Use tampons;

Be sexually active;

Engage in active sports, such as running, tennis, aerobics, mountaineering;

Start playing new sports;

Lift weights.

After long-term treatment Due to infertility, a couple decides to undergo IVF. And it seems that long-awaited pregnancy so close that some women even begin to look in advance for children's things, a stroller, and toys. However, the first in vitro fertilization protocol often does not bring the desired result. Why this happens and what the likelihood of success is, we will tell you in this article.

Reasons for failure

To begin with, it should be noted that not a single doctor, not a single clinic, either in Russia or abroad, can guarantee a 100% pregnancy. You should go to your first IVF with this thought in mind; it will help you overcome failure more easily and move on towards your goal.

Only 45-50% of couples manage to get pregnant the first time. This means that entering the first protocol, the chances of getting pregnant are almost 50x50. Then everything depends on the health of the man and woman, their age, the quality of their eggs and sperm, as well as other reasons. The first IVF is almost always associated with a high load on the woman’s body - she first undergoes an ovarian stimulation procedure, as a result of which doctors are able to obtain more mature eggs for in vitro fertilization.

Hormonal therapy is quite aggressive in nature, which cannot but affect the woman’s health.

The main reasons why the first IVF is unsuccessful are as follows.

• Woman's age. The older the patient, the lower the chances of successful IVF on the first try.

• Hormonal disorders. High level follicle-stimulating hormones, which are used to produce superovulation in the first phase of the menstrual cycle, create not the most favorable background for bearing a baby. If ovarian hyperstimulation syndrome occurs with their enlargement, then the chances of pregnancy are considered quite low.
• Low number of eggs. The fewer oocytes of normal quality obtained as a result of the puncture, the less likely pregnancy is to occur. This often occurs with IVF in natural cycle when hormonal stimulation is not previously applied. Then doctors can get only 1, maximum 2 eggs.
• Small number of embryos. Even if a sufficient number of eggs are obtained, it is not a fact that all of them will successfully pass the fertilization stage. Embryos that begin to develop from fertilized oocytes are subject to careful observation and selection - only high-quality, viable and strong ones are selected for implantation into the uterus. If there is only one such embryo, the probability successful completion protocol will be significantly lower.
• Endometriosis in a woman. If the endometrium is heterogeneous and its thickness is insufficient, implantation may not occur. Even hormonal support for endometrial growth carried out in the first phase of the cycle is not always successful.

• History of abortions and surgeries. If before a woman If you have had an abortion, or undergo diagnostic or therapeutic curettage, the endometrium partially loses its functions. Postoperative changes in the endometrium are also very difficult to correct.
• Genetic incompatibility of partners. To exclude such a reason for unsuccessful IVF, you should visit a geneticist in advance and do tests for the compatibility of partners. Now genetic studies are mandatory for couples who are undergoing IVF only if the woman and man are over 35 years old. Others can do this analysis at their own discretion.
• Chronic and acute illnesses. In the process of stimulating superovulation under the influence of large doses Hormones may worsen a woman’s chronic diseases, for example, pathologies of the kidneys, liver, heart, diabetes. After the embryo transfer, the woman could get sick viral infection or catch a cold, in which case the likelihood of successful IVF is also reduced.
• Low sperm quality. If IVF is carried out using donor material, such a reason is completely excluded, because donor sperm undergoes strict medical control, and a man with abnormal spermograms simply cannot become a donor. When fertilizing eggs with the husband's sperm, there may be certain difficulties if there is male factor infertility.

• Hydrosalpinxes. Sometimes detect fluid accumulation in fallopian tubes during medical examination before IVF it fails - this pathology is not always noticeable even on ultrasound. However, hydrosalpinxes prevent the development of pregnancy. Some doctors are inclined to believe that about a third of unsuccessful first IVF attempts are associated precisely with pipe factor, however, some experts are of the opinion that hydrosalpinx cannot harm the implantation process. Check with your doctor to see what his opinion is.

The first IVF often fails for reasons that even highly qualified doctors cannot explain. These are the so-called idiopathic causes. All tests were normal, embryos were obtained good quality, the transfer was successful, the endometrium was ready, but for some reason implantation did not occur. This outcome is not the rarest and it is recommended to treat it as a process that is simply beyond a person’s control, because in the process of conception and implantation not everything is under the control of doctors.

Reduces the chance of success after the first attempt overweight a woman has an incorrect attitude towards her health. Thus, failure to comply with recommendations to lead a calm, measured lifestyle after replantation, limit physical activity, sleeping at night quite often leads to a lack of positive results.

Smoking or drinking even small doses of alcohol after embryo transfer halves the likelihood of success. The stress that a woman feels from the moment she begins the IVF protocol and which accumulates every day can also interfere with the implantation of embryos, and if it is successful, increases the likelihood of early miscarriage.

Reasons why positive results could not be achieved in the first protocol, may lie in immune and autoimmune processes, as a result of which pregnancy is not cellular level rejected by the woman's body.

Probability of success in figures and facts

The first ultrasound protocol, like the proverbial pancake, may well be “lumpy”. Only half of women under the age of 35 manage to become mothers after the first IVF. If a woman is already 37-39 years old at the time of IVF, then the probability of pregnancy if the woman does not have obvious reasons for failure is about 35%.

At the age of 40, only 15-19% of women become pregnant after the first IVF. At 42-44 years old, this probability is below 8%. And even at this age, the likelihood of getting pregnant in an IVF protocol is generally higher than with natural conception.

A couple in reproductive age If you are healthy and have no problems with the reproductive system, if you have intercourse directly on the day of ovulation, the chances of conceiving the first time are only 7-10%.

The first unsuccessful attempt at IVF is not a death sentence or a reason for despair, if only because approximately 25% of couples who failed in the first IVF protocol achieve spontaneous conception after some time, since reproductive system after hormonal stimulation from the outside it begins to work more efficiently.

In the second and third protocols, the probability of getting pregnant is higher than in the first, by about 5-10%. However, after the fourth or fifth IVF attempt is unsuccessful, the chances of success decrease and amount to no more than 15%.

In 60% of cases, when two or more embryos are transferred, a multiple pregnancy occurs after IVF, and a woman who dreamed of one child gives birth to twins or even triplets.

When to try again?

Only a doctor can answer this question. The most favorable time for the next IVF attempt depends on the health status of the spouses and on the identified reasons for failure in the first protocol. That is why you should not despair, but should act.

Usually, on average, a woman is given about three months to recover. If the first IVF was carried out without hormonal stimulation in the natural cycle, you can plan a new protocol as early as the next month after menstruation ends.

If the first protocol was stimulated, then with a large share chances are there may be eggs or embryos left that meet all the requirements of reproductologists and embryologists, but were not useful the first time. Then, after three months, the woman can be prescribed a cryoprotocol. She will no longer be subject to a “shock” hormonal attack and puncture of the ovaries, in favorable period she will simply undergo the transfer of cryoembryos, previously thawed. In this case there will be no hormone therapy, ovarian puncture, the woman will be less susceptible harmful effects medications and stress, respectively, the likelihood of success will increase significantly.

It is quite difficult to significantly increase the chances of IVF success in any way. But ignoring the recommendations given by the doctor before the first IVF or during the recovery period before the second (third or other) attempt can nullify the doctors’ efforts. Therefore, a woman who is determined to become a mother should remember the following.

• IN mandatory You need to take all recommended tests on time. This will help to find out the reason for the first failure. Based on the test results, the doctor will more effectively adjust the following protocol.
• The depression and anxiety experienced by women who have gone through failed protocols should be a thing of the past. In a dysfunctional psychological and emotional state It’s better not to plan a new attempt, since stress disrupts natural hormonal background and prevent pregnancy. It is advisable to visit a psychotherapist. This specialist will help you cope with disappointment after the first unsuccessful attempt and prepare effectively for the next one.

When conducting artificial insemination, it is not always possible to get pregnant the first time. If this does not work, a second IVF attempt is made. will be successful, with a scrupulous analysis of the previous failure, carrying out additional examination.

Reasons for failure

Despite careful preparation for the procedure, no one gives a complete guarantee of a positive outcome. The first embryo transfer is rarely successful, but the chances of a second IVF attempt increase significantly. Repeated fertilization does not harm the patient’s health and is absolutely safe.

Some parents-to-be are worried about availability possible deviations in children born after frozen embryo transfer. According to the research results, no pathologies in the child’s development were identified. The percentage of children born with any disorders using cryotransfer is no higher than the same figure for children conceived naturally.

Deadlines

After how long can you do a repeat eco? The timing of a new attempt at artificial insemination mainly depends on the recommendations of the attending physician and the desire of the woman. By coordinating these indicators, after a certain time, you can do IVF, usually 2-3 months. But considering individual characteristics body, only the doctor will determine when a second IVF attempt can be made, after two months or after a longer time.

But no specialist guarantees that second IVF attempts will be successful. Therefore, it is important, after each failure, to correctly determine the reasons that prevent pregnancy. But the inability to get pregnant for the first or second time is not a reason for despair. Many factors can be eliminated, and in half of the cases the woman carries and gives birth healthy child.

Only in difficult situations, after three unsuccessful attempts, doctors suggest taking other options. For example, the use of donor embryos, sperm or eggs. Sometimes, only surrogacy is possible. But before making a decision, you should not refuse to make another attempt at fertilization.

Modern medicine uses the latest techniques, and now, almost every woman can become a mother. Everything should be considered as a new step towards successful pregnancy. At the next transplant, they are minimized negative factors previous procedures.

Maria Sokolova

Reading time: 6 minutes

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According to statistics, the effectiveness of the IVF procedure in our country (after the first attempt) does not exceed 50 percent. No one guarantees 100% success, neither in our clinics nor in foreign clinics. But this is not a reason to despair: a failed attempt is not a death sentence! The main thing is to believe in yourself, understand the essence of the problem and act correctly in the future. What are the main reasons for IVF failures, and what to do next?

The main reasons for unsuccessful IVF

Unfortunately, failure with IVF is a reality for many women. Pregnancy is diagnosed in only 30-50 percent, and given percentage significantly decreases in the presence of any diseases. Most common reasons unsuccessful procedure:

• Poor quality embryos. For a successful procedure, the most suitable embryos are 6-8 cells with high division rates. If there is a failure related to the quality of the embryos, you should think about finding a new clinic with more qualified embryologists. In case of failure due to male factor, it makes sense to look for a more qualified andrologist.

• Endometrial pathologies. IVF success is most likely when the endometrial size is 7-14 mm at the time of embryo transfer. One of the main pathologies of the endometrium that prevents success is chronic endometritis. It is detected using echography. As well as hyperplasia, polyps, endometrial thinness, etc.
• Pathology of the uterine tubes. The possibility of pregnancy disappears if there is fluid in the fallopian tubes. Such abnormalities require treatment.
• Genetic problems.
• Similarity between mom and dad based on HLA antigens.
• The presence in the female body of antibodies that prevent pregnancy.
• Problems endocrine system and hormonal disorders.
• Age factor.
• Bad habits.
• Obesity.
• Illiterately drawn up recommendations or the woman’s failure to comply with the doctor’s recommendations.
• Poorly conducted examination (uncompleted immunograms, hemostasiograms).
• Polycystic ovary syndrome (decreased egg quality).
• Decreased follicular reserve. Reasons: ovarian depletion, inflammation, consequences of surgery, etc.
• Availability chronic diseases female reproductive system, liver and kidneys, lungs, gastrointestinal tract, etc.
• Availability infectious diseases(herpes, hepatitis C, etc.).
• Health problems during the IVF procedure (flu, ARVI, asthma or injury, cholelithiasis etc.). That is, any disease that requires the use of the body’s forces to fight it.
• Adhesive processes in the pelvis (poor circulation, sacto- and hydrosalpinx, etc.).
• External genital endometriosis.
• Congenital and acquired anomalies - bicornuate or saddle-shaped uterus, its duplication, fibroids, etc.

And also other factors.

Restoring menstruation

The reaction of the female body to IVF is always individual. The restoration of menstruation usually occurs on time, although a delay after such a procedure is not considered force majeure. The reasons for the delay can be both in the characteristics of the body itself and in general condition health. It is worth noting that self-administration of hormones during a delay after IVF is not recommended - it will provoke a delay in menstruation after taking the hormones themselves. What else do you need to remember?

• Heavy periods are possible after IVF. This phenomenon does not indicate serious problems, there is no reason to panic. Periods may also be painful, longer, and have clots. Considering the fact of ovulation stimulation, these changes are within normal limits.
• The next menstruation should return to normal parameters.
• If there are deviations in the parameters of the 2nd menstruation after IVF, it makes sense to see the doctor who conducted the protocol.
• A delay in menstruation after a failed IVF attempt (and other changes) does not reduce the chances of a successful subsequent attempt.

Can a natural pregnancy occur after an unsuccessful IVF attempt?

According to statistics, about 24 percent of parents who failed their first IVF attempt subsequently conceived babies naturally. Experts explain this “spontaneous conception” by the “launch” of physiological hormonal cycle after IVF. That is, IVF becomes a trigger for turning on the natural mechanisms of the reproductive system.

What to do next after an unsuccessful IVF attempt - calm down and act according to plan!

To achieve pregnancy after failure with the first IVF attempt, many mothers decide to take drastic measures - changing not only the clinic, but also the country in which the clinic was chosen. Sometimes this really becomes a solution to the problem, because a qualified, experienced doctor is half the success. But most of the recommendations for women faced with unsuccessful IVF come down to a number of certain rules. So, what to do if IVF is not successful?

• We rest until the next protocol. This does not mean hibernation under a warm blanket at home (by the way, extra pounds- an obstacle to IVF), but light sports (walking, swimming, exercise, belly dancing and yoga, etc.). It is important to focus on exercises that improve blood supply to the pelvic organs.
• We return to personal life “at will”, and not according to a schedule. During the break, you can abandon the schedules.
• We carry out full examination, necessary tests and all additional procedures to minimize the risk of recurrent failure.
• We use all possibilities for recovery (don’t forget to consult a doctor): mud therapy and acupressure, hirudo- and reflexology, taking vitamins, etc.
• We are getting out of depression. The most important thing, without which success is simply impossible, is a woman’s psychological attitude. Unsuccessful IVF is not a collapse of hopes, but just another step towards the desired pregnancy. Stress and depression sharply reduce the chances of success at the second attempt, so after failure it is important not to lose heart. The support of family, friends, and spouse is extremely important now. Sometimes it makes sense to turn to professionals.

What should a doctor pay attention to after failure?

• The quality of the endometrium and the embryos themselves.
• The level of preparation of the body for a possible pregnancy.
• The quality of the ovarian response to stimulation.
• Presence/absence of fertilization.
• Parameters of endometrial structure/thickness at the time of transfer.
• Quality of embryo development in the laboratory.
• All possible reasons failure to achieve the expected pregnancy.
• The presence of abnormalities in the development of the endometrium during the IVF procedure.
• The need for additional examination and/or treatment before the second procedure.
• The need to make changes to the previous treatment regimen before repeat IVF.
• Timing for repeat IVF (when possible).
• Changes to the ovarian stimulation protocol.
• Changing the dosage of drugs that are responsible for superovulation.
• The need to use a donor egg.

When is a repeat procedure allowed?

A second attempt is allowed in the next month after failure. It all depends on the woman’s desire and the doctor’s recommendations. But most often a longer break is recommended to recuperate - about 2-3 months to restore the ovaries after stimulation and bring the body back to normal after stress, which is essentially IVF.

Tests and procedures indicated after several unsuccessful attempts:

• Lupus anticoagulant.
• Karyotyping.
• Antibodies to hCG.
• Hysteroscopy, endometrial biopsy.
• HLA typing for a married couple.
• Serum blocking factor.
• Study of immune and interferon status.
• Blood test for antiphospholipid antibodies.
• Doppler study of the vascular bed of the genitals.
• Culture analysis to identify a possible causative agent of the inflammatory process.
• Examination of the uterus to determine the estimated parameters of the biophysical profile of the uterus.

If there are hidden inflammatory processes in the uterus (at risk are women after cleansing, abortion, childbirth, diagnostic curettage etc.) Treatment methods may be as follows:

• Drug therapy (use of antibiotics).
• Physiotherapy.
• Laser therapy.
• Sanatorium-resort treatment.
• Methods alternative medicine(including herbal medicine, hirudotherapy and homeopathy).

How many IVF attempts are allowed?

According to experts, the IVF procedure itself has significant negative influence has no effect on the body, and no one can say how many procedures the body will need. Everything is individual. Sometimes IVF requires 8-9 procedures to be successful. But, as a rule, after the 3-4th unsuccessful attempt, they are already considered alternative options. For example, the use of a donor egg/sperm.

IVF statistics are an indicator of the quality and effectiveness of the procedure. Some couples mistakenly perceive the concept of “statistics”; they believe that it shows the likelihood of having a healthy child as a result of IVF. In fact, this term refers to the ratio of the number of protocols performed to the rate of successful pregnancy.

Before the doctor examines the woman’s health condition. The cause of infertility and associated factors that can reduce the success rate of the protocols are clarified. It is important to take into account all the nuances during the preparation process, since this will determine what chances an infertile couple has. The effectiveness of the procedure depends on external and internal factors, from correct tactics doctor's actions.

• The age of the patient is important. In women under 30 years of age, the success rate reaches 60%. IVF at 40 shows good results only in 6-10 patients out of 100 who decided to undergo the procedure.
• Reason for lack of pregnancy. The statistics of successful IVF for tubal infertility is higher than for diseases caused by hormonal disorders: endometriosis, adenomyosis, polycystic disease, fibroids. If a woman genetic diseases, which are the cause of infertility, then the chances of successful IVF are sharply reduced, since such cases are considered the most difficult.
• State men's health. If the cause of infertility is the poor quality of the partner’s sperm, then the use of additional manipulations (ICSI) gives a high chance of pregnancy. It is important that the woman does not have any concomitant diseases.
• Qualification of doctors. It is important to choose a clinic that professionally deals with in vitro fertilization. At the preparation stage, the reproductologist chooses hormonal drugs and the type of protocol; these decisions directly affect the result. When working with embryos, the responsibility and professionalism of the embryologist is important.
• Patient's approach. Increase your chances of successful conception It is possible if you approach your preparation responsibly. Often women are in a hurry to join the program in order to quickly bring themselves closer to their cherished goal. However, there is no need to rush. The patient must be thoroughly examined and, if necessary, undergo treatment.

Reproduction statistics have been compiled relatively recently. However, each clinic using ART can provide its own data on the number of successful protocols. Detailed study of techniques, innovations, and use modern drugs increases the frequency of protocols resulting in pregnancy.

On the first, second or third try?

A successful IVF protocol on the first try is quite possible. The likelihood of such a result is influenced by all the factors that we discussed above. If a woman and her partner are absolutely healthy, and the cause of infertility has not been established, then the probability of successful IVF the first time is on average 45-50% for all ages. The younger the patient, the greater the chance - up to 60%. Also, implantation on the first try often occurs in couples with tubal infertility provided there are no other problems. The success rate of IVF the first time is higher for those women who are implanted with not one, but several embryos at once.

The psychological state of the patient affects the likelihood of pregnancy on the first try. If the protocol is unsuccessful, a second IVF attempt is made, but not everyone decides to do it. It would be a mistake to refuse further procedures. After all, the second time the chance of pregnancy is higher. This is evidenced by generalized statistics from clinics specializing in ART.

The likelihood of success during repeated IVF depends on the condition of the woman’s ovaries. With each stimulation, the number of eggs decreases. If this is aggravated by the patient's age, then the chance of success will be lower.

In this case, the use of donor material increases the percentage of successful transfers. If pregnancy does not occur the first time, you need to be examined and find out the reason for the failure. In the next program, reproductive specialists will take this into account, and this will increase the chance of pregnancy.

In Vitro Fertilization Statistics

According to official data, the average pregnancy rate in Russia with IVF is 38.5 percent.

But you cannot rely trustingly on the statistics of IVF protocols. Each patient’s body is individual, as are the diseases that cause infertility. The chances also depend on the type of protocol.

In a long protocol

Most of the clinics using ART are located in Moscow and St. Petersburg. And they are the ones who determine IVF statistics in Russia. Data from these institutions indicate a 30-60% chance of successful infertility treatment.

– the most difficult, both for the female body and for reproductive specialists. The duration of this scheme is variable and can range from 6 weeks to 6 months. The long protocol shows good results in women with hormonal diseases. With the help medicines The functioning of the gonads is completely controlled. This approach regulates natural processes and minimizes unforeseen situations. The percentage of successful egg fertilization depends on the quality of the reproductive gametes of the man and woman.

In a natural cycle

The success rate with IVF in a natural cycle does not exceed 10. Plus - minimal impact on female body. The patient does not take potent drugs, which facilitates the functioning of the reproductive system. However, in a natural cycle, only one (less often 2 or 3) egg is produced. It is impossible to say in advance what the quality of the gamete will be. Therefore, it often happens that when performing ART in a natural cycle, even the transfer of embryos is impossible due to their low quality.

With cryoprotocol

The chances of getting pregnant with IVF in a cryoprotocol are lower than in a long cycle, but higher than in a natural cycle. An important advantage is the absence hormonal correction. The embryos are transferred after thawing on a suitable day of the cycle. Optimal and natural conditions for implantation.

The pregnancy rate in the cryo protocol is no more than 25%. Decreased results compared to long protocol due to the fact that the state of fertilized cells is affected by the process of vitrification and subsequent thawing.

With a donor egg

The success of in vitro fertilization with a donor egg is quite high rate– up to 46%. Most patients who decide to use another woman’s material are in adulthood. The number of their own gametes in the ovaries does not allow them to carry out stimulation. Therefore, they have almost no chance of successful IVF with their own egg.

Increases the success of the procedure significantly. It is important that after IVF all recommendations for taking maintenance medications are followed.

With ICSI

Intracytoplasmic injection is successful in IVF. Manipulation allows you to select the best and most mature sperm that will fertilize the egg. For primary IVF protocols, statistics (ICSI) is 32-33%. When repeated, success increases to 44%. The number of pregnancies occurring after the fifth attempt reaches 77 per 100 people.

It makes sense to study IVF statistics for couples just for fun. Say what the chance of conception is for certain partners who have own indicators health, only a reproductologist can do it after an examination.