Recurrent IVF Failure

What is Recurrent IVF Failure?

Recurrent embryo implantation failure is the inability of a couple to achieve pregnancy after multiple attempts of in vitro fertilization. This condition is typically defined as the failure to achieve pregnancy after three or more consecutive IVF attempts.

1. Advanced maternal age: As women naturally age, their reproductive capacity decreases, and fertility rates decline. Advanced maternal age is typically considered to be 38 years and older.

  • Declining Egg Quality: In advanced age, women have a lower number of eggs in their ovaries, and the quality of these eggs is reduced. This condition decreases the number of healthy embryos suitable for fertilization and embryo development. The decline in egg quality increases the risk of repeated failures
  • Declining Egg Reserve: In advanced age, women have a reduced egg reserve (the number of eggs remaining in the ovaries). The decrease in egg reserve reduces the number of suitable eggs that can be obtained in each IVF attempt. This increases the likelihood of repeated failures.
  • Increased Genetic Abnormalities: With advanced age, the likelihood of embryos with genetic abnormalities increases. These embryos may experience implantation failure or result in early pregnancy loss.
  • Increased Risk of Complications: Advanced maternal age increases the risk of complications during pregnancy. This can also impact the risk of recurrent IVF failure.

2. Tubal Factor (Tubal Issues): The condition of the fallopian tubes is an important factor during IVF treatment.

  • Hydrosalpinx: It is the accumulation of fluid at the ends of the fallopian tubes. This condition can hinder the implantation of the embryo into the uterus and the establishment of a successful pregnancy. Continuing with IVF treatment without treating hydrosalpinx can increase the risk of recurrent failure
  • Risk of Ectopic Pregnancy: Women with tubal issues have an increased risk of ectopic pregnancy (pregnancy outside the uterus). If the embryo implants in an area outside the uterus, the pregnancy will not be successful. Ectopic pregnancies can lead to recurrent failures in IVF treatment.

3. Hormonal Imbalances: They can affect the reproductive process and can impact the success rate of IVF treatment.

  • Insufficient Hormone Levels: Proper hormone levels support ovulation, promote thickening of the endometrial lining, and facilitate the implantation of the embryo into the uterus during pregnancy. Hormonal problems, such as luteal phase defect, can lead to insufficient hormone levels and contribute to repeated failures.
  • Thyroid Disorders: Thyroid hormones have a significant impact on the reproductive system. Impaired functioning of thyroid hormones can lead to ovulation disorders, decreased endometrial thickness, and difficulties in implantation. Thyroid disorders can increase the risk of recurrent IVF failure.

4. Genetic factors: Embryo development plays a crucial role in the implantation process and throughout pregnancy.

  • Genetic Abnormalities: Embryos with genetic abnormalities can result in failed implantation or pregnancy loss. These abnormalities can occur in chromosome structures or gene mutations. The role of genetic abnormalities should be investigated in couples experiencing recurrent IVF failure.
  • Genetic Carrier Status: Genetic diseases that couples carry can adversely affect the healthy development of embryos and the pregnancy process. In the case of carrier status, embryos can undergo genetic testing to detect carrier status or genetic abnormalities.
  • Genetic Predisposition: In some couples, the healthy development of embryos and the pregnancy process can be challenging due to genetic predisposition. In such cases, recurring failures in achieving successful outcomes in IVF treatments can occur.

5. Immunological System: It enables the body to provide an immune response against foreign substances. However, in some cases, imbalances or excessive reactions in the immune system can have a negative impact on the success of IVF treatment.

  • Autoimmune Diseases: Autoimmune diseases are conditions that cause the immune system to respond against its own tissues. These diseases can have negative effects on the reproductive system and lead to recurrent IVF failures. For example, autoimmune diseases like antiphospholipid syndrome can cause blood clotting and implantation issues.
  • Inflammation and Implantation Disorders: Immunological problems can lead to inflammation and tissue damage, which can affect the quality of the endometrium (the lining of the uterus) and negatively impact the success of implantation.

Which Tests Should Be Done to Couples Who Have Recurrent IVF Failures?

1. Genetic Tests::

  • Karyotype analysis: Examination of the couple's chromosomal structures.
  • Preimplantation Genetic Screening (PGS): Genetic testing of embryos.
  • Carrier testing: Testing of the couple for genetic diseases.

2. Hormonal Tests::

  • FSH (follicle-stimulating hormone) and LH (luteinizing hormone) levels: To evaluate ovulation function.
  • Estradiol (E2), progesterone, and prolactin levels: Analysis of hormonal balance.
  • Thyroid hormone (TSH, T3, T4) test: To evaluate thyroid function.

3. Immune System-related Tests::

  • Antibody screenings: To examine immune system responses during implantation process.
  • Antiphospholipid antibody test: To detect blood clotting and implantation issues.

4. Implantation and Uterine Evaluation::

  • Hysteroscopy: A procedure used to examine the inner lining of the uterus.
  • Endometrial biopsy: Samples taken for the analysis of endometrial tissue.
  • Ultrasonography or MRI for evaluating uterine abnormalities.

5. Embryo Quality and Development Assessments::

  • Evaluation of embryo morphology: Analysis of embryo structure and development (Embryoscope).

Treatment Methods for IVF failure

1. Preimplantation Genetic Testing (PGT): Selecting healthy embryos through genetic testing and increasing the chances of successful implantation.
2. Embryo Selection and Transfer Techniques: :

  • Blastocyst transfer: Developing embryos until the blastocyst stage and transferring them.
  • Hatching technique: Softening or opening the embryo's shell to increase the chances of implantation.
  • Morphological evaluation for embryo selection using techniques such as Embryoscope or artificial intelligence-based methods.

3. Endometrial Preparation::

  • Preparation of the uterine lining using either Natural Cycle or Artificial Cycle, based on the patient's clinical suitability.
  • Providing luteal phase support.

4. Immune Modulation::

  • Immunosuppressive medications to balance the immune system through regulatory treatments.

5. Thrombophilia Treatment::

  • The use of low-dose aspirin and heparin for the treatment of thrombophilia conditions such as antiphospholipid syndrome.

6. Tissue Compatibility and Immunological Treatments::

  • Regulating the immune system with immunological treatments (e.g., intralipid therapy, immunoglobulin therapy).

7. Alternative Reproductive Methods:

  • Using donor eggs or donor embryos.
  • Surrogacy.

(Alternative reproductive methods are not practiced in Turkey and their recommendation is not legal. Personally, I would like to express that I find it morally questionable to suggest the use of someone else's eggs or sperm to a couple.)

About the topic

Frequently asked questions

Advanced maternal age, diminished ovarian reserve, poor sperm quality, unfavorable uterine environment, genetic issues, history of recurrent miscarriages, and unhealthy lifestyle factors (such as smoking, obesity, alcohol consumption, drug use) are associated with unsuccessful IVF attempts.
Optimal ovarian stimulation, preimplantation genetic diagnosis for embryo selection, blastocyst transfer, correction of the uterine environment, supportive medications, and positive lifestyle changes can increase the chances of successful implantation.
Engaging in regular exercise, maintaining a healthy diet, and managing stress can increase the chances of success in IVF treatment.


Miracle Stories

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I know Dr. Düzgüner for the past 3 years since he was part of a great IVF team at Memorial Şişli with Dr. Semra Kahraman. I am a Turkish American living in NY, and even with access to private insurance in the US, I have never been able to talk to my IVF doctor on the phone if there was an emergency nor when I had a burning question that needed to be answered immediately. Doctors in the US do not give you their phone number, and I would have to go through the nurse who would call me back 4 hours later only to leave a message.. But in Turkey, with Dr. Düzgüner, everything was about trust and accessibility from the first day. He immediately sent us his number, and set up a FaceTime with me and my husband. He took a deep dive at all our IVF-related blood/semen work and gave us a very factual but encouraging opinion. I was 45 when I left my doctor in the US, and traveled to Turkey to try IVF with Dr. Düzgüner, and despite my old age he was very clear with expectations but never demoralizing nor discouraging. He and his team was always available through phone, text message, and he was never tired of my endless questions! When Dr. Düzgüner later started his clinic, I wanted to continue with him and his team. We discussed other options with him and he worked with me and my husband in researching and giving us endless advice on what our other options could be and worked with us on next steps. With his guidance and patience, we are now expecting twins (36 weeks, a boy and a girl ❤️). Dr Düzgüner helped me become a mommy at age 47, and I am so happy I worked with him all the way to the end. Even during my twin pregnancy back in the US, he would answer my questions within minutes, if l weren’t able to reach my doctor in the US. He and his team deserves all the stars!!
T. B. Beyazıt
T. B. Beyazıt
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The miracle that comes with half a uterus Our teacher Soner, who was instrumental in our miracle Our paths crossed with our teacher as a result of unsuccessful attempts in an external center with half a uterus. Soner always kept our morale high and gave us hope from the first day. With his unique and modern treatment methods, he led us to hold our baby in our arms at the end of a very difficult and careful process. He is an expert in his job and is with the patients 24/7. He is a doctor who pays attention to the smallest details. First, with the permission of Allah and the opportunity of our teacher, it was impossible, we experienced the miracle. We thank our teacher Soner endlessly. Good thing; our paths crossed There is always hope
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Hayatımda bu kadar zor bir dönemi benim için bu kadar keyifli ve huzurlu bir ekip çalışmasına dönüştüren bir doktorla karşılaşmadım. Ben de yurt dışında çalışan yüksek lisanslı bir hemşireyim. Soner Bey bu zorlu ve stresli tüp bebek tedavisi döneminde karşılaştığım her türlü zorlukta ve mutlulukta benimle birlikte sevinen ya da üzülen bir arkadaş gibi hem çok titiz hem de gerçekten mesleğinde uzman ve hastalarıyla çok ilgili harika bir insan. Onunla çıktığım yolda uzmanlığından hiç şüphe etmedim, ona güvenim hep sonsuzdu ve güzel sonuçlar aldık. Eğer doktorunuza güvenemiyorsanız bu zorlu yola hiç girmeyin derim. Soner Bey tedavi sürecimde çocuk sahibi olabilmem için her detayı titizlikle inceledi ve ben zaten bu kadar titiz ve tecrübeli bir doktordan aldığım tedavi ile sonucun olumlu olacağını biliyordum ve sonunda oldu. Teşekkürler Soner Bey, sizinle bu yolu yürümek gerçekten çok umut verici ve keyifliydi.
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I am glad that we met Soner Hoca in this journey we started with severe male factor and chocolate cyst problems. From the very beginning of the process, he made this journey so easy for us with the support of dear Evrim Hanım, whose interest, expertise and experience in her field made this journey so easy for us that people around me could not believe that I was undergoing a whole baby treatment... We trusted my teacher infinitely. Her highly disciplined and professional approach created an infinite trust in me. I never had any question marks in my head. I knew as much as I needed to know and left myself to the process. I am glad I did so... Our 8-year longing for a child ended in our first IVF trial. The people around me did not believe once again because it is absolutely a MIRACLE to reach a positive result in the first attempt, especially in a situation with factors like ours in the IVF adventure... But this miracle became our reality first with the permission of Allah and then with the support of my teacher Soner. We thank him and Mrs. Evrim a thousand times for their efforts <3
T. B. Beyazıt
T. B. Beyazıt
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The miracle that comes with half a uterus Our teacher Soner, who was instrumental in our miracle Our paths crossed with our teacher as a result of unsuccessful attempts in an external center with half a uterus. Soner always kept our morale high and gave us hope from the first day. With his unique and modern treatment methods, he led us to hold our baby in our arms at the end of a very difficult and careful process. He is an expert in his job and is with the patients 24/7. He is a doctor who pays attention to the smallest details. First, with the permission of Allah and the opportunity of our teacher, it was impossible, we experienced the miracle. We thank our teacher Soner endlessly. Good thing; our paths crossed There is always hope
Meleklerin A.
Meleklerin A.
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In the period when we set out with the severe male factor, after a few surgeries performed outside of Turkey (Lebanon), the result was negative every time, and with the joint decision we made with my wife, we decided that we had no other choice but our doctors in Turkey, and thank God that we had the opportunity to meet with our doctor soner Bey, both his knowledge, his sincere approach to the person and his vast experience always made us feel that we were at the right address, On this path that we started treatment with him and the fact that the result was positive after the first trial made us feel that we continued on the road with the right person again, we thank him very much, thank you very much.
Manal Ghazal
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We are very grateful to our doctor who provided us with… We are very grateful to our doctor who provided us with excellent support during the tube treatment process. They are professional, dedicated and extremely compassionate. We really appreciate them for embracing people, supporting them and helping them complete the family. We are so grateful!
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After trying to conceive almost 8 years and 3 failed of IVF circle I have luckily met finally dr Soner DUZGUNER at his clinic 2020 September. After listening and talking each other for an hour and more my hope increased and we started the first circle with PGT test and other health screening, then the first circle was successful. I had beautiful girl and after a year I tried second cycle we used freezing pgt tested embryos and got a boy. The protocols the doctor was very helpful and he gave me special attention and consideration since I had previous failed circles and of course I was foreigner patients. Still I’m his patient and hoping to have more children. Thank you doctor you were very human, kind and understandable doctor.
Parvina Guliyeva
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Many thanks to Mr. Soner. His care, and his professional behavior, always saying to keep hope, gave me morale. After 5 negative trials in external centers, I am 29 weeks pregnant thanks to Mr. Soner. Thanks to him.
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I'm writing from Germany. I had IVF treatment 3 times in Germany. But the result was always negative. Thanks to Dr. Soner Düzgüner, the pregnancy test was positive for the first time. Dr. Soner Düzgüner is an incredibly excellent doctor and person. Thank God, thanks to Dr. Soner Düzgüner, I am pregnant with twins. Insallah I will give birth in a few weeks. I highly recommend Dr. Soner Düzgüner to apply to Dr. Soner Düzgüner who wants to have a son! Thank you Dr. Bey
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Suffering from endometriosis and after three years of unsuccessful IVF in France, I met Dr. Duzguner and his team in Istanbul. He's a very committed doctor, who listens to his patients, smiles, is available, meticulous and very knowledgeable in the field of assisted reproduction. I was lucky enough to get pregnant on my first transfer and have been a mother for a year now. He was quick to identify the problem and put in place the most appropriate treatment for me. To this day, I still keep in touch with this doctor who follows up his patients and I won't hesitate to call on his services for my next transfer. I recommend him with my eyes closed.

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