Recognizing Signs of an Unsuccessful Embryo Transfer

by Johnny Jacks
In vitro fertilization (IVF) stands as one of the most widely utilized assisted reproductive techniques in today’s medical landscape. However, it’s not uncommon for IVF attempts to result in failure. So, what are the indicators of a failed embryo transfer? We invite you to explore the details in the following article.

Causes of Embryo Transfer Failure

Before delving into the causes and signs of embryo transfer failure, it’s essential to understand the embryo transfer process.

Embryo transfer constitutes the second step in the IVF procedure. Following the fertilization of eggs and sperm in a laboratory setting, the doctor employs a catheter to introduce the embryo into the mother’s uterus.

Typically, doctors implant around 2 to 3 embryos to enhance the likelihood of a successful pregnancy. This procedure is performed immediately after a woman’s ovulation, as this is when the uterine lining is at its most favorable thickness.

Once implanted, the embryo begins to develop and attach to the mother’s uterus. After a period of 14 days, a blood test is conducted to measure the level of beta hCG hormone, which is indicative of pregnancy. During this period, if pregnancy signs emerge, the embryo transfer is considered successful. However, if it proves unsuccessful, there will be signs of a failed embryo transfer, as outlined below.

Poor Quality Embryos

The embryos implanted in the mother’s uterus are typically 3 to 5 days old. The doctor evaluates embryo health based on their developmental progress. If they meet specific criteria, the embryo transfer is carried out.

For 3-day-old embryos, health assessment relies on factors like the number of cells, cell size, and fragmentation. Type 1 embryos are considered the healthiest, with the highest chances of success. Type 2 embryos are average, while grade 3 embryos are of poor quality, with a lower success rate.

In the case of 5-day-old embryos, health assessment is based on the size of the blastocyst cavity. Larger, multicellular, compact, and non-fragmented embryos are considered superior.

Poor embryo quality often contributes to embryo transfer failure. Weak embryos struggle to adhere to the mother’s uterine lining, making them prone to detachment and vaginal bleeding.

Embryos result from the fusion of eggs and sperm. Consequently, if the mother’s eggs are of suboptimal quality or the father’s sperm is weak (or both), it can lead to the development of poor-quality embryos, increasing the likelihood of embryo transfer failure.

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Age plays a significant role in determining the success or failure of embryo transfer. Research indicates that the success rate of embryo transfer is 45% for women between 20 and 30 years old, decreasing to 32% for those over 35 years old, and halving to 16% for women over 45 years old.

The decline in success rates with age is primarily attributed to the diminishing quantity and quality of a woman’s eggs as she grows older. An option to address this issue and preserve egg quality, potentially mitigating the risk of unsuccessful embryo transfer, is egg freezing.

Abnormal Uterine Lining

A woman’s uterus features an inner lining known as the uterine mucosa. This lining typically measures between 8 to 13 mm in thickness, depending on the phase of a woman’s menstrual cycle (thinning or thickening).

When the uterine lining is excessively thick or thin, it can be unfavorable for the embryo’s attachment and implantation. If embryo transfer occurs when the uterine lining is less than 7mm thin, the likelihood of failure is higher.

Several other factors can make the uterine lining less receptive to embryos, including chronic endometritis, uterine polyps, uterine septum or adhesions, the timing of embryo transfer (pre-implantation or post-implantation), and the degree of uterine perfusion. Therefore, prior to embryo transfer, patients undergo tests to evaluate the uterine receptivity.

Post-Embryo Transfer Care Regimen

The journey towards welcoming a baby through artificial insemination can be emotionally taxing for couples dealing with infertility. Pregnant mothers often experience feelings of anxiety, nervousness, stress, tension, and even fear of the unknown outcome. These emotions can lead to hormonal imbalances that might affect the success of the embryo transfer. Hence, it’s essential for pregnant mothers to maintain an optimistic and calm mindset as they navigate these changes, fostering an environment conducive to healthy embryo development.

In addition to psychological well-being, dietary choices also play a crucial role in the success of embryo transfer and implantation. Poor eating habits, skipping meals, or consuming foods unsuitable for expectant mothers can increase the risk of failed embryo transfer.

Furthermore, lifestyle and resting habits can be contributing factors to embryo transfer failure. It’s imperative for pregnant women to adopt a balanced and healthy lifestyle, as well as practice appropriate resting habits to safeguard their overall well-being.

Recognizing Signs of Embryo Transfer Failure

Understanding the signs of embryo transfer failure is crucial for expectant mothers. If a pregnant mother experiences any of the causes mentioned earlier, it can significantly increase the likelihood of an unsuccessful embryo transfer. So, what are the indicators of failed embryo transfer?

Absence of Morning Sickness

Is the absence of morning sickness symptoms indicative of embryo transfer failure? Typically, around one week after embryo transfer, signs of pregnancy like morning sickness begin to manifest. Pregnant women may become sensitive to certain foods they usually consume daily, experiencing nausea and vomiting.

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However, if a pregnant mother does not experience the aforementioned symptoms, particularly the absence of morning sickness, it is often considered one of the signs of embryo transfer failure.

Vaginal Bleeding

Vaginal bleeding is a common occurrence after embryo transfer, but the nature of bleeding can differ between successful and unsuccessful embryo transfers.

In a successful embryo transfer, the embryo attaches to the uterine lining, triggering increased hormonal secretion in the mother’s body, which can affect blood vessels and result in bleeding. Pregnancy-related bleeding is typically light pink and lasts for a short duration, typically 1 to 2 days.

In contrast, when embryo transfer fails due to the embryo’s inability to attach to the uterine lining, the lining is shed in a manner similar to the menstrual cycle. This type of bleeding is characterized by dark brown blood and is often more substantial, accompanied by abdominal discomfort.

If a pregnant mother experiences this type of bleeding, it may be an indicator that the next embryo transfer attempt holds better prospects for success.

Beta hCG Levels Remain Unchanged

Following the 14-day period post-embryo transfer, patients typically undergo a blood test to assess their Beta hCG levels, which helps determine whether they are pregnant. If the Beta hCG levels fail to increase or show a decrease, this is often an indication of embryo transfer failure.

Menstrual Return After Unsuccessful Embryo Transfer

When it is confirmed that the embryo transfer has not resulted in a successful pregnancy, the doctor may prescribe medication to the expectant mother. After taking this medication for 3 to 5 days, women will typically experience the return of their menstrual periods.

Owing to the influence of ovulation and the impact of earlier ovulation stimulation through injections, it may take 1 to 3 months for the menstrual cycle to normalize. During this period, mothers can plan for subsequent embryo transfers.

Methods to increase the success rate of embryo transfer

Having signs of failure after embryo transfer does not mean that a pregnant woman can no longer get pregnant. It is completely possible for the couple to have a second artificial insemination based on the first failure to do better.

After the first time, the doctor will better understand the condition of the pregnant mother, thereby giving more specific techniques suitable to the mother’s physical properties. If there are signs of embryo transfer failure, pregnant women can refer to some techniques to increase the rate of successful embryo transfer as follows.

Treatment for Uterine Abnormalities

The uterus plays a pivotal role as it serves as the site for embryo development. Any irregularities within the uterus can directly impact the outcome of embryo transfer. Therefore, if a pregnant woman encounters issues related to the uterus, such as uterine adhesions, a septate uterus, double uterus, uterine fibroids, or a T-shaped uterus, prompt treatment is essential.

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Blastocyst Culture

As previously mentioned, embryos reach the blastocyst stage on day 5 of development, exhibiting superior quality compared to day 3 embryos. The success rate of implanting day 5 embryos is 1.35 times higher than that of day 3 embryos. Day 5 embryos are more robust and exhibit enhanced mucosal adhesion. Additionally, they reduce the likelihood of multiple pregnancies because each implantation typically requires only 1 to 2 embryos while still ensuring a high pregnancy rate. Therefore, blastocyst culture stands as an effective technique for achieving successful artificial insemination.

Preimplantation Embryo Genetic Testing (PGT) for Chromosomal Abnormalities

Preimplantation genetic testing (PGT) is a reproductive medicine technique employed to identify chromosomal abnormalities in embryos produced through IVF. PGT aids in screening and selecting aneuploid embryos for transfer, elevating the pregnancy rate and diminishing the risk of miscarriage, stillbirth, and abnormal pregnancies. This technique proves effective in boosting the pregnancy rate because chromosomal aberrations significantly impact the embryo transfer process, with embryo transfer failure due to chromosomal misalignment accounting for up to 70% of cases.

Endometrial Sensitivity Analysis (ERA)

Endometrial Receptivity Analysis (ERA) is a test designed to assess the endometrium’s ability to accept embryos in women undergoing IVF. The test involves obtaining a sample of the uterine lining, which is then sent to a laboratory in Japan for analysis using next-generation gene sequencing techniques. This advanced test examines up to 248 genes in the patient, optimizing the timing of embryo placement in the uterus to enhance implantation and pregnancy outcomes while also detecting potential uterine abnormalities. Based on the results, suitable solutions can be provided to pregnant women.

What Should Women Do After Experiencing Signs of Embryo Transfer Failure?

In the event of displaying signs indicative of embryo transfer failure, it is essential for pregnant women not to become overly anxious. Instead, they should exercise patience and await the 14-day mark for accurate Beta hCG level testing.

During this period, pregnant women are advised to:

  • Maintain a stable, positive, and optimistic mindset, remaining resilient throughout the process.
  • Consume a balanced diet with regular meals while avoiding caffeine and alcohol.
  • Engage in gentle daily exercise for approximately 30 minutes to enhance blood circulation and boost metabolism.
  • Adhere to a rational and scientifically sound rest schedule, avoiding excessive periods of lying down to prevent adverse effects.
  • Periodically monitor their health and promptly seek medical attention if any abnormalities are detected.

In addition to addressing common questions about signs of embryo transfer failure among pregnant women, offers an abundance of information and knowledge related to reproductive health and maternal well-being. We invite you to explore our resources further.

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