Why is an in vitro fertilization treatment canceled?

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When a cycle of in vitro fertilization (IVF) is initiated, it is necessary to perform periodic ultrasound examinations to verify that the stimulation occurs adequately and that the ovary responds adequately to the medication, since problems could arise.

In case the ovary does not respond adequately, due to having too poor response or because it is excessive, it might be necessary to cancel the cycle, be it a conventional IVF or an ICSI.

It is also possible that only the last step of the treatment, embryo transfer, is canceled for various reasons. In that case, there are several strategies to follow depending on the reason that caused the cancellation of the cycle.

Below you have an index with all the points that we will discuss in this article.

Index

Why is an in vitro fertilization treatment canceled?

Cancellation of the IVF cycle

A complete cycle of in vitro fertilization is divided into several parts:

  • Ovarian stimulation
  • Follicular puncture
  • Cultivation and embryonic development
  • Embryo transfer

In each of these parts problems can arise that, finally, lead to a cancellation of the cycle. Depending on the phase of the treatment in which the woman is found, the cancellation can be total, if no embryos or ovules have been obtained, or partial, if it has been possible to freeze ova or embryos for future attempts.

When a couple or a woman is in one of these situations, questions arise such as: Why is the cycle canceled? Would there be any risk of not doing it? In which cases is it necessary to cancel it?

Next, we will discuss some factors that may affect the normal development of the treatment and delay the cycle:

Low response to stimulation

For the treatment of IVF, it is necessary to do a controlled ovarian stimulation with hormonal medication that allows the ovaries to develop several follicles at once instead of just one.

It is possible that the ovary does not respond adequately to the medication administered, so it may be necessary to cancel the cycle for different reasons:

  • Development of few ovarian follicles
  • Low or altered hormone levels that indicate poor oocyte quality
  • Spontaneous ovulation and loss of ovules

In case no egg gets matured properly or is lost with spontaneous ovulation, the cycle would be canceled to try it in the next with a new protocol of stimulation and different medication.

It is important to warn women who have had a spontaneous ovulation during an IVF treatment that they do not have sexual intercourse or do so with protection, since the risk of multiple pregnancy is very high.

When few ovules are obtained due to low response or low ovarian reserve, the woman or the couple has to decide whether to continue with the process or not. There is no risk in terms of women's health, but the probability of success is very low.

You can also consider the option of making an accumulation of ovules during several cycles, so that all are fertilized at the same time to obtain the embryos when an acceptable number has been achieved.

To obtain more information on this topic and to know the possible strategies to increase the success rate in cases of low response, we recommend reading the following article: The low response to ovarian stimulation.

Poor response to ovarian stimulation

Risk of ovarian hyperstimulation

The opposite case of ovarian response would be ovarian hyperstimulation. This refers to the excessive response to hormonal medication which, in the most severe cases, can lead to ovarian hyperstimulation syndrome (OHSS).

The excess of estrogens as a result of hyperstimulation can cause an excessive growth of the ovaries. It is also possible that the release of follicular fluid to the area of ??the belly and chest after ovulation takes place, which could lead to more serious problems.

Finally, OHSS causes an increase in the permeability of blood vessels, which can compromise the function of the hepatic, hematological, renal and respiratory systems, endangering the life of women in the most serious cases.

The high response to ovarian stimulation occurs when 15 or more ovules are obtained in the follicular puncture or when a blood estradiol level higher than 3,000 pg / ml is obtained on the day that ovulation is induced.

In case of ovarian hyperstimulation that can lead to a syndrome of this type, there are two options to try to avoid any complications:

Cancellation of follicular puncture interrupts the stimulation treatment and the administration of hormones. It is important to warn the woman or partner not to have unprotected sex because of the risk of multiple pregnancy and the late OHSS that would appear with pregnancy. Vitrification of embryos In this case, the follicular puncture is done to obtain the ovules, but these are fertilized and vitrified to transfer them in a later cycle. This is because, if a pregnancy were to occur in this cycle, the increase in hCG that this would imply could lead to suffering from OHSS.

It should be noted that, in this last strategy, the vitrification of embryos and not of the ovules takes place because, in this way, the specialists make sure to freeze embryos that are of quality, that they have been able to survive after days in culture.

Measures to avoid SHO

Inability to obtain semen

Another problem that could occur at the time of the follicular puncture and the fertilization of the ovules could be related to the masculine part of the couple, that is to say, the one that contributes the semen with the sperm.

Once the woman's ovules are obtained, there is a time limit to fertilize them in the laboratory for around 4 hours. Once this time has passed, the ovules will have aged and will no longer be able to fertilize.

Therefore, it is very important to have the semen of the couple or the donor prepared to do the fertilization.

The problems that may arise in this regard are the following:

  • Inability to obtain the sample by masturbation, either by nervousness or other alteration.
  • Semen without sperm in patients with severe oligospermia.
  • Bad defrosting of the semen sample that supposes the death of the sperm.
Inability to obtain sperm

If you suspect that any of these things could happen, it is best to leave several samples of previously frozen semen so that, if you can not get fresh semen, it is possible to use cryopreserved.

Cancellation of embryo transfer

At other times, although stimulation and ovarian puncture develop normally, the transfer of embryos may have to be canceled for other reasons.

These causes that prevent embryo transfer in the last steps of IVF treatment are the following:

There are no embryos due to failure to fertilize or stop the development of embryos in culture, especially in long cultures to blastocyst.Indometrium not receptivosi embryos are transferred at a time other than the window of implantation, it is very likely that embryos can not be nested in the endometrium and there is a failure of implantation. Cancelation of embryo transfer

Fertilization failure occurs on rare occasions and may be due to the male factor, the female factor or a combination of both. If it occurs, it is necessary to study the cause before starting a new cycle of IVF.

As for the arrest of embryonic development, it is most likely that it is due to genetic alterations that prevent the evolution of them. It is also possible for embryos to stop when a long culture is done to obtain blastocysts, since the formation of a blasto is a critical step that not all embryos can complete.

If none of the embryos manage to survive until the day of the transfer, it will be necessary to start a new cycle of IVF.

In Assisted Reproduction ORG we have agreements with several Spanish clinics to offer assisted reproduction treatments at a cheaper price. If you want to get a discount and a first free visit without any commitment, you can enter the following link: See discounts on IVF / ICSI.

Questions from users

Why is a frozen embryo transfer canceled?

Two reasons can happen mainly. First of all, it is possible that the endometrial preparation does not go well and the proper thickness is not achieved after weeks with the hormonal medication. On the other hand, it can also happen that vitrified embryos do not survive after thawing, although it is not usually normal. The survival rate of vitrified embryos is close to 99%.

Is it possible to cancel the embryo transfer in an oocyte donation?

Although it is not normal, it is possible that there is some complication that makes cancel the cycle, especially when the egg donation is fresh. This assumes that donor and recipient must be synchronized so that the donor's ovules and the endometrium of the recipient go hand in hand, which is a bit complicated. Normally, donated ovules are usually vitrified until the recipient has the endometrium in optimal conditions for transfer.

Recommended reading

As we have said, an IVF treatment consists of several phases and lasts approximately one month. To know in detail each of these stages, you can continue reading the following post: The process of in vitro fertilization step by step.

As with in vitro fertilization, it is also possible that problems arise during an artificial insemination treatment that obliges to cancel the cycle. If you want to read more about this topic, you can visit the following article: Risks in artificial insemination.

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