Impact of Age & Repeated IVF Cycles on Pregnancy Tweetinar on Cloudnine

May 25, 2022
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On 27th June, 2018, Cloudnine conducted a live Tweetinar on Impact of Age & Repeated IVF Cycles on Pregnancy on its Twitter handle @CloudnineCare. It was led by Dr. Sathya Balasubramanyam, Fertility Specialist at Cloudnine Hospital, T Nagar, Chennai. The Tweetinar touched on a bouquet of topics related to assisted reproduction and fertility. Here are some of its highlights.

Specialist Details: Dr. Sathya Balasubramanyam

Specialty: Fertility

Clinical Focus and Expertise: Infertility evaluation, infertility treatment, in vitro fertilisation (IVF), high-risk pregnancy care

Book an Appointment with Dr. Sathya Balasubramanyam for fertility related concerns.

Tweetinar Questions & Answers

1. Can malfunction of the male thyroid gland be a cause of IVF failure?

Thyroid malfunction may affect sperm mobility. However, this usually only impacts natural conception. IVF remains unaffected.

2. Does the probability of a successful cycle reduce after 3-4 attempts of IVF?

After 3-4 cycles, the probability of conception drops to about 15%. In such cases, it is best to scan the embryo beforehand for genetic abnormalities.

3. The age of the female partner is always considered an important factor for conception. To what extent does the age of the male partner contribute to a couple's diminished fertility potential?

The quality of semen reduces after the age of 40. Conditions like autism are more common in babies with fathers aged 40 or above, during conception.

4. Do repeated IVF cycles impact a woman's hormones? Also, are repeated IVF cycles not advisable for women with hypothyroidism?

Repeated IVF cycles can diminish the ovarian reserves at a faster rate. As far as hormones go, other than AMH, there is no other significant hormonal impact. Also, there's nothing stopping women with hypothyroidism from undergoing repeated IVF cycles.

5. Does IVF pose any risks?

There are risks of a preterm delivery and a multiple pregnancy. Also, sperm and egg reserves may become diminished in quality.

6. What is the average success rate of IVF?

The average success rate of IVF lies somewhere between 35-40% per embryo transfer, if the woman is below 38. If she is above 38, then the success rate falls in proportion with age.

7. What are the side effects of IVF?

A multiple pregnancy, an ectopic pregnancy and ovarian hyperstimulation are some potential side effects of IVF.

8. Does repeated IVF take a toll on a woman's body?

IVF takes more of a mental toll than a physical one. Up to 5 cycles are considered perfectly safe for a woman; there is no evidence to suggest otherwise.

9. Will IVF treatment affect my day-to-day life?

You may experience some interruptions to your routine, like frequent clinic visits and abstinence from sexual intercourse.

10.Are there any health conditions where IVF is not advisable?

IVF is not advisable if a woman is over 45 years of age or if the uterus is irreversibly damaged. Also, if both male and female gametes are depleted, a couple can choose to undergo the IVF process with a donated gamete.

11. Do fertility hormones pose long-term health risks?

No, there is no such evidence.

12. What are the most common reasons that an implantation fails after IVF?

Chromosomal abnormalities in the embryo, endometrium not being receptive, embryo falling outside the uterus after transplantation are some possible reasons.

13. How soon can a woman take a pregnancy test after an IVF transfer?

The earliest one should take a pregnancy test is 12-16 days after an IVF transfer.

14. How do repeated IVF cycles affect my health?

More than anything, they may affect you psychologically. Practise stress-relieving activities before and between procedures.

15. Can hormonal surges caused by IVF give rise to certain types of cardiovascular diseases in older women?

There is no such medical evidence.

16. How must one prepare mentally before undergoing an IVF cycle?

We suggest that you have very realistic expectations. It is important to practise stress management before taking on a cycle.

17. How long does an IVF cycle last?

One cycle lasts up to 2-3 weeks.

18. Is there hope of a normal life after repeated failed IVF cycles?

Life will be normal if you live it that way! Opt for counselling to overcome psychological issues.

19. Can repeated IVF cycles lead to birth defects?

The number of IVF cycles has no bearing on birth defects.

20. How can one maximise the chances of a successful outcome after repeated failed IVF cycles?

Causes must be looked at. Preimplantation genetic screening is advisable to rule out chromosomal anomalies.

21. Can the quality of a clinic's IVF lab impact the outcome of a cycle?

Labs where embryos are grown require a controlled environment with respect to temperature, pH and humidity. If all these factors are up to the mark, the odds of a successful cycle increase.

22. What is the age limit for IVF?

Women should ideally be below 45, and men, below 50.

23. Do the chances of a successful outcome diminish with each successive IVF cycle?

After the third IVF cycle, the chances of a successful outcome start declining.

24. Does IVF always lead to twins or multiples?

There's only a 25% chance of multiples, but this risk can be minimised by performing a single embryo transfer.

25. How long does it take for an embryo to implant after a transfer?

It can take several weeks for the implantation process to complete.

26. What is the recommended gap one should maintain between IVF cycles?

Between frozen embryo cycles, a break isn't required. Between fresh embryo cycles, a break of one month is recommended.

27. What are my options for unused embryos?

You can either donate them to a couple or for research, or discard them.

28. Will IVF treatment have an effect on my general health and skin?

Physical health may be impacted by ovarian hyperstimulation, a rare complication of IVF. Emotional wellbeing may be affected and can be managed with the help of counselling sessions.

29. What factors qualify or disqualify a woman from undergoing IVF?

Major health risks and age (over 45) may serve to disqualify a woman from IVF. Qualifying criteria typically include polycystic ovarian syndrome (PCOS), blocked fallopian tubes, stage 3-4 endometriosis and previously failed IUI cycles.

30. What is the ideal age for IVF?

The ideal age is 35 or under.

31. Is IVF painful? Is it performed under general anaesthesia?

Embryo transfer doesn't require any anaesthesia; however, a sedation may be given in some cases. During the egg retrieval process, local anesthesia is administered. Neither procedure is painful.

32. Does obesity play a role in repeated failed IVF cycles and can it cause complications during pregnancy?

Obesity reduces the chances of conception and increases the risk of premature delivery and diabetes.

33. Are there any precautions a thalassemia patient must take when trying for a baby?

First, it is important to know if your husband is also a carrier. If yes, then the embryo transferred should be checked so that the baby doesn't get affected.

34. How much does a single IVF cycle cost, on an average?

The cost hinges on various factors including your medical background and body mass index (BMI).

35. How long can eggs and embryos be stored?

According to guidelines provided by the Indian Council of Medical Research, they can be stored up to 5 years.

36. Does a woman's age impact the efficacy of an IVF cycle?

The ovarian reserve starts depleting after the age of 30. Hence, age plays a crucial role in determining a successful IVF outcome.

37. What is the impact of age on AMH? At what age does AMH start declining?

AMH declines with age. This depletion becomes more pronounced after the age of 30.

38. How can one control PCOS?

Lifestyle changes and medication are recommended.

39. I have experienced 2 recurrent miscarriages but my reports indicate no problem. What should I do?

In 5% of cases, miscarriages are unexplained. In the future, you may want to opt for preimplantation genetic screening of the embryo. As a last resort, you may want to consider surrogacy.

40. How can I get pregnant with PCOS?

Lifestyle modifications are a good place to start. For treatment, ovulation induction, followed by intrauterine insemination may be suggested. IVF may be advised as a last resort.

41. Does IVF work for obese women? What is the best way forward?

The best option is to undergo bariatric surgery and then think about IVF treatment. Consult your doctor to seek a surgical course of action.

42. Can we use our frozen embryos to try a second round of IVF, given that our first cycle was unsuccessful?

Yes, frozen embryos are just as good as fresh ones. Rest assured, your chances of conception are high!

43. What are the complications of trying to conceive at 40?

Getting pregnant may be difficult at 40, thanks to a low egg count. The chances of miscarriage and chromosomal anomalies are also higher.

44. I have been married for six years, have regular periods but have been diagnosed with PCOS. What is the best route I can take to conception?

Try IUI as a first step. If you do not see results within three cycles, you can always move to IVF. Also, have your husband's sperm tested for DNA fragmentation.

45. I suffer from irregular periods, which has made conception a challenge. Why is my menstrual cycle so unpredictable?

There may be several causes: hyperprolactinaemia, premature ovarian dysfunction, rapid weight gain or weight loss.

46. Is it possible to get pregnant with endometriosis?

It's possible, depending on the stage of endometriosis.

47. I had an abortion a year ago and recently decided to start a family. However, despite trying for five months, I haven't seen any success. What could this be due to?

Your fallopian tubes may have got blocked after your abortion. Have them checked to rule out a blockage.

48. I typically have irregular periods but last month, I got my period within 28 days. I took that as a sign and planned intercourse between the 14th and 17th days of my cycle this time. Can I hope for a pregnancy?

If you have a regular cycle, timing intercourse between the 14th and 20th days is advisable.

49. Despite taking adequate rest, my wife suffered from a miscarriage. Her test reports are normal. What could the reason be?

A conclusion can only be drawn based on a thorough evaluation.

50. During a surgical procedure to remove an ovarian cyst, one of my fallopian tubes was cut. With only one healthy tube, do I have a reduced chance of conceiving a baby?

With a single healthy tube, your chances of natural conception are still good!

50. I am over 35 and have undergone a range of tests and several courses of medication. Unfortunately, I am still not pregnant. Although my fallopian tubes have been deemed healthy, I have a low ovarian reserve. What should I do?

Since you are over 35, try assisted reproductive methods.

51. I am 28 years old, have normal test reports but have been unable to get pregnant. What does this indicate?

This may be a case of unexplained infertility. If you have been married for more than 3 years, IUI may be a suitable option.

52. I am 39 years old and have recently been told that my ova are not adequately developing and that my uterine lining is too thin. What should I do?

Consider a hysteroscopy to evaluate the lining in greater depth. Also, test for tuberculosis. If all is well, you can be administered platelet-rich plasma (PRP) therapy to improve your lining.

53. I have had two IVF failures and my doctor has advised me to undergo a laparoscopy before opting for a third IVF cycle. I am already 40 years old. What are my chances of getting pregnant?

A third IVF cycle, as is, won't help. First, opt for preimplantation genetic screening to rule out genetic anomalies in the embryo.

54. I have a septum in my uterus. Can I still conceive a child?

Septum removal might help. If that still doesn't work, consider fertility treatment.

55. I have low AMH and high ANA levels. What does this indicate?

High ANA levels are indicative of immune disease. Consult a rheumatologist to assess the possibility of an autoimmune condition. Then, you can move to assisted reproduction.

Must read - Superfoods That Help Your Success Rate In IVF.