SOLUTION TO FAILED IVF/ICSI

SOLUTION TO FAILED IVF/ICSI

Janini IVF, the best ivf center in Delhi NCR, hails in treating previous failed cases. Majority of patients that get referred to us from other doctors are such cases who had IVF or ICSI attempt(s) elsewhere but unfortunately failed. Our 'Faith reborn' campaign specifically addresses the care and priority that previous failed IVF patients deserve. Through our customised approach to RIF (recurrent implantation failure) patients we have given miraculous positive results in scores of patients who were distraught and frustrated by failed treatments earlier. Many patients come to Janini IVF after their first or second fertility centres gave up on them, denying them treatment unless they agree for donor gametes. Here at Janini, we are committed to helping patients conceive with their own eggs and sperm.

Recipient of numerous awards and accolades, one of the few FNB degree holders in the country, Dr Rutvij Dalal, the best IVF specialist in Delhi, and medical director of Janini IVF, has a special passion for giving a baby to previous failure cases. Nothing gives more satisfaction than successfully treating challenging cases. Again, highly renowned and accomplished Dr Akanksha Mishra, post-graduate from Oxford University, UK and chief embryologist at Janini IVF has years of experience to deal with patients who repeatedly see negative results in spite of having 'good' embryos in previous cycles. She has also given numerous invited lectures on the same topic in International meetings. Over a number of years we have successfully given results to even those couples who've had several failed attempts of IVF/ICSI elsewhere.

After your failed attempts, we know exactly how you feel. We know that while you see other couples seemingly easily getting success and sharing their positive reports of pregnancy there hangs a cloud of desperation, depression and desolation over your minds. Why can't we also get positive? Why can't we also do it? Trust us, you will. Just give it some time. But you will.

What do we do differently?

At Janini IVF, the best ivf centers in West Delhi, we have tailor-made solutions to failed IVF patients. Our state-of-the-art embryology laboratory ensures your embryos are made in the best possible environment. Besides, Dr Dalal's expertise in individualised controlled ovarian stimulation protocols would help even those patients with a very poor ovarian reserve and those who didn't have good quality eggs in previous attempts. Constantly striving to push the boundaries of excellence, we at Janini IVF can offer you options that other IVF centres cannot. Some of them include:

  • Laser assisted hatching of embryos
  • Blastocyst transfer or sequential transfer
  • Hysteroscopic evaluation of uterine cavity
  • Immune testing
  • Removal of hydrosalpinx, if present through laparoscopy
  • Removal of fibroids in the uterus through laparoscopy
  • If the quality of eggs was told to be poor we can use adjuvants like Vitamin D, anti-oxidants, DHEA, etc.
  • Frozen cycle instead of fresh cycle
  • IMSI (intra-cytoplasmic morphologically selected sperm injection). Dr Dalal and Dr Mishra have done significant work on this topic and they are pioneers of the same. IMSI selected sperms are better in DNA health and lead to higher liver birth rates and Lowe miscarriage rates. Read more about their publication in an International Journal :
    https://www.jaypeedigital.com/doi/pdf/10.5005/jp-journals-10016-1027
  • Pre-implantation genetic screening (PGS) or PGT-A of embryos
  • ERA or endometrial receptivity analysis
  • Endometrial scratch therapy or hysteroscopic scratch surgery
  • Sperm DFI or DNA fragmentation Index that tells us about quality of sperm. If DFI > 30 we might take testicular sperm instead of sperm found in the ejaculate as testicular sperm have a lower DFI.
  • Embryo glue
  • Using special adjuvants including G-CSF that might optimise the endometrial receptivity
  • Lastly, changing the gametes (egg donation) or embryo (embryo donation)
 

Surprising to you it may sound, but many times, it is not what you do differently but what you do excellently that counts. Indeed, the same techniques used in a better way would give results that were not seen earlier. Individualised stimulation protocols would maximise yield of good quality eggs. Better sperm selection methods like IMSI or PICSI would give the best quality sperms to use for ICSI. All this would lead to much better quality embryos than before. And if these better quality embryos are transferred to a receptive endometrium (could be confirmed through ERA) we would definitely get success.
In a soothing, professional and scientific environment, see why Janini IVF is a leading destination for couples seeking a positive outcome from past struggles of repeated failures.

Frequently asked questions

We understand that a failed cycle takes a toll on your emotional health. Any cycle that doesn't lead to pregnancy feels bad. When you have invested energy, time and money your hopes are bound to be higher; and this leads to more frustration when things don't go as per plan. Best thing to do is give yourself time to heal, grieve and let the emotions flow. Do understand that reproductive medicine has advanced so much that most couples today eventually do get a baby. It takes some couples more attempts than one, that's all. Have a positive approach towards life and try to have happy, positive thoughts. This will help

When you come to Janini IVF, the best TESA treatment center in Delhi NCR, make sure you carry ALL your reports from the previous treatments. We would carefully see your investigation reports, the ovarian stimulation you received, embryology details, whether any embryos are frozen or not and finally try and figure out why your cycle failed.

This is totally false and is nothing but a myth. Today, using advanced technology and scientific protocols one can easily get pregnant even in the first cycle of IVF or ICSI. Indeed, at Janini IVF, under the able guidance of Dr Dalal's expertise and Dr Mishra's skills in embryology, having a success rate of approximately 70% (woman age less than 35 in self cycles and donor cycles) would mean that out of 100 couples 70 would get a positive result in the first attempt itself.
Age of the female partner (only applicable if self eggs are taken, with egg donation women more than 60 years of age can also get pregnant), ovarian reserve, semen analysis report (quality of sperms), endometrial thickness and receptivity, type and duration of infertility, fresh or frozen cycle, blastocyst transfer, the centre at which IVF was done, qualification and experience of the treating doctor, qualification and skill of the embryologist who makes your embryos inside the lab (this is perhaps the most important factor), embryo transfer technique, freezing-thawing technique, among many others.
Dr. Dalal, the best ivf doctor in Delhi, is one of the most experienced clinicians in using the "Natural IVF" or "Mini IVF". With this protocol, he not only manages to harvest good quality oocytes from patients with poor reserve but also at a much lower cost. The principle behind IVF Lite is basically using minimal or low-dose gonadotropins to stimulate growing only the best egg in the ovaries. By doing so, we are reducing cost of the IVF cycle significantly to almost negligible levels. After repeatedly harvesting good-quality eggs in this fashion, they are all frozen successively. After "Cryo-accumulation" of these good quality eggs, they are subject to ICSI with the partner's sperm and then good quality blastocyst(s) transferred thereafter. This way, challenging cases like patients with advanced age or those with low AMH levels can also get a baby in their arms.

Poor embryo quality is one of the main reasons why a particular IVF cycle fails. Embryos are usually graded by morphological evaluation (observing them closely and grading based on certain criteria) by the embryologists. Since embryo is made after the union of a sperm and an egg, having a good embryo would mean we need good quality sperms and good quality eggs. For sperms, using a good technology like IMSI or PICSI; and for eggs optimising ovarian stimulation protocols would be helpful. Most importantly, it is to be seen that these embryos get the best environment to grow in. We have some of the best quality lab incubators that would ensure 37 degree Celsius temperature, low (5%) O2, pH of 7.4 at all times, which mimics the human body environment. We have regular and continuous quality control (QC) and quality assessment (QA) of all our lab equipment to confirm that it is always working optimally. This helps in generating the best embryos that are fit fo implant in the uterus.

In addition, a point is to be mentioned about genetic testing. Human reproduction is such that no matter what we do, some of the total embryos formed will be genetically defective. Either they will have a chromosome more/less in number or have structural defects in the chromosome(s). These defective embryos ironically do not look bad. So if we go ahead and transfer these embryos, in spite of being grade A embryos, they would give a negative result or a positive result but an abortion later on. To prevent this from happening, we now have a reliable technology called PGS (pre-implantation genetic screening) or PGT-A (pre-implantation testing for aneuploidies). We take a few (6-8) cells out of the trophectoderm (outer layer of cells in a blastocyst) and send them for genetic testing. If the report is normal then we prefer transferring these normal embryos instead of the abnormal ones. We can get a much faster result this way that will progress all the way into a healthy, normal baby.

There are many reasons of failed implantation in spite of putting in good or grade 1 embryos. It's possible the embryo transfer procedure was not carefully done or there was trauma while doing it. It is possible your endometrium couldn't reach an ideal thickness of 7 - 14 mm. It is possible that there was a polyp or fibroid inside your uterus, or simply there was an active infection which was not tackled properly. But most commonly, the reason is idiopathic - or unknown. We now seem to have a remedy for this 'unknown' reason of implantation failure. And that is ERA.

ERA or endometrial receptivity assay is taking bits of your endometrium and sending them to the genetic laboratory to see if the endometrium is 'receptive' or good enough. ERA involves an elaborate technology of looking for numerous genes that are active inside those group of cells and working out a statistical model to categorise the endometrium into pre, post, or receptive endometrium. Depending on the report, we go ahead with the transfer exactly same day (if nothing is wrong with endometrium) or make appropriate changes with transfer day (pre-receptive or post-receptive). This way, when we are putting your uber precious embryos inside, at least we know that the endometrium is receptive and there is a much higher chance of those embryos implanting inside.

For a FREE SECOND CONSULT, please call +91 9717 99 66 55 or write to us at info@janiniivf.com
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Janini IVF
A3/12, First Floor Paschim Vihar, New delhi - 110063
+91 9717 99 66 55
011-25 25 66 55
info@janiniivf.com

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