Since there are many causes of infertility and often several of them are combined, it is very risky to establish a common prognosis for all the cases. It, therefore, implies a personalized evaluation of each case.
It is important to differentiate between the factors to be studied before treatment and the factors that would have a prognostic value when another IVF attempt is carried out after a failure.
Most relevant pre-treatment factors:
Maternal age. As we explained in this post, the effect of advanced age causes a decline in the number and quality of oocytes.
If the starting point of the treatment is an altered massculine factor.
Body mass index (BMI). In women, the ideal BMI is between 19 and 30. Its deviations, especially BMI >30, can lead to a low rate of fertilization and pregnancy. In this case, the patients tend to have ovulatory problems and present a higher risk of miscarriage. In men, obesity adversely affects their reproductive system and it has been observed to tend to increase oestrogen level and reduce testosterone level.
Cause of infertility. Whether it is single or multiple.
Having endometriosis.
Antral follicle count (AFC). It is directly related to maternal age and anti-mullerian hormone (AMH) values. With increasing age, we observe a decrease in the follicle count and AMH values.
Toxic factors. Habits of use of harmful substances, such as tobacco and alcohol, as well as environmental factors, impair treatment outcome.
If the cause of the sterility is of unknown
Anatomical abnormalities that may difficult the pregnancy.
Suffering from a tubal factor.
Post-failure factors:
Ovarian factor. Depending on the ovarian response in a previous cycle, we can modify and/or customize a new attempt based on certain hormone levels. Also, progesterone levels can help us know if endometrial receptivity is optimal.
Endometrial factor. Abnormalities in the intrauterine cavity, poorly proliferated endometrium, endometritis, immunological factors and blood coagulation abnormalities are the causes of repeated implantation failure (learn more)
Semen quality. Although with a low number of spermatozoa we can carry out an ICSI, there are certain parameters that could influence the rate of fertilization and that must be considered in a new attempt.
Embryonic quality. Embryos that reach the blastocyst stage are classified according to their degree of expansion and the quality of their cells. Consequently, a good quality embryo will have a higher pregnancy prediction rate (learn more)
Laboratory quality control. This category includes air quality, pH, type and characteristics of incubators, use of dim light and type of media in which embryos are cultured. The IVF laboratory must guarantee the best conditions for embryo development
Experience of embryologists