Infertility is a complex topic and most women who seek fertility treatments may not be successful the first time around. Some may require several attempts with fertility treatments before conceiving while some may not even succeed at all. After a detailed consultation and investigation with the gynaecologist, the dose of fertility drugs to be injected daily would be determined based on the hormonal blood tests and ultrasound scans.
The commonest reason for the follicles (eggs) not growing despite daily fertility drug stimulation could be that the predicted dosage is too low so there is no response. If this happens and is recognised during the early part of the stimulation process, the fertility drug dosage can be increased to see if this would lead to a more favorable response with regards to follicular growth subsequently. If unsuccessful stimulation occurs during one IVF cycle, the fertility drug dosage can be increased for the next IVF cycle.
A balance has to be struck to achieve the desired controlled ovarian follicle stimulation without causing OHSS (ovarian hyperstimulation syndrome) which can potentially be life-threatening. For a minority of patients, their follicles can still fail to grow despite high doses of fertility drugs. This could be because of poor egg quality or low egg numbers and usually correlates with advanced maternal age or premature menopause. If a woman is found to have menopaused, then her only option would be to look for donor eggs from a younger woman.
For most women, there should be mature follicles to collect after IVF stimulation. After the initial oocyte (egg) collection procedure, fertilisation (ICSI) is then attempted using the partner's sperm. If fertilisation fails to occur, this is most likely due to poor egg quality, genetic abnormalities, poor quality sperm (unlikely as the best sperms are selected) or even poor fertilisation techniques (also unlikely as the fertility centres here in Singapore pride themselves with good results and proper techniques).
