Failed IVF? Ask an Expert

A failed IVF cycle can be devastating, and disheartening, for many. Certainly, it is a big financial commitment but, moreover, IVF requires a huge investment of time, heart, and hope. When your investment results in a failed IVF attempt you likely re-evaluate your next steps toward conceiving a child.


The Reality of IVF to Treat Infertility

For couples, and individuals, pursuing pregnancy via IVF, you may feel overwhelmed. The truth is all the months of testing and assessing your fertility issues, medication, and precision planning doesn’t always result in pregnancy. In fact, some couples need to go through a series of cycles in order to finally achieve success.

The good news is, for infertile couples, your odds increase with additional IVF cycles. Based on a 2016 British study, success rates with IVF continue to increase cumulatively at least up to 8 cycles. This suggests that, if a cycle fails based on embryo quality or just by chance alone, the treatment should be continued because the odds will steadily increase over time and with more embryo transfers.

As to why your IVF failed, there can be many reasons, or a combination of reasons. Thankfully, there are also a few different options to help improve your odds for a successful IVF cycle the next time around.


Some Reasons for Failed IVF

Understanding failed IVF helps many couples with determining next steps. Here are some of the more common reasons IVF doesn’t succeed.

No Viable Eggs or Sperm

A successful pregnancy, no matter how it is achieved, depends on viable genetic material from both father and mother. Upon retrieval of your eggs, it’s imperative they be determined for their viability. Should an embryologist test your eggs and find many, or all, of the eggs from that particular cycle aren’t able to result in a fertilized embryo, the cycle will have failed.

Sperm is also tested for viability. If your partner’s sperm isn’t able to fertilize your eggs, another course is necessary. Often, though, sperm viability is determined before IVF is started.

Embryo viability is the most important and luckily the survival rate after freezing and thawing is quite high. At LA IVF embryology laboratory, this rate is as high as 98%.

Fertilization Simply Does Not Occur

In some cases, even when sperm and egg are determined to be healthy and viable, fertilization just doesn’t happen. Your physician will combine your healthy egg with thousands of healthy sperm. If no sperm fertilizes the egg, another process may need to be introduced.

Intracytoplasmic sperm injection (ICSI) is when fertilization is achieved via direct injection of one sperm into a healthy egg. This process of IVF has been highly successful for couples with male factor infertility, especially when the man has a low sperm count.

In cases of normal sperm, ICSI may yield a higher number of embryos and is commonly used to fertilize to eggs especially in cases of decreased ovarian reserve, unexplained infertility and severe endometriosis cases.

Failed Implantation

Those 7 days after your IVF can seem interminable. You hope and pray that tiny little embryo, or blastocyst, has found its way into the lining of your uterus and started dividing its cells, and growing successfully.

When implantation doesn’t occur, the result is a failed IVF. There are several reasons why implantation fails to happen, primarily an unhealthy uterine lining, or an unhealthy embryo. Embryos with certain chromosomal abnormalities often fail to implant, no matter how pregnancy is achieved.

Sometimes, the transfer process is at fault. In these cases, it could be an issue with your fallopian tubes such as hydrosalpinx. A complete assessment of the pelvis using the dye test called HSG or laparoscopy can be very useful.

Chromosomal Abnormalities

When an embryo is created, no matter the process, it should share genetic material from each parent, in the form of 23 chromosomes from the sperm, and 23 from the egg. If all is well, the embryo will then develop into a unique being with its own set of 23 pairs of chromosomes. If there is a chromosomal abnormality, a missing, or extra chromosome, the result often leads to failed implantation, or miscarriage.

Sometimes there are no obvious reasons behind a failed IVF treatment. However, once you experience an unsuccessful IVF, there will be a sense of loss and grief. It’s crucial for your own health to be able to discuss those feelings freely with someone, either a friend, loved one, or therapist.


A Word About Miscarriage

When you’ve endured months, or years, of trying to conceive a child, only to end up unsuccessful, a miscarriage after IVF can seem downright cruel. You may be concerned that the IVF procedure put you at risk for pregnancy loss, or something you have done has caused this tragedy. Rest assured, IVF does not contribute to miscarriage, and likely neither did anything you did.

Early miscarriage is not uncommon. Roughly 20-50 percent of all pregnancies end in early miscarriage. The two most common causes are implantation failure, and chromosomal abnormalities. There are many reasons for failed implantation, from uterine lining issues caused by an autoimmune disorder, or thyroid conditions, to anatomical irregularities of the uterus itself. Your doctor can examine the cause, and assign the appropriate treatment.

In the case of chromosomal abnormalities, the reason behind up to 80% of miscarriages, the cause is typically found in the egg. Women over 40 typically have diminished egg supply, as well as poorly viable eggs. Egg donation may be a consideration once your doctor has determined the need, and once you’re ready.


What to Do After a Failed IVF Cycle

After you realize your IVF cycle has failed, your first step is to contact your fertility specialist and schedule an appointment. Knowing what was behind your failed IVF enables you and your doctor to proceed with additional knowledge. Once you sit down and discuss your options, you can plan to pursue another cycle of IVF, or look at another avenue to having a child.

Ultimately, for those couples, and individuals struggling with their fertility, IVF remains the most effective form of advanced reproductive treatment. Speak with your physician and your own fertility expert or attend a fertility seminar and determine whether you can take steps to improve your odds, or if you should investigate other options.