Unsuccessful IVF can be a heartbreaking and shocking experience. Know that it’s not uncommon to need more than one IVF attempt. Success can vary with age, ovarian reserve, underlying causes of infertility, and more. It also depends on the number of children couples want to have to build their family.

Orchid offers advanced genetic testing for couples who want their child to have the best shot of a healthy life. As part of our “Pregnancy and Fertility” series, we distill down your fertility treatment options and help you navigate the complex process.

Why does IVF “fail”?

IVF is backed by decades of clinical practice and solid science—but it’s still a very delicate, complex procedure. So when the procedure fails, it could be for a number of reasons. Your fertility doctor will review the previous cycle, discuss a plan together, and review any new indications for diagnostic treatment or referral to other specialists if necessary.

With each IVF cycle, fertility doctors see what can be done differently to optimize further treatments. They will look at factors from the previous cycle that impact success — the number of mature eggs, sperm quality, fertilization report, embryo morphology grading, endometrial lining thickness and receptivity, among others.

Some common reasons for an unsuccessful IVF cycle may include:

Too few or no viable embryos were created

The process of embryo creation acts much like a funnel of diminishing returns. It’s important to know that eggs and embryos are naturally lost along the way; you do not end up with the same number of embryos as the number of eggs you retrieved. In a good IVF lab with high-quality embryo growing conditions, you should expect about half of your fertilized eggs to make it to usable blastocysts for transfer.

When you undergo an IVF cycle, you’re given fertility drugs to stimulate your ovaries. This causes the maturation of many eggs, and once they’re retrieved they get fertilized with sperm. Sometimes follicles are empty and don’t contain an egg. Eggs can also fertilize unsuccessfully or abnormally, or embryos don’t grow and develop properly in the embryology lab.

The embryo that was transferred didn’t implant

An embryo that was transferred into the uterus can fail to implant. Even for a chromosomally normal (euploid embryo), this can happen over 40% of the time.

There weren’t enough eggs to retrieve

Patients with a history of diminished ovarian reserve or women older than 35 with poor ovarian reserve can often anticipate needing more than one IVF cycle to create viable embryos.

Certain Lifestyle Factors

While you’re hoping to create a new life, it’s important to take care of yourself while undergoing fertility treatment. Discuss with your fertility doctor to make an action plan for how to fuel your body with the right foods and best practices for healthy living and fitness.

What to Do After a Failed IVF Cycle

It can be difficult to plan for next steps after an unsuccessful IVF cycle. When you’re ready, know that you have some options for what to do next:

Attempt another IVF cycle

Attempting more than one IVF cycle is common, especially for individuals or couples who struggle with infertility or have certain medical conditions. An unsuccessful round of IVF doesn’t predict future outcomes.

Fertility doctors will take the experience you had with your previous IVF cycle into account to see how your treatment protocol can be adapted to improve your chances of success. This may include adjusting IVF medication dosages or protocol approaches. Openly discuss with your fertility doctor to create a plan, and don’t be afraid to ask clarifying questions.

With a new IVF cycle, fertility doctors may recommend certain procedures such as diagnostic tests that evaluate a woman’s uterine cavity, endometrial receptivity testing to predict when the best time for embryo implantation is for you, or embryo genetic testing for chromosomal abnormalities (PGT-A). Lifestyle changes and emotional mindfulness support are also part of a collaborative effort to boost your fertility treatment journey. And lastly, sometimes, no changes to treatment plan are needed, but it is about trying again.

Consider the use of donor gametes or a gestational carrier

The use of an egg or sperm donor may be an option for you. Donors are thoroughly evaluated and screened. A gestational carrier may be also considered for individuals or couples who have experienced multiple unexplained failed IVF attempts despite the transfer of viable, good quality embryos.

Keep adoption in mind

Adoption is not for everyone, but it can be a good option for some individuals or couples. You can explore whether this option may be right for your family. RESOLVE has put together a list of resources for your unanswered questions about adoption.

Should I switch clinics?

It’s not uncommon to need to go through multiple IVF cycles to achieve a healthy pregnancy. After the first IVF cycle, your doctor will have individualized reference points to dictate which changes need to be made and whether or not it’s worth attempting another cycle.

Many women tend to think that if they switch clinics for their next IVF cycle, they’ll have better luck. However, this isn’t necessarily the case. You should only consider switching clinics if you don’t feel comfortable or connected to the doctor and his or her team. If you do plan on switching clinics, be sure to do your due diligence and request medical records and all the necessary information before your first consultation.

If you need help finding a new clinic, you can check out our guide on what to look for here. Know that you will resolve your situation one way or another and that if you want a child, you will get the child that was meant for you — don’t give up and lose hope.

Fertility treatment and reproductive medicine have come a long way since IVF was first introduced over 40 years ago. If you are planning on starting or growing your family, check out our expert guides on all things genetics and fertility. Today, advanced genetic screening is now available to couples who want their child to have the best shot of a healthy life. Explore how Orchid helps you conceive with confidence.