Common Reasons IVF Treatment May Fail And What To Do Next

Whether you’re undergoing your first cycle of IVF or have been through several, experiencing an unsuccessful treatment can be emotionally challenging. While it’s natural to feel disheartened, remember that you are not alone. Many people require multiple treatment cycles before they achieve success.

Research shows IVF success rates can vary. For instance, 33% of people conceive after their first cycle, up to 59% after three cycles, and up to 77% after eight cycles, according to a study from Australia and New Zealand. It’s crucial to stay hopeful, even after a failed cycle, as future attempts may bring success. Understanding the reasons behind a failed cycle can help you and your doctor plan your next steps.

Common Reasons for Unsuccessful IVF Treatment

Too Few or Too Many Eggs

In IVF, your doctor aims to collect several eggs for fertilization. However, if your ovaries don’t produce enough follicles, your cycle may be canceled. On the other hand, if too many follicles develop, there’s a risk of ovarian hyperstimulation syndrome (OHSS), which can also lead to a canceled cycle. Similarly, for intrauterine insemination (IUI), your doctor needs one or two eggs to fertilize. If too many follicles are growing, the cycle may be canceled to avoid multiple pregnancies.

Unsuccessful Fertilization

Fertilization issues can arise when sperm have abnormalities, such as poor morphology, making it difficult for them to fertilize the egg. In some IVF cycles, 5-10% of eggs may not be fertilized at all. Techniques like intracytoplasmic sperm injection (ICSI) can help overcome this by directly injecting a sperm into an egg, improving fertilization chances. If fertilization continues to fail despite using ICSI, you might consider using donor sperm.

Poor Egg, Sperm, or Embryo Quality

The quality of eggs, sperm, and embryos plays a significant role in the success of IVF. If eggs are immature or have abnormalities, they may not be used for fertilization. Similarly, sperm quality can affect embryo development. Issues like poor sperm morphology and low motility can impair embryo growth. Even if embryos appear healthy, they may not be able to develop into a viable pregnancy due to underlying quality concerns.

The Embryo Doesn’t Implant

After fertilization, the embryo needs to implant in the uterus for a successful pregnancy. If the uterine lining is too thin, the embryo might not implant. In some cases, women may require additional treatments to help prepare their uterine lining. On the other hand, if the lining is too thick, it can also hinder implantation. Conditions like endometriosis, uterine polyps, or low estrogen levels can affect the uterine lining, making implantation more difficult. There is also a possibility that the embryo may implant outside the uterus, leading to an ectopic pregnancy, which often requires surgical intervention.

Chromosomal Abnormalities

Chromosomal abnormalities are a common cause of failed IVF cycles. These abnormalities can prevent embryos from developing into viable pregnancies. In fact, up to 15% of naturally conceived pregnancies end in miscarriage due to chromosomal issues. If your doctor suspects this is the cause of failure, they may suggest genetic testing of embryos during IVF to screen for these abnormalities, depending on your country’s laws.

Lifestyle Factors

Certain lifestyle choices can reduce the chances of a successful IVF cycle. Smoking, for example, lowers pregnancy rates by 30% and increases the risk of miscarriage and ectopic pregnancy. Obesity also contributes to lower pregnancy rates and higher miscarriage risks. If lifestyle factors are identified as contributing to a failed treatment, your doctor will advise on changes that can improve your chances in future cycles.

Miscarriage

Sometimes, even with a successful pregnancy, miscarriage can occur. While it’s often impossible to pinpoint the exact cause, the risk of miscarriage increases with age. Most early miscarriages are due to chromosomal abnormalities. If you’ve experienced a miscarriage, it can be an emotionally and physically draining experience. Seeking support from a counselor can be helpful as you navigate this difficult time.