Why IVF Can Fail: Understanding Causes and Next Steps

Grace Fertility

Authored & Verified by:

Dr. Reubina Singh

MS (OB/GYN), MBBS - Senior Infertility Specialist

Infertility is an exhausting experience that leaves many couples wondering what’s next. IVF is a common treatment option that could possibly lead to a positive result; however, it cannot be guaranteed. Testing negative for pregnancy after multiple cycles of IVF can be particularly devastating.

In this blog, we will discuss the major reasons why IVF fails and explore possible solutions to help you remain well-informed and hopeful in your journey toward parenthood.

Most Common Reasons for Implantation Failure in IVF

1. Embryo Quality

Embryo quality is one of the most influential aspects of IVF success. Eggs and sperm come together to form embryos, which must be of high quality for a successful outcome.

Age: Egg quality decreases, especially after age 35. This impacts the probability of generating a functional embryo, rendering the success of pregnancy more challenging.
Underlying Health Conditions: Disorders such as endometriosis can reduce egg quality and thus, affect embryo potential. These underlying issues can be rectified and ensure optimal health through professional consultation with a specialist.

2. Uterine Health

The uterus constitutes the embryo implantation site, and its pathology may lead to embryo attachment failure in the uterine cavity.

Uterine Structure: An irregularly shaped uterus, fibroids, or polyps can create physical barriers to implantation.
Endometrial Thickness: The endometrium (the uterine lining) should be thick enough to support a growing embryo and not too thick, which may highlight imbalances in progesterone. Implantation failure can also occur because the endometrium is not thick enough or has insufficient blood supply.

3. Autoimmune Response

Another possible cause of IVF failure is autoimmunity, in which the body’s immune system mistakenly recognizes an embryo as an invading organism and rejects it.

Immune Response: In some people, the immune system mounts a response that works against the embryo and does not allow implantation to take place. Experts can conduct specific tests that help identify an immune problem and suggest treatments that inhibit certain immune responses in the setting of IVF.

4. IVF Laboratory Quality

The laboratory process where the embryos are created is also critically important to IVF success.

Embryo Culture Conditions: Well-equipped, high-quality labs with controlled environments help embryos to develop in a stable, nurturing environment. An experienced lab can make a huge difference in embryo quality and the likelihood of embryo implantation.

5. Method of Fertility Specialist

The ability and methods of the fertility specialist — especially for embryo selection and transfer — can affect odds of IVF success.

Embryo Picking: The best quality embryos will be selected by a skilled specialist; this step is important for implantation and a successful pregnancy.
Embryo Transfer: Embryo transfer technique can influence IVF outcomes. A gentle approach in transfer promotes the right positioning of the embryo for implantation.

6. Unexplained IVF Failure

Sometimes, there is no identifiable reason for IVF failing despite a good-quality embryo and a healthy uterus.

Individual Variability: Every person responds differently to IVF, and sometimes there is no known medical reason for a particularly failed cycle. This also means that when this happens, a second opinion or alternative IVF strategies that may improve success rates may be beneficial.

What to Do if Your IVF Might Have Failed

1. Optimize Embryo Quality

Consider Genetic Testing: Preimplantation genetic testing (PGT) can be performed to test embryos for chromosomal abnormalities prior to implantation, which can increase success rates.
Healthy Lifestyle Modifications: Egg and sperm quality can be improved by modifying lifestyle habits, including nutrition, exercise, alcohol, and caffeine avoidance. Some supplements — including folic acid, CoQ10, and antioxidants — may also help improve fertility.
Increased Sperm Quality: If male fertility plays a part, changes to diet, lifestyle, and some supplements may also improve sperm quality, resulting in improved embryo quality.

2. Address Uterine Health Issues

Surgery: Some conditions, like fibroids, a polyp, or a misshapen uterus, can sometimes be surgically repaired. Your reproductive endocrinologist may perform procedures to optimize the uterine milieu and increase the probability of implantation.
Embryo Transfer Timing: The time at which an embryo is placed back into the uterus is critical. Endometrial receptivity analysis (ERA) testing can help determine the best time for transfer based on the receptivity of the uterine lining.

3. Immune Testing and Treatment

Preventative Immunosuppressive Treatment: If autoimmunity is suspected, your doctor can propose treatments to temporarily suppress immune responses, allowing the embryo to implant successfully.
Immune/Autoimmune Disorder Testing: Certain fertility clinics offer specific testing to detect immune issues that may impact implantation and allow for targeted treatment options.

4. Select a High-Quality IVF Lab

Research Lab Standards: The success of the IVF process also depends on the laboratory where it is conducted. Ask agents about the lab’s embryo development process, culture techniques, and success rates to ensure the best possible care.
Advanced Techniques: If the lab offers advanced culture methods and time-lapse imaging, or performs embryo biopsy procedures, these methods can support better embryo development and increase the chances of success.

5. Consider a Second Opinion

If you’ve had multiple IVF failures, other fertility specialists might recommend different protocols, treatments, or tweaks that might increase success rates in these difficult cases.

6. Think About Lifestyle Changes and Mental Health Support

Stress Less: Research shows that stress may adversely affect fertility. Engaging in mindfulness practices, relaxation techniques, and regular physical activity can help relieve stress and create a healthier environment for conception.
Emotional Support: Joining support groups, connecting with those who have experienced infertility, or seeking counseling can help manage the emotional costs of infertility.

How to Go Forward After IVF Failure

If you’ve just had a failed IVF cycle, you may wonder: What is wrong with me?! Remember, many factors influence IVF success, and many of those can be managed or improved.

With careful collaboration with your fertility specialist and a tailored plan, you will be empowered to confront the uncertainties of infertility with more confidence and optimism. The journey to parenthood can be full of surprises, with each cycle allowing you to learn more and move closer to success.

Every fertility journey is unique, and if you find yourself at a crossroads, know that guidance, support, and advanced fertility techniques exist. With the right team around you, you can start taking steps toward one day realizing your dream of starting a family.