Assisted reproduction technologies like IVF can provide a chance at getting pregnant – but it’s not a guarantee. But what are the reasons IVF might not result in a pregnancy? And what comes after the heartbreak of a failed cycle? Let’s break down the process and look at where you might want to go from here.
IVF failure is more common than you realize
On one hand, IVF is one of the most powerful reproductive technology we currently have access to. By fertilizing the eggs outside the body with the father’s sperm, then returning the developing embryos to the uterus, IVF bypasses numerous steps along the usual process of getting pregnant. Thanks to this, many couples who wouldn’t otherwise have been able to conceive have been successful with IVF.
But just as sex doesn’t always lead to pregnancy, neither does a round of IVF. An embryo has to be successfully fertilized, develop normally, and implant in the endometrium. If just one of these steps doesn’t go to plan, the mom may not be able to get pregnant. Even under promising conditions, some couples may be unable to conceive on the first, second, or even third try.
What causes IVF failure?
If a developing embryo is transferred, but you still don’t get pregnant, it’s a sign the embryo didn’t successfully implant into the uterine lining. Although it’s often not possible to say why a particular cycle didn’t work, there are some factors known to affect implantation chances.
“Embryo competence” refers to the fertilized egg’s ability to grow and develop. If an embryo has problems like chromosomal abnormalities, it may not be able to implant. Chromosomal abnormalities are thought to be a major factor in IVF failures, and they’re more likely if there are underlying issues with the quality of the egg (or more rarely the sperm cells).
Fertility experts use embryo grading to work out which embryos are most likely to implant, although sometimes even a healthy-looking embryo isn’t able to develop normally.
Implantation relies on a high degree of synchronization between the endometrium and the embryo. While embryo competence is usually seen as the main factor in implantation, sometimes couples with high-quality embryos also will fail to achieve a pregnancy. It’s thought that anatomical factors in the uterine lining, such as fibroids and polyps, could be interfering with the implantation process in cases like these.
A woman is born with all the ovarian follicles she’s ever going to have, so these egg cells age alongside her. As they do, they decline in number, and they’re more likely to accumulate wear and tear. Embryos fertilized from these older egg cells are more likely to have chromosomal abnormalities, and seem to have a harder time getting pregnant through IVF.
What happens after IVF fails?
Although not everyone is able to successfully conceive a child with IVF, those who undergo three cycles of IVF have an around 70% rate of getting pregnant. However, after a failed cycle, your fertility doctors may want to discuss some options before you proceed.
Preimplantation genetic testing
Preimplantation genetic testing allows fertility specialists to identify genetic problems in a fertilized embryo, discarding those that have abnormalities that would prevent implantation. Theoretically, this increases the precision with which an embryo is selected for transfer.
However, it’s not universally accepted, and the costs can easily add another several thousand dollars to the IVF process. Talk it over with your fertility care team to see if you’re a good candidate.
Women who are overweight or underweight for their height are more likely to have trouble conceiving, either through IVF or the old-fashioned way. It’s thought that this is connected to reproductive hormone levels. Speak to your doctor about getting weight into a healthy range when you’re trying to conceive: a change in the weight could tip the scales of fate in your favor.
Going through a failed cycle can be heartbreaking, and you and your partner may need time to grieve. Depression and anxiety are common in couples undergoing an unsuccessful IVF cycle. No matter when or if you want to try again, you might find it useful to talk to a therapist or counselor with experience in infertility issues.
If IVF failed, it wasn’t your fault
A failed cycle of IVF can be devastating, and it’s not uncommon to start beating yourself up. But the reality is, not every IVF cycle is going to result in a successful pregnancy, even if the embryo seemed fine in the lab. For all our technical know-how, it’s often impossible to identify the reason why an embryo doesn’t stick. Even if an embryo doesn’t happen to implant after an IVF, it doesn’t mean you did anything wrong.
Talk it over with your fertility specialist and your partner if you’re thinking about when or if you want to try again – and above all, be kind to yourself. IVF can be a rough road, but you don’t have to go it alone.