Last Updated on June 7, 2019
Failed IVF cycles are devastating for many couples and women. Why does IVF fail, and why is IVF failure so devastating? As the below article points out, IVF can fail due to a number of reasons, including failed implantation, lack of viable eggs or sperm, no fertilization, and complications with embryo transfer.
The financial investment in in vitro fertilization can be significant. It’s understandable, then, that when IVF fails, couples feel devastated. On average, a single cycle of IVF costs between $8,000 and $12,000. If couples choose to use a surrogate, the costs skyrocket. Couples and women must choose to either spend more money and try again, or to stop trying. For some, the costs are so prohibitive that they can only afford one or two attempts. It is devastating to come to the realization that if this first or next cycle of IVF fails, there cannot be a second due to financial circumstances.
As women age, IVF success rates drop. So age can be another reason failed IVF is devastating. Older women who experience failed IVF may not be in the best position to simply try again, as the success rates drop even more with each subsequent failure.
Emotional and mental stress
Of all of the reasons failed IVF devastates couples and women, the emotional and mental stress stands out the most. IVF brings with it the hope of pregnancy and healthy baby in cases where, barring IVF, neither would be possible. So when IVF fails, the emotional impact can be traumatic.
Considering the time, effort, and cost involved with IVF, many couples and women feel very let down when IVF fails.
Why does IVF fail?
As stated earlier, the answers to the question are numerous. Sometimes, a pregnancy simply does not occur – just like with natural conception. However, the IVF process should increase the likelihood of pregnancy due to the fact that it intervenes at the most critical point – fertilization. IVF treatments combine careful planning and diagnosis with specialized procedures, and should, in theory, increase the chances of success even greater than natural conception.
But even with the most careful planning and treatment, IVF fails from time to time. Success rates range from as high as around 80% in very unique circumstances to as low as less than 10%. So many different factors impact those success rates.
If IVF fails, here are the four most likely reasons.
After a woman leaves the fertility clinic to go through the 14 day waiting period before a pregnancy test, implantation should occur. The embryo or blastocyst should bury itself in the lining of her uterus, and begin to divide.
However, that doesn’t always happen, for any number of reasons. Sometimes, the lining of the uterus isn’t healthy enough for implantation. Or, the embryo or blastocyst may die or stop dividing prior or after implantation. Unhealthy embryos, or those with any sort of chromosomal abnormalities may not implant successfully.
Embryo health and uterine health impact implantation significantly. However, so does the transfer process itself. Where the embryo is placed in the uterus as well as the insertion and removal of the tube also impact success.
No viable eggs or sperm to use
Egg and sperm retrieval are both part of the IVF process. Sometimes, the ovaries do not produce enough viable eggs to use for IVF, leading to IVF failure.
Egg retrieval requires great care – both during retrieval as well as afterward. Once fertility specialists retrieve the eggs, they must grade them and determine their viability. An embryologist may disqualify certain eggs from being used in the IVF cycle. Depending on how many eggs the fertility specialist retrieved and how many she or he discards, it’s possible that the specialist may find no viable eggs.
Additionally, eggs and sperm are removed from the body, placed in petri dishes, and must survive in this external situation. Or, they must survive being frozen and then thawed. Couples and women should understand the risk involved with handling such tiny organisms.
Fertilization doesn’t happen
Embryologists and fertility specialists try to encourage and facilitate fertilization but sometimes, sperm simply do not fertilize the egg.
Typically, a fertility specialist combines a woman’s healthy egg with thousands of her partner’s healthy sperm. One of those sperm penetrates the outer layer of the egg and then fertilization occurs. That’s the normal course of events. However, sometimes, no sperm fertilize the egg. Motility and sperm volume play a big role in this, but so do egg health and quality.
Because of the potential for failed fertilization, many clinics suggest ICSI, which is Intracytoplasmic Sperm Injection. During ICSI, embryologists inject a sperm directly into an egg to assist in fertilization. Even in these cases, however, fertilization sometimes fails.
Complications with embryo transfer
IVF should eliminate natural selection and successfully facilitate the fertilization of egg and sperm. If the fertility doctor does not successfully transfer an embryo or blastocyst, IVF cannot result in a pregnancy.
For this reason, many experts say that the transfer has the biggest impact on success rates. “No matter how good the IVF laboratory culture environment is, the physician can ruin everything with a carelessly performed embryo transfer,” says Dr. Richard Sherbahn. The fertility doctors must transfer the embryos correctly, in a timely manner, and using the right procedures.
Some fertility doctors use their own transfer techniques, and differentiate themselves from other specialists in that way. This may be one reason some clinics have higher success rates than others.
What’s next after IVF failure
Rest and heal
After a failed IVF cycle, a woman should rest and resist the temptation to worry over all of the ways she could have prevented it. Maintain a healthy emotional state, and consider that natural pregnancies are as rare as IVF pregnancies. Infertile women and couples may also want to avoid getting into situations where they’ll have to hear about someone else’s pregnancy news at this time. So, take some time away from other and just focus on staying emotionally healthy.
Begin another cycle
Some women choose to begin another cycle of IVF immediately after a failed attempt. Studies show that second and third attempts in IVF lead to a greater overall chance of success. Because of this, many fertility clinics offer payment programs that include subsequent rounds. Therefore, in these situations, fertility clinics may have already scheduled the second and third attempt for IVF. It is not that they are anticipating failure; they are simply preparing for it just in case.
Discuss your options
Repeated attempts don’t benefit everyone. Sometimes, trying again won’t change the outcome, and in these cases, continued attempts simply increase cost without increasing chances of success. Fertility doctors evaluate the cause of failure for each IVF attempt.
In certain cases, a specialist may suggest another fertility treatment – or, he or she may suggest a medical treatment for the women or her partner, in order to increase odds of success. The best thing to do is remain open to a variety of options.
How long to wait before next IVF attempt
First, anyone who’s had a failed IVF treatment should wait a little while to process everything. Then, consider all of the options.
- Age: IVF succeeds more often with younger women than with older women. Therefore, a fertility specialist may consider the age of a woman in determining how long to wait before the next IVF attempt. For example, a 42 year old woman cannot wait as long as a 28 year old woman, as each 6 months decreases chances of success.
- Multiple/consecutive cycles: Some women opt into special plans that anticipate multiple or consecutive cycles. In those cases, the next attempt could be immediate or spaced out based on preferences or cost.
- Special considerations for Surrogate IVF: If a couple chooses to use a surrogate, the time between IVF attempts depends largely on the surrogates willingness to continue undergoing treatment.
Ultimately, why does IVF fail? The answers range from natural causes to mishandling of embryos to poor transfer procedures. While age may be one factor, or uterine health may impact success, specialists cannot always pinpoint the reason IVF cycles fail. Fertility issues are often very complex.
Fortunately, many fertility clinics offer high quality, specialized treatment options designed to minimize failure, and greatly increase chances of success.