Why didn’t my IVF cycle work?

The most common and unanswerable question posed is that which follows one failed IVF cycle.  Although our success rates continue to improve, on average about 1 in 3 couples is successful after one IVF attempt. However there are a growing number of studies that show that that success rate at least doubles when couples undergo at least 3 cycles. This is according to a just released report out of Sweden. A larger study published in the New England Journal of Medicine earlier this year was even more optimistic. In a study which followed more than 6,000 women through nearly 15,000 IVF cycles, they found that the live birth rate on the third attempt was between 65% and 86% in younger women and between 23% and 42% for women beyond age 40. Yet despite these advances in success rates, many couples drop out after only one attempt.

I regularly counsel my patients that a single IVF cycle can provide valuable information that can be used to plan future treatment; yet rarely does a single cycle serve to definitively identify those that will not conceive with one or more additional attempts. As a former IVF patient I personally understand the frustration at receiving a negative pregnancy test. That’s why I feel it is essential that good communication occurs throughout the treatment process.

Current estimates from the National Center for Health Statistics indicate that over 6 million women between the ages of 15 and 44 are affected by infertility. Yet many either never seek treatment or don’t complete enough therapy to be certain of their potential benefit. As our treatment attempts become increasingly more successful, I think it’s important to realize that a single cycle of IVF might only be the beginning of treatment and should only rarely be considered the end of the line.

13 thoughts on “Why didn’t my IVF cycle work?

  1. Just curious – do you refer to a failed cycle as failed implantation or early miscarriage? Is it the same for those of us who do get pregnant (2 for 2 now) but miscarry both times within the first 7 weeks?

    1. Dear Cindy, I consider any cycle that doesn’t result in a live birth to be a “failed cycle.” Exactly what the outcome is provides unique insight into your specific diagnostic situation. Based upon the information that you’ve posted, you should check my post on “New Hope For Couples with Recurrent Early Pregnancy Loss.” This is another example of how the technology now offers new options or at least explanation.

      Best thoughts,

  2. Dr. Greene,

    I am nearly fourty-two years old. I have had a failed fresh cycle in March 09 and a failed FET in Oct. 09. The frozen ET was due to ohss. Will that affect the quality of the transfered embryo’s.
    The doctor says that I respond like I am in my twenties. I had a tubal eighteen years ago after the birth of my fifth child. I have had five c-sections.
    I’m not sure if we should chance using our other seven frozen embroyo’s if the quality has been affected by the ohss.
    Any information will be appreciated. Julie

  3. Dear Julie,
    There are MANY factors that must contribute to a cycle’s success. I doubt very much that your center would have frozen embryos unless they thought they were of good enough quality to give a good chance for a successful pregnancy. You can rest assured that OHSS alone should not have a negative impact upon them.

    Best thoughts,

  4. I recently went through my first IVF cycle and it was unsuccessful we had transfered two high quality blastocysts on day 6. Unfortunately we had nothing to freeze.
    Our clinic has very little experience with blasts as they do mainly day 2/3 transfers We did not know this when starting out.
    I just turned 25 during the ivf cycle and my husband is 39.
    We had a 100% fertilization rate with standard ivf,
    and all of our nine embyros where developing fine until day 4 when they slowed down but none arrested even at the end.
    So the end result was two blasts.
    Is there any hope for us?
    We’ve been trying to conceive for several years now and only ever had one pregnancy 3 and half years ago which was ectopic.
    And it took us 3 years trying naturally to get to that pregnancy.
    5 iui’s failed, and now 1 ivf too.
    We’re planning our 2nd cycle with a better clinic now.
    But are not sure of our chances anymore.

    1. Dear Ashling,
      Although I don’t know very much about you or your partner, the limited information that you’ve supplied here is very encouraging. I explain to my patients all of the time that even when an IVF cycle fails, the information that is gained provides more insight into the fertility issues than any other combination of tests that can be ordered. So although I don’t have any specific advice for you, I can reassure you that this sounds very encouraging. If you’re anywhere near northern California or would be interested in considering here for treatment, I’d encourage you call my office to set up a free consultation. During such an encounter I can review your history in detail and provide you with more specific insights.

      Best thoughts,

      Robert Greene, MD, FACOG
      Medical Director–SIRM Northern California

  5. Hi there Dr. Greene,
    We had 8 embryos that fertilized and are top graded… First IVF was unsuccessful. We just had an FET this month, and was unsuccessful. Both times, the clinic said there was NO trace of any implantation in my blood from either transfers. I have blocked tubes and no uterine issues….What would you conclude from this??? They dont believe it is the embryos because they are “perfect”. Please any advice would be appreciated.

    1. Dear teresa,
      I’m so sorry that you’ve been through so much and haven’t yet had any success nor any clear answers as to your problem. I am in the process of writing a blog post that will answer your question much more completely than I can in this response. The topic will be the weakness of embryo selection based upon appearance and the latest update on genetic testing prior to embryo transfer. I am certain that you’ll find this information very useful and empowering so please check back. It should be posted within a week.
      Best thoughts,

      Robert Greene, MD, FACOG
      Medical Director
      SIRM–Northern California

  6. hiDr. Greene,
    we been trying for 7year and no joy so we had ivf and it did not work. we was told that 1 in4 ivf work, did if we do it again is it still be 1in 4 of it working

    1. Dear Brian,
      Your chance of a successful outcome should be tailored to your unique history as well as that of your partner. Typically, an IVF attempt reveals certain information that may alter your prognosis further. Therefore, it is best for you to have this discussion with your doctor. Sorry that I can’t be more helpful to you in clarifying your chances for a successful outcome.
      Best thoughts,

      Robert Greene, MD, FACOG

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