There is perhaps nothing more frustrating than an in vitro fertilization (IVF) failure. Most couples and individuals who pursue IVF have already spent years trying to get pregnant. For many, IVF felt like their last hope. But an IVF failure -- even multiple failures -- doesn't have to spell doom for your fertility plans. Only about 25% of IVF attempts work, which means you have a roughly 1 in 4 chance of a pregnancy each time. Individual factors, as well as the quality of medical care you receive, can increase or decrease your odds of success.
If you have suffered from previous IVF failures, you need and deserve help to get pregnant. But this doesn't mean that a pregnancy is impossible. Let the Center of Reproductive Medicine help you chart a course forward.
Why Does IVF Fail?
Fertility medicine is as much an art as it is as a science. And while your doctor might be able to measure hormone levels, tell you why you're not getting pregnant, and assess the quality of egg and sperm, it's impossible to predict whether you will get pregnant in any given cycle. In many ways, a single pregnancy is a matter of luck. Even the youngest and most healthy couples only have about a 1 in 4 chance of getting pregnant each time they try; this is roughly the same as IVF odds.
Some common reasons IVF fails include:
- The embryo did not implant in the uterus due to anomalies in the uterus.
- Hormonal imbalances caused an early miscarriage.
- Chromosomal abnormalities in the developing embryo caused an early miscarriage.
- An undiagnosed medical issue, such as an infection or autoimmune disease, caused your body to reject the embryo.
- The quality of the egg or sperm used in the IVF procedure was low, or there were not enough eggs or sperm to maximize the odds of a successful pregnancy.
Diagnosing the Cause of IVF Failure
Many IVF failures occur not because you fail to get pregnant, but because the pregnancy ends in miscarriage. Some evidence suggests that IVF-induced pregnancies are slightly more likely to end in miscarriage. No one knows why this is. It could be that the individual fertility factors that made pregnancy difficult also make it more difficult for the body to sustain a pregnancy.
In many cases, the reason for the IVF failure is unclear -- just as it's not always clear why a person gets pregnant one month but not in another month. If IVF fails, your doctor might opt to perform more tests, including additional blood work, assessments for egg and sperm quality, evaluations of your reproductive system's structures, and -- in the case of a miscarriage -- examination of the embryo to determine the cause.
Variations in Individual Clinics
IVF is not an easy procedure to perform. Your provider must know how to carefully extract gametes, how to safely grow the embryo, how to implant the embryo to maximize the chances of growth, and how to address other health issues. For example, if you have a hormonal imbalance, your doctor must carefully assess the quantities of each hormone you need to sustain the pregnancy. And if your doctor opts to administer drugs to increase egg production prior to IVF, he or she must balance the benefits of producing multiple eggs with the risks of overstimulating your follicles.
It's no wonder, then, that there is a huge continuum of success across reproductive clinics. Some have hardly any success with IVF at all, while others boast rates significantly higher than national averages. Statistics are not a guarantee of success, and cannot predict the outcome in your case. Nevertheless, the more experienced your provider is, and the higher his or her success rate, the more likely it is that you will become a parent through IVF.
Choosing Your Provider
The provider you choose matters. You need and deserve a provider who takes IVF seriously. After all, you're investing your hard-earned money, not to mention the intangible investment of emotional labor, time, and effort.
Before agreeing to work with a specific provider, ask about success rates. Then inquire as to how your specific medical history might affect your odds of success. The best providers will be honest with you, giving you a comprehensive evaluation of the risks and benefits of treatment, so you can make an informed decision. Listen carefully, and if anything is unclear, keep asking questions until you get an answer that makes sense to you.