Sometimes, regardless of maternal age and embryo quality, some IVF cycles fail. When this happens it is a devastating blow, both emotionally and financially and the most common question is WHY?

Here are some of the most common reasons your IVF Cycle Failed…

Implantation Failure

When good quality embryos do not implant there may be issues with:

  • Uterine anatomical abnormalities can include Fibroids, polyps and septums which may interfere with the embryo’s ability to implant and grow. 
  • Lack of luteal support is when your progesterone levels are too low or additional estrogen support is required.
  • Immune issues or an increase in NK cells could mean that your body is attacking your embryo. Immune testing is not a routine fertility test and not conducted by all fertility clinics. Make sure to speak to your doctor about this or see a reproductive immunologist for additional testing to rule out immune issues. 
  • Thrombophilia and blood clotting issues include conditions in which there’s an imbalance in naturally occurring blood-clotting proteins, or clotting factors that could keep blood from flowing properly to your uterus or create clots that interfere with implantation.
  • Receptivity issues / endometrial thickness may not be achieved if your lining is under 8mm at the time of your trigger shot. This may mean that you need additional estrogen and progesterone support. Your receptivity can be measured using an ERA test during a mock transfer. 
  • Genetic issues (aneuploid embryo) for non tested embryos.
  • Zona pellucida issues: embryo hatching abnormalities
  • Poor choice of transfer day if your clinic doesn’t operate every day.

Arrested Embryonic Development

When embryos stop growing in the embryology lab before embryo transfer the causes may be because of…

  • Egg Quality issues are usually suspected if an embryo arrests during the cleavage stage of embryonic development (days 1-3) as the maternal genome is in charge of cell divisions during this time. Failure of embryonic genome activation is suspected if the embryo does not progress beyond 8 cells. On day 3 of embryonic development, the embryo has to switch its genome on and take over cell divisions – if this doesn’t happen the embryo cannot continue to develop.
  • Poor Sperm Quality or sperm DNA fragmentation
  • Genetic Reasons (aneuploidy)
  • Poor embryology lab quality is usually down to poor culture environment/embryo handling. Ask your clinic for their Key Performance Indicators (KPIs). What is their overall fertilisation rate for your age group? What are their cleavage and blastocyst formation rates? Compare these to international benchmarks.

Ask your embryologist for your personal statistics and compare these to the benchmarks for your age group. In some cases small adjustments to a future cycle can make a difference between an IVF cycle fail and success.

Sometimes, however, the only option is to gather the strength to try again and remember that IVF is a treatment with cumulative chances of success.