Repeated IVF failures
Undergoing IVF and waiting for the results is a stressful moment in life. All the hopes are shattered if it fails. The chance of a single embryo resulting in a successful pregnancy is 25-30%. If 2 embryos are transferred, the success rate is 60-65%. If 3 good embryos fail to implant, it is called recurrent implantation failure / repeated IVF failure.
Some common questions related to repeated IVF failure include:
How common is repeated IVF failure?
The prevalence depends on the diagnostic criteria used. Usually, the prevalence of repeated IVF failure is between 5-8% in couples undergoing IVF.
Why embryos don’t implant?
The three main causes for implantation failure include:
- Embryo quality – embryos may be genetically abnormal or of poor quality
- Unfavorable uterine environment – quality of endometrium in terms of thickness or receptivity may be inadequate
- Immunological abnormalities – involving antigen – antibody reactions which hinder implantation of embryo.
What are the tests for diagnosing the cause of repeated IVF failure?
The tests which may help include:
- Diagnostic hysteroscopy – to rule out any abnormality inside the uterus which hinders implantation.
- Endometrial receptivity array – analysis the proteins in the uterine lining and helps in personalized embryo transfer at the right time of the cycle, based on the results.
- Nk cell assessment in the uterus / blood – to rule out immunological abnormalities
How to treat recurrent implantation failure?
Some treatments which can be offered include:
- Intralipid infusion prior to embryo transfer
- Injection of PRP or GCSF inside the uterus
- Preimplantation genetic testing/ PGTa to test the chromosomal make-up of embryo prior to transfer
- Assisted hatching to aid implantation
Which doctor is best for recurrent implantation failure/ repeated IVF failure treatment?
Dr Sneha J is a Gynecologist and the best fertility specialist. She has completed MD OBG from the top university AIIMS , Delhi and University fellowship in Fertility/ Reproductive medicine. She had further training in dealing with these conditions, as a visiting fellow at high output centres in Madrid, Spain and Chicago,USA. A Gynaecologist with training in Reproductive Medicine/ fertility procedures is best for treating Repeated IVF failure.
Frequently Asked Questions
No. Repeated IVF failure does not automatically mean that another attempt will be unsuccessful. The outcome can depend on factors such as embryo quality, age, uterine conditions, ovarian response, and previous treatment history. A detailed review can help develop a more appropriate repeated IVF failure treatment plan.
There is no single number that applies to every couple because age, embryo quality, number of embryos transferred, and clinical circumstances matter. When good-quality embryos repeatedly fail to implant, a specialist may consider an evaluation for recurrent implantation failure rather than simply repeating the same treatment.
The number of embryos transferred can influence the chance of pregnancy, but transferring more embryos does not necessarily guarantee success and may increase the risk of multiple pregnancy. Decisions about embryo transfer should consider embryo quality, patient age, previous treatment outcomes, and current clinical recommendations.
Yes. Polyps, fibroids, adhesions, a uterine septum, or other cavity abnormalities can sometimes interfere with implantation. A hysteroscopy for IVF failure may be recommended in selected patients to examine the uterine cavity and identify problems that may require treatment.
In selected situations, preimplantation genetic testing can be considered to assess embryos for certain chromosomal abnormalities before transfer. Whether PGT-A after IVF failure is appropriate depends on factors such as age, embryo availability, previous IVF history, and the advice of the fertility specialist.
Having several embryos does not necessarily mean that all have the same potential for implantation and development. Embryo morphology, developmental stage, and genetic factors can influence outcomes, making embryo quality in IVF an important part of evaluating repeated implantation failure.
Yes. The embryo and the uterine lining need to be appropriately synchronized for implantation. In selected cases, tests assessing endometrial receptivity may be considered to help determine whether the embryo transfer timing is appropriate for an individual patient.
A repeated failed cycle may warrant reviewing factors involving both partners rather than focusing only on the woman's uterus. Depending on the history, doctors may reassess ovarian response, embryo development, semen parameters, previous treatment details, and other relevant factors as part of a couple fertility assessment.
Sometimes a different approach may be considered, but changing medication or protocol without identifying a likely reason for previous failure may not be beneficial. The next plan should be based on the individual's previous response, embryo development, uterine findings, and other relevant factors as part of personalized IVF treatment.
Patients can ask what may have contributed to the previous outcome, whether additional investigations are appropriate, how embryo quality will be assessed, whether the uterine cavity needs evaluation, and what changes are being considered for the next cycle. Preparing these questions can make a fertility treatment consultation more productive.
