Why did my IVF cycle fail doctor ?

When an IVF cycle fails , patients are distraught, and demand an explanation . This is especially true when the IVF cycle was perfect , and a top quality blastocyst was transferred smoothly into a receptive uterus, and the doctor was very optimistic about the chances of the patient getting pregnant at the time of embryo transfer .

When the IVF cycle fails , patients feel cheated and they want answers . The doctor is therefore forced into creating answers, even though the truth is that medical science is not capable of answering this basic question.

In order to placate the patient , the standard response is to order an additional battery of expensive tests , such as the ERA ( endometrial receptivity assay), and PGT ( embryo biopsy), because patients believe that the more the tests the doctor orders, the more thorough and careful he is.

 However, the sad reality is that none of these tests actually help to improve pregnancy rates - and they often reduce them – a dirty little secret which doctors don’t share, because they make money by ordering these tests.

More tests is really not the answer , and this is because embryo implantation is still a complex biological process , which we don't have the tools to understand or control.

 This is why the answers of all the additional tests are misleading. An honest answer would be – We don’t know why perfect IVF cycles fail – just like we don’t know why they succeed, and we are terrible at predicting the outcome of an individual IVF cycle.

 Patients need to be realistic , and understand that there are lots of things which modern reproductive medicine still can’t control, which is why the success rate for IVF is not 100%. Getting frustrated does not help.

 Also, from a practical point of view, this is a poor quality question to ask . After all, an IVF clinic is not a research laboratory which is trying to find out why IVF cycles fail !

A far better question the patient should be asking is – What what can I do to increase my chances of success for the next IVF cycle ?

Form a pragmatic perspective, your options are limited to the following:

1.      Repeat the cycle , because the process went perfectly, and hope you get lucky the next time

2.      Change something. The only things you can change are:

a.       the eggs ( donor eggs)

b.      the sperms ( donor sperm)

c.       the embryo ( donor embryos)

d.      the uterus (surrogacy)

e.       the clinic .

 This is a difficult decision to make, so please list all your possible options , and then start working backwards to decide which one you prefer , and which is Plan B.

The truth is that IVF outcomes are always going to be uncertain , but if you listen to your brain and your heart and your gut, you will have peace of mind you did your best , so you have no regrets later on in your life that you didn't give yourself the best chance of getting pregnant