If you tried to conceive on your own for a while with no success, you’re likely familiar with the disappointment that follows a negative pregnancy test. Given the high stakes of in vitro fertilization (IVF) — the medications, the physical and emotional side effects, the cost — finding out you’re not pregnant can hurt a whole lot more than you expected. For some people, a failed transfer feels like a miscarriage because an embryo made it to the uterus, it just didn’t implant.
A failed embryo transfer
Although it’s easy to wonder what you did wrong, a failed embryo transfer is not your fault. Most people need more than one embryo transfer to bring home a baby. The good news is, your odds of success are fairly high within six cycles. About 86% of those 35 and under get pregnant within six IVF cycles and about 42% of those over the age of 40. “Most clinics will also offer PGS/PGD genetic testing, that is generally more meaningful than grading embryos visually in a lab. Higher grade embryos have a statistically higher chance of leading to viable pregnancies,” for example some research shows a 95% success rate with three normal genetically tested embryos. PGS stands for Preimplantation Genetic Screening and can be used to screen for genetic abnormalities, while PGD (or Preimplantation Genetic Diagnosis) is used when one or both parents have family histories of certain issues to search for those specific genetic abnormalities.
Egg quality is the biggest predictor of success. Highly graded, genetically screened normal embryos are the most likely to implant. But even genetically screened normal embryos with good grades can fail to result in pregnancy. There aren’t always clear answers when it comes to why some embryos implant and others don’t.
When you’re ready, you can try again. If you have frozen embryos, you don’t have to do another retrieval, unless you prefer to bank more embryos. If you decide to do another retrieval, your doctor may change your medication protocol to see if that changes the quantity and quality of the eggs and embryos.
If you’ve had multiple failed embryo transfers, your doctor may want to perform additional tests like a hysteroscopy, which uses a scope to look inside the uterus and rule out any potential uterine issues, like polyps. Uterine masses, like polyps and fibroids, and inflammation, can make it difficult for an embryo to implant, so diagnosing these issues ahead of time is key. Your doctor may also adjust your transfer protocol to see if that leads to a better outcome. For example, they may add more progesterone or have you take a different form of progesterone.
A mental health note
Staying busy and preparing for your next transfer can be a helpful distraction, but it’s also important that you take time to process your grief. Find people you can open up to about how you’re feeling, whether that’s a partner, friend, or mental health professional. It may also help to talk to someone who gets what you’re going through. Some fertility clinics offer support groups for their patients. If your clinic doesn’t have a support group, you can ask them to create one, or see if Resolve: The National Infertility Association offers a local or virtual support group.
Reviewed by the Ovia Health Clinical Team
- Karayalçın, Rana, et al. “Office hysteroscopy improves pregnancy rates following IVF.” September 2012. https://pubmed.ncbi.nlm.nih.gov/22818094/
- Malizia, Beth A., Michele R. Hacker, and Alan S. Penzias. “Cumulative live-birth rates after in vitro fertilization.” January 2009. https://www.nejm.org/doi/full/10.1056/nejmoa0803072
- Scott, Richard. “Normal Embryo Success Rate Based on IVF: RMA Research Study” https://rmanetwork.com/blog/women-with-three-normal-embryos-have-95-chance-of-pregnancy-rma-research-shows/