IVF Unsuccessful Reasons: Why IVF Fails and How to Improve Success

Understanding IVF and Its Challenges

IVF (In Vitro Fertilisation) is one of the most advanced reproductive treatments currently available to assist couples struggling with infertility. The technique works by fertilising an egg with sperm outside the body, combining them to create an embryo, and then transferring the embryo into the uterus, thus avoiding many of the barriers to conception that naturally occur. However, despite developments in medical technology and clinicians' input, there is no assurance that an IVF treatment cycle will be successful. Many couples find themselves in the unfortunate situation of potentially having to cope with an unsuccessful cycle of treatment, which can often lead to corresponding emotional, physical and financial strain.

Whereas IVF success rates across the world are generally 40 - 50% with women under 35, this rate drops significantly with women ageing. In India, success rates can vary, with women demonstrating improved outcomes depending on age, fertility health, lifestyle, and clinical infrastructure. Understanding the exact reasons for IVF failure helps couples improve their chances the next time. Once the cause is determined, clinicians can better alter the next cycle of IVF, and couples can prepare themselves emotionally and physically.

Common Medical Reasons for IVF Failure

Poor Egg Quality

• Egg quality decreases with age and health. Women over 35 are at greater risk of chromosomal abnormalities.
• Lifestyle habits, a low ovarian reserve, or nutritional deficits can also interfere with normal egg development.
• Lower-quality eggs have difficulty fertilising and developing into embryos that will implant.

Low Quality of Sperm

Sperm contributes half of the genetic material to the embryo. Poor sperm motility, abnormal shape (morphology), or a very low sperm count can all impact the successful fertilisation of an egg. Even with an advanced procedure such as intracytoplasmic sperm injection (ICSI), exceptionally poor sperm might lead to early embryo arrest. This is why semen analysis and special tests like sperm DNA fragmentation tests are essential prior to an IVF cycle.

Embryo Implantation Issues

Even a healthy embryo can experience failure to implant in the uterus if:

• The uterine lining is too thin
• There are issues with receptivity
• Fluctuation in hormones during the luteal phase

Genetic Factors

Genetic abnormalities in eggs, sperm, or embryos can lead to pregnancy failure in IVF and to early miscarriages.

Technical and Procedural Factors

• Clinical expertise and laboratory precision play a vital role in improving success rates.
• Laboratory conditions (temperature, culture environment, air quality) directly affect embryo growth.
• An embryologist's skill in handling eggs, sperm, and embryos is crucial.
• Timing of embryo transfer, ovarian stimulation protocol, and medication response should also be done with due consideration and care
• Medication response: Some women respond too much or too little to stimulatory drugs, affecting egg maturity.

Age-Related IVF Unsuccessful Reasons

Advancing age is one of the strongest predictors of IVF outcomes.

• Women aged 35–38 years may have lower egg reserves, poor-quality eggs, and reduced embryo viability.
• With ageing, implantation chances decline. Miscarriage risk also goes up due to genetic abnormalities in eggs.
• For those at higher risk, fertility preservation options like egg freezing provide better outcomes in the future.

How to Improve IVF Success After Failure

IVF success can be improved after an unsuccessful outcome. It starts with a personalised treatment plan, based on a detailed analysis of the prior attempt. Pre-treatment evaluations, including hormonal analyses, the embryo receptivity assessment (ERA), and high-level sperm quality analyses, are imperative for addressing potential concerns. Learning how to manage stress effectively, including access to mental health counselling, leads to better outcomes. In addition, certain lifestyle changes, a healthy diet, and regular exercise definitely help. In certain situations, one could also consider donor eggs or sperm to boost the chances of success.

Conclusion

IVF failure can pose medical, technical, lifestyle, or age-related challenges. Getting informed about these factors helps couples prepare better and make the best decisions. With the right medical guidance, emotional support, and a tailored approach, many couples experience success in subsequent IVF cycles. The journey may be difficult, but hope, preparation, and expert care significantly improve the chances of achieving parenthood.