After Unsuccessful IVF: Reviewing Results and Considering Next Steps

An unsuccessful IVF cycle can be distressing, particularly after repeated attempts. A review looks at the treatment history, embryo development, transfer details and relevant medical factors. The aim is to understand the available options and their limitations, rather than promise that one cause or solution will be found.

Areas your doctor may review

1. Embryo quality

An important factor. Egg quality generally declines with age, and embryos with chromosomal abnormalities may not implant. Depending on your situation, options may include changing the stimulation protocol, PGT-A (which has limits), or donor eggs.

2. The uterus

• Polyps, fibroids or scarring (Asherman’s) — hysteroscopy can check and treat
• Thin endometrium
• Chronic endometritis (low-grade inflammation)
• Hydrosalpinx (fluid-filled tube) — may need treatment before transfer

3. Sperm and other factors

Sperm DNA fragmentation, thyroid function or lifestyle (smoking, weight) may play a role. Evidence for routine thrombophilia or immune testing is limited, so your doctor decides which tests, if any, are relevant to you.

When to consider donor eggs

If your history points to egg-related factors, especially at older ages, donor eggs may be discussed. Low AMH reflects egg quantity rather than quality, so it is read together with age and previous cycle results. See the egg donation process.

When to consider gestational surrogacy

If good-quality (or genetically tested) embryos repeatedly fail and the uterus is the likely cause, gestational surrogacy may be discussed. Repeated implantation failure does not qualify automatically: Armenian law requires a medical contraindication to pregnancy, which the doctors assess individually.

A practical plan

1. Collect all previous cycle reports (stimulation, embryos, transfers)
2. Get a second-opinion review
3. Complete targeted tests
4. Decide together: change protocol, PGT-A, donor eggs, or surrogacy

Our coordinators can arrange a review of your history with doctors at our partner clinics. Request a free consultation. See also Asherman’s syndrome and PGT-A explained.