IVF Failure

What to Do in Case of IVF Failure – Clinical Guide

General Approach

IVF failure is not due to a single cause. Embryo, endometrium, and systemic factors must be evaluated together.

1. Embryo Factors

• Embryo quality should be evaluated
• PGT (genetic testing) should be considered if necessary
• Blastocyst transfer strategy should be reviewed

2. Endometrial Assessment

• Thickness (investigate if <7 mm)
• Cavity assessment with hysteroscopy
• Endometrial receptivity issues

3. Transfer Technique

• Is there a difficult transfer?
• Experienced operator
• Catheter selection and technical optimization

4. Immunological Factors

• Assessment in selected patients
• Treatments such as steroids / intralipids can be discussed

5. Thrombophilia and Blood Flow

• Coagulation disorders
• Aspirin / heparin use if necessary

6. Sperm Factor

• DNA fragmentation
• IMSI / PICSI / microchip assessment

7. Protocol Modification

• Different stimulation protocol
• Dual stimulation
• Trigger modification

8. Transfer Strategy

• Fresh vs frozen transfer
• Freeze-all approach
• Single embryo transfer

9. Lifestyle Factors

• Smoking and alcohol cessation
• Weight management
• Stress management

10. Clinical Experience

Choosing an experienced center and laboratory affects success.

When to Conduct Further Investigation?

• Further investigation should be performed after 2–3 failed attempts.

Clinical Reality

The most common cause is the genetic quality of the embryo.

Conclusion

In IVF failure, the chance of success can be increased with a systematic and personalized approach.