When IVF Fails: Next Steps & Coping Strategies
Complete compassionate guide for after failed IVF. Why cycles fail, how to cope emotionally, medical next steps, when to try again, what tests to consider, and how to decide whether to continue treatment.
Why did my IVF cycle fail?
Most failures (70%) are due to embryo quality issues (chromosomal abnormalities, especially with age). Other causes: implantation failure (20%), uterine lining issues, or early miscarriage.
When can I try IVF again?
Physical recovery: 1 cycle minimum (4-6 weeks). Emotional recovery: varies—take time you need. No rush improves success rates; prioritise emotional readiness.
What should I do after failed IVF?
Allow yourself to grieve, rest, schedule follow-up with RE in 4-6 weeks, consider additional testing after 2-3 failures, and seek emotional support from counsellor or support groups.
You are not alone: With 30-40% success rates per cycle, 60-70% of IVF cycles fail—this is normal, not a reflection of your worth or what you "did wrong." Failed IVF is devastating, and your grief is valid. This guide covers emotional coping strategies, medical next steps (additional testing after 2-3 failures, when to try again, protocol changes), and how to decide whether to continue. Most women need 2-3 cycles to succeed. Take time to grieve, seek support, and remember: one failure doesn't mean IVF won't work for you.
Table of Contents
The First Hours & Days: What to Do Right Now
If you're reading this right after receiving a negative pregnancy test or beta hCG result, first: we're so sorry. This is incredibly painful, and your grief matters.
Immediate Self-Care (First 48 Hours)
Cry, scream into a pillow, rage, or curl up in bed. Whatever you're feeling is valid. Don't try to "be strong" right now.
You wouldn't work the day you found out a loved one died. This is grief too. Give yourself permission to rest.
Don't carry this alone. Let them know you need extra support today.
Eat something comforting, stay hydrated. Your physical health matters even when your heart is breaking.
Tempting to numb the pain, but alcohol is a depressant and can worsen mood. Wait until acute grief subsides.
Seeing pregnancy announcements right now will hurt. Give yourself permission to mute/unfollow or take a break.
Wait at least a week before deciding whether to try again, switch clinics, or pursue other options. Decision-making in acute grief is rarely wise.
You did nothing wrong: IVF failure is not because you exercised too much, ate the wrong foods, thought negative thoughts, or didn't "relax enough." The vast majority of failures are due to chromosomal abnormalities in embryos—completely outside your control. You did everything you could.
Why IVF Fails: Understanding the Reasons
IVF can fail at different stages. Understanding why can help you make informed decisions about next steps.
| Failure Stage | % of Failures | Main Causes |
|---|---|---|
| Embryo Quality Issues | 70% | Chromosomal abnormalities (increases with age), poor egg/sperm quality, suboptimal embryo development |
| Implantation Failure | 20% | Uterine lining issues, receptivity window timing, immune factors, anatomical abnormalities (polyps, fibroids, adhesions) |
| Early Miscarriage | 10% | Embryo implanted but pregnancy didn't continue—often chromosomal, thrombophilia, or progesterone deficiency |
Common Specific Causes
1. Poor Egg Quality (Most Common Age 38+)
As women age, the proportion of chromosomally abnormal eggs increases dramatically: 30% at age 30, 50% at 38, 80% at 42. Even if embryos look morphologically perfect, they may be aneuploid. This is why PGT-A testing is valuable for women 38+.
2. Thin Endometrium (<7mm)
Uterine lining needs to be at least 7mm for optimal implantation. Causes of thin lining: previous D&C/abortion, Asherman's syndrome (adhesions), inadequate oestrogen, poor blood flow. Treatments include: oestrogen supplementation, vaginal Viagra (improves blood flow), vitamin E, L-arginine, acupuncture.
3. Hydrosalpinx (Blocked Fallopian Tube with Fluid)
Reduces IVF success by 50% because toxic fluid leaks into uterus. Solution: surgical removal of affected tube (salpingectomy) before IVF significantly improves success rates.
4. Endometriosis
Moderate-severe endometriosis reduces egg quality and creates inflammatory environment hostile to implantation. Success rates 10-15% lower than unexplained infertility. Treatment options: surgery before IVF (controversial—may harm ovarian reserve), immunomodulation protocols.
5. Male Factor
Severe male factor (very low sperm count, poor morphology, high DNA fragmentation) affects embryo quality. Even with ICSI, sperm DNA integrity matters. Sperm DNA fragmentation >30% reduces success by 20-30%.
6. Unexplained (20-30% of failures)
Sometimes, even after extensive testing, no cause is found. This doesn't mean you'll never succeed—it means current medical science can't identify the issue. Next cycle may work.
Emotional Coping Strategies
The Grief is Real
IVF failure is a profound loss: loss of the hoped-for pregnancy, loss of control, loss of time and money, and sometimes loss of hope for genetic children. Studies show 20-40% of women experience clinical depression after failed IVF, and 30-50% have significant anxiety.
You're allowed to grieve. This isn't "just" disappointment. It's legitimate grief that deserves acknowledgment and support.
Evidence-Based Coping Strategies
1. Practice Self-Compassion
Speak to yourself as you would to a dear friend. Instead of "I failed" → "My body tried its best." Instead of "What did I do wrong?" → "This is biology, not my fault."
Exercise: Place hand on heart, say aloud: "This is really hard. I'm suffering right now. May I be kind to myself. May I give myself the compassion I need."
2. Allow Grief Without Judgment
Grief isn't linear. You'll have good days and crushing days. Both are normal. Don't force yourself to "get over it" on anyone's timeline.
Give yourself permission to: Cry whenever you need to, skip social events with babies/children, feel angry or jealous of pregnant women, have bad days even weeks/months later.
3. Set Boundaries
You don't owe anyone details about your fertility journey. It's okay to say:
- • "I'd rather not discuss it right now."
- • "We're taking a break from treatment."
- • "That's not helpful, but I appreciate your concern."
- • "I won't be attending [baby shower]—I hope you understand."
4. Engage in Gentle Self-Care
Physical self-care supports emotional healing:
- • Movement: Gentle yoga, walks in nature, swimming
- • Nutrition: Anti-inflammatory foods, reduce alcohol/caffeine
- • Sleep: Prioritise 7-9 hours—grief is exhausting
- • Pleasure: Massage, hot baths, favourite comfort foods, binge-watch TV guilt-free
5. Limit Triggers
It's okay to protect yourself:
- • Unfollow or mute pregnant friends on social media (temporarily or permanently)
- • Skip baby showers, christenings, or "sprinkle" parties
- • Avoid the baby section in shops
- • Ask your partner to field questions from family
This isn't "giving up"—it's protecting your mental health during acute grief.
6. Find Meaning (When Ready)
Some women find healing through:
- • Volunteering with fertility support organisations
- • Advocacy work (policy changes, insurance coverage)
- • Blogging/sharing their story to help others
- • Creative expression (art, writing, music)
Important: This is not required for healing. Only if it feels right for you.
Free Coping After IVF Failure Workbook
Evidence-based exercises for processing grief, self-compassion practices, decision-making frameworks, and resources for emotional support.
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Finding Support
1. Professional Counselling
Fertility counselling: Therapists specialising in infertility understand your unique grief. They can provide CBT, ACT, or EMDR tailored to fertility trauma.
Find one: BICA (British Infertility Counselling Association), Fertility Network UK therapist directory, or ask your clinic for recommendations. Cost: £60-120 per session, some clinics offer subsidised counselling.
2. Support Groups
Connecting with others who truly understand can be incredibly healing.
UK:
- • Fertility Network UK (local groups + online forum)
- • Infertility Network UK
Online:
- • Reddit: r/infertility, r/IVF
- • Facebook: IVF Support Groups (search by country/clinic)
- • BabyCenter IVF Community
3. Your Partner
You may grieve differently—and that's okay. Your partner might process silently, focus on solutions, or seem less affected (they're likely protecting you). Have honest conversations about needs.
Helpful phrases: "I need you to just listen right now, not problem-solve." "Can we schedule a time to discuss next steps? I'm not ready today." "How are YOU feeling about this?"
4. Trusted Friends/Family
Choose carefully—not everyone will understand. Look for people who can sit with your pain without trying to "fix" it or offering platitudes ("It'll happen when you relax!").
Crisis Support: If you're experiencing suicidal thoughts, please reach out immediately: Samaritans (UK): 116 123 | National Suicide Prevention Lifeline (USA): 988 | Crisis Text Line: Text "HOME" to 741741. You matter, and help is available 24/7.
Medical Next Steps
Follow-Up Appointment with Your RE
Schedule this for 4-6 weeks post-failure (gives emotions time to settle and physical recovery to complete). Come prepared with questions.
Questions to Ask Your RE:
- •Why do you think this cycle failed? (Based on embryo development, hormone levels, lining quality)
- •What were my egg/embryo numbers and quality grades?
- •What was my peak oestrogen level? Progesterone before trigger?
- •What was my endometrial lining thickness at transfer?
- •What protocol changes would you recommend for next time?
- •Should I do additional testing before the next cycle? (ERA, hysteroscopy, PGT-A?)
- •What are my realistic success chances for the next attempt?
- •When is the earliest I can try again?
- •Should we consider donor eggs/sperm, or other alternatives?
Potential Protocol Changes
1. Different Stimulation Protocol
If you had poor response: Try higher FSH dose, priming with oestrogen/testosterone, switch to Microdose Lupron Flare protocol. If you over-responded: Try lower dose, antagonist protocol, or Mini IVF.
2. PGT-A for Next Cycle
If unexplained failure or you're 38+, genetic testing can rule out chromosomal abnormalities. Costs £2,500-4,000 extra but prevents transferring aneuploid embryos.
3. Freeze-All Instead of Fresh Transfer
If you had elevated progesterone (>1.5 ng/mL) or high oestrogen, frozen embryo transfer (FET) in a later cycle can improve success by 5-10%.
4. Assisted Hatching or Laser Zona Thinning
For women 38+ or previous failed implantation, thinning embryo shell may improve hatching. Costs £300-500 extra.
5. Immunomodulation (Controversial)
Some clinics offer intralipid infusions, prednisolone, or IVIG for suspected immune issues. Limited evidence but may help in specific cases of recurrent failure.
Additional Testing to Consider
When to do additional testing: After 2-3 failed cycles with good-quality embryos, or after recurrent miscarriage.
| Test | What It Tests | Cost (UK) | When Recommended |
|---|---|---|---|
| ERA (Endometrial Receptivity Analysis) | Optimal implantation timing—tests if your window is shifted | £600-1,000 | 2+ failures with good embryos |
| Hysteroscopy | Examines uterine cavity for polyps, fibroids, adhesions, septum | £800-1,500 | 2+ failures, abnormal lining on ultrasound |
| PGT-A (next cycle) | Genetic testing of embryos for chromosome abnormalities | £2,500-4,000 | Age 38+, unexplained failure, recurrent loss |
| Thrombophilia Panel | Blood clotting disorders (Factor V Leiden, MTHFR, Protein C/S) | £200-400 | Recurrent miscarriage, family history |
| Sperm DNA Fragmentation | Sperm DNA integrity—damage >30% reduces success | £300-500 | Male factor, poor embryo development |
| Immune Testing (NK cells, APA) | Natural killer cells, antiphospholipid antibodies (controversial) | £400-800 | 3+ failures, some clinics don't offer (limited evidence) |
When to Try Again: Physical & Emotional Timeline
Physical Recovery
Minimum wait time: 1 menstrual cycle (4-6 weeks)
Your body needs time to:
- • Normalise hormone levels (oestrogen, progesterone, hCG from trigger)
- • Allow ovaries to shrink back to normal size
- • Clear stimulation medications from system
- • Restore natural menstrual cycle
Extended wait recommended if: Had OHSS (wait 2-3 cycles), doing additional testing (ERA, hysteroscopy), making significant protocol changes, or need financial recovery time.
Emotional Readiness
There's no "right" timeline. Some women feel ready immediately. Others need months or years. Both are valid.
Signs you might be ready to try again:
- • You can think about IVF without crying
- • You've processed the acute grief (still sad, but not overwhelming)
- • You're excited (or at least hopeful) about trying again
- • Your relationship with your partner feels stable
- • You have the financial resources and energy
Signs you need more time:
- • The thought of another cycle fills you with dread
- • You're still in acute grief (crying daily, can't function)
- • You feel pressured by age/family but don't truly want to
- • Your relationship is strained from previous cycle
- • You're burnt out and need to focus on other life areas
Research finding: Studies show no difference in success rates between women who try again immediately (next cycle) vs those who wait several months. The decision should be based on YOUR readiness, not fear that waiting will harm your chances (unless you're 42+ and time is genuinely limited).
Should You Try Again? Decision Framework
This is the hardest decision. There's no objectively "right" answer—only what's right for you.
Factors to Consider:
1. Success Probability
Try again if: First or second failure, good embryo quality, under 38, no major issues identified.
Consider alternatives if: 5+ cycles with no pregnancies, poor egg quality consistently, age 43+, severe diminished reserve.
2. Financial Resources
Can afford: How many more cycles can you fund without going into debt?
Alternatives: Donor eggs (more expensive per cycle but higher success), embryo adoption (cheaper), stop treatment.
3. Emotional Capacity
Be honest: Do you have resilience for another potential failure? Is IVF consuming your life in unhealthy ways? Would stepping away bring relief or regret?
4. Relationship Impact
Is your partnership strong enough for more treatment? Are you both on the same page? Some couples grow closer through adversity; others fracture. Check in honestly.
5. Life Goals Beyond Parenthood
What else matters to you? Career, travel, relationship, hobbies? If continuing treatment means putting entire life on hold indefinitely, is that trade-off acceptable?
Alternatives to More IVF with Own Eggs:
- 1.Donor Eggs: Success rates 50-60% regardless of your age. Costs £8,000-15,000 (UK). Allows genetic connection for partner. Loss of genetic link for you.
- 2.Donor Embryos: £3,000-6,000 (UK). No genetic link for either partner, but experience pregnancy/birth. Shorter wait times.
- 3.Surrogacy: If implantation is issue but egg quality fine. £50,000-100,000+ (UK/USA). Legal complexities. Lengthy process.
- 4.Adoption/Foster Care: Build family without genetic connection. Lengthy process (1-3 years). Age/health restrictions vary.
- 5.Child-Free Living: Reclaim life, invest in other meaningful pursuits. Grieve loss of parenthood dream. Find fulfilment in different ways.
Give yourself permission to stop. Deciding not to continue treatment doesn't mean you've "given up" or failed. It means you're choosing your wellbeing, relationship, finances, or life beyond fertility treatment. That's a valid, courageous choice. And you can always change your mind later if circumstances or feelings shift.