The First Cycle: Why Didn’t it Work?

The First Cycle: Why Didn’t it Work?

It’s very common for many people to think that after the first IVF (in vitro fertilisation) cycle, they will be pregnant and holding their baby in no time at all. This is a completely reasonable hope for women and couples who have spent many months, if not years trying to conceive without the assistance of IVF. There is always the hope that IVF will be the “quick fix”.

Unfortunately, if you find yourself at the end of your first IVF cycle without success, you may find some of the following information helpful.

Understanding Success Rates

Indeed the first cycle can be successful, but unfortunately this is not always the reality. There is no such thing as a success rate for IVF that is 100%. The likelihood of an IVF cycle being successful is impacted by a number of important factors. The most important factor is the age of the female partner. Understanding success rates and your individual factors will help you to understand why your first IVF cycle was sadly not successful and help you to approach the next cycle.

There is a good chance that your fertility specialist discussed success rates at one or more of your consultations. Generally speaking, the success rates (live birth) following an embryo transfer are:

• • Under 30 years – 32%
• • 30-34 – 33%
• • 35-39 – 26%
• • 40-44 – 12%
• • Over 45 – less than 3%

It’s important to acknowledge that, while age is the most important factor affecting success, there are also some other key aspects that can have an impact on cycle outcomes.

So what factors affect the above success rates?

• • Length of infertility
• • Previous pregnancies/live births
• • The females ovarian reserve
• • The number of egg that were retrieved in the IVF cycle
• • When the embryo transfer occurred. Was it Day 2-3 v Day 5?
• • Embryo quality

Other reasons for a failed IVF cycle

Unfortunately, no apparent reason for a failed cycle, is the most common “reason” we see. This can be very difficult for patients to understand or accept. With the knowledge and science behind IVF, how is it possible to not know why a cycle was unsuccessful?

Why should I do another cycle?

There is some good news about embarking on your second IVF cycle. Firstly, now your fertility specialist has some key information about how you respond to FSH stimulation, fertilisation results and embryo quality. In some cases, this can help with making decisions and possible changes to your next treatment. This may seem strange, but your specialist may also decide to keep things exactly the same. The old saying goes, “if it ain’t broke, don’t fix it” – surely it is broken, if it didn’t work? IVF specialists and scientists have spent many years studying and researching the best protocols for IVF stimulation and laboratory practices. It is certainly not uncommon for a patient to do multiple cycles using the exact same protocol and not have success for many months or years. The advice here is to trust the protocol your doctor has chosen for you, particularly when embarking on your first few cycles. It just might take a little time for it be successful. It doesn’t mean it’s broken and needs fixing.

The number of IVF attempts you have, also affects the chance of success. For most people, the chance of having a baby actually remains the same with each round until the fifth cycle. So while the disappointment of a failed cycle can be awful, there is hope and reason to keep trying.

Coping with failed cycles

It goes without saying, infertility and the treatment process is sadly about loss for the most part. Some of the loss experienced in relation to infertility may not even be that obvious. Some people may experience a feeling of loss associated with the following aspects:

• • Loss of time and the idea of their naturally achieved family
• • Loss of control
• • Loss of intimacy in relationships
• • Loss of friendships and connection with peers
• • Miscarriage and pregnancy loss
• • Financial stress
• • Loss of feeling biologically adequate i.e. sperm, egg, embryo issues etc.

Remaining positive and hopeful during the IVF process is difficult. No fertility specialist or nurse will ever argue with that. But there are a few ways that you can try and approach IVF, to ensure the process is less traumatic. IVF clinics will always have a referral process to specialised fertility counselling services. Accessing their services does not mean that you are failing yourself, it simply means you are using specialised tools that are available to support and guide you through a process that have an enormous impact on so many aspects of your life.

Dr David Moore is a specialist in gynaecology, fertility, and obstetrics. He can provide continuity of care from pre-conception, through to pregnancy care, birth, and beyond.

David is friendly, professional, and devoted to individualised care and positive health outcomes for women.

As a proud father of two young boys and a baby girl, David understands what a privilege and honour it is to be able to care for women and couples as they grow their family, and he enjoys building sincere, trusting and effective relationships with his patients.