When IVF Does Not Work — Recurrent Implantation Failure and Multiple Failures

Our approach to unsuccessful cycles

After two failed cycles or one cycle that didn’t go as expected, we run a structured troubleshooting consultation. This is not a quick clinic visit — it’s a dedicated session reviewing every step of the previous cycle in detail: stimulation response, oocyte quality, fertilisation rate, embryo development pattern, transfer technique, luteal support. From that review, the next plan is built.

Recurrent implantation failure (RIF)

RIF is conventionally defined as failure of clinical pregnancy after three or more good-quality embryo transfers. Investigation covers endometrial receptivity, uterine cavity (hysteroscopy), thrombophilia/immunology where indicated, sperm DNA fragmentation, PGT-A consideration, and lifestyle factors. We avoid blanket use of all available add-on tests — each is added when the evidence base supports it and the result would change management.

Multiple IVF failures

After multiple cycles, the conversation often shifts from technical optimisation to broader considerations — donor pathways, alternative family-building options, and the emotional cost of continued cycles. We treat these conversations as serious and structured, not as concessions.

Improving egg quality

Where oocyte quality is the suspected limitation, we discuss the evidence-based interventions (CoQ10, lifestyle modification, weight optimisation where relevant) honestly. The internet has substantial misinformation here; we discuss what actually has evidence and what doesn’t.

Troubleshooting topics

Guidelines we follow

• ESHRE Guideline on Recurrent Implantation Failure
• ESHRE Guideline on Recurrent Pregnancy Loss
• Cochrane reviews on IVF add-ons
• RCOG Green-top Guideline on recurrent miscarriage

Where this fits

Troubleshooting follows from cycle process and may direct toward advanced lab techniques or special-case planning.