Reasons Why IVF Don't Work & What You Can Do About It

You’ve probably heard the saying, “If you don’t succeed the first time, keep trying.” For in vitro fertilization (IVF, a type of assisted reproductive technology in which doctors combine eggs and sperm in a lab dish before implanting the embryo into the uterus), the proverb is probably ‘try, try.

While it may not be reassuring, IVF is difficult, and despite being one of the most successful forms of assisted reproductive technology, the Society for Assisted Reproductive Technology The live birth rate drops to 4.1% for people over the age of 42, according to SART, and even those who undergo treatment take an average of 3.6 cycles to conceive, according to the National Institutes of Health. IVF is required.

A short story

After all, I am above average. As of this writing, her husband and I have had four failed IVF attempts on her. We obeyed the rules. I set my medication alarms, gave my daily injection cocktails at the right time, and went to the clinic flawlessly every other day to monitor my appointments, which included blood tests and ultrasounds, but I got nowhere. The cycle resulted in a negative pregnancy test and a complete abortion of the embryo transfer because of excess fluid in the endometrium, creating an inhospitable environment for the embryo.

My infertility is because of a blocked fallopian tube, possibly due to scar tissue from a myomectomy where she removed nearly 20 fibroids. When I think about my entire reproductive journey, it just seems like one thing after another. Besides, I didn’t really realize failure was an option until the first failed cycle last spring. This is where we invested all our time, money, and energy, and there was nothing to show for it. But then I read that Chrissy Teigen’s first round failed too (she’s my IVF heroine). Her story comforted me, with new hope, and a desire to get back in the ring.

It turns out I’m not the only one: According to the NIH, 11% of US women of childbearing age have fertility problems. I also learned that black women like me are about twice as likely to be infertile as white women.

 There are common reasons why an IVF cycle fails.

According to Roohi Jeelani, M.D., a reproductive endocrinologist and fertility specialist in Chicago, chromosomal abnormalities are common (both embryonic and birth) and can contribute to failed IVF cycles

According to the National Human Genome Institute, these abnormalities are numerical or structural. Abnormal numbers are when there are too many or too few chromosomes in a cell. If there is a structural abnormality, the structure of the chromosome has changed. There is mixed evidence about how many chromosomal abnormalities affect the success rate of IVF, but they are one factor (unfortunately, we cannot control them).

Genetic testing is optional

If chromosomal abnormalities are a contributing factor, choose to undergo a test called preimplantation genetic testing (PGT) if comfortable, available, and within your means, I can do it. During the procedure, a technician will take a cell sample from her five-day-old embryo and send it to a lab to check for chromosomal abnormalities. Embryos deemed abnormal will not be transferred, according to the Center for Reproductive Medicine, University of Washington School of Medicine.

Our doctor recommended his PGT for the rest of the embryos and about half were considered genetically normal, so we had a second egg retrieval. It is important to note that PGT does not guarantee successful implantation or a newborn without genetic abnormalities, according to the American College of Obstetricians and Gynecologists. PGT is usually not covered by insurance and can be very expensive (exact numbers vary, but can be $200 or more per embryo). Still, I wish I had considered it at the beginning of my IVF journey as it saved me time and heartache, but hindsight is 20/20.

Allow extra time into your IVF schedule if possible

This is a marathon, not a sprint. And as a friend once told me, IVF is a full-time job on top of your actual full-time job. Plan and prepare accordingly. But don’t use too many.

IVF is completely unpredictable, so it’s a good idea to schedule as far in advance as possible to accommodate appointments and procedures. Ultimately, it all depends on how your body responds to the drug. Every person’s cycle is different. What worked for your friend or your last time may not work this time.

If possible, relax on the day of the transfer and for the next few days. Your body has been through a lot: hormones, planning, and preparation. If possible, take a pregnancy test day off so you can digest the results without worrying about Slack.

While it may not be reassuring, IVF is difficult, and despite being one of the most successful

forms of assisted reproductive technology, the Society for Assisted Reproductive Technology

The live birth rate drops to 4.1% for people over the age of 42, according to SART, and even

those who undergo treatment take an average of 3.6 cycles to conceive, according to the

National Institutes of Health. IVF is required.

Allow extra time into your IVF schedule if possible

This is a marathon, not a sprint. And as a friend once told me, IVF is a full-time job on top of

your actual full-time job. Plan and prepare accordingly. But don’t use too many.

IVF is completely unpredictable, so it’s a good idea to schedule as far in advance as possible to accommodate appointments and procedures. Ultimately, it all depends on how your body

responds to the drug. Every person’s cycle is different. What worked for your friend or your last

time may not work this time. 

 Remember how far you’ve come

After failing 4 times, you might want me to give up. And I do it for some days. I am hopeful and cling to my beliefs, but sometimes I lose my footing.

At that moment, I scream, cry, shut out the world, and return to Yasmine Cheyenne’s poems that remind us that there is great power to continue to try. “You dream and you believe,” she writes. “Silence your literal magic.”

IVF, like grief, is not always linear. And it’s certainly not for the faint of heart. There are highs and lots of lows. What helped me was (1) I’m not alone. (2) I am insanely strong (but it doesn’t have to be always). (3) Timely everything. So for now, I’m going to stay true to my faith.