RESOURCES
Supporting The Journey
Preparing for IVF: Emotional Considerations
Coping techniques2
01
Learn about the normal responses to infertility.
Do not panic if you feel rotten on most days.
02
Give yourself permission to cry and be angry.
Don’t suppress your feelings. If you need to cry about yet another pregnancy announcement, please do.
03
Give your spouse/partner permission to feel and cope differently than you.
It is important to know that everyone processes their emotions differently.
04
Tell your spouse/partner how you want to be helped.
Our partners are mere humans, incapable of mind reading. If you want to be hugged, or massaged, or left alone for a few minutes, or just listened to without any response, you’ll be more likely to get what you want if you ask.
A Support System
Relaxation and mindfulness
Remembering that you are not alone
Counselling
Unsuccessful fertility treatment?
Treatment success rates may vary between countries, within a country, and between individuals.
Reasons treatment might not be successful
Too few or too many eggs
If you’re undergoing IVF or ICSI, your doctor will want to collect several eggs to be fertilised. If your ovaries don’t grow an adequate number of follicles, your doctor may cancel your cycle because they won’t be able to collect enough eggs.4 Your cycle may also be cancelled if you’re growing too many follicles, as this increases your risk of ovarian hyperstimulation syndrome (OHSS).4 If you’re undergoing IUI, you need to ovulate one or two eggs for the sperm to fertilise. If your doctor identifies that you have too many follicles developing the cycle may be cancelled because of the risk of multiple pregnancy.1
Unsuccessful fertilisation
While IUI and IVF can overcome some sperm abnormalities, there are some cases where the sperm are still not able to successfully fertilise the egg. In IVF, 5-10% of cycles do not result in a fertilised egg.5 This can be because of abnormal morphology of the sperm or for an unexplained reason. Problems with sperm can usually be overcome with techniques such as ICSI which may increase fertilisation rates.6 If you continue to experience unsuccessful fertilisation with ICSI you may want to consider using a sperm donor.
Poor embryo, egg or sperm quality
A common cause of an unsuccessful IVF cycle is poor embryo quality. The quality of the egg and sperm determine the quality of the embryo. Some eggs may not be used for fertilisation because they’re not mature or have visual abnormalities. There’s currently no way to test the quality of normal-looking eggs so some lower quality eggs may be used in fertilisation.7 However, research is ongoing. The quality of sperm is easier to assess under a microscope. Factors like poor morphology and low motility can influence the quality and development of embryos.8 If an embryo is of poor quality, it is unable to develop into a baby.
The embryo didn’t implant
If you undergo fertility treatment, there’s a chance the embryo may not implant in your uterus. This may be because the lining of your uterus, called the endometrium, was not thick enough for the embryo to embed in.9 In some women this can be a recurring reason for failed treatment cycles, and they may need additional treatment to prepare the lining of the uterus for embryo transfer. It’s also possible for your uterus lining to be too thick for the embryo to implant.10 Undesirable uterine lining can be caused by endometriosis, uterine polyps, low levels of estrogen and some medications.9 Sometimes a fertilised egg may implant outside the uterus, this is known as an ectopic pregnancy. Unfortunately, it is not usually possible to save an ectopic pregnancy and the fertilised egg may have to be removed from the fallopian tubes using treatment or surgery.11
Chromosomal abnormalities
Chromosomal abnormalities in embryos are common in both naturally conceived pregnancies and those conceived through fertility treatment. Some chromosomal abnormalities mean the embryo is unable to grow and would not be able to develop into a baby. 10-15% of all naturally occurring pregnancies result in miscarriage and around 50% are due to these types of chromosomal abnormalities.12 If your doctor thinks your treatment was unsuccessful because of chromosomal abnormalities, they may recommend genetic testing of your embryos as part of IVF treatment, provided this is allowed under the applicable laws in your country.
Lifestyle Factors
There are some lifestyle factors that can increase your chance of having an unsuccessful treatment cycle. Women who smoke have 30% lower pregnancy rates with IVF compared to those who don’t smoke. They are also at a higher risk for miscarriage and ectopic pregnancy13. Obesity can also contribute to unsuccessful treatment, studies have shown lower pregnancy rates and higher miscarriage rates in obese women.14 If your doctor believes the reason for your unsuccessful treatment is due to lifestyle factors, they will discuss changes you can make to improve your chances with future treatment. You can also browse our lifestyle tips to learn more about the impact of some factors while trying to conceive.
Miscarriage
Unfortunately, it’s not always possible to know why a miscarriage happens, but the risk increases with the age of the woman.15 Most miscarriages cannot be prevented and most early miscarriages (that occur during the first 3 months of pregnancy) are usually caused by chromosomal abnormalities.15 Going through a miscarriage can be a physically and emotionally draining experience. You may want to consider reaching out for advice and support from a counsellor.16
2Victorian Assisted Reproductive Treatment Authority (VARTA). How likely are you to have a baby after one, two or three IVF cycles? Available at: https://www.varta.org.au/resources/news-and-blogs/how-likely-are-you-have-baby-after-one-two-or-three-ivf-cycles. Accessed January 2023.
3Chambers GM et al., The Medical Journal of Australia 2017;207(3):114-118
4Rachel Gurevich. Cancelled IVF Cycle? Why It Happens and What’s Next. Verywell Family. 2021. Available at: https://www.verywellfamily.com/canceled-ivf-cycle-4151945. Accessed January 2023.
5Mahutte N, Arici A, Current Opinion in Obstetrics and Gynecology 2003;15(3):211-218.
6Cardona Barberán A et al., Diagnosis and Treatment of Male Infertility-Related Fertilization Failure. Journal of Clinical Medicine. 2020;9(12):3899.
7Moro AM et al., Egg quality in females – how to achieve high-quality oocytes. inviTRA. 2022. Available at: https://www.invitra.com/en/quality-of-the-eggs/#how-is-the-quality-of-the-eggs-evaluated Accessed September 2023.
8 Piccolomini MM et al., JBRA Assist Reprod. 2018;22(2):89-94.
9Liu KE et al., Human Reproduction 2018;33(10):1883-1888.
10Rachel Gurevich. Endometrium Conditions and Diseases. Verywell Family. 2022. Available at: https://www.verywellfamily.com/understanding-the-endometrium-1960066. Accessed September 2023.
11NHS. Ectopic pregnancy. Available at: https://www.nhs.uk/conditions/ectopic-pregnancy/ Accessed: September 2023
12Soler A et al., Cytogenet Genome Res 2017;152:81-89
13American Society for Reproductive Medicine (ASRM). Smoking and Infertility. 2014. Available at: https://www.reproductivefacts.org/globalassets/_rf/news-and-publications/bookletsfact-sheets/english-pdf/smoking_and_infertility_factsheet.pdf. Accessed September 2023.
14 American Society for Reproductive Medicine (ASRM). Weight and Fertility. 2015. Available at: https://fertanswers.wpenginepowered.com/wp-content/uploads/2016/04/weight-and-fertility.pdf. Accessed September 2023.
15Tommy’s. What causes a miscarriage? Available from: https://www.tommys.org/baby-loss-support/miscarriage-information-and-support/causes-miscarriage. Accessed September 2023
16 NHS. Miscarriage. Available from: https://www.nhs.uk/conditions/miscarriage/ Accessed September 2023
Next steps after failed cycle
Before starting to consider your next steps, give yourself time to recover from the complex emotions you may experience following an unsuccessful cycle. You should also make sure you are getting access to the support you might need. No matter where you are on your fertility journey, there are options available to you. Your doctor will be able to present the options suitable for you and support you when making this decision.
Grieve
It’s so important to take the time to grieve and process this loss. Keep in mind that you and your partner may grieve in different ways, and that’s okay. You may feel like crying, talking it out, expressing what you are feeling through art or music, spending time in nature, journaling, moving your body, or crying some more.
Try again
You might decide to try the same treatment again, either with the same protocol or using a different combination of fertility medication or with additional steps to your treatment. You can also try a different fertility treatment, for example if you’ve had multiple unsuccessful IUI cycles, you might be recommended to try IVF treatment next. Talk to your doctor to find out the best next step for you.
Consider other options
If you’ve had multiple unsuccessful IVF/ICSI cycles, there are other options you can consider to increase your chances of pregnancy, for example using a donor, provided that is allowed according to the local applicable laws.
Take a break
Take some time away from fertility treatment to consider your next steps or simply to have a break from the physical and mental toll treatment can take.
Seek professional advice
Speaking to a fertility counsellor can help you understand the implications of your options and potentially make the decision of what to do next easier. They can help you cope with your emotions after unsuccessful treatment and explore how you feel about future treatment. This will allow you to feel in control when making decisions. Speak to your fertility clinic or visit your local fertility association website to find a counsellor near you.
2Rescripted, available at: https://rescripted.com/posts/6-things-to-do-after-a-failed-ivf-cycle. Accessed July 2024.
