In-Vitro Fertilization is the gold-standard treatment for infertility. Even so, it is nowhere near 100% successful. In general, it’s about 20-50% successful and in a very good case scenario, one can have expectations of 60-80% success. Because it does represent the ultimate in treatment, it is especially devastating when a cycle fails.

I often have to help my patients face this problem. The most common scenario is when they come to me after having failed IVF at another program. We have a policy of offering a reduced fee to those who can prove they have failed IVF elsewhere. This tends to draw more than our fair share of difficult cases. But these challenges are a very welcome intellectual puzzle for me. I analyze these cases in the following manner.

First, we acknowledge that there are three things that determine the success or failure of an IVF cycle:

1. Quality of Embryos
2. Receptivity of Uterus
3. Embryo Transfer Technique

In basic terms, the three questions are as follows. Are any of the embryos perfect enough to become a baby? Is the uterus a friendly enough home for the embryos? Are the embryos placed gently into the right location?

Whenever I get a patient who has already failed IVF at another program (or with me), I go over these three questions. To break it down even further, there are four things that determine the quality of the embryos. And there are two things that determine the receptivity of the uterus:

1. Quality of Embryos
   1. Characteristics of the Patient
   2. Stimulation Protocol
   3. Embryology Lab
   4. Luck or Randomness
2. Receptivity of Uterus
   1. Macroscopic Factors
   2. Microscopic / Hormonal Factors
3. Embryo Transfer Technique

So if your IVF cycle was successful, then congratulations! You probably have your hands full with you baby (or babies) right now. However, if your cycle failed, watch for future posts as we discuss some of these specific topics.