Lessons Learned from IVF Failure

In vitro fertilization (IVF) is an assisted reproductive technology (ART) available for individuals who are unable to conceive naturally. Although IVF has a high success rate, failure may occur due to endometriosis, progesterone resistance, and other underlying medical conditions. After IVF failure, your fertility doctor will reassess the process and outcomes to help determine the next course of action. Here are a few lessons learned from failed IVF:

Identifying Undiagnosed Conditions

You can pursue IVF when natural conception is not possible after several months of unprotected intercourse. The procedure is also an option for those looking to postpone childbirth or after certain medical procedures, such as cancer treatment. In this process, eggs are harvested early and cryopreserved for later use. When you are ready to conceive, doctors fertilize the eggs outside the womb, test embryos for defects, and implant them in the uterus.

Despite IVF’s effectiveness in addressing male and female infertility factors, some cycles may still fail. A possible reason for IVF failure is the presence of undiagnosed medical conditions, such as endometriosis, endometritis, or progesterone resistance. These conditions affect the uterine lining, disrupting the implantation process. They may lead to failed or improper implantation, increasing the chances of a miscarriage. Failed IVF often prompts comprehensive evaluations to identify previously undiagnosed conditions.

Addressing Silent Endometriosis

Endometriosis is a medical condition that occurs when endometrial cells grow outside the uterus; this is not where they belong. These abnormal growths can appear in the fallopian tubes, pelvic cavity, or around the ovaries. Endometrial cells usually grow throughout the monthly menstrual cycle in preparation for fertilization and implantation. When fertilization doesn’t happen, the cells are shed as part of menses. Abnormal growths behave similarly, but may not have a proper exit during menses, so they sometimes block the fallopian tubes.

While endometriosis often causes pain, inflammation, or symptoms such as heavy periods, some cases are asymptomatic. Silent endometriosis doesn’t have obvious symptoms, but it still affects fertility and can lead to failed IVF. Fertility doctors use a BCL6 test, which checks for markers of uterine wall inflammation. If the test comes back positive, further evaluation is required to confirm endometriosis. Treatment can involve medication or surgical removal through laparoscopy.

Treating Chronic Endometritis

Endometritis is another condition that may go undiagnosed during initial evaluations. Chronic endometritis involves persistent inflammation of the uterine lining, and it is caused by bacterial infection. The infection disrupts the endometrial receptivity, making it thin and unstable for implantation. Poor receptivity increases the chances of implantation failure or early miscarriage. Doctors may recommend a CD138 test, which checks for plasma cell markers. 

An increase in plasma cells indicates that the body is fighting some type of infection. If the test comes back positive, doctors can perform biopsies to confirm the infection. Treatment involves targeted antibiotics and follow-up biopsies to help restore a supportive uterine environment.

Addressing these infections helps improve the chances of success in future IVF cycles. Experienced fertility specialists may recommend comprehensive evaluations using both CD138 and BCL6 tests to rule out or confirm possible endometritis and endometriosis. Taking these tests before your first IVF cycle can reduce the risk of failure and the need for repeated procedures.

Exploring Alternative Treatments

IVF is one of many treatment options for infertility. If your first cycle is unsuccessful, doctors may adjust the process and schedule another attempt. Other fertility treatments include intrauterine insemination, donor sperm and egg, frozen embryo transfer, and surrogacy. After a failed IVF cycle, the doctor may schedule specialized testing beyond standard bloodwork and ultrasounds. These tests include:

• BCL6 testing

• CD138 testing

• Progesterone resistance testing

• Endometrial receptivity testing

Even with normal progesterone levels, some women experience resistance, where the uterine lining doesn’t respond to the hormone. This condition can be associated with endometriosis and other health issues. Testing for resistance allows doctors to adjust treatments and progesterone support to improve the uterine conditions for successful implantation. Endometrial receptivity testing also evaluates the condition of the uterus to improve the timing of embryo transfer. These targeted interventions allow doctors to address underlying medical conditions before the next cycle.

Learn More About IVF Failure

IVF is a successful procedure that can help women conceive when natural methods are unsuccessful. Before beginning a cycle, find out if conditions such as endometriosis, endometritis, or progesterone resistance are contributing to your infertility. Identifying these issues can reduce the need for additional assisted reproductive techniques or improve the likelihood of IVF success. Ask your doctor about BCL6 and CD138 testing today.