When a Cycle Isn’t Successful

These Mountains you are carrying

The definition of insanity is doing the same thing, and expecting different results. Well in our experience we have found that many clinics are creating insanity for our clients, and Surrogates, duplicating protocols that weren’t successful in the previous month, without even a consultation or conversation with the Surrogate, or Intended parents. The confirmation of a failed embryo transfer can feel devastating. After weeks, sometimes months, of contracts, medications, and monitoring, a negative pregnancy test result often leaves both intended parents and surrogates feeling confused, angry and even a bit hopeless. The good news is that a negative pregnancy test now does NOT mean there won’t be a positive test in your future. While we often won’t have an exact reason as to why your transfer failed, here’s a look at a few common culprits.

  1. Egg and Embryo Quality. Sometimes eggs and embryos that look great on transfer day fail to divide and multiply properly once inside the surrogate’s uterus. Most IVF doctors use an Embryo grading system based on factors such as symmetrical cell structure, large inner cell mass, and evidence of as few fractions as possible in the cells to determine the quality of the embryo. However, even embryos with a high grading may fail to result in a positive pregnancy test. Occasionally genetic defects in the developing embryo are also believed to play a part in a failed transfer.
  2. Sperm Quality. Occasionally a sperm head can contain abnormal DNA. If the sperm used to fertilize the egg does not have competent DNA, the embryo may fail to divide properly leading to a negative pregnancy result. Factors known to have an impact on sperm quality include exposure to chemicals and tobacco use.
  3. The Uterine Lining. A thin endometrium (uterine) lining is a leading cause for failed transfer in all IVF transfers. The surrogate will be monitored closely in the weeks preceding transfer in order to ensure that her lining is thickening nicely. In most cases medication protocol can be altered to try and thicken the lining. If an optimum lining cannot be reached the transfer may be cancelled, or potentially unsuccessful if completed.
Here are our Top 5 Questions to ask after a failed embryo transfer.
1. What could we have done differently? Can you tell us what may have impacted the success?
2. Is there a different protocol that you would suggest? Different medications or more monitoring?
3. Can you tell us the grading of our embryos, when transferred, and what that means?
4. Could it be us? Is our match an incompatible one?? Should we part ways?
5. If we are using our own genetic material, should we be looking at a donor??
These questions should be asked in person, or by Skype/phone, with the Doctor. It’s so important that you all have the information, and that this conversation happens with you, the Doctor and your Gestational carrier.