When a fertility treatment fails, we ask ourselves the following questions: what went wrong? When can I try again?
Obviously, in the event of a failure, the possible causes must be assessed. However, oftentimes, a negative result does not warrant a specific study to find out the reason. Not all embryos implant and an unsuccessful cycle does not require searching for the cause. The medical team (gynaecologists, andrologists and embryologists…) will assess your case to determine if specific additional tests are needed to broaden the implantation failure diagnosis. Unfortunately, however, we do not yet have an answer for all unsuccessful cycles.
If this is your case, it is normal for you to feel disheartened but, although fertility treatments have a high success rate, more than one attempt is often necessary to achieve a pregnancy. Specialists know this and a failed treatment is actually considered “normal” because the pregnancy rate is simply a statistic. The circumstances of each patient and each embryo are different for each attempt and each treatment.
Therefore, when faced with a failed fertility treatment, multidisciplinary fertility teams always try to gather as much information as possible to try to avoid a repeat of the problem in a new attempt. This leads to the other key question: how long do I have to wait to try again?
The answer depends on each case and there are many factors to consider:
- Whether the patient has more embryos available or needs to start a new hormonal ovarian stimulation treatment.
- Whether the cycle has resulted in a spontaneous miscarriage.
- Whether the patient has a previous history of recurrent pregnancy loss.
- Whether the negative result is due to implantation failure.
- In the case of pregnancy loss, whether it has occurred before or after 20 weeks of pregnancy.
- The patient’s age, medical history, state of mind and emotional state are also important factors to take into account.
Your doctor’s medical opinion is very important in making the decision to try again, as your doctor knows each case and its progress. But the final decision to start another treatment or when to try again is up to the patient and her partner, provided, of course, that there are no risks or medical circumstances that make it inadvisable.
“In general, if the medical team considers that additional tests are not necessary and the patient has high-quality vitrified embryos, a new embryo transfer can be carried out immediately. It is a different matter if there has been a miscarriage after a fertility treatment, in which case the treatment can be restarted after three months. Obviously, if additional tests are needed to determine the possible cause of the miscarriage, this period could be extended,” explains Dr Buenaventura Coroleu, a senior consultant of the Reproductive Medicine Unit at Dexeus Mujer.
If an IUI is performed during a natural cycle or with gentle stimulation, there is no need to wait. A new attempt can be carried out at the next ovulation.
In short: a first failed cycle does not imply an implantation failure. Therefore, a new treatment can be started without the need for further tests or a rest period. That being said, the next step must always be assessed individually and carefully.