To make the best decision about whether to do another IVF, your first step is usually to sit down with your doctor and review your history and the details of the failed cycle. This would include a discussion of the rationale behind attempting IVF in the first place and a careful examination of the results of the IVF cycle. Clearly, if a woman can conceive only through the use of IVF (for example, because she has no fallopian tubes or because her partner’s sperm is of such poor quality that no other alternative is available), then the decision becomes one of whether another attempted IVF is warranted.

In reviewing the previous IVF cycle, the woman’s response to the stimulation protocol, as well as the findings at the time of egg collection should be carefully examined. If the eggs appeared immature at the time of egg collection, then in the future, the trigger shot should probably be withheld until the follicles reach a larger diameter. If the stimulation and number of eggs are appropriate but fertilization was unexpectedly poor, then the use of ICSI for a future IVF cycle could be considered. If stimulation, fertilization, and embryo development were good and yet the cycle still failed, then consideration should be given to either an FET cycle (if appropriate) or a repeat cycle of IVF. If the stimulation was poor and the number of eggs was suboptimal, then other stimulation protocols should be discussed. If maximum doses were used and a poor response was still seen, then Stimulated Cycle IVF may not be an appropriate choice. In such a case, other options—ranging from Natural Cycle IVF to IUI to donor egg or adoption—may warrant discussion.

In cases where patients have frozen embryos remaining from the fresh IVF, we usually encourage them to attempt pregnancy with a frozen embryo transfer. Many patients who fail to conceive on a fresh IVF will conceive on the FET.

The post-IVF consultation is one of the most useful discussions that a couple can have with the physician. It allows the couple to review all aspects of their care and to determine whether IVF represents the best approach to their particular situation. We firmly believe that this feedback is crucial to develop an appropriate plan of treatment for each couple.

Kristin comments:

Obviously, this is a very personal decision that is based on your own emotional, physical, and financial situation. For us, the answer was easy: Yes! At our post-cycle consult with the RE, he reassured us that IVF could work for us.We discussed the quality of our remaining frozen embryos and the chances of conceiving through a FET and ultimately decided to pursue another fresh IVF cycle. We jumped right back into IVF, doing two back-to-back fresh cycles. They were not easy months, emotionally or physically. I had wonderful support from family and friends, and this helped to keep me focused on my ultimate goal of creating a family with my husband. I believe it is very important to have somebody to discuss your fears, concerns, and frustrations with while cycling, be it an online buddy, family member, friend, or professional counselor. So often the focus is on the financial and physical ramifications of IVF, but the emotional toll is often the worst.