When IVF keeps not working
If you've had two or more failed IVF cycles, the right next step isn't another identical attempt — it's a careful review. We take apart everything that's been tried, find what changed isn't being asked, and rebuild the plan.
Three failed cycles is a signal to pause
"Recurrent implantation failure" doesn't have one universal definition, but the working definition most specialists use: failure to achieve pregnancy after 2-3 transfers of good-quality embryos in a woman under 40, with no other obvious explanation.
When this happens, the temptation — for both patients and clinics — is to keep trying with small protocol variations and hope. That's almost always the wrong move. The right move is to stop, take everything apart, and figure out which of the four major causes is the real one before the next attempt.
Read our long-form blog post: Recurrent IVF Failure — When to Pause, Reassess, and Try Again →
Which of these is causing your failures?
When we review recurrent failure cases, this is what we're trying to figure out. Each requires a different next step.
Embryo problems
Embryos that look morphologically good but are chromosomally abnormal. Female age is the biggest driver — at 38, around 50% of embryos are aneuploid; at 42, around 80%. PGT-A testing identifies these.
Endometrial / receptivity problems
The lining isn't ready, isn't thick enough, or has timing issues. Polyps, fibroids in the cavity, scar tissue, or silent chronic endometritis can all be causes — often missed on routine ultrasound.
Immunological / clotting factors
A subset of cases involve immune-mediated rejection or thrombophilia preventing implantation. Specific testing is reserved for cases where clinical suspicion is present.
Process / protocol problems
Wrong stimulation drugs or doses, suboptimal lab handling, incorrect transfer technique, mistimed support. The most fixable category — and often the most overlooked.
What we actually do
Don't rush back into a cycle
The first thing we do is slow down. Give us 2-3 weeks to investigate and plan. Starting another cycle the same week is almost always counterproductive.
Review every old record
Hormonal reports, stimulation drug logs, scan measurements through the cycle, embryology grading, lining thickness, transfer technique notes — bring everything from previous clinics. Often the answer is hidden in there.
Targeted investigations
Hysteroscopy. Endometrial biopsy for chronic endometritis. Sperm DNA fragmentation. Karyotyping. Receptivity testing if needed. We don't shotgun every test — we order what's likely to change the plan.
Rebuild the protocol
Based on findings, the next cycle is rarely "more of the same". Different drugs, different timing, different lab adjuncts, sometimes PGT-A, sometimes FET, sometimes a different conversation entirely.
If a clinic recommends a 4th cycle without changing anything
— please get a second opinion. There should always be a documented, specific reason to expect a different outcome. "Let's just try again" is not a plan.
Get a Second OpinionIf your previous IVF was elsewhere
A significant share of our recurrent-failure consultations are second opinions from patients treated in other cities — Bangalore, Mumbai, Pune, Hyderabad, occasionally abroad. Coming to a different clinic doesn't mean walking away from your earlier care — it means getting a fresh pair of eyes on a complex situation.
What we'd ask you to bring: every report, every prescription, every scan, every embryology summary, billing records if relevant. The more we can see of what was actually done, the more useful the consultation will be.
Hubli is well-connected by air (HBX) and rail to all major South Indian cities. Many of our out-of-town patients combine the consultation with a 2-3 day visit during which all key investigations are completed.
And sometimes the answer is donor egg
One of the hardest conversations in fertility medicine. For women over 42 with severely diminished ovarian reserve, success rates with own-egg cycles can be very low — sometimes 5-10% per cycle — while donor egg success rates may be 50%+.
We don't push donor egg. We don't pull from it either. We have the conversation honestly, share the realistic numbers, give you time, and respect whatever you decide. Donor egg, donor embryo, surrogacy (where legally permissible), or stopping treatment — all are legitimate, and all are personal.
If this is where your situation is heading, we ensure you've heard the alternatives and that the decision is yours, made with full information.
Common questions about recurrent failure
2-3 failed cycles with good-quality embryos in a woman under 40 is the typical threshold for serious reassessment. Don't wait for a 4th identical attempt.
A typical comprehensive review includes hysteroscopy, endometrial biopsy for chronic endometritis, sperm DNA fragmentation, karyotyping for both partners, thrombophilia screen if indicated, sometimes endometrial receptivity testing. We don't shotgun every test — we order what's likely to change the plan.
Yes — and we want them. Hard copies, soft copies, PDFs, photos of reports — whatever you can bring. The more we see of what was tried before, the more useful the consultation will be.
For recurrent failure cases we book 60-75 minutes — your story, all the records, time to ask questions, and a clear plan at the end. We don't rush these.
A senior consultation is ₹500–₹800. Investigations are quoted separately based on what's needed. If a revised IVF cycle is recommended, you receive an itemised written estimate — same range as any IVF cycle (₹1.5–2.5 lakh). See our pricing page.
Don't repeat. Rebuild.
Bring your previous IVF records. We'll review every detail, suggest what should change, and only then talk about another attempt.
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