Why Does IVF Fail? The 7 Most Common Reasons — Explained by Dr. Ankita Mandal

1. Embryo chromosomal abnormality (most common) Up to 50–70% of all embryos — even those that look perfect on Day 5 — carry chromosomal errors that prevent implantation or cause early miscarriage. This is the leading cause of IVF failure, especially in women over 35. Solution: PGT-A testing selects only chromosomally normal embryos for transfer. 2. Poor egg quality Related to age, AMH, and oxidative stress. Even good-looking embryos may have compromised mitochondrial function. Solution: Pre-IVF optimisation (CoQ10, DHEA, antioxidants) + personalised stimulation protocol. 3. Poor sperm DNA quality High DNA fragmentation in sperm causes early embryo arrest even after fertilisation. Solution: DFI testing, ICSI with sperm selection techniques (PICSI/MACS), or TESA. 4. Uterine receptivity issues A cavity with polyps, fibroids, adhesions, or thin endometrium will not accept even the best embryo. Solution: Hysteroscopy, ERA test (endometrial receptivity assay) to find the optimal implantation window. 5. Stimulation protocol mismatch Over-stimulation or under-stimulation affects egg quality. The wrong protocol for your AMH, age, or diagnosis is a preventable cause. Solution: Protocol adjustment based on your specific response and reserve assessment. 6. Implantation failure (displaced window) The endometrium is most receptive for only a narrow 12–24 hour window each cycle. The ERA test identifies if your window is shifted — and allows transfer timing to be personalised. 7. Lifestyle factors Smoking, high BMI, alcohol, uncontrolled thyroid or blood sugar, and unaddressed stress all reduce IVF success rates. These are modifiable — and should be addressed before the next cycle.