If you don't get pregnant after your IVF attempt, you'll be disappointed. Remember - this is not the end - it's just the beginning! 

If you don't get pregnant after your IVF attempt, you are likely to be very disappointed and disheartened. However, remember that this is not the end of the road - it's just the beginning! At the end of the IVF cycle, you need to sit down with your doctor and analyse what you learnt from it. Was the ovarian response good? Was the endometrium receptive? Did fertilisation occur? Why didn't pregnancy occur? (Though this is a question we still can't answer!) Can you repeat the same treatment, or do you need to make changes before going in for your next attempt? When can you go in for your next IVF cycle? And even if you do not get pregnant, at least the fact that you attempted IVF should give you peace of mind that you tried your best , using the latest technology medical science has to offer.
 

The Second Time Around - the Next IVF Cycle

Most doctors would advise you to wait for a month before starting a new cycle. While it is medically possible to do the next cycle immediately, most patients need a break to marshall their emotional strength before starting again. 

Your doctor may need to modify your treatment, depending upon an assessment of your previous cycle. For example, if the ovarian response was poor, the doctor may advise you to increase the dose of drugs used for superovulation. If fertilisation did not occur, you may need to go in for microinjection (ICSI). If the quality of the embryos was poor, you may be advised to consider a ZIFT rather than IVF. 

When an IVF cycle fails, many patients want to do "something new" or "something different" in the next cycle. However, do remember that the commonest reason for a failed IVF cycle is the failure of the embryos to implant - and since this is still an area of profound ignorance, there is little we can do to increase the probability of successful implantation occurring the next time. Rather than look upon the cycle as a "failure", it's better to treat it as having provided valuable information - for example, evidence that the sperm can fertilise the egg, which proves that they are normal ! 

For patients who have had an embryo transfer, the odds are stacked in their favour that they will get pregnant sooner or later. Nevertheless, there is a lot of pressure to try the "newest or latest advance" the next time - which is why many clinics now offer expensive techniques such as immunologic testing and even immunotherapy - but these are still in the realm of "scientific witchcraft" and have not been proven to be helpful. In fact,  if the IVF cycle was satisfactory, the doctor will often advise you to repeat exactly the same treatment again - and all that it may take to achieve your IVF success is time and another attempt. 

When an IVF cycles fails, there is a lot of pressure on both patient and doctor. Many patients will change the doctor because they do not conceive - but this is not usually a good idea, unless you are unhappy with your medical care. Doing a second IVF cycle in the same clinic is usually better than changing doctors, because your doctor can now tailor his treatment based on his observations during your earlier treatment cycle. Interestingly, we often find that couples going through a second IVF cycle are much more relaxed and in control. This may be because they are aware of all the medical and procedural minutiae, and are better prepared for these; and also because they have had a chance to establish a personal relationship with the medical team. Also, since they have already faced failure the first time around, many of them are much better able to cope with the stress of IVF, since they are prepared for the worst.