Knowing the reasons why your IVF cycle may be canceled or interrupted can help relieve disappointment

There are many reasons why your IVF cycle may be canceled. To avoid disappointment, distress, and anxiety, it’s important to be prepared for these ten potential reasons that can cancel or interrupt your IVF cycle before undergoing treatment.

Distressing for you as it may be, it’s not unusual for an IVF cycle to be canceled or interrupted at various stages along the way. According to SART, the Society for Assisted Reproductive Technology, between 5-17% of IVF cycles get canceled for one reason or another prior to egg retrieval. Your IVF cycle can also be canceled after egg retrieval, after fertilization, or before the transfer. And while canceling your IVF cycle at any stage can cause immense disappointment, it’s important to understand that the over-arching reason for cancellation is that conditions are just not ideal for this cycle leading to a pregnancy. 

Reasons why your IVF cycle may be canceled or interrupted

While most IVF cycles proceed as how you and your doctor planned, it’s important to understand when and why your IVF cycle may be canceled while undergoing treatment.

• Ovarian cysts. We look for ovarian cysts during pre-stimulation ultrasound screenings. Ovarian cysts are fluid-filled sacs that develop in the ovary when a follicle doesn’t release an egg or doesn’t shrink after releasing an egg. Because cysts may interfere with the proper egg development during the stimulation phase of an IVF cycle, we often wait for cysts to resolve before continuing treatment. In general, most cysts will clear up in a month or two with birth control. In some cases, we may need to be aspirate the cyst.
• Poor response to ovarian stimulation. Sometimes your stimulation protocol does not produce enough mature eggs to harvest. Three or less follicles will often warrant your cycle to be canceled before retrieval. In some cases, your team may recommend switching to an intrauterine insemination cycle if conditions are ideal. Otherwise, tweaks will be made in your stimulation medication regimen in a subsequent attempt.
• Excessive ovarian response. When your ovaries over-respond to your stimulation medications, this can lead to ovarian hyperstimulation syndrome, OHSS, a serious condition where the ovaries become overly stimulated, producing too many follicles and potentially causing significant health complications. In this case, your team may decide it’s best to cancel before retrieval and try again with a different medication protocol.
• No mature eggs retrieved during egg collection. Called “empty follicle syndrome,” this occurs when follicles appear on ultrasound but no mature eggs are present inside when examined by the embryologist under a microscope. This can happen for several reasons, including improper timing of your trigger shot, premature ovulation (when the follicles release eggs too early), or poor ovarian response related to your age or an underlying medical condition.
• Poor fertilization. Few or no eggs fertilizing can be due to several reasons, including immature eggs, poor egg quality due to age or primary ovarian insufficiency, issues with the sperm, genetic problems with the egg, or issues with the egg’s outer layer preventing fertilization. In cases of poor fertilization, our team of doctors and embryologists will work together to review your case to help determine the cause.
• Embryo development issues. Once fertilized, embryos are allowed to grow in the lab for several days in preparation for transfer. However, embryo development can stall due to a variety of reasons such as faulty genetics, cell division errors, chromosomal abnormalities, and poor quality of eggs and/or sperm. Older women are more likely to experience embryonic arrest.
• Poor embryo genetics. If your embryos are genetically tested using PGT-A, in some cases all of the tested embryos may be abnormal and are not suitable for transfer.
• Abnormal uterine lining. Regular ultrasounds monitor the thickness of the uterine lining to ensure it is optimal for embryo implantation. If the uterine lining is not thick enough or has irregularities, your team will recommend delaying your embryo transfer. Uterine fibroids, polyps, intrauterine adhesions, poor blood flow and hormonal imbalances can lead to an unhealthy uterine lining. In these cases, your doctor will prescribe treatment to improve uterine conditions, such as surgery or hormones.
• Patient illness during the cycle. Unfortunately, life happens and an unexpected health issue, such as the flu or COVID-19, may arise during your cycle that necessitates cancellation.
• Unanticipated events. Here in South Louisiana, it is not unusual for a hurricane or another weather event to delay or cancel a procedure during an IVF cycle. 

Be prepared for changes

You can help avoid disappointment and distress during your IVF cycle by being prepared for a non-linear path. Depending on your situation, you may experience a cycle where some steps may need to be repeated, such as different stimulation protocol or even another egg retrieval. Other tiems some steps are delayed. You may even change treatment altogether, such as converting to an IUI cycle, opting for donor sperm, or even donor egg. The best advice is to expect the unexpected.

If your IVF cycle gets canceled, take heart. Often this just means that your journey is temporarily postponed or interrupted, not forever canceled. Abandoning a cycle may help you avoid more serious complications, such as ovarian hyperstimulation syndrome, and ensure a better chance of success in the future. Cancellation may also help you avoid spending money on a procedure that will not be successful.