No Embryos After an IVF Cycle: What It Means and What to Do
Today, I want to talk about IVF and specifically, what to do when things don’t go as planned—like when you don’t have any embryos or any normal embryos. I want you to know what to consider when things don’t go your way, or when you don’t get the outcome you were hoping for. Sometimes, not getting embryos may be perfectly expected for your scenario. It doesn’t mean you’ll never get them, and it doesn’t mean we shouldn’t evaluate the cycle and make changes, but it is something important to consider along the way.
Understanding IVF: A Quick Overview
IVF is essentially trying to get one month’s group of eggs all to grow at the same time. Here’s a helpful way I like to think about it:
Inside your ovary is a vault where all your eggs are kept. Each month, a group of eggs comes out of that vault. The number of eggs varies depending on your ovarian reserve—younger patients tend to have more eggs, while older patients have fewer. I imagine a “vault keeper” controlling how many eggs come in and out to keep the vault at the perfect level.
During IVF, our goal is to get all the eggs that month to grow, which goes against your body’s natural instincts. Normally, your body wants just one egg to grow each month. So we are asking your body to override its natural brain-ovary communication.
Two key factors impact IVF success:
Ovarian reserve and egg quantity – Fewer eggs mean fewer chances for fertilization.
Age and egg quality – Eggs degrade over time, and older eggs are more likely to have chromosomal abnormalities.
Another important factor often overlooked is your environment and inflammation, which can affect both egg and sperm quality. Smoking, marijuana, and other toxins can damage DNA and reduce IVF success.
Step 1: Know Your Potential
Before starting IVF, it’s essential to understand how many eggs you can expect. Most doctors determine this using:
Antral Follicle Count (AFC) – an ultrasound that counts eggs ready to grow
AMH (Anti-Müllerian Hormone) – a blood test that estimates your overall egg reserve
Knowing your expected egg count helps guide medication doses, protocols, and goals. For example, if your tests suggest you might get 16 eggs, but you only have 5 eggs growing during your cycle, this is a huge discrepancy and should trigger a conversation with your doctor.
Step 2: Evaluate the Cycle
If your numbers are off, it’s time to ask questions like:
Should we have canceled the cycle?
Can we change the protocol to get more mature eggs next time?
Should we adjust suppression or stimulation medications?
Did we trigger at the right time?
IVF involves a lot of trial and error, and small adjustments can make a big difference. Some eggs may be immature (M1 stage), others degenerating, and timing can impact fertilization success.
Step 3: Look at Fertilization and Embryo Development
Once eggs are retrieved, fertilization success is critical:
Typically, 75–80% of mature eggs fertilize
Around 50% progress to a blastocyst (day 5–6 embryo)
Genetic normalcy depends heavily on age (younger patients tend to have more normal embryos)
If you have no normal embryos, it’s important to look at the details:
Was fertilization low? Should ICSI (injecting sperm into the egg) be considered?
Did embryo development stall at day 3? This can sometimes signal male factor or environmental issues.
Lifestyle and environmental factors can have a huge impact on outcomes. Both partners should evaluate habits and exposures that may be contributing to low-quality eggs or embryos.
Step 4: Consider Next Steps
Not getting embryos doesn’t mean never getting embryos. Sometimes it just means:
You may need another cycle to reach your desired outcome
Adjustments to protocol or medications may help next time
Lifestyle and environmental changes can improve egg and sperm quality
It’s essential to hear from your doctor about your specific results. Ask for a dedicated discussion to review your cycle—what I call the “WTF visit”—to understand what went wrong, what can improve, and what your next steps should be.
Final Thoughts
IVF can be complicated, emotional, and sometimes confusing, but understanding your own potential, cycle specifics, and actionable changes can help you be a better advocate for yourself. No normal embryos in one cycle doesn’t define your journey—it’s an opportunity to learn and adjust.
