IVF cycle cancellation usually is referred to when a low number of follicles develop in the ovaries during the stimulation phase of treatment, and the egg retrieval is canceled. Women whose ovaries do not produce enough eggs (or follicles) during treatment are indeed called “poor responders.”
While failure to develop sufficient follicles worthy of egg retrieval is one reason for a canceled IVF cycle, one’s cycle may be cut short, delayed, or fail to be completed for other reasons as well.
Having one’s IVF cycle canceled or delayed can be heartbreaking. By this point, one has invested time, emotional energy, and significant funds. Not getting to the embryo transfer stage can indeed be painful.
That said, having one canceled or delayed cycle does not mean one’s next cycle is destined for the same unfortunate ending.
Why Your IVF Cycle May Be Cancelled, Delayed or Fail to Complete
Just about every person who does start an IVF cycle knows that pregnancy and a live birth are not guaranteed. But many are indeed surprised if they do not make it to the embryo transfer.
Baseline ultrasound or blood work problematic:
At the start of an IVF cycle (or any sort of fertility treatment cycle), a baseline ultrasound and blood work are ordered. This is primarily done to confirm that there are no cysts on the ovaries. If a cyst is found, treatment may be required to be delayed.
These cysts are typically benign and will rather go away without additional intervention. Once it is of course resolved, one may be able to start the IVF cycle after a short delay, or it may be pushed off to another month.
Not enough follicles are developing:
Mentioned earlier, this is when the ovaries do not respond as well as expected to the fertility drugs. How many is “not enough” follicles? The definition of “too low” varies between doctors, but usually, three or fewer follicles will indeed lead to cancellation. Some doctors will rather cancel a cycle if there are fewer than five follicles.
Low estrogen levels:
If one’s estrogen levels are lower than expected during the ovulatory stimulation part of one’s cycle, this may also indicate problems with follicle development.
Estrogen levels are too high:
This can lead to ovarian hyperstimulation syndrome (OHSS), a condition that if left untreated can become dangerous. In severe, rare cases, it can also result in loss of fertility and even death.
If one’s estrogen levels are too high, one cycle may be canceled. This may also occur before the trigger shot, before the egg retrieval, or after egg retrieval. If cancellation does occur after egg retrieval, and some healthy embryos do develop in the lab, those embryos may be cryopreserved. They can later be thawed as well as transferred via a frozen embryo transfer cycle, or FET.
Unexpected dropping estrogen levels:
Some IVF protocols do have an expected drop in estrogen prior to the egg retrieval stage. This is not a really a problem.
In case the estrogen levels drop unexpectedly before egg retrieval, this can be a bad sign. Your doctor may recommend you cancel the egg retrieval, to save money and emotional energy on continuing a cycle that is unlikely to succeed.
No eggs retrieved:
Theoretically, every follicle needs to contain an egg. But it does not work like that. Sometimes, the follicles are rather empty. If there are no eggs, fertilization cannot happen. The cycle would end here.
Progesterone levels too high:
Progesterone is a hormone that does rise after ovulation. It does help prepare the endometrial lining, whereby the embryo will hopefully get an implant, and it also helps maintain a pregnancy. Progesterone should not start to rise until after egg retrieval (or ovulation).
No embryos for transfer:
Occasionally, a good number of eggs are retrieved, yet fertilization does not happen. This also does mean there will be no embryos to transfer.
Showing signs of OHSS risk:
Ovarian hyperstimulation syndrome can indeed be very serious if left untreated. If one’s symptoms, ultrasound, or blood work does indicate a high risk of OHSS, one’s cycle may be canceled or postponed.
This can occur before egg retrieval or even after retrieval but no doubt before embryo transfer.
Illness unrelated to IVF:
If either of the partners does come down with a serious illness in the midst of treatment, the cycle may be canceled or delayed. High fever can negatively impact sperm counts.
Be honest with one’s doctor if one has a high fever or are coming down with something during one’s treatment month.
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