Unspoken outcomes: When IVF doesn’t go to plan

In this Hatching a Plan podcast episode, Simon Tomes and Emma the Embryologist discuss what IVF really means, why “just do IVF” is an oversimplification, and how treatment can stop unexpectedly before an embryo transfer. Emma outlines the typical IVF process—stimulation, egg collection, lab fertilisation and embryo culture—and explains that there are multiple biological hurdles before a pregnancy test is even possible.

They cover common points where cycles can end early, including not being able to stimulate, collecting no eggs, getting eggs that are immature and unusable, having eggs but no sperm on the day, failed fertilisation, embryos failing to divide, embryos not reaching blastocyst stage, PGT-A results showing all embryos are chromosomally abnormal, and rare cases where a frozen embryo doesn’t survive thawing.

Emma emphasises global relevance, the role of clinic monitoring and policies, the importance of context and asking clinics about their experience, and the reality that clinicians don’t always have answers. The episode ends with a recent success story and an update on Fertility Action, a charity advocating for improved NHS fertility funding and providing free support groups.

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