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Most infertile women know that IVF represents their best chance of having a baby, which is why they sign up for the first IVF cycle. Those who have realistic expectations understand that the failure rate in one cycle will always be more than the success rate, which is why they should be prepared for the fact that they may need to do a second or third cycle before they achieve their goal of having a baby.

However, we find that once they have failed an IVF cycle, many women just stop doing anymore treatment. The dropout rate in IVF treatment is extremely high and it's worth trying to figure out why this happens. In a perfectly rational world, once a women decided to do an IVF treatment cycle, logically she would continue doing the treatments until she finally achieved her goal of getting pregnant.

This is why, if the first IVF cycle fails, she should be both mentally and physically prepared to do a second.However, lots of patients decide not to do a second cycle and there could be many reasons for these - some rational and some not so rational.

The cost factor 

Some people can't afford to do a second cycle for financial reasons because they've run out of money. That is a perfectly rational reason.Other patients may find the experience too emotionally draining or too stressful, which is why they don't want to put themselves through it again.

I guess that's a perfectly rational explanation as well, but surprisingly, there are some who could afford to do another cycle and don't find the experience too hard to deal with, who decide that just because their first cycle failed, they are not going to try a second cycle.

This is partly because they're worried about how much money they've already wasted on the first treatment; and partly because their confidence in IVF treatment has been shaken up, because the first cycle failed.

Patients have excessively high expectations of success in the first IVF cycle for many reasons. They have high hopes that this is the magic solution which will give them their longed-for baby.

Media also at fault 

The press is also responsible, because it highlights only the IVF success stories, and does not talk about the failures. Doctors are also responsible for this misplaced optimism, because they try to present as rosy a picture as possible, in order to "hook" the patient. The downside to all this is that when the cycle fails, it's very hard for some of these patients to recover. They then decide not to pursue IVF treatment at all .

Sadly, they've actually made their own bad situation even worse because a second or third IVF cycle would actually be their best treatment option, purely from a logical objective point of view. However, humans aren't always rational and we make decisions which we then regret later on, as time goes by.The best way of preventing this kind of situation is :

  • For patients to have realistic expectations before they start the cycle and
  • To be prepared for the fact that success may involve more than one or two attempts
  • This is why guaranteed pregnancy option programs are so useful ! It's not because they end up saving the patient's money, but because they help the patient to reframe their perspective and understand that IVF treatment may not always succeed at their first try.
Patients who enroll for these programs are mentally prepared to invest as much time and energy in their treatment as is required for them to achieve success, rather than to think of it as a single shot hit or miss affair.

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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