A failed IVF transfer is particularly disappointing when the embryo has been tested by PGT-A and found to be chromosomally normal (euploid). After repeated failures, patients often wonder whether there is an underlying implantation problem and whether additional investigations or treatments are needed.
A large 2026 study in Fertility and Sterility* provides reassuring—but also thought-provoking—evidence. The study included 5,811 patients and 7,763 single euploid embryo transfers.
The estimated cumulative probability of achieving at least one live birth increased from 63.1% after one euploid embryo transfer to 83.0% after two, 92.0% after three, 96.0% after four and 98.3% after five.
Importantly, the chance of live birth per transfer remained relatively stable after the second attempt. This suggests that failure of one or more euploid embryos does not necessarily predict failure of the next embryo.
Is recurrent implantation failure really that common?
The study also challenges the concept of recurrent implantation failure (RIF). Only 3.2% of patients failed to achieve a live birth after three consecutive euploid embryo transfers.
This suggests that repeated failure may sometimes reflect biological probability rather than an underlying abnormality of the uterus or endometrium. The study therefore does not support automatically moving to extensive additional testing or unproven treatments after early failed euploid transfers.
What does this mean for patients?
The message is encouraging: a failed euploid embryo transfer is a setback, not a prediction of future failure.
For patients who are able to obtain several euploid embryos, persistence with sequential embryo transfer can result in a very high cumulative chance of having a baby. Approximately three euploid embryos were associated with a 90% or greater estimated chance of at least one live birth in this study.
However, these figures are population estimates rather than guarantees. Age, ovarian reserve, the ability to produce euploid embryos, uterine factors and individual reproductive goals must always be considered.
In IVF, the outcome of one embryo does not tell the whole story. What often matters more is the cumulative reproductive potential of all the embryos available.
The take-home message
A failed euploid embryo transfer is a setback, not a prediction that future transfers will fail. Before labeling a patient as having recurrent implantation failure or introducing unproven treatments, we should remember that each additional euploid embryo represents another meaningful chance of success.
Perhaps the better question is not “Why did this embryo fail?” but “What is my cumulative chance of success with the euploid embryos I have?”
*Durbin C, Parra CM, Blakemore JK, DeVore S, Wertz B, Fino ME, Licciardi F, Berkeley A, McCaffrey C, Grifo JA, Cumulative probability of a live birth after up to six sequential single euploid embryo transfers, Fertility and Sterility (2026), doi: https://doi.org/10.1016/ j.fertnstert.2026.07.016.
