Reasons for Cancellation of Treatment

Reasons for IVF Cycle Cancellation: Understanding Setbacks and Moving Forward

Introduction

Hearing that your IVF cycle has been cancelled can be disappointing and stressful. However, cycle cancellation is sometimes necessary to protect your health and maximise your chance of success in future cycles. Most cancellations occur before egg retrieval or embryo transfer and can be managed with adjustments to medications or protocols. Understanding the reasons behind a cancellation can help you prepare for next steps.

At Dr Aksoy IVF, we prioritise patient safety and high‑quality care. Our team monitors your response closely during ovarian stimulation and embryology to decide whether to proceed or pause. Below are the most common reasons why a cycle may be interrupted.

1. Poor Ovarian Response

When the ovaries do not respond adequately to stimulation drugs, producing fewer than three mature follicles, the probability of retrieving enough eggs for a viable embryo is low. Continuing with egg retrieval in this situation exposes you to unnecessary medical and financial risks. Your specialist may recommend canceling the current cycle and using a different stimulation protocol or adjusting medication doses in a future cycle. Poor response can be predicted by tests such as antral follicle count, anti‑ müllerian hormone (AMH) levels and day‑3 FSH. Age and previous response also influence risk. Learn more about how we manage ovarian stimulation on our page Stimulation of the Ovaries.

2. Empty Follicle Syndrome and Premature Rupture

Very rarely, follicles appear to develop normally on ultrasound but no oocytes are retrieved during egg collection. This condition, called empty follicle syndrome, occurs in less than 1% of cycles. In other cases, follicles may rupture prematurely before retrieval, which happens in about 3–5% of patients depending on the stimulation protocol. Both scenarios result in no eggs being collected and require cancelling the cycle. Your doctor will review the timing of the trigger injection and may modify the protocol to prevent recurrence. For information about the egg collection procedure, see Egg Retrieval.

3. Failed Fertilisation

Even when eggs are successfully retrieved, fertilisation may not occur. This is rare in the era of intracytoplasmic sperm injection (ICSI), but about 2–5% of cycles may see no fertilisation due to poor egg or sperm quality. If no embryos are formed, the transfer cannot proceed and the cycle is cancelled. Reviewing the stimulation protocol and performing additional sperm tests can help refine the approach for the next cycle. You can learn about fertilisation techniques on our page Fertilisation: IVF and ICSI.

4. Embryo Arrest (Lack of Cleavage)

Sometimes fertilised eggs fail to divide or develop after fertilisation. Embryologists check embryos at fertilisation and again at the blastocyst stage (days 5–7). If embryos do not cleave or arrest before reaching transfer stage, the cycle is cancelled. This situation is linked to chromosomal or metabolic abnormalities within the eggs and cannot always be predicted. Our laboratory team may suggest adjustments to the culture environment or recommend preimplantation genetic testing in a future attempt. Find out more about embryo transfer on our Embryo Transfer page.

5. Absence of Sperm in Azoospermic Partners

In some cases, a male partner with azoospermia may not yield spermatozoa even after surgical retrieval attempts (TESA, TESE or micro‑TESE). If no sperm cells are obtained on the day of egg retrieval, the cycle must be cancelled. Your doctor will discuss alternative options, such as donor sperm or further surgical interventions, and you can read more about procedures for azoospermic patients on our page Sperm Retrieval in Azoospermic Subjects.

6. Hyperstimulation Risk (Excessive Response)

An over‑response to stimulation drugs can lead to ovarian hyperstimulation syndrome (OHSS), a potentially serious condition. If too many follicles develop and estrogen levels become very high, your provider may cancel the cycle to protect your health. Adjusting medication doses or using a GnRH agonist (Lupron) trigger in future cycles reduces the risk. Learn about the signs and prevention of OHSS on our page

7. Inadequate Estradiol Rise or Hormonal Imbalance

During stimulation, estradiol levels should rise steadily as follicles develop. An unexpected drop may indicate that follicle growth has stalled or that the cohort is not viable. In this situation, your physician may decide to cancel the cycle and start again. Similarly, uncorrected thyroid or prolactin imbalances can impair response and may lead to postponing the cycle until the hormones are controlled.

8. Pre‑Treatment Findings (Ovarian Cysts, Endometrial Issues)

Ultrasound scans and blood tests performed before or during stimulation may reveal ovarian cysts, polyps or other uterine abnormalities. These conditions can interfere with follicle development or embryo implantation. In such cases, your cycle may be delayed or cancelled while the cyst or uterine issue is treated. Once the issue is resolved, IVF can resume.

9. No Healthy Embryos after Genetic Testing

For couples using preimplantation genetic testing (PGT) to screen for chromosomal or single‑gene disorders, it is possible that none of the biopsied embryos are genetically normal. When this occurs, embryo transfer is cancelled. Your doctor may suggest using donor eggs or sperm, or continuing with another cycle to obtain more embryos for testing. Read about our genetic testing services on the Preimplantation Genetic Diagnosis page.

Coping with Cancellation and Planning Ahead

Although cycle cancellation can feel discouraging, it often leads to valuable insights. After a cancelled cycle, your fertility team will review your response, laboratory findings and test results to tailor a better approach. Changes may include different medications, altered timing of the trigger injection, or additional pre‑IVF tests. It’s also a good time to discuss lifestyle factors such as nutrition, stress management and weight, which can influence fertility. For an overview of pre‑IVF evaluations, visit our Pre‑IVF Testing page.

Staying resilient and informed improves your chances of eventual success. Keep communication open with your doctor, ask questions, and remember that many couples who experience a cancelled cycle go on to achieve a successful pregnancy.

Conclusion

IVF cycle cancellation is an infrequent but important part of fertility treatment. Whether due to poor ovarian response, empty follicles, fertilisation problems, embryo arrest, lack of sperm, hyperstimulation, hormonal imbalances or genetic testing results, cancellations are implemented to safeguard your health and optimise future outcomes. At Dr Aksoy IVF, our experienced team is dedicated to providing individualised care and guiding you through every step of the process. Contact us for support and expert advice on how to move forward after a cancelled cycle.