Updated by the Progyny Clinical Team — June 2025.
While most in vitro fertilization (IVF) cycles proceed as planned, some cycles may need to be postponed or interrupted. It is important to be aware of these potential problems before undergoing treatment.
Ovarian cysts
During pretreatment screening, an ultrasound will check for ovarian cysts. If one or more cysts are present, your IVF cycle may be delayed. Cysts may interfere with the proper development of your egg cohort, and it may be best to wait for resolution of the cyst before continuing treatment.
In general, most cysts will clear up on their own in one or two months. If the cyst does not spontaneously resolve, medication may be provided. In rare cases, if the cyst doesn’t go away with time or medicine, a minor procedure may be needed to drain it.
Poor response to stimulation drugs
Some people respond poorly to the fertility medications used to stimulate the ovaries and will not produce enough eggs. Usually, if a patient grows fewer than three follicles, the chances of achieving pregnancy are very low. This low yield will often result in a canceled IVF cycle, and a different medication regimen may be considered for any future cycles.
If your diagnosis permits, insemination may provide an equally effective option in that cycle. Please consult with your fertility team to see if this is an option.
Drop in estradiol level
Estradiol is a type of estrogen that is produced in your ovaries. As egg follicles develop, levels of estradiol increase continuously through the stimulation cycle.
If there is an unexpected drop in this hormone level, there may be a problem with follicle development, and the cycle may be cancelled. Your fertility provider may consider another protocol or simply wait for another month to start again.
Few or no eggs retrieved
Normally, an ultrasound examination will detect the number of mature eggs prior to retrieval, but in some cases, fewer eggs than expected are collected. In rare cases, no egg cells are obtained, and the cycle will need to be cancelled. In these situations, your provider will:
- Evaluate your cycle.
- Review the stimulation and trigger medications.
- Attempt to remedy this outcome for the next cycle.
Poor fertilization
Poor egg or sperm quality may hinder the fertilization process and yield a low number of embryos. It’s uncommon for there to be no fertilization at all, but in these cases the cycle will have to be cancelled. Your provider may consider the types of medications used for stimulation and perhaps the duration of the stimulation as well.
Male health parameters will be reevaluated, and the embryologists’ opinions will be sought. A team recommendation is formulated, and another attempt is undertaken once a thorough review of the cycle is complete.
Embryo arrest
Embryos may stop development in the laboratory. Embryos are typically checked at fertilization and at the blastocyst stage (days 5 to 7). During these scheduled checks, the embryologist may unfortunately determine that embryo development has ceased. Your provider will collaborate with the embryology team and formulate a revised treatment plan.
Hyperstimulation
Just as your ovaries can underreact to fertility drugs, they can overreact as well. An excessive response to fertility medications may result in the development of too many follicles. This increases the risk of ovarian hyperstimulation syndrome, and the cycle may be cancelled. Subsequent cycles will be tried with an adjusted medication protocol.
Unsuccessful embryo screening
In some cases, the embryo may be screened for chromosome analysis or specific genetic disorders. In some cases, all tested embryos may be abnormal and not suitable for transfer. Please speak to your provider regarding the specific risks of your case and the likelihood of a successful screened cycle.
Although canceling a cycle can be very disappointing, it is often a necessary course of action. Abandoning a cycle may help you avoid more serious complications and ensure the best chance of success in the future. A thorough evaluation of your case by your provider and embryology team will improve the odds of future success.
If you have questions or concerns, Progyny is here for you. Please contact your Progyny Care Advocate for support.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.