Lucy Solie-Vilker
May 6, 2026
Last updated September 2026
A failed IVF cycle can leave you with more questions than answers, and after the second or third one, the question of what to do next gets heavier, especially if you are in your late 30s or early 40s and have been using your own eggs. This guide covers what usually happens after IVF fails, what national data show for women 38 to 42, how donor eggs fit into the decision, and how to take care of yourself through the grief that comes with it.
It draws on a conversation between donor egg advocate and author Victoria Niño and reproductive endocrinologist Dr. Aimee Eyvazzadeh on The Egg Whisperer Show. Victoria went through five or six IVF cycles with her own eggs and a stage three endometriosis diagnosis before becoming a mother twice through donor eggs, so she talks about this as someone who has lived it.
What happens after IVF fails?
After a failed IVF cycle, most clinics schedule a follow-up consultation to review how you responded to the medications, how many eggs were retrieved and fertilized, how the embryos developed, and what any genetic testing showed. From there, the usual paths are another cycle with your own eggs (sometimes with a changed protocol), moving to donor eggs or donor embryos, or taking a break before you decide.
For women 38 to 42 who have had two or more failed cycles with their own eggs, the age of the eggs is usually the biggest factor in which of those paths makes sense.
What your doctor looks at in a failed IVF review
A review appointment is where your doctor tries to separate the parts of a cycle that can be changed from the parts that cannot. They typically look at your hormone levels and ovarian response during stimulation, the number of mature eggs, fertilization and blastocyst development, PGT-A results if your embryos were tested, and the transfer itself, including your uterine lining. When embryos considered viable have been transferred repeatedly without a positive pregnancy test, the European Society of Human Reproduction and Embryology calls this recurrent implantation failure and recommends looking for a cause.5 When the pattern points to few eggs, few embryos reaching blastocyst, or few chromosomally normal embryos, egg quality becomes the more likely explanation.
Questions worth bringing to that appointment:
- How did my response compare with what you expected for my age and ovarian reserve?
- How many of my embryos reached blastocyst, and how many tested as chromosomally normal?
- Is there anything about my uterus or lining you would investigate before another transfer?
- What would you change in another cycle with my own eggs, and what are my odds with that change?
- At what point would you recommend donor eggs for someone with my history?
Why egg age matters most after 38
As women get older, a larger share of their eggs carry the wrong number of chromosomes, and embryos made from those eggs are less likely to implant and more likely to end in miscarriage. The American Society for Reproductive Medicine (ASRM) puts it plainly: “egg quality associated with age is the primary barrier to pregnancy in older women.”2 In a study of more than 15,000 embryo biopsies, the chance of having no chromosomally normal embryo at all was 2% to 6% for women aged 26 to 37, compared with 33% at age 42.3
National data from the Society for Assisted Reproductive Technology (SART) show how that plays out in live birth rates. The figures below come from SART's final report for 2023, the most recent year with complete outcomes.1
| Egg source and age | Live birth rate | What SART measures |
|---|---|---|
| Own eggs, under 35 | 53.2% | Per intended egg retrieval, all embryo transfers |
| Own eggs, 35 to 37 | 39.9% | Per intended egg retrieval, all embryo transfers |
| Own eggs, 38 to 40 | 26.2% | Per intended egg retrieval, all embryo transfers |
| Own eggs, 41 to 42 | 13.2% | Per intended egg retrieval, all embryo transfers |
| Own eggs, over 42 | 4.1% | Per intended egg retrieval, all embryo transfers |
| Fresh donor eggs, all recipient ages | 38.5% | Per recipient cycle start |
| Frozen donor eggs, all recipient ages | 37.9% | Per recipient cycle start |
IVF live birth rates by age and egg source, United States, 2023. Source: SART Final National Summary Report for 2023.1 Own-egg and donor egg rates are counted differently, so read them as a general picture instead of a direct comparison.
Two failed IVF cycles: what now?
After two failed IVF cycles, you generally have four options: try another cycle with your own eggs, change the approach with genetic testing or a new protocol, move to donor eggs or donor embryos, or pause treatment while you decide. None of these is a wrong choice, and plenty of people move between them over time. The table below lays them out side by side so you can see where each one tends to fit.
| Option | What it involves | Often considered when | What to weigh |
|---|---|---|---|
| Another cycle with your own eggs | A new round of stimulation and retrieval, often with a changed medication protocol | Earlier cycles produced chromosomally normal embryos, or your doctor sees a specific issue to address | Per-cycle odds fall with age, and each cycle adds cost, time and physical strain |
| Own eggs with PGT-A testing | Embryos are biopsied and tested for chromosomal errors before transfer | You want to avoid transferring embryos that are unlikely to implant | Testing helps choose which embryo to transfer, but it cannot increase the number of normal embryos you make |
| Fresh donor eggs | A screened donor is matched to you and completes a retrieval for your family | You want a larger number of eggs from one cycle, or you are planning for siblings | A longer timeline for matching and screening, and cost that varies with donor compensation |
| Frozen donor eggs | You choose a donor whose eggs have already been retrieved and banked | You want a shorter timeline and a set price for a defined number of eggs | Fewer eggs per purchase, so it helps to plan how many you need |
| Donor embryos | Embryos created with donated eggs and sperm, or donated by another family, are transferred to you | You are open to no genetic link to either parent, or cost is a major factor | Fewer donor choices, and no genetic connection to either parent |
| A break from treatment | Time to recover physically, emotionally and financially before deciding | You feel depleted or need time to grieve | Time affects own-egg options much more than donor egg options |
Common options after two failed IVF cycles with your own eggs. Donor egg outcomes are not considered to depend on the recipient's age.9
Donor Nexus works with intended parents on three of these paths, through fresh donor matching, our frozen egg bank, and donor embryos, and our team can talk through how each one fits your history and budget.
How many IVF cycles should you try before donor eggs?
There is no fixed number of IVF cycles to try before donor eggs, and the right point depends on your age, how you responded in earlier cycles, your embryo results, and your finances. What the data do show is that repeating cycles adds less as age rises. In a UK study of nearly 157,000 women, those aged 40 to 42 had a 12.3% chance of a live birth in their first cycle and an estimated 31.5% cumulative chance after six cycles, while women under 40 reached an estimated 68.4% over the same six cycles.4
ASRM lists women who have had multiple failed IVF cycles and women over 38 among the patients for whom donor eggs are commonly used.10 Victoria answers this question from her own experience in How many failed IVF cycles is too many?, including the moment a doctor first raised donor eggs with her.
The grief of failed IVF cycles, and why it deserves to be named
A failed IVF cycle is a real loss, even when there was never a pregnancy. What ends is the hope you carried through weeks of injections, blood draws and waiting, along with the picture of the child you had started to imagine. On The Egg Whisperer Show, Victoria describes that loss in words many intended parents recognize right away.
Research reflects how heavy this is. In a Dutch study that followed women through consecutive treatment cycles, women showed no emotional recovery in the six months after unsuccessful treatment, and more than 20% showed signs of anxiety or depression at follow-up.6 A review of more than 21,000 patients found that the psychological and physical burden of treatment was one of the most common reasons people stopped,7 and a later review found that people whose treatment did not lead to parenthood had lower mental health and well-being than comparison groups.8 Feeling flattened after a failed cycle is a normal response to a real loss, and it often gets harder when cycles run back to back with little time to process each one.
When exhaustion turns into openness to donor eggs
For most women, the shift toward donor eggs happens gradually. It often starts as a thought you push away, comes back after another negative result, and eventually becomes a question you are willing to look into. Victoria reached the point where continuing with her own eggs no longer made sense on any level.
She is also clear that looking into donor eggs does not lock you into anything. Reading donor profiles, asking a clinic about costs, or talking with a woman who has used donor eggs gives you information to sit with, and you can still pause or change your mind afterward. As she writes, “You’re allowed to pause without deciding anything forever.”
Overcoming shame and the fear of judgment
Many women who consider donor eggs carry a quiet fear of how other people will react, whether that is a parent who may not understand, a friend with intrusive questions, or a culture that kept donor conception secret for a long time. Victoria talks about moving through that fear without waiting for it to disappear first, and about the community of donor egg families she found on the other side, whose children are growing up knowing their stories.
If you are not ready to talk with family yet, a peer group can be an easier first step. Our guide to donor egg support groups lists places to start, and Victoria shares what helped her in 7 ways I learned to cope with infertility grief and in her post on letting go of the genetic child she imagined.
Donor eggs after failed IVF: what to know
Donor egg IVF uses eggs from a young, screened donor, and because egg age drives most of the decline in IVF success, donor egg outcomes depend largely on the donor's age instead of yours. ASRM notes that the success of egg donation “is not considered to be related to the recipient's age.”9 You still carry the pregnancy and give birth, and your body plays an active part in your baby's development from implantation onward.
Since 2012, Donor Nexus has completed more than 1,000 donor retrievals, and more than 2,000 babies have been born through our programs. There are two ways to use donor eggs with us, and each suits a different set of priorities. The outcomes below are Donor Nexus program data from 2012 to 2025, shown separately for each program because they measure different things.12
| Fresh donor matching | Frozen egg bank | |
|---|---|---|
| How it works | A donor is matched to you alone and completes a retrieval for your family, working with your chosen clinic | You choose a donor whose eggs were already retrieved and frozen, and they are shipped to your clinic |
| Eggs | All eggs from the cycle, an average of 28.9 retrieved and 22.6 mature | A cohort of 6 frozen donor eggs |
| Donor Nexus outcomes | An average of 18.2 eggs fertilized and 7.2 euploid embryos where PGT-A was performed | 90.7% of eggs survived thawing, 83.1% fertilized, and 81.1% of recipients obtained at least one blastocyst |
| Timeline | Several months, depending on matching and donor screening | Usually shorter, since the eggs are already banked; shipping takes up to 4 weeks |
| Cost | Varies with the donor's compensation, which each donor sets | $19,500 to $29,500 per cohort, depending on the donor's compensation, experience and eggs available |
| Often chosen for | Planning for more than one child from the same donor | A shorter timeline and a more predictable cost |
Donor Nexus fresh and frozen donor egg programs compared. Outcomes are program data from 2012 to 2025 and do not predict results for any individual cycle.12
Victoria became a mother through a different route each time. By her second child, when she was 42, she chose frozen donor eggs.
For a closer look at how the two compare on success rates, cost and logistics, see fresh vs. frozen donor eggs: understanding your options, what donor egg success rates actually mean, and our success rates page.
How many donor eggs do you need?
The number of donor eggs you need depends mostly on how many children you hope to have. With a donor under 35, it typically takes about 4 to 5 mature eggs to reach one chromosomally normal embryo, which is why a single frozen cohort of 6 eggs is usually planned around one child, while families hoping for siblings often look at two cohorts or a fresh cycle. Our guide to how many donor eggs you actually need breaks this down by family-size goal and walks through the research behind it.
Choosing an Open ID donor
One thing Victoria says she would do differently is choose an open donor relationship from the start. With an Open ID donor, your child has the option to contact the donor when they are old enough to choose, which is different from having an ongoing relationship with the donor during pregnancy or childhood. How you feel about openness can change as your child grows and starts asking questions, so it is worth thinking about before you choose a donor. Donor Nexus offers both non-ID and Open ID donors, and our guide to nonidentified, identified and Open ID egg donation explains the differences.
Does a baby born from donor eggs feel like your own?
Wondering whether a donor egg baby will feel like yours is one of the most common fears women bring to this decision, and Victoria and Dr. Aimee spend real time on it in the episode. Part of the answer comes from pregnancy itself. Researchers have found that the lining of the uterus releases molecules that the early embryo takes up, and those molecules may influence how the embryo's genes are expressed.11 This area of science, called epigenetics, is still developing, but it points to a biological connection between a birth mother and the baby she carries that goes beyond DNA. We explain the research in more detail in epigenetics and donor eggs.
Victoria is honest that bonding did not require her to have finished grieving first. She says she was “probably halfway there” when she became pregnant, and that “the moment my daughter's eyes met my eyes, I was fully there.” In the video below, she talks about what bonding with her donor egg baby looked like in practice.
Victoria Niño on bonding with a baby born from donor eggs.
Victoria's one regret, and what she would tell you now
Asked what she would do differently, Victoria says she wishes she had moved to donor eggs sooner. She does not question the path that led her to her children, but the years of repeated cycles, the shame she felt about considering donor eggs, and the fear of choosing wrong were harder than they needed to be.
She is not suggesting the grief can be skipped. Her advice to anyone in the “what now” moment is to start gathering information, because looking at donor profiles or booking a consultation keeps every option open while you work out what you want. She talks about this in more depth in the video below and in her post Should I use donor eggs? Will I have any regrets?
Victoria Niño on her only regret about using donor eggs.
Listen to the full Egg Whisperer Show episode
Victoria's conversation with Dr. Aimee Eyvazzadeh goes further into the grief of failed cycles, fresh and frozen donor eggs, open donor relationships, epigenetics, and the “am I the real mom?” question than we can here. If you are in that place right now, or someone you love is, it is worth making time for.
The Egg Whisperer Show with Dr. Aimee Eyvazzadeh and guest Victoria Niño.
Read the episode notes and full transcript on Dr. Aimee's website, or listen on Spotify or Apple Podcasts.
About Victoria Niño
Victoria Niño is a donor conception advocate, author, and mother of two through donor eggs. She founded Infertility Unfiltered, a community built on honest, inclusive conversation about every path to parenthood, and wrote Our Hearts Match, a children's book about donor conception. You can follow her on Instagram at @expectinganything.
Frequently asked questions about IVF failure
What are the chances of IVF working at 40 after two failed cycles?
Your chances with your own eggs at 40 depend heavily on what your earlier cycles showed. Nationally, women aged 38 to 40 had a 26.2% live birth rate per intended egg retrieval in 2023, and women aged 41 to 42 had 13.2%.1 Previous unsuccessful cycles, especially ones with few eggs or no chromosomally normal embryos, can mean lower odds than those averages, so ask your doctor for an estimate based on your own results.
Why did my IVF fail with good embryos?
Embryos that look good under a microscope can still carry chromosomal errors, and those errors become more common with age.3 Other possible factors include the uterine lining, the timing of the transfer, and conditions such as endometriosis, although often no single cause is found. If embryos considered viable have repeatedly failed to implant, your doctor may recommend testing for recurrent implantation failure.5
How many IVF cycles should I do before using donor eggs?
There is no set number of IVF cycles before donor eggs. In a large UK study, women aged 40 to 42 had an estimated 31.5% cumulative chance of a live birth over six cycles with their own eggs,4 and ASRM lists multiple failed IVF cycles and age over 38 among the common reasons for using donor eggs.10 Your age, embryo results, finances and emotional reserves all shape when that point comes for you.
Do donor egg success rates depend on my age?
Donor egg success rates depend mainly on the donor's eggs, and ASRM does not consider them related to the recipient's age.9 In 2023, U.S. live birth rates per recipient cycle start were 38.5% with fresh donor eggs and 37.9% with frozen donor eggs.1 Your overall health and your uterus still matter, which is why your clinic evaluates you before a transfer.
Is it normal to grieve after a failed IVF cycle?
Yes, grief, anger, numbness and anxiety are all common after a failed IVF cycle, and research shows these feelings can last for months, particularly after more than one unsuccessful attempt.6 A counselor who specializes in fertility, a peer support group, or time off between cycles can help. If low mood or anxiety is affecting your daily life, talk with your doctor or a mental health professional.
How do I know if I'm ready to consider donor eggs?
You do not need to feel completely ready before you start learning about donor eggs. Reading donor profiles, talking with a donor egg agency, or hearing from women like Victoria can help you figure out where you stand, and none of those steps commits you to a decision. Victoria says she was about halfway through grieving her genetics when she became pregnant, and the rest came when she met her daughter.
Sources
- Society for Assisted Reproductive Technology. Final National Summary Report for 2023.
- American Society for Reproductive Medicine. Age and Fertility: A Guide for Patients. ReproductiveFacts.org.
- Franasiak JM, Forman EJ, Hong KH, et al. The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening. Fertility and Sterility. 2014;101(3):656-663.
- Smith ADAC, Tilling K, Nelson SM, Lawlor DA. Live-birth rate associated with repeat in vitro fertilization treatment cycles. JAMA. 2015;314(24):2654-2662.
- ESHRE Working Group on Recurrent Implantation Failure, Cimadomo D, de los Santos MJ, et al. ESHRE good practice recommendations on recurrent implantation failure. Human Reproduction Open. 2023;2023(3):hoad023.
- Verhaak CM, Smeenk JMJ, van Minnen A, Kremer JAM, Kraaimaat FW. A longitudinal, prospective study on emotional adjustment before, during and after consecutive fertility treatment cycles. Human Reproduction. 2005;20(8):2253-2260.
- Gameiro S, Boivin J, Peronace L, Verhaak CM. Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Human Reproduction Update. 2012;18(6):652-669.
- Gameiro S, Finnigan A. Long-term adjustment to unmet parenthood goals following ART: a systematic review and meta-analysis. Human Reproduction Update. 2017;23(3):322-337.
- American Society for Reproductive Medicine. Egg Donation. ReproductiveFacts.org fact sheet, revised 2023.
- American Society for Reproductive Medicine. Third-Party Reproduction: A Guide for Patients. ReproductiveFacts.org, revised 2018.
- Vilella F, Moreno-Moya JM, Balaguer N, et al. Hsa-miR-30d, secreted by the human endometrium, is taken up by the pre-implantation embryo and might modify its transcriptome. Development. 2015;142(18):3210-3221.
- Donor Nexus. Success rates and outcomes, program data 2012 to 2025.
- Eyvazzadeh A. When IVF fails: the “what now?” moment and finding hope through donor eggs, with guest Victoria Nino. The Egg Whisperer Show.
Keep reading
Medical disclaimer
This article shares general information about IVF failure, donor eggs and coping with grief, and it is not medical advice. Your fertility doctor knows your history, test results and treatment plan, so their guidance comes before anything you read here. Victoria Niño's quotes reflect her personal experience, and success rates from national data or Donor Nexus programs do not predict the outcome of any individual cycle.
If grief, depression or anxiety is affecting your daily life, reach out to your doctor or a mental health professional. In the U.S., you can call or text 988 at any time to reach the 988 Suicide and Crisis Lifeline.
Last updated September 2026. The research cited here is drawn from the sources listed above.
Lucy Solie-Vilker
Lucy Solie-Vilker is the CEO of Donor Nexus, where she's helped build one of the most established platforms in egg and embryo donation. Since 2012, her work has contributed to more than 2,000 babies born to Don…
Ready for the next step?
If you are ready to get started or just need more info, contact us today.