Introduction: Success on the First Try Is Good Fortune; Scientific Adjustment Is Strategy

In my consultation room at Olympia Reproductive Medical Center, Cambodia, I often hear patients ask:

“Doctor, can I succeed with just one IVF cycle?”
“If the first attempt fails, does that mean there is no hope?”
“Why did someone else get pregnant on the first try, while I couldn’t?”

Behind these questions lie hope and anxiety.

As a doctor, I want to tell you very frankly: Although IVF technology is mature, there is no “100%” in medicine. Success on the first try is fortunate, but needing more than one cycle is by no means a failure – it is a valuable collection of “medical information” that allows us to understand more clearly where the problem lies and how to adjust next time.

Today, I would like to explain clearly, in one article, why some people need more than one IVF cycle.

1. Why Can’t IVF Guarantee Success on the First Try? – Five Key Variables

IVF is a complex process involving multiple stages and multiple factors working together. A deviation in any one link may affect the final outcome. The main influencing factors include:

1. Egg Quality
Egg quality is the foundation determining embryo quality. The older the woman, the higher the rate of chromosomal aneuploidy in eggs, and the lower the proportion of high-quality eggs. Even if a certain number of eggs are retrieved after ovarian stimulation, not all of them will necessarily form healthy embryos.

2. Sperm Quality
Sperm count, motility, morphology, and sperm DNA fragmentation rate all affect fertilisation and embryo development. Severe oligoasthenozoospermia, teratozoospermia, or an excessively high DNA fragmentation rate may lead to fertilisation failure or embryonic developmental arrest.

3. Embryo Development
After successful fertilisation, the embryo needs to continue developing in the laboratory. Not all fertilised eggs can develop into transferable high-quality embryos. Some may arrest at the cleavage stage, and some may fail to form blastocysts. Even if a blastocyst forms, it may still have chromosomal abnormalities.

4. Embryo Implantation
After the embryo is transferred into the uterus, whether it can successfully implant depends on embryo quality, endometrial receptivity, transfer timing, uterine environment, and immune factors. Sometimes the embryo is good, but if the endometrial conditions are not ideal, implantation may still fail.

5. Age
Age is one of the most core factors affecting IVF outcomes. It affects not only egg quantity and quality but also the rate of normal embryonic chromosomes and the uterine environment. Older patients often require more cycles to select transferable healthy embryos.

In addition, the ovulation induction protocol, drug response, laboratory conditions, psychological state, and other factors may also influence the outcome.

2. What Will the Doctor Do After the First Unsuccessful Attempt? – Review and Adjustment

If the first treatment is unsuccessful, it does not mean it was “done in vain.” On the contrary, that cycle provided a great deal of valuable information. At Olympia Reproductive Medical Center, Cambodia, doctors organise a case review and evaluate from the following aspects:

1. Analyse Cycle Data

• Number of eggs retrieved, proportion of mature eggs;

• Fertilisation rate, cleavage rate, blastocyst formation rate;

• Embryo grading, whether there are transferable embryos;

• Endometrial thickness, morphology, difficulty of transfer;

• Hormone level changes and drug response.

2. Look for Possible Causes

• Is it a fertilisation problem? An embryo problem? Or an implantation problem?

• Is it an egg factor? A sperm factor? Or a uterine/immune factor?

• Is it a protocol problem? Or a timing problem?

3. Adjust the Next Plan
Based on the review results, the doctor may adjust:

• Types and dosages of ovulation induction medications;

• Fertilisation method (conventional IVF or ICSI);

• Whether to perform PGT embryonic genetic screening;

• Transfer strategy (fresh embryo transfer or frozen embryo transfer, single or double embryo transfer);

• Endometrial preparation protocol;

• Whether hysteroscopy, immune, or coagulation-related examinations are needed.

4. Further Examinations When Necessary
If there is repeated implantation failure or recurrent miscarriage, the doctor may recommend hysteroscopy, endometrial receptivity testing, immunological testing, chromosomal karyotyping, and other examinations to find deeper causes.

3. How Does Third‑Generation IVF PGT Help Reduce Ineffective Attempts?

For patients with advanced age, recurrent miscarriage, repeated implantation failure, or chromosomal abnormalities, third‑generation IVF technology (PGT) is of great significance.

PGT can perform genetic screening on embryos before transfer, selecting embryos with normal chromosomes and no disease-causing mutations for transfer. Our centre is equipped with internationally leading genetic testing platforms capable of comprehensive and precise screening of all 23 pairs of chromosomes.

The value of PGT lies in:

• Avoiding the transfer of embryos with chromosomal abnormalities, reducing implantation failure and miscarriage;

• Improving the success rate of a single transfer;

• Reducing the time and physical toll caused by blind transfers;

• Providing a clearer basis for embryo selection in the next treatment.

In other words, PGT helps doctors pick out the “embryos that may succeed,” making each transfer more confident.

4. How Does ORC Prepare for the “Next Time”?

At Olympia Reproductive Medical Center (ORC), Cambodia, we always believe: Every treatment, regardless of the outcome, accumulates information for eventual success.

We provide the following support for patients who need multiple cycles:

• International-standard laboratory: Blastocyst culture, embryo biopsy, vitrification, and other technologies provide the best culture environment for embryos.

• Authoritative expert team: Medical Director Dr. Lin Mingde has over 30 years of experience in reproductive medicine research; Chief Consultant Dr. Chartree is a Professor at Chulalongkorn University, Thailand, and a leading authority on third-generation IVF in Thailand.

• Personalised plan adjustment: Based on the results of the previous cycle, a new strategy for ovulation induction, fertilisation, screening, and transfer is developed for each patient.

• Legal and compliant policy support: Cambodia supports donor sperm, donor eggs, HIV sperm washing, sex selection, and other assisted reproductive services, providing more options for families with different needs.

• Psychological and privacy support: Membership and appointment-based system, offering one-on-one private consultation rooms and multilingual services (Chinese, English, Khmer) to help you relieve stress and receive treatment with peace of mind.

5. What Can Patients Do? – Improving the Chances of Success Next Time

As a patient, you can also proactively prepare for the next treatment:

1. Actively cooperate with examinations: Do not only examine the woman; semen analysis for the man is equally important.

2. Improve lifestyle: Quit smoking and drinking, control weight, maintain a regular schedule, and ensure balanced nutrition.

3. Follow medical advice on medication: Take medication on time, attend follow-up appointments on time, and do not adjust on your own.

4. Manage stress: Excessive anxiety can affect endocrine function and the uterine environment. Try relaxation training or psychological counselling.

5. Communicate fully with your doctor: Tell your doctor promptly about your questions, concerns, and physical sensations.

6. Do not compare blindly: Everyone’s physical condition is different; someone else’s protocol may not suit you.

Please remember: The cumulative success rate of IVF is often higher than the success rate of a single transfer. Through scientific evaluation and plan adjustment, many families eventually achieve pregnancy in the second or third cycle.

Conclusion: Every Attempt Brings You Closer to Success

Why do some people need more than one IVF cycle?

Because IVF outcomes are influenced by multiple factors, including egg quality, sperm quality, embryo development, embryo implantation, and age. If the first attempt is unsuccessful, the doctor can evaluate the results and adjust the subsequent treatment plan according to the specific situation, preparing for the next attempt.

This is not a failure, but a medical “calibration.”

At Olympia Reproductive Medical Center, Cambodia, we are willing to accompany you every step of the way with professional technology, a rigorous attitude, and warm support. Whether you are on your first attempt or preparing for the next one, we are with you.

Technology assists pregnancy, love continues. Your journey to parenthood begins here.

Olympia Reproductive Medical Center (ORC), Cambodia

• Address: Building C5, Olympia City, No. 161, Sangkat Chey, Phnom Penh, Cambodia

• Hotline: +855 715158899, +86 15005080508

• Service Languages: Chinese, English, Khmer, and other multilingual services