10 Questions to Ask Your Doctor After Failed Embryo Transfers

After repeated failed transfers, the consult should produce a plan, not just sympathy. These ten questions steer the conversation from “it didn’t work” to a structured review you can act on. Bring your transfer log and PGT-A results, and write the answers down. The aim is to find the next useful, evidence-based step — not to assign blame. General education, not individual medical advice.

The 10 questions

1. “Was my uterine cavity evaluated (SHG or hysteroscopy), and were polyps, fibroids, or a septum found?”
   Why: structural lesions are a leading, treatable cause.

2. “What was my endometrial lining thickness and pattern at each transfer?”
   Why: thin or non-receptive lining is a modifiable factor.

3. “Were the transferred embryos chromosomally screened (PGT-A)? If not, should they be?”
   Why: separates embryo aneuploidy from receptivity.

4. “Has sperm DNA fragmentation been tested? If not, why not?”
   Why: an often-missed, low-cost, treatable factor (read more).

5. “Was chronic endometritis or a hydrosalpinx ruled out?”
   Why: both are treatable and easy to miss.

6. “Given my age and embryo results, how much is aneuploidy vs uterine receptivity?”
   Why: keeps the conversation honest instead of guessing.

7. “Which tests are evidence-based for my case — and which are speculative?”
   Why: guards against over-testing (see the divide).

8. “Would donor eggs/embryos or a gestational carrier change the picture?”
   Why: an honest option when uterine or ovarian factors dominate.

9. “What exactly changes for the next transfer, and why?”
   Why: leaves with a concrete plan, not a shrug (use the checklist).

10. “Is a second opinion or specialist review of my records worthwhile?”
    Why: a fresh read of the same data can reveal a missed option.

How to use these questions

• Print them and tick answers during the visit.
• Lead with Q1 and Q3 — they define the problem space.
• If the clinic can’t justify offered tests, that itself is information.
• Keep the tone collaborative; you’re building a review, not a confrontation.

What good answers will and won’t give you

• Will give: a clear problem domain and a justified next step.
• Won’t give: a guarantee. RIF remains probabilistic; the aim is to shift the odds with better information.

Related reading

• The framework: What Is Recurrent Implantation Failure?
• Read your records: How to Read Your IVF Transfer and Implantation Record
• Plan the next transfer: What to Review Before Your Next Transfer
• Treatment decision: Should You Change Your Transfer Protocol After RIF?

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Your next step

Walk in prepared: the IVF Case Clarity Assessment builds a one-page summary and these questions around your numbers.

Medical disclaimer

General education only; not individual medical advice. Your specialist remains the decision-maker for testing and treatment.

References

1. Coughlan C, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online. 2014;28(1):14–38.
2. Practice Committee of ASRM. Role of immunotherapy in in vitro fertilization: a committee opinion. Fertil Steril. 2018 (updated).
3. Practice Committee of ASRM. Preimplantation genetic testing: a committee opinion. Fertil Steril. 2024.
4. ESHRE Guideline Group on RPL. ESHRE guideline: recurrent pregnancy loss. Hum Reprod Open. 2024.