Woman looking at pregnancy test and wondering about failed implantation of fertilized egg

3 symptoms of failed implantation of fertilized egg

Medically reviewed on August 1, 2022 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


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In vitro fertilization (IVF) can offer hope for couples who wish to have children but are unable to get pregnant without help. IVF involves combining an egg with sperm in a laboratory environment before returning the fertilized egg or eggs to your uterus [1].

When IVF is successful, the fertilized egg implants in the uterus and becomes a viable pregnancy. However, there aren’t any guarantees with IVF. For a variety of reasons, fertilized eggs may fail to implant.

This guide will walk you through what to look for if you’re concerned that your IVF wasn’t successful. It will also provide some tips for increasing your chances of successful implantation. It’s important to remember that IVF is not always successful on the first or even the second attempt so don’t feel hopeless if your first try doesn’t work.

What is the unsuccessful implantation of a fertilized egg?

IVF treatment involves returning fertilized eggs to your uterus. The goal is that one of the eggs will implant in the uterine wall and become a viable pregnancy. Unsuccessful implantation happens when the egg doesn’t attach and, instead, exits the body.

It isn’t immediately apparent if implantation has been successful or not. Typically, implantation can take several days. Your healthcare provider or fertility doctor may provide you with progesterone to increase the likelihood that the fertilized egg will implant successfully [1].

What causes unsuccessful implantation?

However, even when all precautions are taken, sometimes embryo implantation isn’t successful. Healthcare providers or fertility specialists don’t fully understand all of the causes of failed implantation but some reasons can include [2]:

  • Embryo quality – While precautions are taken to use healthy eggs and sperm during the IVF process, sometimes the quality of the embryo isn’t good enough for successful implantation. Some defects might not be apparent in the lab but can still prevent the embryo from becoming viable. This may have to do with the age or quality of the eggs or sperm, although many unknown factors can also contribute to poor embryo quality.
  • Uterine problems – Implantation requires that the uterus be able to successfully allow the embryo to attach. Any malformations in the uterus can result in recurrent implantation failure. Some individuals are born with anatomically different uteruses while other problems can be acquired during one’s lifetime. These include uterine fibroids and other issues that can impact your uterine health.
  • Chromosomal issues – Some embryos may have chromosomal abnormalities that make it difficult or impossible for them to implant in your uterus. Both the sperm and egg are more likely to have chromosomal abnormalities as you age. Therefore, your age may influence your ability to conceive successfully with IVF.
  • Lifestyle factors – While you cannot control biological factors that influence the likelihood of a successful implantation, there are a few other causes that you can control. First, those who smoke have a much higher likelihood of implantation failure or early pregnancy loss than those who do not. Furthermore, maintaining a healthy weight may also help you to become pregnant through IVF. Finally, stress can hurt your chances of successful implantation so healthy stress management practices are also critical.

How common is failed implantation?

Failed embryo implantation is complex and more common than you may think. In a natural pregnancy, it’s believed that somewhere between 40 to 60% of embryos are lost during the period between fertilization and birth [3]. However, all of these aren’t the result of failed implantation.

During IVF, approximately 5% of those who try to get pregnant this way will fail during at least two consecutive attempts [2]. Nearly 75% of these failed attempts are thought to be due to implantation failure. Keep in mind that those who seek out IVF may have existing factors and complications that interfere with the ability of embryos to implant in their uterus. This makes it difficult to pin down the exact likelihood of success and failure of implantation.

How do you know implantation hasn’t been successful?

Successful implantation leaves subtle signs, such as implantation bleeding, stomach cramps, bloating, and breast tenderness [1]. Symptoms of failed implantation of fertilized eggs can be tough to distinguish from those that indicate successful implantation, as at times they are very similar.

Some signs that may indicate that implantation has failed include:

1. Vaginal bleeding and stomach pain

One of the earliest ways many people find out that implantation has failed is by getting their period [4]. When an embryo doesn’t implant, you might experience the normal symptoms associated with menstruation, such as:

  • Cramping
  • Bleeding
  • Headaches
  • Nausea
  • Breast tenderness
  • Mood changes
  • Pain in your lower back

If you experience the symptoms you typically get with your period after undergoing IVF, these signs can indicate that implantation wasn’t successful.

2. Negative pregnancy test result

However, getting your period isn’t a sure way to tell that implantation failed. As we mentioned, some of the same symptoms can be an indication of success. Instead, you will need to take a pregnancy test to confirm that you are or are not pregnant.

Pregnancy tests work by detecting the presence of the hormone hCG [5]. This hormone is produced only once the fertilized embryo has implanted in the uterine lining. If a pregnancy test doesn’t detect hCG and it’s been two weeks since your procedure, it’s likely that it was unsuccessful.

3. Lack of activity during an ultrasound

Sometimes, you may think that implantation has occurred, only to find out during an ultrasound that it has failed. There might be several reasons for this, including [6]:

  • Chemical pregnancy – A chemical pregnancy occurs when the fertilized egg doesn’t implant or fails to develop after implantation. This may cause you to miss your period and can even result in a positive pregnancy test. However, when you go for an ultrasound, your doctor won’t be able to detect the pregnancy.
  • Missed miscarriage – In rare cases, you may have a miscarriage but the tissue doesn’t exit your uterus. This is known as a missed miscarriage. When this occurs, you might not be aware that implantation has failed until you get an ultrasound.
  • Ectopic pregnancy – Finally, one of the potential risks of IVF is an ectopic pregnancy [7]. An ectopic pregnancy occurs when the fertilized egg gets trapped in the fallopian tubes instead of implanting in the uterus. You will still have a positive pregnancy test but the pregnancy isn’t viable and can be life-threatening if not detected and treated by a doctor. The symptoms of an ectopic pregnancy can include stomach pain and vaginal bleeding, making it difficult to differentiate from signs of pregnancy.

What can you do to prevent failed implantation?

Many factors that lead to infertility or failed implantation after IVF are beyond your control. However, you shouldn’t feel hopeless if you’ve had problems conceiving. Priming your body to be at its healthiest can help improve the chances that IVF is successful. Some steps that you can take include [8]:

  • Change your lifestyle behaviors – Smoking and frequent alcohol use will both interfere with your health and your body’s ability to maintain a viable pregnancy. Even if you don’t smoke or drink regularly, your partner’s consumption can be a problem. Smoking and overuse of alcohol can cause damage to healthy sperm, making it less likely that a viable embryo will result from IVF.
  • Maintain a healthy weight – Your weight can also impact your ability to get pregnant during IVF. Either being overweight or underweight can cause problems with implantation. Maintaining a healthy weight through proper diet and exercise may help improve the chances that your body is ready for a healthy pregnancy.
  • Screen for underlying health conditions – Sometimes underlying health conditions can prevent an embryo from implanting. These can include uterine problems, hormonal issues, thyroid problems, diabetes, and many others. Even a prior infection can cause implantation troubles. A thorough health screening before you attempt IVF may help your doctor make recommendations to increase the chances that the procedure will be successful.

Finally, when your other fertility treatment options have been exhausted, your doctor may recommend surgical, immunomodulatory, or hormonal treatments to improve the likelihood of implantation. The successful pregnancy rate of these treatments varies and the costs can be quite high.

Check your fertility markers with Everlywell

In vitro fertilization or IVF treatment can help those who have trouble getting pregnant achieve their dream of having a baby. However, IVF isn’t always successful. It’s important to watch out for signs that implantation has failed such as heavy bleeding, stomach pain, and a failure to locate a heartbeat during an ultrasound. There are many reasons why a fertilized egg may fail to implant, most of which are beyond your control.

If you’ve been trying to start a family but haven’t had success, you may want to check your fertility levels before taking the next steps. The Everlywell Women's Fertility Test is a simple, at-home test that can measure certain hormones that influence your fertility. Once you learn more about your hormones and fertility levels, you can take the appropriate next steps.

All the test requires is a simple, finger-prick blood sample. It couldn’t be easier to take control of your health with Everlywell.

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References

  1. What is IVF? Planned Parenthood. URL. Accessed August 1, 2022.
  2. Recurrent Implantation Failure. Reproductive Biology and Endocrinology. URL. Accessed August 1, 2022.
  3. NIH. URL. Accessed August 1, 2022.
  4. Assessment and Treatment of RFI. PubMed. URL. Accessed August 1, 2022.
  5. Surviving the Two-Week Wait. The National Infertility Association. URL. Accessed August 1, 2022.
  6. Miscarriages. Planned Parenthood. URL. Accessed August 1, 2022.
  7. Abdominal Ectopic Pregnancy After IVF. Reproductive Biology and Endocrinology. URL. Accessed August 1, 2022.
  8. Efficacy of Therapies and Interventions for RFI. Nature. URL. Accessed August 1, 2022.
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