How many IVF cycles are needed for a successful pregnancy – Real Patient Cases

At EmbryoClinic IVF in Thessaloniki, the medical team, led by Dr Elias Tsakos MD, FRCOG, sees patients with very different backgrounds but one shared hope: to become parents. Some arrive after only a few months of trying, others after years of unsuccessful attempts or repeated disappointments with IVF at other centres.

The following case studies illustrate just how varied infertility can be:

• A 43-year-old woman with good ovarian reserve but unexplained infertility, who first tried timed intercourse and IUI before ultimately achieving pregnancy with IVF.
• A 42-year-old woman and her 51-year-old husband, both facing multiple risk factors, turned to IVF again after several failures and finally succeeded following surgical and laboratory interventions.
• A 44-year-old woman with a history of thyroid disease and fibroid surgery, who, despite multiple failed cycles and donor attempts in other clinics, achieved a healthy pregnancy with her own genetic material.

Each case demonstrates that success in IVF is not only about embryo quality — it is also about careful diagnostics, personalised treatment, and perseverance. By combining medical expertise with compassionate care, EmbryoClinic helps patients overcome even the most complex challenges.

The following cases show us how the medical team helps patients to overcome different difficulties and finally get pregnant with IVF: 

Patient Case Study no. 1

Patient background

A 43-year-old woman and her 37-year-old husband presented to our clinic, seeking fertility treatment. The patient had a normal BMI (19.7) and reported primary infertility for eight months, without any other notable conditions in her personal history and no prior ART treatment. Despite her apparent clinical infertility, her AMH levels were remarkably promising for her age, measuring 2.5 ng/ml. Her husband also had a normal BMI (22.3) and had no notable clinical conditions related to infertility. His most recent semen analysis was within the normal, expected range. 

Diagnostic findings

Given the lack of any apparent causes of infertility with the couple, a complete pre-IVF investigation was carried out, including physical, imaging, laboratory and genetic investigations. About the husband, a repeat semen analysis confirmed normal sperm parameters, and investigations also revealed that he was heterozygous for beta-thalassemia and cystic fibrosis. Diagnostic investigations of the patient herself revealed a subserosal uterine fibroid, 2.2 cm in diameter. No other fertility-related findings were present.

Protocols and procedures

Our initial approach for the particular case was very conservative, due to the couple’s own wishes, since they wanted to try timed intercourse first. We offered guidance based on menstrual cycle duration and provided ultrasonographic and hormone levels monitoring throughout. However, these attempts were unsuccessful. Subsequently, maintaining their mindset, the couple opted for an IUI cycle, which, unfortunately, did not result in pregnancy either. Given the failure of the more conservative methods, the couple ultimately chose to undergo an ovarian stimulation and IVF cycle, which was performed in accordance with our clinic’s protocol.

Before the embryo transfer

The ovarian stimulation protocol ultimately resulted in the collection of 15 oocytes, 12 of which were mature and suitable for fertilisation. Following fertilisation with the partner’s sperm, 8 blastocysts were created (Quality assessed via the Gardner Scale, grades: 3AA, 4AA, 4AB, 3AA, 3AA, 4AB, 2AA, 4BA).

The Embryo transfer

Embryo transfer took place two years after initial contact and within two months of the decision to undergo IVF. A fresh transfer of a single embryo was performed following the stimulation cycle, which resulted in implantation failure. The remaining embryos were cryopreserved, and two months later, two embryos were thawed and transferred, resulting in a positive beta-hCG test and pregnancy.

After the embryo transfer

Pre-natal ultrasound confirmed the presence of a gestational sac with normal heart function. At the time of writing, the patient’s pregnancy is ongoing, entering her 8th month.

Clinic’s experience with this kind of case

Elements of this specific case are present in many other couples treated at our Clinic as well. Unexplained infertility in particular accounts for a large number of infertility cases we treat annually; therefore, our team is highly experienced in the management of such cases.

Doctor’s perspective

Dr Elias Tsakos, EmbryoClinic’s Medical Director:

“This case demonstrates the effectiveness of IVF as a treatment option, compared to IUI or timed intercourse and that sometimes one attempt is more than enough to achieve pregnancy and have additional embryos for future attempts”. 

Patient Case Study no. 2

Patient background

This is a case of a 42-year-old woman and her 51-year-old husband, who visited our clinic in order to undergo ART treatment. The woman was overweight (BMI: 27.8) and the husband was obese (BMI: 31.2). From their medical history, of note were a long history of infertility (6 years), a salpingectomy operation (surgical removal of the right fallopian tube due to hydrosalpinx) 3 years prior, low ovarian reserve (AMH: 0.8 ng/ml) and an untreated, unsymptomatic varicocele on the part of the husband. The couple had undergone 2 IVF attempts at a different clinic and one attempt at our clinic.

Their first attempt (other clinic) resulted in the collection of 6 oocytes and the creation of 2 good-quality embryos. A fresh transfer was performed, which resulted in implantation failure and a subsequent frozen-thawed transfer was performed 3 months later (blastocyst, 3AA quality), which resulted in biochemical pregnancy. Their second attempt (other clinic) resulted in the collection of 5 oocytes and the successful creation of a single viable embryo, which was cryopreserved and transferred 3 months later, an attempt that resulted in implantation failure. Following that, the couple visited our clinic seeking further treatment.

Diagnostic findings

The couple underwent a complete fertility investigation at our Clinic, including physical, imaging, laboratory and genetic investigations. About the woman, hysterosalpingography revealed the presence of hydrosalpinx on the left side and confirmed the low ovarian reserve. Investigation of the husband revealed oligoasthenospermia (low sperm concentration and motility).

Protocols and procedures

The couple underwent one ovarian stimulation and IVF cycle, in accordance with our clinic’s protocol; however outcomes were unsuccessful. Therefore, it was recommended that the patient undergo salpingectomy to address the underlying hydrosalpinx, and another IVF attempt was made, which also utilised a more advanced sperm preparation method (microfluidic-based sorting).

Before the embryo transfer

The initial IVF attempt yielded 5 oocytes and resulted in the creation of two viable embryos, one of which was transferred on the third day of development in the same cycle (first transfer); however resulted in implantation failure. The second was cryopreserved and transferred at a later date, also failing. Following the interventions mentioned in the previous section, another IVF attempt was made, resulting in 7 oocytes and the creation of 4 embryos, all of which were cryopreserved at the blastocyst stage (4AA, 3AA, 3AB, 4BB). 

The Embryo transfer

The final successful embryo transfer took place approximately 2 years following the initial introduction of the couple to our clinic. One high-quality blastocyst (4AA) was thawed and transferred.

After the embryo transfer

The transfer resulted in a positive beta-hCG level, and later pregnancy was confirmed ultrasonographically. Nine months later, the couple confirmed via phone that they delivered a healthy baby boy 

Clinic’s experience with this kind of case

Many couples we treat face a similar situation to the one described here. They have already made a few failed IVF attempts in the past, and both female and male factors are present. 

Doctor’s perspective

Dr Elias Tsakos, EmbryoClinic’s Medical Director:

“The present case constitutes a nice example of a common case of combined couple with infertility, who have already had a few unsuccessful attempts at IVF in the past. Although we have treated even more challenging cases, the present and other couples with a similar background are easily disheartened and require support and encouragement to keep trying. Sometimes, a few additional attempts with minor tweaks to the treatment protocol are all that separates the couple from successfully achieving pregnancy”.

Patient Case Study no. 3

Patient background

A 44-year-old woman and her 51-year-old husband with healthy BMI (22.3 and 24, respectively) visited our clinic with the intention to undergo ART treatment. The couple had a history of multiple IVF attempts in the past 5 years without success. In particular, the couple reported 6 IVF cycles in two different clinics, with the last one utilising oocyte donation. All five cycles utilising the woman’s own oocytes resulted in the creation of 8 viable embryos, none of which resulted in an ongoing pregnancy. Their oocyte donation attempt resulted in 3 viable embryos, the transfer of which again resulted in failure. From their medical history, of note was the woman’s history of abdominal surgery for uterine fibroids in her thirties, in addition to her chronic thyroiditis, for which she was receiving T4 supplementation. The husband was relatively healthy, reporting only occasional smoking. His semen analysis parameters revealed mild asthenospermia (low sperm mobility).

Diagnostic findings

The couple underwent a thorough assessment, although much information was already available, due to their numerous IVF attempts. The presence of low ovarian reserve (AFC = 4) was confirmed, which was somewhat expected for her age, along with the partner’s asthenospermia. Additional investigations revealed an increase in the woman’s TSH levels, prompting a referral to her endocrinologist for treatment modifications until adequate thyroid control was established. 

Protocols and procedures

The couple had conceded that the chances of pregnancy with their own genetic material were low, but wished to try once more anyway. In respect of their wishes, we proceeded with controlled ovarian stimulation as per our clinic’s protocol. 

Before the embryo transfer

The stimulation cycle resulted in the collection of four oocytes and the successful creation of two viable embryos, which were cultured until day 5 and were graded as 4AB and 3AB by our Embryologists.

The Embryo transfer

A fresh embryo transfer was performed in the same cycle. This was within five months of the couple’s initial presentation to our clinic. A double embryo transfer was performed, without any cryopreserved material remaining.

After the embryo transfer

Positive beta-hCG was detected, and later a single intrauterine gestational sac was confirmed. The pregnancy progressed smoothly until the 27th week, when gestational diabetes was diagnosed and the woman was placed under strict glycaemic control with insulin. She ultimately delivered prematurely via caesarean section at 36 weeks and 2 days of gestation. Despite that, the couple’s daughter was very healthy and has been growing normally for two years as of the time of writing.

Clinic’s experience with this kind of case

Cases similar to the one described here are somewhat common occurrences at EmbryoClinic. Typically, these couples achieve pregnancy via an oocyte or embryo donation programme, given the multiple prior failures and the typically advanced reproductive age of the woman. The present case contrasted this trend, achieving a successful pregnancy with their own genetic material, which is a deviation from the norm. 

Doctor’s perspective

Dr Elias Tsakos, EmbryoClinic’s Medical Director:

“The present is a good example of a more challenging case that required multiple IVF attempts prior to conceiving and of the need for couples to persist in their attempts. As only minor changes were made compared to their previous attempts, this case demonstrates the role of chance in IVF, as sometimes multiple attempts are required in order for all prerequisites of implantation to be favourable. This does not negate the need for attentive monitoring, treatment individualisation and high-quality laboratory procedures, as these steps contribute significantly to improving the odds”.