What Happens If the First Embryo Transfer Fails in Surrogacy?

Short answer: If the first embryo transfer does not result in an ongoing pregnancy, the journey is not necessarily over. The fertility clinic reviews the cycle, determines whether additional evaluation or a change in protocol is appropriate, and discusses when another transfer may be attempted if the surrogate and intended parents want to continue.

A failed transfer does not automatically mean something is wrong

Embryo transfer is a medical treatment with a probability of success, not a guarantee. Even a good-quality embryo can fail to implant or may stop developing after implantation. The likelihood of success depends on multiple factors, including embryo characteristics, the age of the egg provider, uterine factors and the individual clinical situation.

The CDC reports IVF outcomes by retrieval and by transfer because a single treatment cycle can involve more than one stage and more than one embryo transfer. See the CDC guide to interpreting ART success rates.

What usually happens next?

The fertility physician will usually review the embryo, transfer procedure, medication protocol, endometrial preparation and relevant test results. Depending on the circumstances, the doctor may recommend another transfer using the same approach or may suggest additional evaluation before trying again.

There is no universal waiting period. Timing depends on the surrogate’s medical situation, the clinic’s protocol and whether any testing or treatment is needed before another attempt.

Will the surrogate need to be screened again?

Not necessarily. A failed embryo transfer by itself does not mean the surrogate is no longer medically suitable. However, the clinic may repeat or add testing if it believes there is a clinical reason to do so. Medical clearance remains the responsibility of the fertility program.

Does one failed transfer mean the embryo was abnormal?

No. A failed transfer cannot by itself establish why implantation did not occur. Embryo chromosomal status is only one of many possible factors. Even embryos that have undergone PGT-A do not come with a guarantee of implantation or live birth.

How many embryos should intended parents have available?

There is no fixed number that guarantees success. Some journeys result in pregnancy after one transfer and others require additional attempts. Intended parents should discuss embryo availability and family-size goals with their reproductive endocrinologist before committing to a transfer strategy.

Related answer: How Many Embryos Do You Need for Surrogacy?

Should more than one embryo be transferred next time?

Usually not simply because a previous transfer failed. ASRM strongly recommends single-embryo transfer in gestational-carrier cycles because multiple gestation increases health risks for the carrier and babies. The fertility physician should decide transfer strategy based on the individual medical case. Read ASRM’s gestational-carrier recommendations.

What about the legal agreement?

Surrogacy agreements often address the expected number of transfer attempts, what happens after an unsuccessful transfer, payment of transfer-related expenses and what happens if either party no longer wishes to continue. Exact provisions vary, so both the surrogate and intended parents should rely on their own independent attorneys.

Key takeaway

A failed first transfer is disappointing, but it is not unusual for IVF treatment to require more than one attempt. The right next step is a medical review—not an assumption about blame. The clinic should determine whether another transfer is appropriate and whether anything should change before the next attempt.

This article is educational and is not individualized medical or legal advice.