Excellent embryos, zero pregnancy: Nigerian fertility specialist reveals why IVF fails

L-r: Dr Victor Ajayi, fertility specialist; Mrs Precious Balogun, fertility counsellor and Mr Pillot Gbolahan, psychologist, all of Nordica Fertility Centre, Lagos during the forum on failed IVF cycles organized by the Fertility Awareness Advocate Initiative (FAAI) held at the Radisson Hotel, Ikeja, Lagos, recently.

Dr Victor Ajayi, a leading fertility specialist at Nordica Fertility Centre, has disclosed that pregnancy is never guaranteed even when embryos graded excellent under the microscope.

Ajayi disclosed this at a packed fertility awareness event, organised by the Fertility Awareness Advocacy Initiative (FAAI) in Lagos.

According to him, “Patients come to us and we show them beautiful embryos like five-day blastocysts, perfectly expanded, graded 5AA. They look like works of art. Then two weeks later the pregnancy test is negative. The common question is: ‘Doctor, why didn’t even one stick?’ The honest answer, is painful. Science is delicate, and implantation remains the biggest mystery we have.”

Speaking on the topic “Why IVF Cycles May Fail,” Ajayi listed the hidden biological hurdles that can derail treatment despite flawless laboratory work, explaining that high oestrogen levels after egg collection, can make the uterine lining unreceptive. In such cases, freezing all embryos and transferring them in a later, calmer cycle dramatically improves chances, he averred.

“For some women, especially those with endometriosis, the uterus is quietly inflamed. You can have the best embryos in the world, but if the soil is not ready, the seed will not grow,” he added.

Endometriosis, a condition affecting one in ten Nigerian women of reproductive age, often goes undiagnosed for years and is a leading silent cause of implantation failure, Ajayi stated, adding that, timing, hormones, egg and sperm quality, genetic normality of embryos, and immune factors all play roles that no clinic, not even the best in Europe or America, can fully control.

Read also: Medical experts proffer solutions to fertility challenge between couples

“Worldwide, the live-birth rate per IVF cycle hovers between 30 percent to 40 per cent for women under 35 in top centres. That means 60 percent to 70 percent of cycles, even with perfect-looking embryos, do not result in a baby. It is not always the doctor, the laboratory, or the patient. Sometimes it is simply biology,” Ajayi stressed.

The emotional fallout from these failures dominated the FAAI event. Couples shared stories of selling land, cars, and jewellery, only to face repeated negative tests. One man recounted how he almost skipped the Lagos programme after five failed cycles, only to win a fully funded IVF cycle in the event’s raffle, a moment that triggered tears and applause across the hall.

Pillot Gbolahan, clinical psychologist told the gathering that failed IVF triggers genuine grief, stating that, “Couples mourn the loss of hope, identity, and control. Depression rates can reach 24 percent, anxiety 28 percent. In Nigeria the pain is compounded by stigma and family pressure.”

Mrs Vivian Patrick, FAAI vice president, whose seven-year-old son was conceived through IVF, urged couples never to walk alone, stating that, “A failed cycle is not the end of your story, it is a chapter. There are options: frozen transfers, donor eggs or sperm, adoption, or trying again with a different protocol. But first you must heal emotionally.”

Organisers raffled one complete IVF cycle and four additional treatment vouchers, offering immediate hope to five families.

Dr Abayomi Ajayi, medical director of Nordica Fertility Centre, closed with a call for diligence, stating, “Research your clinic, ask tough questions, and remember that experience matters. Never surrender your right to understand every step.”

Ajayi affirmed that IVF failure is common, often unexplained, and always heartbreaking, but with the right medical insight, psychological support, and community, hope can be rebuilt, one cycle at a time.

Royal Ibeh is a senior journalist with years of experience reporting on Nigeria’s technology and health sectors. She currently covers the Technology and Health beats for BusinessDay newspaper, where she writes in-depth stories on digital innovation, telecom infrastructure, healthcare systems, and public health policies.

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