American Surrogacy Blog

After experiencing a termination for medical reasons (TFMR), the question of whether to pursue fertility treatments again isn’t simple. The thought of IVF after TFMR can feel overwhelming, even when your heart still yearns for parenthood.

If you’re not sure you can go through that again right now, you’re not alone. Many hopeful parents feel stuck between their desire to grow their family and their fear of experiencing another loss.

If you’re already wondering whether IVF is still right for you, or you’re open to other possibilities, fill out our form today to explore a path that protects your hope and your heart.

This article explores the realities of pursuing IVF after TFMR, and an alternative that honors your healing process while preserving your dreams of parenthood.

Should I Try IVF Again After TFMR?

After a TFMR, you may find yourself questioning if you can or should pursue another pregnancy. Ask yourself:

• Am I physically healed from my last pregnancy and any complications?
• How does the idea of another round of IVF make me feel emotionally?
• Do I feel prepared for both the best- and worst-case outcomes?

These questions don’t have right or wrong answers, but they can help guide conversations with your doctor, partner, or a counselor. Whether you pursue IVF again or choose a different path, the decision is deeply personal — and yours alone to make.

What Are My Chances of Success with IVF After TFMR?

According to the Mayo Clinic, the risk of miscarriage after experiencing one pregnancy loss is about 20%. However, this statistic doesn’t account for the various factors that influence success rates or the specific circumstances surrounding TFMR.

Maternal age remains one of the most significant predictors of IVF success, regardless of previous pregnancy experiences. Any underlying fertility conditions that may have contributed to your initial conception challenges will likely continue to affect your chances of success.

However, if your TFMR was due to a genetic condition or a fetal abnormality, you may be a candidate for advanced testing like PGT-A (preimplantation genetic testing for aneuploidy).

Genetic Screening After TFMR

PGT-A (preimplantation genetic testing for aneuploidy) can screen embryos for chromosomal abnormalities before transfer. It may reduce the risk of implanting embryos with known issues.

But not all conditions that necessitate TFMR can be detected through testing. Some fetal anomalies develop during pregnancy and cannot be identified at the embryonic stage.

Additionally, PGT-A testing focuses primarily on chromosomal abnormalities and doesn’t detect all genetic conditions or structural problems that might emerge later in pregnancy.

If you’re considering PGT-A for a future IVF cycle or for embryos you’ll use with a surrogate, learn how how this process fits into your journey.

What to Ask Your Fertility Doctor About IVF After TFMR

When you’re considering IVF again after a TFMR, your fertility doctor can help guide you. Here are some important questions to ask:

• How does my TFMR history affect my chances of success with IVF?
• Are there any additional risks I should be aware of?
• Should I consider PGT-A or other genetic screening?
• Could surrogacy be a safer option for my circumstances?

These conversations can help you clarify your goals and identify the family-building path that best fits your emotional and medical needs.

The Hidden Risks of IVF After TFMR: Are You Prepared?

Recovery time varies significantly based on individual circumstances. While some people feel physically ready to pursue IVF after TFMR within a few months, others require longer healing periods.

Here are some risks and complications to consider:

• Recovery time may depend on the gestational age and method of delivery. Late-term terminations, especially those requiring cesarean delivery, can lead to uterine scarring or other complications.
• Hormonal fluctuations after pregnancy termination can persist for several months, potentially impacting fertility treatment.
• Irregular menstrual cycles or ovulation patterns may follow TFMR, requiring medical monitoring and adjustments to treatment.
• Physical healing may require several normal menstrual cycles before your body is ready for another round of IVF.

Your fertility specialist will likely recommend waiting for several normal cycles to ensure your body has returned to baseline function and it’s safe to try IVF again after a TFMR.

The Emotional Impact of IVF After TFMR —When Your Heart Isn’t Ready

Even if your body is “ready,” your heart may not be.

Fertility treatments can feel especially stressful after pregnancy loss. Hormone shots, frequent appointments and the wait for embryo transfer can increase anxiety.

Milestones like embryo transfer or the first ultrasound can reawaken grief. Some people describe feeling emotionally numb or fearful of feeling any hope.

These reactions don’t indicate weakness or lack of readiness; they represent normal responses to trauma that deserve acknowledgment. Working with providers who understand the specific support needed after pregnancy loss can significantly improve your treatment experience.

Emotional Support Resources for IVF After TFMR

Finding the right emotional support can make all the difference. Here are a few trusted communities and resources:

• TFMR Mamas offers various support groups
• Through the Unexpected focuses on post-pregnancy loss healing
• Subreddits like r/IVF offer forums for peer support
• Trauma-informed counselors can help with reproductive grief and pregnancy loss

Financial Considerations of IVF After TFMR

IVF can be expensive, especially if your care now requires genetic testing, additional monitoring or specialized procedures. Insurance may not cover repeat attempts or testing, depending on your provider.

Beyond direct medical costs, IVF after TFMR can be emotionally draining. The possibility of treatment failure after previous pregnancy loss can make each cycle feel like a significant risk.

This pressure may influence treatment decisions or create additional anxiety during already stressful procedures.

Some families find that alternative paths like surrogacy prove more cost-effective over time by reducing the likelihood of repeated failed attempts. You may want to consider what works best for your family.

Surrogacy may offer greater peace of mind and financial predictability. If you’re recovering financially from previous IVF failures, learn about why financing surrogacy after IVF failure is worth it.

What if IVF Feels Too Risky? Exploring Surrogacy as a Path Forward

Feeling scared, exhausted or disconnected from the idea of IVF after TFMR? Your body and mind have endured significant stress, and hesitation doesn’t indicate weakness. Sometimes the bravest decision involves acknowledging when you need a different approach.

You don’t have to abandon your dreams of becoming a parent. Gestational surrogacy offers hope without requiring you to physically carry another pregnancy.

It can be a safer path after multiple losses. You can still use your embryos or create new ones, and your surrogate will carry the pregnancy on your behalf.

This option allows you to pursue parenthood at your own pace, with additional support throughout the process. You deserve a family-building option that respects your grief and protects your hope.

Surrogacy vs. IVF After TFMR: What’s Safer?

Here’s how surrogacy compares to IVF after TFMR:

IVF:

• Physical Demands: High
• Emotional Control: Often feels fragile
• Timeline: Shorter, but unpredictable
• Cost: Lower per attempt
• Safety: May carry risks for certain conditions

Surrogacy:

• Physical Demands: None for intended parents
• Emotional Control: Shared support throughout
• Timeline: More structured once matched
• Cost: Higher upfront, but may reduce cumulative cost from failed cycles
• Safety: Safest path for those with health risks

How American Surrogacy Supports Families After Loss

American Surrogacy understands that families pursuing surrogacy after pregnancy loss may be struggling with hesitation and fear. Our comprehensive screening process ensures that the surrogates we work with are physically, emotionally and mentally prepared to carry a pregnancy.

When you’re ready to explore IVF alternatives after TFMR, contact us online for more information.

There’s no “right” timeline for healing after pregnancy loss, and we’re prepared to meet you wherever you are in your journey.

Experiencing multiple failed in vitro fertilization (IVF) transfers can leave you wondering if you’ll ever hold your baby. You’ve done everything right, yet it seems like your body continues to work against your dreams of parenthood.

Many hopeful parents discover that their repeated IVF failures stem from Asherman’s syndrome (uterine adhesions) that went undiagnosed for months or even years.

If you’re ready to explore family-building alternatives, we can help. Contact us today for more information about gestational surrogacy.

This article explores why IVF with Asherman’s presents unique challenges and what treatment options exist.

What Is Asherman’s Syndrome? – and How Does it Affect IVF?

Asherman’s syndrome is a condition in which scar tissue (also called intrauterine adhesions) forms inside the uterus. This scarring can significantly affect fertility by disrupting the natural function of the uterine lining.

For those experiencing IVF with Asherman’s, this condition often explains persistent implantation failure despite high-quality embryos. Understanding this underlying condition can be the first step toward reclaiming control over your fertility journey.

Why Does IVF Fail With Asherman’s?

When someone has Asherman’s syndrome, scar tissue interferes with the way the uterine lining builds up and functions. For IVF to succeed, the endometrium must be thick, healthy and receptive to the embryo.

Unfortunately, in many people with Asherman’s, the lining remains too thin or irregular, making successful implantation much less likely.

Even when your embryos are chromosomally normal and considered high quality by your fertility team, they may struggle to implant. This can lead to emotional exhaustion and financial strain for many families.

Still unsure why IVF isn’t working? Here are questions you can ask your doctor if you suspect Asherman’s might be affecting your results

What Causes Uterine Adhesions?                                   

Uterine adhesions often develop after procedures like dilation and curettage (D&C), typically following a miscarriage or childbirth. They can also form after C-sections, fibroid removal or other uterine surgeries.

In some cases, untreated infections or chronic inflammation from conditions like endometriosis can cause adhesions to develop over time.

These adhesions aren’t always obvious. As a result, many people don’t know they exist until they try getting pregnant with Asherman’s syndrome.

If your diagnosis was delayed, it’s understandable to feel frustrated, but it’s never too late to explore a new path forward.

Can You Do IVF After Treating Asherman’s? Your Options Explained

Yes, in mild or moderate cases, doctors may recommend hysteroscopic adhesiolysis, a procedure that carefully removes scar tissue from the uterus.

This minimally invasive outpatient surgery typically takes 30 to 60 minutes. Your fertility team may place an intrauterine device (IUD) or prescribe estrogen therapy afterward to prevent the adhesions from reforming as your uterine lining heals.

However, the success of surgical treatment varies significantly based on the severity and location of your adhesions.

When multiple surgical attempts don’t fully restore your uterine environment, your care team may recommend exploring alternative approaches.

Support and Resources for Those Struggling with IVF with Asherman’s Syndrome

• r/IVF: A subbredit for patients undergoing IVF to share their struggles and experiences.
• Asherman’s Syndrome Awareness and Support: A Facebook group created by the International Asherman’s Association for women to share their experiences and receive peer support.

When IVF Fails with Asherman’s: Signs You’re Ready for Surrogacy

If you’ve experienced multiple failed embryo transfers, it may be time to consider surrogacy as your next step. This decision isn’t about giving up on your dreams; it’s about finding another option if your uterus can’t carry a baby.

Wondering if it’s the right time to consider surrogacy? Consider these signs:

• You’ve experienced two or more unsuccessful IVF cycles, even with high-quality embryos.
• Doctors suspect persistent implantation issues despite previous treatments.
• You’re feeling emotionally exhausted from ongoing attempts without results.
• You’re concerned about how continued treatments will affect your finances and long-term goals.

Recognize yourself in these signs? Surrogacy might be the compassionate next step forward. Learn more about surrogacy after failed IVF.

How Surrogacy Solves the IVF Challenges Caused by Asherman’s Syndrome

Surrogacy allows you to use your own embryos and transfer them into the uterus of a gestational carrier. This approach completely bypasses the implantation challenges caused by Asherman’s syndrome while still allowing you to have a biological connection to your child.

Your surrogate will be carefully screened by both medical professionals and our agency to ensure they’re prepared to carry a pregnancy. With the right support team in place, you can focus on building your family in a way that works for your situation and your future.

Why Work with a Surrogacy Agency After IVF with Asherman’s Syndrome?

If you’re dealing with uterine adhesions and IVF failure, a surrogacy agency can help make your journey smoother and more successful. Here’s how:

• Expert coordination between your fertility clinic, legal team and surrogate to streamline every step of the process
• Thorough screening of surrogates to ensure they are medically qualified and emotionally prepared
• Personalized emotional support to help you process grief or trauma from past IVF failures

You don’t have to figure this out alone. The right agency can offer clarity, guidance and reassurance during a time that feels uncertain.

Surrogacy After IVF with Asherman’s: A Hopeful Next Step

Surrogacy after failed IVF isn’t a last resort. It’s a hopeful, proactive choice many families make when their uterus can’t safely carry a pregnancy.

You don’t have to go through another failed cycle. You don’t have to keep wondering if this time will be different. Like many families affected by Asherman’s, you deserve to explore a path that brings lasting hope.

Our team is here to help you explore your next steps with clarity and compassion.

Contact a surrogacy specialist today to learn more about surrogacy.

World IVF Day is a moment to honor the countless intended parents who have bravely navigated the highs and heartbreaks of fertility treatments. Whether you’re just beginning IVF or are in the midst of your journey, this day is about your story and your dreams of building a family.

For families whose IVF path hasn’t led to the outcome they hoped for, we’re here to help you explore a new, empowered way forward.

If you’re ready to take the next step beyond IVF, we’re ready to guide you. Let’s find a path to parenthood that works. Fill out our simple form today to get connected with a surrogacy specialist. 

What Is World IVF Day? 

World IVF Day, observed annually on July 25, commemorates the birth of Louise Brown in 1978, the world’s first baby born through in vitro fertilization (IVF).

Since then, World IVF Day has become a global acknowledgment of the millions of families who have grown through assisted reproductive technology (ART).

Whether you’re just beginning IVF or have been through multiple cycles, this day symbolizes resilience and hope.

Why IVF Is Both a Hopeful and Hard Journey 

World IVF Day isn’t just a celebration, it’s a complex emotional marker for many intended parents. IVF brings immense hope, but it also often comes with failed cycles, physical tolls, emotional burnout and significant financial costs.

Some couples see success early, while others endure years of procedures, losses, and uncertainty. World IVF Day shines a light on the resilience of those who persist in the face of repeated heartbreak, reminding us that every attempt reflects deep love and determination to build a family.

What Happens If IVF Doesn’t Work? 

World IVF Day shines a light on the resilience of those who persist in the face of repeated heartbreak, reminding us that every attempt reflects deep love and determination to build a family.

Some couples see success early, while others endure years of procedures, losses and uncertainty. The natural question becomes: what now?

For families who have already created embryos through IVF, surrogacy can be the next step forward offering a renewed chance at parenthood without starting over.

Wondering what comes next after IVF? Explore how surrogacy could be the next step for your family.

When Is It Time to Consider Surrogacy? 

For many intended parents, the decision to pursue surrogacy only comes after years of trying to conceive on their own or through IVF treatments. But how do you know when it’s time to shift your focus? 

Here are some common signals: 

• You’ve had multiple failed IVF cycles with no clear medical explanation. 
• Your doctor has advised against carrying a pregnancy for health reasons. 
• You’ve experienced recurrent pregnancy loss. 
• IVF treatments have become emotionally or financially exhausting

World IVF Day is an ideal moment to reflect not just on where you’ve been—but where you want to go. If you feel like you’ve done everything possible and still aren’t closer to holding your baby, surrogacy may offer the next right step.

How Surrogacy Complements the IVF Journey  

Many people don’t realize how deeply connected IVF and surrogacy really are.

For those who’ve undergone IVF and created viable embryos, those embryos can be used in your surrogacy journey to be transferred to a surrogate—someone who carries the pregnancy but has no genetic link to the child. 

On World IVF Day, it’s important to recognize that surrogacy isn’t giving up, so much as an extension of your fertility efforts.

Already created embryos through IVF? Reach out to day to be matched with a surrogate quickly and fast track your path to parenthood.

IVF vs. Surrogacy: Comparing Cost, Success and Time to Parenthood

World IVF Day is a time to celebrate how far fertility treatments have come—but also to take an honest look at where your own journey stands.

Here’s how IVF and surrogacy compare when it comes to three of the most important factors: cost, efficacy and time to parenthood.

Cost: What You’re Really Spending 

IVF: One IVF cycle can cost $15,000–$25,000, and many families undergo 3–5 cycles before achieving pregnancy, often totaling $60,000–$100,000 or more. Costs can rise with medications, genetic testing, and embryo storage.

Surrogacy: A full surrogacy journey through an agency typically ranges from $100,000-$200,000 including surrogate compensation, medical expenses, legal work and agency coordination.

While the upfront cost may seem higher, many intended parents find that surrogacy avoids the emotional and financial toll of repeated IVF failure.

Worried about affording surrogacy after costly IVF cycles? Learn how American Surrogacy helps families find financial clarity.

Efficacy: What Are the Chances It Will Work? 

IVF Alone: IVF success rates depend on age and fertility diagnosis, but average around 30–50% per cycle. Many intended parents face unexplained failures or implantation issues that remain unresolved even after multiple attempts. 

Surrogacy: When using healthy embryos with a thoroughly screened gestational carrier, success rates may be higher, particularly with agency-managed matches with highly-qualified surrogates. This makes surrogacy more efficient and more predictable after failed IVF.

Time: How Soon Can You Hold Your Baby? 

IVF: Each cycle takes 6–8 weeks, with weeks of prep and follow-up. Failed cycles mean starting over. The timeline can stretch to years with uncertain outcomes. 

Surrogacy: With an agency like American Surrogacy, you may match with a surrogate in as little as 1-4 months, and move directly to embryo transfer (especially if you already have frozen embryos). For many, it’s the quickest path to parenthood after years of trying.

World IVF Day is about honoring your journey, but also about being honest with what comes next. Surrogacy may offer a clearer, faster and ultimately more successful path forward.

Why Some Families Choose Surrogacy After IVF 

For many families, surrogacy becomes a life-changing decision after IVF has failed or is no longer medically advised.

Conditions like uterine abnormalities, recurrent pregnancy loss, or health concerns can make carrying a pregnancy unsafe or unsuccessful, even with healthy embryos.

Surrogacy offers intended parents the opportunity to have a biologically related child, even if they cannot carry the pregnancy themselves.

It’s a decision that involves trust, emotional surrender and courage, but for many, it leads to the joy and closure they’ve been longing for.

How American Surrogacy Can Help You Grow Your Family—Faster and Safer 

At American Surrogacy, we specialize in turning fertility frustration into forward motion. Here’s how we make a difference: 

• Pre-screened surrogates ready for matching 
• Legal, medical, and emotional coordination under one roof 
• Transparent pricing and cost-efficiency compared to repeat IVF rounds 
• Support for using your existing embryos via gestational surrogacy 

You’ve already invested so much into becoming a parent—we’re here to help you reach that goal sooner.

Your Family Journey Isn’t Over—It’s About to Begin 

At American Surrogacy, we understand the emotional cost of IVF—and we know how exhausting it is to keep trying without answers. If you’re ready to stop cycling and start moving forward, we’re ready to help. 

Talk to a surrogacy specialist today. 

Let’s create a plan that’s built around your embryos, your vision, and your timeline—so you can grow your family with confidence, not exhaustion. 

With the rise of advanced fertility technologies, many hopeful parents are asking: Can you choose genes with IVF, and if so, how much?

IVF allows for detailed genetic screening, but not genetic engineering. Knowing which traits can be selected (and which cannot) helps you make empowered, ethical and medically sound choices for your journey.

In this article, we’ll explain:

• What you can and cannot choose through IVF
• How preimplantation genetic testing (PGT) works with surrogacy
• When and why genetic screening may be recommended

If you’re searching for an IVF clinic that provides genetic screening for embryos, we can connect you with a reputable clinic in your area. Fill out our easy form today.

Can You Choose Your Baby’s Genes With IVF?

The short answer is no. At least, not in the way pop culture often suggests. While modern fertility treatments offer powerful genetic insights, they don’t let you pick traits like eye color, intelligence or personality.

Instead, many IVF programs incorporate preimplantation genetic testing (PGT), a tool that helps identify embryos with specific genetic conditions before they are transferred to a gestational surrogate. There are two common types:

• PGT-A (Preimplantation Genetic Testing for Aneuploidy): Screens for chromosomal abnormalities that could impact development or lead to failed implantation.
• PGT-M (Preimplantation Genetic Testing for Monogenic/Single Gene Disorders): Detects inherited diseases like cystic fibrosis or Tay-Sachs.

These tests don’t change or edit an embryo’s genes. Rather, they provide a detailed look at the genetic makeup that’s already present when sperm and egg combine.

Think of PGT like reading a book, not rewriting the story. You can choose which embryo to transfer based on that information, but you cannot modify or select specific traits beyond medical screening.

Have questions about IVF and genetic screening? Learn more about pre-implantation genetic testing for IVF and surrogacy.

What Can You Choose With IVF?

Most of the traits people imagine choosing, such as eye color, hair color, intelligence or athleticism are polygenic, meaning they are influenced by multiple genes and complex environmental factors.

These traits involve thousands of genetic interactions that science is still learning to decode. Current IVF technology cannot detect or select for these traits, and no test can guarantee them.

What IVF can do is help screen for certain inherited conditions and chromosomal abnormalities, allowing you to prioritize embryo health and pregnancy success. Below is a breakdown of what’s possible and what isn’t.

Can You Choose Eye Color With IVF?

No, you cannot choose eye color with IVF. Although eye color is genetic, it’s influenced by multiple genes that control pigmentation.

IVF clinics do not screen for these cosmetic traits. Preimplantation genetic testing (PGT) is focused on identifying serious medical conditions, not selecting for appearance.

Can You Choose Hair Color With IVF?

No, hair color selection is not possible with IVF. Like eye color, hair color involves multiple genes and can change over time.

IVF with PGT doesn’t include analysis of pigmentation genes and cannot guarantee any particular hair color in a child.

Can You Choose the Sex of Your Baby With IVF?

Yes — to a degree. When using PGT-A, the sex chromosomes of each embryo are visible during testing. This means if you have multiple healthy embryos of different sexes, you can choose which embryo to transfer first.

However, you can only choose from the embryos you already have. There’s no guarantee you’ll produce viable embryos of both sexes, and selection doesn’t influence the creation of future embryos.

Concerned about sex-linked conditions? Learn more about IVF and embryo sex selection.

Can You Remove Certain DNA Through IVF?

No, IVF cannot remove or change an embryo’s DNA. This is a common misconception.

While PGT allows you to analyze the DNA of embryos, it does not modify them. The embryo’s genetic makeup is fixed at the moment of fertilization.

Removing, editing, or altering DNA, such as through CRISPR gene-editing, is not part of any standard IVF or surrogacy process and is not legally permitted in clinical practice in the U.S.

Can IVF Avoid Autism?

No, IVF cannot be used to prevent autism. Autism spectrum disorder is influenced by multiple genes and environmental factors, and no single genetic marker determines whether a child will be autistic.

There is currently no test that can screen for or eliminate autism through IVF, and reputable clinics will not make such claims.

Can IVF Avoid Down Syndrome?

Yes, IVF combined with PGT-A can screen for chromosomal abnormalities like trisomy 21, the cause of Down syndrome. If an embryo has an extra copy of chromosome 21, it will be identified during genetic screening. This allows intended parents to avoid transferring affected embryos, reducing the risk of a Down syndrome diagnosis.

Can You Use IVF to Avoid Cystic Fibrosis?

Yes, IVF can screen for cystic fibrosis (CF) using PGT-M, which looks for mutations in the CFTR gene. If both genetic contributors are carriers, PGT-M helps determine which embryos inherited the faulty gene.

Intended parents can then choose to transfer only unaffected embryos — a crucial option for families with a history of genetic conditions.

How Does Sex Selection Work with IVF and Surrogacy?

Sex selection is one of the few traits you can choose during the IVF process but it’s important to understand how and why.

When you undergo preimplantation genetic testing for aneuploidy (PGT-A), embryologists analyze the chromosomes of each embryo.

As part of this process, they can determine whether each embryo carries XX chromosomes (female) or XY chromosomes (male). If you have healthy embryos of both sexes, you can choose which one to transfer first.

For intended parents pursuing IVF with surrogacy, this may offer a degree of choice, but only within the limits of what your embryo pool allows.

Pros of Sex Selection through IVF

• Family balancing: Can help shape desired family composition
• Medical necessity: May help prevent sex-linked genetic diseases
• Planning flexibility: Gives intended parents more choice in embryo selection

Cons and Considerations

• Ethical concerns: Raises questions about gender preferences and fairness
• Limited embryo options: You can only choose from the embryos available, if none match your preferred sex, you cannot “create” one
• Cultural and societal pressures: May unintentionally reinforce gender stereotypes or biases

So while sex selection is one small area where IVF gives you limited control, it’s not equivalent to choosing or changing your baby’s genes. It fits within the broader context of informed embryo selection, not genetic engineering.

Should I Pursue Genetic Screening With IVF for Surrogacy?

Deciding whether to pursue PGT-A or PGT-M involves weighing several factors.

Factors to Consider

Cost is a major consideration. These tests are often paid out-of-pocket:

• PGT-A: ~$2,000 to $5,000 per IVF cycle
• PGT-M: ~$7,000 to $12,000+ per condition

Insurance coverage varies significantly, and many intended parents must plan for these expenses independently.

However, the potential to avoid a failed transfer or a genetic condition may outweigh the cost, depending on your personal circumstances.

When Genetic Screening May Be Recommended

Your fertility specialist may recommend PGT if any of the following apply:

• Maternal age of 35 or older
• History of recurrent pregnancy loss
• Known genetic conditions in your family
• A previous child with chromosomal abnormalities
• Male factor infertility tied to chromosomal issues

For those using donor gametes or gestational surrogates, screening may help ensure that only viable, genetically healthy embryos are transferred, an important step in maximizing success and minimizing risk.

The Role of Genetic Counselors

One of the best resources available during this decision-making process is a genetic counselor. These professionals can:

• Review your medical and family history
• Explain the scope and limitations of testing
• Clarify what conditions PGT may detect in your case
• Help you weigh the cost vs. benefit of testing

You might ask your genetic counselor:

• What specific conditions would testing identify in our case?
• How could the results influence our embryo transfer decisions?
• What’s the accuracy of PGT for our situation?

What Genetic Screening Means for Surrogacy

In the context of surrogacy, genetic screening is not just a medical tool, it’s a key part of the planning process. For intended parents wondering can you choose genes with IVF, the real power lies in understanding genetic information before embryo transfer, especially when a gestational carrier is involved.

Why Timing Matters

Most intended parents complete embryo creation and preimplantation genetic testing (PGT) before matching with a surrogate. This timing is important for several reasons:

• Informed embryo selection: You’ll know which embryos are genetically viable
• More predictable outcomes: You reduce the risk of failed transfers or medical complications
• Clearer communication: Everyone,  including the surrogate, understands what to expect

This upfront clarity allows for smoother planning and can ease the emotional toll of later-stage complications or surprises.

Emotional Support During a Complex Process

At American Surrogacy, we understand that genetic testing can reveal difficult realities such as fewer viable embryos than anticipated or the presence of inherited conditions. These moments can be emotionally intense and may affect your decisions about how to move forward.

That’s why our team is committed to walking with you through every step, offering both practical guidance and empathetic support.

Whether you’re interpreting test results, making decisions about embryo transfer, or just looking for reassurance, we’re here to ensure you feel confident and informed.

Genetic Screening Helps You Prepare — Not Control

Ultimately, while you cannot choose or change your baby’s genes with IVF, you can choose how much information you want before proceeding with a transfer. That information helps shape your surrogacy journey with intention and peace of mind.

Ready to Learn More About IVF and Surrogacy?

Building a family through IVF and surrogacy is about love and intention. You deserve clarity and support as you navigate the possibilities of genetic testing.

We’re here to help you build your family in an informed, ethical way. Whether you’re just beginning to explore surrogacy or ready to move forward, having the right support makes all the difference.

Fill out our form to get free information and connect with a surrogacy specialist today.

If you’re ovulating on letrozole but not getting pregnant, you’re facing one of the most perplexing—and exhausting—PCOS hurdles.

Letrozole is a powerful medication, especially for women with PCOS, but ovulation is only part of the story.

Ready to turn the page?Contact a surrogacy specialist today, and let’s map out a path that finally turns hope into a heartbeat.

Ovulating on Letrozole But Not Getting Pregnant? PCOS May Be to Blame

Letrozole stimulates ovulation, particularly for women with PCOS. However, successful conception involves more than just ovulation.

Many PCOS patients have perfectly timed intercourse yet still face a blank pregnancy test. Why? Because chronic low-grade inflammation and insulin resistance alter the very genes that make the uterine lining “sticky.”

Research shows PCOS endometrium can express fewer integrins and HOXA-10 proteins, crucial for implantation.

Add a fibroid distorting the cavity, or a partner’s subtle DNA fragmentation, and the odds shrink further.

In other words, you can be ovulating on letrozole but not getting pregnant simply because the embryo’s landing pad or its chromosomal package isn’t quite right.

Learn How Embryo Implantation Works

Other Reasons Letrozole May Not Be Working

Here are some additional reasons letrozole might not lead to conception:

• Luteal Phase Defect: The second half of your cycle may be too short to support implantation.
• Endometrial Issues: Letrozole can thin the uterine lining, making implantation harder.
• Poor Egg Quality: Ovulating doesn’t always mean the eggs are viable.
• Male Factor Infertility: A semen analysis may uncover low motility or count.
• Tubal Blockage: HSG tests can reveal whether the tubes are open.
• Thyroid or Prolactin Levels: Hormonal imbalances can quietly interfere with conception.

If letrozole isn’t working on its own, the next step is simply about gathering more insight—answers that can help guide you toward a path that feels right and hopeful.

How Many Cycles of Letrozole Does it Take to Get Pregnant with PCOS?

Clinical registries reveal that 65–70 % of letrozole-related pregnancies arrive within the first three medicated cycles.

After the sixth cycle, success curves flatten, leading most reproductive endocrinologists—and the latest ASRM practice guidance—to recommend a strategy shift.

So if you’re ovulating on letrozole but not getting pregnant by cycle four, it’s less about “failure” and more about guarding your calendar, your finances, and your emotional bandwidth before moving to higher-yield options.

When IVF Protocol With Letrozole Is Failing

For some patients who are using letrozole in conjunction with IVF, especially those with a history of thin lining, poor ovarian response or PCOS, letrozole may not deliver the needed hormonal balance or follicular boost when used in antagonist IVF protocols.

In women with PCOS, additional complexities such as insulin resistance, higher baseline LH levels, or impaired endometrial receptivity may further diminish the efficacy of a Letrozole-based approach.

If you’ve experienced recurring implantation failure, it may be time to consider other options like surrogacy, which allows you to bypass the issues contributing to IVF failure.

If you’re utilizing IVF with letrozole for PCOS but not getting pregnant, learn more about when it may be time to consider other options.

Turning Frustration into Insight With Testing

A thorough work-up transforms guesswork into data-driven next steps. Your doctor may start with a hysterosalpingogram (HSG) to map your tubes, follow with a saline sonogram to spot polyps or scar tissue and finish with an expanded hormone and metabolic panel, including fasting insulin, thyroid antibodies and prolactin.

Each test asks a specific “why” behind ovulating on letrozole but not getting pregnant, revealing whether the hurdle lies in anatomy, metabolism or hormonal imbalances. Armed with answers, you can pivot confidently instead of circling the same protocol.

Treatment Power-Ups If You’re On Letrozole for PCOS But Not Pregnant

If you’re not pregnant after multiple letrozole cycles, consider these alternatives:

• Metformin + Letrozole: Lowers insulin, improves egg mitochondria, and modestly bumps clinical pregnancy rates.
• Low-Dose Gonadotropins: Adding tiny FSH doses can double conception odds versus letrozole alone in PCOS cohorts.
• Progesterone Support: Extends a short luteal phase so the embryo isn’t evicted before it settles.
• IVF + PGT-A: Bypasses tubal issues, selects chromosomally normal embryos and slashes miscarriage risk.
• Donor Eggs/Embryos: A compassionate shortcut when egg quality—not uterine environment—is the root block.

When the egg quality roadblock just won’t budge, donor eggs or embryos can offer a compassionate and hopeful path forward, especially if the uterine environment is healthy.

Surrogacy Solutions if You’re Ovulating on Letrozole but Not Getting Pregnant with IVF

For some, the issue is no longer the egg—it’s the uterus. Years of PCOS-related hyperplasia, repeated D&C procedures or adenomyosis can make carrying a pregnancy medically risky or anatomically impossible.

When you’ve produced healthy embryos yet remain ovulating on letrozole but not getting pregnant, surrogacy becomes a logical, evidence-backed next step.

Your genetic or donor embryo is transferred into a carefully screened carrier whose uterus offers the receptivity yours lacks, turning decades of reproductive science into tomorrow’s baby shower.

If you’ve experienced IVF failure using letrozole for PCOS but still not pregnant, learn more about surrogacy after failed IVF.

American Surrogacy’s Blueprint to Growing Your Family

Choosing surrogacy is choosing partnership. We coordinate directly with your fertility clinic to secure embryo shipment, match you with a surrogate who has passed medical, psychological and background clearances and wrap the entire journey in legal and financial transparency.

You receive milestone updates—first heartbeat, anatomy scan, delivery plan—while your surrogate receives 24/7 support. It’s a dual-care model that keeps your dream and her wellbeing front and center, ensuring that being ovulating on letrozole but not getting pregnant is merely a chapter, not the ending.

Next-Step Action Plan

It’s okay to feel frustrated or exhausted after months (or years) of trying. But please know, even when letrozole isn’t’ successful, you still have options.

Whether your next step is more testing, a shift to IVF, or exploring surrogacy, you have choices—and you have support.

American Surrogacy can guide you through the possibilities surrogacy can bring with care and compassion.

Explore Our Surrogacy Programs

A growing number of hopeful parents are facing barriers to building families, not because of medical infertility, but due to social infertility.

Social infertility affects many individuals and couples who are biologically able to have children but are held back by external circumstances. These may include relationship status, sexual orientation, gender identity, or systemic policies that limit access to fertility care.

If you’re ready to explore inclusive options for becoming a parent, connect with a surrogacy specialist today — your journey starts here.

This article explores what social infertility is, who it affects, and how surrogacy offers a compassionate and empowering path forward for those ready to grow their families.

What Is Social Infertility?

Social infertility is the inability to conceive or carry a child due to social or relational circumstances rather than medical ones. This includes individuals who are healthy and fertile but face barriers because they are single, in same-sex relationships or in partnerships that lack biological compatibility.

Unlike medical infertility, which stems from physical conditions, social infertility arises from systemic limitation, including outdated clinic protocols, restrictive insurance policies and narrow definitions of family in reproductive care.

Who Is Affected by Social Infertility?

Several groups of people face social infertility:

• Single individuals who want to raise a child but don’t have a partner and cannot access fertility treatment without one
• Same-sex couples who require a combination of egg donors, sperm donors and/or gestational surrogates
• Trans and non-binary individuals who may not be biologically compatible with their partners or may face discrimination
• Families with financial limitations whose insurance may not cover fertility treatments unless a medical diagnosis is present

Despite rising awareness, social infertility often remains underrepresented in mainstream conversations. Many of these intended parents encounter extra emotional and logistical challenges on the road to family.

American Surrogacy welcomes all family structures. Whether you’re single, partnered or LGBTQ+, we ensure that your journey is supported with legal, emotional and logistical guidance every step of the way.

If you’re an LGBT parent wanting to grow your family, learn more about our programs for LGBT families.

Emotional Impact of Social Infertility

Experiencing social infertility can come with a wave of complex emotions:

• Grief over not being able to pursue a traditional path to parenthood
• Frustration when facing policies or systems that don’t reflect your reality
• Loneliness, especially when there are few resources or communities that address your situation
• Self-doubt rooted in societal stigma, leaving you wondering if your dream of parenthood is even possible

At American Surrogacy, we want to affirm that your desire to become a parent is valid and that your journey, while different, is no less worthy of support or celebration.

Why Social Infertility Matters

Social infertility is not just a personal issue. It reflects larger shifts in society that deserve recognition and response.

• Changing Social Dynamics: More people are marrying later or not at all, yet still want children. In 2024, the U.S. Census Bureau reported that the median age for first marriages is 28 for women and 30 for men.
• LGBTQ+ Rights and Advocacy: While legal protections have improved, barriers persist. A 2022 report found that 36% of LGBTQ+ adults experienced discrimination in the past year.
• Medical Industry Shift: Clinics and agencies are becoming more inclusive, but many are still structured around heterosexual couples.

Without visibility and acknowledgment, critical resources lag behind. Insurance coverage, legislation and support systems often fail to serve people experiencing social infertility. Greater awareness leads to better care for everyone.

How Surrogacy Can Help Hopeful Parents Facing Social Infertility

Surrogacy can be a powerful and empowering solution for people facing social infertility. It helps hopeful parents build families by offering a path that accommodates unique personal circumstances, including being single or part of the LGBTQ+ community.

Here’s how gestational surrogacy works:

• Step 1: The intended parent(s) work with an agency to create a plan.
• Step 2: If needed, they find an egg or sperm donor.
• Step 3: An embryo is created through in vitro fertilization.
• Step 4: The embryo is transferred to a gestational surrogate.
• Step 5: The surrogate carries the pregnancy and delivers the baby.

If you’re concerned about budgeting for journey to parenthood, learn more about our affordable surrogacy options and other financing resources available to you.

Social Infertility Isn’t the End — Take the First Step Toward Parenthood

Experiencing social infertility doesn’t mean your dream of parenthood has to end — just that the path forward may look different.  If you’re ready to explore how surrogacy can support your parenting goals, we invite you to speak with a surrogacy specialist today.

Let’s create a path to parenthood that fits your life. Fill out our free form to get started today.