The IVF dropout dilemma: When the treatment becomes harder than the hope

When Mrs Mehta and Mr Mehta (names changed) decided it was finally time to start a family, they felt ready. Both journalists had spent years building their careers before deciding to become parents. Mrs Mehta was 35, and Mr Mehta was 37. With a long history of endometriosis, Mrs Mehta's gynaecologist advised her not to delay and referred her to an IVF specialist.

During their first consultation at a leading fertility clinic in New Delhi, the doctor was candid. IVF was not a miracle, they were told. Conceiving and carrying a pregnancy to a live birth could take multiple attempts. Mrs Mehta prepared herself mentally for at least three IVF cycles.

The first cycle failed.

"It broke my heart, but I still had hope," Mrs Mehta recalls.

A few months later, the couple tried again, only to face another disappointment. By then, they had already spent more than Rs 15 lakh on treatment and related medical expenses. Unable to afford another cycle immediately, they decided to pause.

A year later, when Mrs Mehta was 37, they gave IVF another chance. This time, she became pregnant.

"But I couldn't carry the pregnancy to term," she says. "I had a miscarriage."

They went ahead with one final IVF cycle in 2025, but by then the years of treatment had taken their toll.

"We were financially drained. I was physically exhausted, and my mental health had suffered immensely. Mr Mehta was carrying the weight of it all too."

After months of reflection, they made the painful decision to stop IVF, not because they had given up on becoming parents, but because they had reached the limits of what they could emotionally, physically and financially endure.

Instead, they welcomed a pet into their home.

"He is our family, our joy, and in every way that matters to us, our baby."

Mrs Mehta and Mr Mehta's story reflects what fertility specialists increasingly describe as infertility fatigue: the emotional, physical and psychological burnout that leads many couples to step away from treatment even when another cycle may still offer hope.

This keeps their identities anonymous while maintaining a natural, news-feature style.

THE REALITY BEHIND IVF SUCCESS STORIES

For many couples struggling with infertility, beginning IVF (In Vitro Fertilisation) represents hope after months or years of trying to conceive naturally.

Yet while successful pregnancies often dominate conversations around IVF, another reality remains largely hidden.

Many patients never complete treatment.

Some stop after a failed cycle. Others discontinue after multiple attempts despite still having a reasonable chance of success.

International studies suggest this silent dropout is far more common than many people realise. Research has found that 30% to 60% of couples discontinue fertility treatment before achieving pregnancy, with emotional distress ranking among the leading reasons for stopping treatment.

India currently lacks comprehensive national data tracking IVF treatment discontinuation. While the Assisted Reproductive Technology (ART) Registry records treatment outcomes, publicly available information on how many patients abandon treatment midway remains limited.

Experts believe the actual numbers could be substantial given the high out-of-pocket costs of fertility treatment, social stigma surrounding infertility and limited access to psychological counselling.

THE EMOTIONAL JOURNEY BEGINS LONG BEFORE IVF

People often associate IVF with injections, egg retrieval, embryo transfer and hormone medicines.

But according to fertility specialists, the emotional journey usually begins years before treatment starts.

Many couples reach fertility clinics after years of trying to conceive naturally. Some have experienced miscarriages, repeated negative pregnancy tests or unsuccessful treatments. Others struggle with uncomfortable questions from relatives, social expectations and feelings of guilt.

According to Dr Sunita Tandulwadkar, President of the Indian Society for Assisted Reproduction (ISAR) and Head of IVF & Endoscopy at Ruby Hall Clinic, Pune, these emotional struggles are often overlooked.

"When people think about IVF, they usually talk about hormones, scans, injections and success rates. These medical aspects are important, but they are only one part of what patients experience. Behind every IVF treatment is a couple carrying hope, uncertainty and emotional exhaustion," she says.

She believes emotional wellbeing deserves as much attention as medical treatment because every failed cycle can feel like another personal loss.

WHAT IS INFERTILITY FATIGUE?

Although infertility fatigue is not an official medical diagnosis, fertility specialists and psychologists increasingly recognise it as a real phenomenon experienced by many people undergoing prolonged fertility treatment. Every IVF cycle follows a similar emotional pattern. Patients wait for ovarian stimulation to work, eggs to be retrieved, embryos to develop and finally for the pregnancy test.

Every stage is filled with hope and anticipation. When a cycle fails, many describe feeling as though they have to grieve before finding the strength to begin all over again. Over months or even years, this repeated cycle of hope, uncertainty and disappointment can gradually lead to emotional, psychological and physical burnout, a state that fertility experts refer to as infertility fatigue.

Doctors say infertility fatigue may present as:

Many patients also experience guilt, believing they have somehow failed despite infertility often being beyond anyone's control.

WHY DO COUPLES STOP TREATMENT?

Doctors say there is rarely a single reason why couples discontinue IVF treatment. Instead, it is usually the result of several challenges building up over time. Repeated failed cycles gradually chip away at hope, while the financial burden continues to grow with each attempt. Frequent hospital visits, balancing work commitments and the emotional demands of treatment can become overwhelming. Relationships may come under strain, and pressure from family or society often adds to the stress.

Eventually, many couples reach a point where continuing treatment feels emotionally impossible, even though another IVF cycle could still offer a chance of pregnancy.

WHAT RESEARCH SHOWS

Several international studies have highlighted how common treatment discontinuation has become.

A major review published in Human Reproduction Update found that psychological burden and treatment-related stress are among the leading reasons patients discontinue IVF, even when doctors believe they still have a reasonable chance of success.

Other studies estimate that between one-third and one-half of couples stop treatment before completing the recommended number of IVF cycles. Interestingly, many discontinue despite having embryos available or favourable medical outcomes, suggesting emotional resilience can be just as important as biological factors.

India currently lacks comprehensive national data on IVF discontinuation, making it difficult to estimate the true scale of the problem.

MENTAL HEALTH IS FERTILITY CARE TOO

According to Dr Megha Jindal, Fertility Specialist at Birla Fertility & IVF, Dwarka, fertility care extends far beyond medical procedures.

"Fertility care has evolved significantly over the years, with advances in diagnostics, personalised treatment protocols and improving clinical outcomes enabling more couples to pursue their parenthood goals. Yet fertility care is about more than medical intervention alone. Every fertility journey involves important decisions, periods of waiting and moments of uncertainty, making emotional wellbeing an equally important part of comprehensive care."

She explains that infertility fatigue is usually not caused by a single treatment or procedure. Instead, it develops gradually as patients cope with repeated setbacks, difficult decisions and ongoing uncertainty throughout their fertility journey.

To protect emotional wellbeing, Dr Jindal recommends setting boundaries around fertility conversations, preparing questions before clinic appointments, relying on trusted medical information instead of overwhelming online advice, maintaining regular sleep and exercise routines, communicating openly with partners and seeking professional counselling whenever emotional distress begins affecting daily life or relationships.

She adds that emotional wellbeing does not mean remaining positive every day. It means having accurate information, supportive relationships and enough emotional space to make informed treatment decisions.

LOOKING BEYOND PREGNANCY RATES

India's fertility sector has expanded rapidly over the past decade, offering hope to thousands of couples every year. Yet experts say measuring success only through pregnancy rates tells only part of the story.

For every successful IVF journey, countless others quietly end behind closed doors, not because medicine failed, but because the emotional and financial burden became too heavy to carry.

Recognising infertility fatigue, integrating psychological counselling into routine fertility care and preparing couples for the emotional realities of treatment may help more patients stay in treatment when appropriate. Equally important, experts say, is supporting those who decide to stop without making them feel they have failed.

Because for many couples, the journey to parenthood does not always end with a baby.

Sometimes, it ends with acceptance.

And sometimes, as one woman discovered after years of hope and heartbreak, family finds a different way of taking shape.