When should we stop IVF? The conversation we have first.

No. The number of failed cycles matters less than what those cycles showed.

Three cycles that each gave good embryos tell a very different story from three cycles where fertilisation failed. In the UK, the NHS may fund up to 3 full cycles for women under 40 and 1 for women aged 40 to 42. That is a funding rule, not a medical limit. Your own limit comes from your age, your egg reserve, the sperm, and how your embryos behaved.

A pattern that repeats across cycles, not one bad result.

One cycle with poor embryos can be bad luck or the wrong protocol. When the same problem comes back after the plan has been changed, the file is telling you something. Dr Vani has written down the findings that make her say further treatment is unlikely to help. They are about the eggs, the embryos and the sperm, and two are about safety and the law.

Each one points to a problem that another cycle of the same treatment cannot fix.

Extremely low reserve over 40 means very few eggs, and age affects their quality. Repeatedly poor eggs means eggs that look abnormal cycle after cycle. Failed fertilisation means eggs and sperm did not combine, even when the method was changed. Consistently poor embryos, or embryos that stop growing (embryo arrest), usually reflect the eggs or sperm they came from. No viable sperm means none were found, even by surgical retrieval.

Not always. Stopping one route can open another.

Where the eggs are the problem, donor egg IVF may still be possible. Where no sperm can be found, donor sperm may be. Some couples choose adoption. Some decide to live without children, and that is a real ending, not a failure. We explain each option and the law around it, and the choice stays yours.

Because it is the hardest conversation in fertility care, and it is easier to have when nobody is under pressure.

Before cycle one, we agree together what would make us change plan, what would make us pause, and when we would honestly recommend stopping. You leave with it in writing: the Stopping Conversation card, signed by your doctor and both of you. [CONFIRM: publish the card] Then every cycle has a reason, and nobody is kept in a loop.

You do. The doctor's job is to give you an honest prognosis and say plainly what the file shows.

The UK regulator, the HFEA, advises asking your doctor for an honest prognosis and weighing what treatment is costing you both. Partners often reach the answer at different times. Talk to each other, and to someone outside the family if that helps. A session with our counsellor is available. [CONFIRM: counsellor and fee policy]