You have been through the process. The egg collection went well, the embryos were graded as good quality, the lining was measured and declared ready — and then nothing happened. No pregnancy. Perhaps this has happened more than once.
This is one of the most disorienting situations in fertility medicine. Everything that can be checked has been checked, and everything looks fine. Yet the transfer did not work. Clinics often describe this as "unexplained" or, more formally, as recurrent implantation failure. What they mean is: we do not know why.
From a Traditional Chinese Medicine perspective, we do not accept "we do not know" as a final answer. In clinic, we look for patterns in the whole person — patterns that standard investigations are not designed to detect. When we see patients who have had good embryos fail to implant, certain things come up again and again.
Five things we often find
1. Chronic stress and anxiety
The fertility journey itself is one of the most psychologically demanding experiences a person can go through. But chronic stress does more than affect mood. From a TCM perspective, sustained anxiety and emotional pressure disrupt the flow of Qi — the body's functional energy — particularly in the Liver system, which governs the smooth circulation needed for a receptive uterine environment. Physiologically, high cortisol levels are associated with changes in uterine blood flow and endometrial receptivity. When the nervous system is stuck in a state of alert, the body is not fully in a state suited to supporting new life.
2. Physical exhaustion and overwork
Many patients who come to us are high-functioning, professionally demanding people who have continued working at full pace throughout their treatment cycles. The body treats an IVF cycle as a significant physiological event — hormone stimulation, egg retrieval, and recovery all draw on reserves. When those reserves are already depleted from overwork, sleep deprivation, or not enough recovery time between cycles, the uterine environment may not have the resources to support implantation even when the embryo is excellent. TCM refers to this as a depletion of Kidney and Spleen energy — the deep reserves that sustain reproductive function.
3. Low basal body temperature
In TCM diagnosis, we pay close attention to body temperature patterns across the cycle. A consistently low basal body temperature — particularly in the second half of the cycle — is a sign of insufficient Yang energy. Yang provides the warmth, circulation, and metabolic activity that the uterus needs to be receptive. A cold or underpowered uterine environment may be inhospitable to implantation regardless of embryo quality. This is something that standard investigations do not measure, but that we find clinically relevant in a significant proportion of patients presenting with repeated transfer failure.
4. Hydrosalpinx
A hydrosalpinx is a blocked, fluid-filled fallopian tube. Even in IVF, where fertilisation happens outside the body, a hydrosalpinx is relevant: the fluid it contains can leak back into the uterine cavity around the time of transfer and impair the conditions for implantation. Studies have shown that the presence of an untreated hydrosalpinx roughly halves IVF success rates. It is worth asking your clinic directly whether imaging has excluded this, particularly if you have a history of pelvic infection, endometriosis, or prior tubal surgery.
5. Low-grade uterine inflammation
Chronic endometritis — a low-grade inflammation of the uterine lining — is found in roughly one quarter of women with recurrent implantation failure, according to published research. Crucially, it is often completely asymptomatic: no pain, no unusual bleeding, nothing that would prompt investigation. It does not show up on a standard scan. Diagnosis typically requires a biopsy. When present, it disrupts the receptivity of the endometrium. It is treatable with antibiotics, and studies show that treating it significantly improves subsequent IVF outcomes. If you have had multiple failed transfers and this has not been investigated, it is worth raising with your specialist.
What can be done — TCM preparation before the next transfer
When a patient comes to us after repeated implantation failure, our aim is to address the underlying pattern — not simply to time treatment around the next cycle. That typically means a period of preparation of eight to twelve weeks before the next transfer.
The core of the programme is personalised herbal medicine, adjusted across the phases of the menstrual cycle, with the aim of improving the uterine environment, supporting the body's regulatory systems, and building the reserves that sustained reproductive function requires. Acupuncture may be used alongside, particularly in the weeks around transfer, where it has evidence for supporting uterine blood flow.
We also work with patients on the factors that are within their control: sleep, pacing, stress management, and temperature support. These are not minor additions — in our clinical experience, the body's state in the weeks before transfer matters as much as the state on the day of transfer.
The goal is not to override the IVF process. It is to give the embryo — which may already be excellent — a better environment to land in.
Why this matters
Recurrent implantation failure is a diagnosis that can leave patients feeling that the problem is unsolvable. "Good embryos" becomes a phrase that haunts rather than reassures, because it rules out the most straightforward explanation. In our experience, when we look carefully at the whole person rather than the embryo alone, there is almost always something to address. The five patterns described here are not rare or exotic — they are common, and most of them are modifiable.
If you have had one or more failed transfers with good-quality embryos and feel that the standard pathway has not explained what is happening, we would be glad to assess your case and discuss whether preparation with TCM might be appropriate before your next attempt.