Get Started

Intended Parents

Chronic Endometritis and IVF Failure: Your Complete Guide On What To Do Next

When you’ve been through IVF cycle after cycle with no clear explanation for why they keep failing, there might be something your doctors haven’t checked yet.

It’s called chronic endometritis, and research shows it’s affecting up to 60% of people who keep experiencing recurrent implantation failure. This silent uterine infection can sabotage even your highest-grade embryos, and what’s particularly frustrating: your hormone levels, ovarian function, and embryo quality might look completely normal on paper.

While antibiotic treatment exists for the infection, the bacterial infection doesn’t always clear up completely. Multiple studies show treatment failure rates of 20-40%, which is why many people in your situation have found their most reliable path to parenthood through surrogacy after failed IVF.

Learn more about surrogacy options

If you’ve been through embryo transfer after failed transfer wondering what piece of the fertility puzzle you’re missing, understanding why IVF fails and this hidden endometrial condition might finally give you the answers you’ve been desperately seeking. More importantly, it can help you determine whether continuing IVF treatment or pursuing surrogacy makes the most sense for your situation.

What Is Chronic Endometritis and Why Does It Go Undetected?

Chronic endometritis is a stubborn, low-grade bacterial infection that sets up camp in your endometrium—that’s the functional layer of your uterus where embryos are supposed to implant during the luteal phase. What makes this endometrial infection so maddening is that unlike acute pelvic inflammatory disease, the condition doesn’t announce itself with fever, pelvic pain, or abnormal discharge. It just quietly disrupts implantation while you wonder why nothing seems to be working.

The bacterial troublemakers behind this persistent endometrial inflammation include organisms you might recognize: Mycoplasma hominis, Ureaplasma species, Chlamydia trachomatis, Enterococcus, and Streptococcus.

These pathogenic bacteria can colonize your system for months, even years, creating a hostile inflammatory environment where embryos simply can’t achieve successful implantation, regardless of their morphological grade or genetic normalcy.

Diagnostic challenges include: Most cases present with no symptoms at all. Routine fertility workups including hysterosalpingography and transvaginal ultrasound don’t screen for bacterial endometrial infections. Definitive diagnosis requires specialized endometrial biopsy testing that many fertility specialists still don’t routinely perform.

Peer-reviewed research shows this endometrial infection lurks in 14-67% of people whose embryos just won’t implant, yet it remains one of the most underdiagnosed causes of “unexplained” infertility.

Even when you receive targeted antibiotic therapy with drugs like doxycycline, azithromycin, or fluoroquinolones, the infection sometimes refuses to budge—particularly when dealing with antibiotic-resistant bacterial strains.

What if the answer isn’t fixing your uterus, but finding a healthier one for your embryos? Many people in your situation have already found their path to parenthood through surrogacy—and you could be next.

Learn about your surrogacy options

Can Chronic Endometritis Cause IVF to Fail?

The heartbreaking answer is absolutely yes. The infection is directly linked to IVF failure through multiple published studies in fertility and sterility journals.

When you have this endometrial infection, your chances of successful implantation drop by up to 50%, your clinical pregnancy rates decrease significantly, and you face a 3-fold increased risk of pregnancy loss even if initial implantation occurs.

During what should be the critical window of implantation, your embryo needs your endometrium to achieve optimal receptivity—a precisely timed molecular cascade involving estrogen and progesterone signaling, proper vascular development, and targeted gene expression patterns.

But when the infection triggers persistent inflammatory responses, that welcoming endometrial environment becomes hostile territory for even the most viable blastocysts.

The statistics from fertility research are devastating: The infection shows up in 60% of patients diagnosed with recurrent implantation failure after multiple IVF cycles, reduces implantation success rates by up to 50% compared to infection-free endometrium, and increases first-trimester pregnancy loss risk by three times.

If you’ve been watching morphologically perfect embryos with normal chromosomal arrays fail transfer after transfer, the infection could be the hidden culprit. You might have excellent ovarian reserve, textbook follicular development, high-quality oocytes, and optimal embryo development to the blastocyst stage—but this endometrial infection is sabotaging implantation at the cellular level.

The good news? Those same “failed” embryos often succeed beautifully in a healthy surrogate. Your embryos aren’t the problem—your uterine environment is.

When Treatment Doesn’t Work: Facing Persistent Uterine Issues

Standard treatment typically involves targeted antibiotic therapy based on endometrial culture and sensitivity testing. First-line treatments often include oral doxycycline, azithromycin, or fluoroquinolones like ciprofloxacin. For polymicrobial infections, combination antibiotic regimens might include metronidazole plus doxycycline.

However, treatment success rates vary dramatically between 60-80%, meaning 20-40% of patients continue to face persistent endometrial infection and fertility challenges even after completing what should have been curative antibiotic therapy.

After you followed your fertility specialist’s antibiotic protocol exactly as prescribed, completed the full course, and yet follow-up endometrial biopsy might still show persistent plasma cell infiltration. Treatment resistance isn’t your fault. Several well-documented factors make the infection incredibly stubborn to eradicate, including antibiotic-resistant bacterial strains and biofilm formation by pathogenic bacteria that creates protective matrices antibiotics can’t penetrate.

Many patients tell us they feel trapped in an impossible clinical decision: continue pursuing additional antibiotic courses, IV therapy, or experimental treatments with uncertain efficacy, or accept that their endometrial environment may remain compromised and explore alternative paths after IVF. That feeling of being caught between continued treatment hope and realistic outcome expectations is emotionally exhausting.

For some patients, the condition becomes treatment-refractory and fundamentally alters long-term fertility prognosis. This clinical reality doesn’t mean your dream of genetic parenthood is over.

It just means your optimal path to a healthy baby might look different than you originally envisioned, and that’s medically and emotionally valid. Sometimes the most important fertility decision you can make is recognizing when it’s time to stop fighting the underlying endometrial pathology and start working around it through surrogacy instead.

Many people don’t realize: you could be matched with a pre-screened surrogate and moving toward embryo transfer in as little as 3-4 months. The journey to parenthood doesn’t have to take years longer.

Explore how surrogacy could shorten your timeline

Why Surrogacy May Offer a Path Forward

When the infection proves treatment-refractory despite multiple courses of targeted antimicrobial therapy, surrogacy offers a scientifically sound solution: bypassing the compromised endometrial environment that’s preventing successful embryo implantation. Instead of continuing to battle persistent endometrial inflammation and infection, this approach allows you to use your own genetic material while utilizing a carrier’s healthy, receptive endometrium for embryo transfer and pregnancy maintenance.

Surrogacy makes compelling medical sense when dealing with treatment-resistant cases:

You Can Bypass Endometrial Pathology Entirely: A carrier with a healthy endometrium, normal implantation markers, and no history of endometrial infection can successfully achieve implantation and maintain pregnancy with the same euploid blastocysts that repeatedly failed to implant in your inflamed endometrial environment.

Your Genetic Parentage Remains 100% Intact: This path preserves complete genetic parentage using your own oocytes and your partner’s sperm (or donor gametes as medically indicated). Your carrier serves only as a temporary biological incubator, providing the optimal endometrial environment your embryos need for successful implantation, trophoblast invasion, and placental development.

Your Fertility Success Rates Actually Improve: Working with a carefully screened carrier who has demonstrated prior pregnancy success often results in odds of achieving clinical pregnancy and live birth that exceed what’s statistically achievable even with optimal treatment. Data shows that intended parents using this approach can achieve pregnancy rates of 70-80% per embryo transfer cycle, compared to the 20-40% implantation rates typically seen with treated but persistent infection.

Choosing surrogacy after recurrent implantation failure due to the infection isn’t abandoning your fertility goals—it’s selecting the most medically appropriate pathway forward based on your endometrial pathology and treatment response history.

Imagine finally seeing two pink lines that stick. Imagine a pregnancy that progresses beautifully week after week. That future is closer than you think—and it starts with one conversation about surrogacy.

Schedule your consultation today

Can I Still Have a Genetic Child? How Surrogacy Makes It Possible

This is probably one of the first questions that crossed your mind when someone mentioned surrogacy, and we completely understand why genetic parentage is so important to your family-building goals. The answer is yes, absolutely—your child will be genetically yours in every single biological aspect that matters for heredity, family resemblance, and genetic inheritance.

If you have vitrified blastocysts in frozen storage from your previous IVF attempts, those embryos can be thawed and transferred directly to your surrogate through a frozen embryo transfer protocol. Having high-quality cryopreserved embryos with normal genetic testing results already available can significantly accelerate your timeline.

Fresh IVF cycles can also create new blastocysts optimized for surrogacy, using your preferred gamete combination: your oocytes and your partner’s sperm, your oocytes with donor sperm, donor oocytes and your partner’s sperm, or donor gametes if that represents your optimal strategy.

What matters most about the genetic aspects: your carrier has zero genetic contribution to your developing child. She provides the optimal uterine environment—like a specialized biological incubator—for your genetic embryo to implant, develop, and grow to term.

The child developing inside her uterus will carry your DNA, your partner’s genetic markers, your family’s hereditary traits, and all the physical characteristics determined by your combined genetic material.

Something that might provide significant hope for your fertility future: patients dealing with the infection often have excellent embryo quality with normal chromosomal composition. Your primary problem was never oocyte quality, fertilization capacity, or embryonic development—it was that your endometrial microenvironment couldn’t support successful implantation due to persistent inflammation and infection.

Ready to turn those frozen embryos into the family you’ve been dreaming of? Families who start the process today often hold their genetic babies within 12-18 months.

Working With a Surrogacy Agency: What to Expect

After everything you’ve been through, understanding what surrogacy actually involves can help you feel more in control and confident about this next step. The process typically involves five key steps: finding your agency, meeting your perfect match, getting legal agreements sorted, coordinating the medical aspects, and receiving pregnancy and birth support.

Working with agencies that keep pre-screened surrogates available can cut your waiting time dramatically. Thorough screening processes have already done the heavy lifting—they’ve verified medical histories, completed psychological evaluations, run background checks, and reviewed previous pregnancy outcomes. This means you won’t waste months screening someone who might not work out.

With pre-screened databases, you could be matched within 1-4 months instead of waiting 6-12+ months for individual screening after matching. If you already have embryos from your previous IVF cycles, this faster timeline means you could be doing an embryo transfer within 3-6 months of starting the process.

Want to keep things moving? Learn more about surrogacy wait times.

What Does Surrogacy Cost—and How to Afford It

The reality is that surrogacy represents a significant financial investment. Total costs for a complete cycle typically range $100,000-$200,000+, depending on geographic location, agency fee structures, surrogate compensation rates, medical complexity, and legal requirements. We understand that after everything you’ve already invested in fertility treatments, IVF cycles, and infection treatment, this financial commitment might feel overwhelming.

We completely understand that the financial aspects can feel intimidating, particularly after what you’ve already invested. Don’t let funding concerns prevent you from exploring this option. More financing resources exist than most intended parents initially realize:

Many intended parent families combine multiple funding sources to make surrogacy financially manageable within their household budget.

Get personalized financing guidance

Finding Strength: Emotional Support After IVF Failure

Experiencing recurrent implantation failure, multiple IVF cycle cancellations, and treatment-resistant infection can represent one of the most emotionally isolating experiences in fertility medicine. Well-meaning friends and family members might try to provide support, but unless they’ve personally navigated the trauma of repeated embryo transfer failures due to endometrial pathology, they often can’t fully comprehend the depth of grief, frustration, and anxiety you’re experiencing.

Thousands of intended parents are walking this same difficult path, dealing with treatment-refractory endometrial conditions, recurrent pregnancy loss, and the complex grief that accompanies IVF failure after IVF failure.

Consider working with fertility psychiatrists and psychologists who focus on the unique mental health aspects of recurrent pregnancy loss, treatment-resistant infertility, and fertility trauma.

Online communities like r/IVF and r/InfertilitySucks provide supportive spaces where members discuss treatment failures and coping strategies. FertilityIQ community forums offer discussion boards for intended parents who’ve transitioned from IVF to surrogacy after medical complications.

You’ve already shown incredible strength by not giving up on your dream of parenthood. Now let us show you how surrogacy can be the bridge between where you are and where you want to be.

Connect with our compassionate team

Ready to Move Forward? Start Your Surrogacy Journey Today

If treatment-resistant infection has made traditional pregnancy through your own uterus medically inadvisable or repeatedly unsuccessful despite multiple antimicrobial therapy attempts, surrogacy can provide the evidence-based pathway that finally leads you to successful parenthood. With the right agency, skilled medical team, and carefully matched carrier, you can transition from the ongoing frustration and emotional trauma of failed embryo transfers to the hope and excitement of a successful pregnancy and healthy live birth.

Take your next actionable steps toward parenthood:

You’ve already demonstrated incredible resilience and determination by not abandoning your dream of genetic parenthood despite facing significant medical obstacles. Don’t let recurrent IVF failures define the final outcome of your family-building journey. Your biological child is waiting for you—they might simply need a different, healthier uterine environment to reach you safely.

Contact our specialists today

Ready to learn more about how surrogacy can help you move past endometrial pathology and toward the genetic family you’ve dreamed of? Our medical team has provided guidance and support to countless intended parents who’ve faced exactly the same medical challenges you’re navigating. We understand your unique fertility journey and the complexity of your medical situation. We’re here to give you the personalized, compassionate guidance and support you need to take this next crucial step toward parenthood with complete confidence.

Get Started