Repeated in-vitro-fertilization (IVF) failure is perplexing for patients as well the infertility team providing care. In spite of repeated placement of what appear to be healthy embryos, ongoing pregnancy does not occur. These patients usually have had extensive evaluations that include careful evaluation of the uterine cavity, genetic testing of both parents, testing for clotting disorders (thrombophilias) in the woman, comprehensive endocrine assessment, and evaluation of the male. Conventional wisdom has been that there is most likely a genetic explanation for these repeated failures. That notion may be incorrect based on a recent study.