What is Repeated Implantation Failure?
Repeated implantation failure refers to the failure torepeated
implantation failure achieve pregnancy in an IVF cycle after
transfer of at least three to four good-quality embryos in a minimum
of three fresh or frozen cycles in a woman under the age of 40 years.
Successful IVF, IVF-ICSI is good procedures, but
still in some cases in spite of repeated attempts with
good embryos the procedure is not successful.
Successful embryo implantation requires synchronous
development and interaction between the embryo and the endometrium.
Recurrent implantation failure causes a lot of mental and financial
stress on the infertile couple. It is also very difficult for the
treating doctor to explain the reasons for not being successful
in spite of everything being right. RIF may be both of embryonic or uterine factors or both.
Repeated Implantation Failure (RIF) may be due to several causes:
Congenital uterine abnormalities, such as endometrial polyps, uterine fibroids,
adhesions, hydrosalpinges, endometriosis, etc.
Male factors such as severe oligoasthenozoo-spermia with increased
sperm DNA fragmentation may also impact on the grading of the embryo.
Aneuploidy in embryos
Metabolic disorders like uncontrolled diabetes, impaired thyroid function or prolactin level, etc. in the couple
Thrombophilias or antiphospholipid syndrome
Immunological factors.
Impaired endometrium:
Impaired endometrium can be a common cause of recurrent
IVF failure. When morphologically good embryos are transferred,
the question arises as to whether the problem is due to incompetent
embryo or endometrium or both.
If the patient is young and there are morphologically
good embryos then there is a greater chance that the problem
lies with endometrium, either in terms of thickness, character,
vascularity or immunology.
For successful implantation to occur, there are several
chemical signals between the embryo and endometrium.
Maternal blood tests
Clotting factors – Small clots in the blood have been identified
as a possible cause for pregnancies failing to progress.T
hese patients can be treated with aspirin or low dose heparin.
Immunologic factors – High levels of uterine natural killer cells
and auto-antibodies can also be the cause for RIF.