Recurrent implantation failure
Causes of Recurrent Implantation Failure
1. Embryo-Related Factors
- Poor Embryo Quality: Sometimes, chromosomal abnormalities in the embryo can reduce the chances of successful implantation.
- Genetic Defects: Embryos with aneuploidy (abnormal number of chromosomes) often fail to implant.
2. Uterine and Endometrial Factors
- Thin Endometrial Lining: A lining which is less than 7-8mm can make the implantation process difficult.
- Endometrial Receptivity Issues: If the uterus is not receptive during the implantation window, embryos may not attach.
3. Immunological and Blood Clotting Disorders
- Autoimmune Disorders: An overactive immune response may attack the embryo, which prevents implantation.
- Antiphospholipid Syndrome (APS): Due to this condition, abnormal blood clotting happens in the body. This can block proper placental development.
Recurrent Implantation Failure Treatment
Recurrent Implantation Failure (RIF) is the inability of an embryo to implant in the uterus after multiple in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) attempts. It is typically diagnosed when three or more high-quality embryos fail to implant after assisted reproductive treatments. RIF can be frustrating and emotionally challenging for couples trying to conceive, making it essential to identify the underlying causes and explore effective treatment options.
Treatment and Management of RIF
1. Optimizing Embryo Quality
- Genetic Screening (PGT-A): This ensures only chromosomally normal embryos are transferred.
- Blastocyst Transfer: Here, transferring embryos at the blastocyst stage (Day 5) increases implantation chances.
2. Enhancing Uterine and Endometrial Receptivity
- Endometrial Scratch: It is a minor procedure to improve implantation success.
- Hormone Therapy: Here, estrogen and progesterone can support endometrial thickness.
- Platelet-Rich Plasma (PRP) Infusion: This improvement can improve uterine lining.
Diagnosis of Recurrent Implantation Failure
A thorough evaluation includes:
- Genetic Testing of Embryos: Preimplantation Genetic Testing (PGT) can detect chromosomal abnormalities.
- Hysteroscopy or Sonohysterography: It checks for uterine abnormalities.
- Endometrial Receptivity Analysis (ERA): It determines the best window for implantation.
- Thrombophilia and Autoimmune Screening: It detects blood clotting or any immune issues.
- Hormone and Thyroid Tests: These assess progesterone, estrogen, and thyroid levels in the body.