Recurrent implantation failure (RIF) is a condition where transferred embryos fail to implant following several in vitro fertilization (IVF) treatment cycles.
There are several causes of implantation failure, which can be categorized as embryonic, uterine, and systemic. Here are some common causes of RIF:
- Chromosomal abnormalities in the embryo
- Uterine abnormalities, such as endometrial polyps or fibroids
- Hormonal or metabolic disorders, such as thyroid dysfunction or diabetes
- Immunological factors, such as antiphospholipid syndrome.
- Male factors, such as sperm DNA fragmentation
- There is ongoing research into new areas of RIF which include natural killer cells.
There are several ways to improve the success of embryo transfer in patients with RIF.
The treatment options depend on the underlying cause of implantation failure. Here are some ways to improve the success of embryo transfer:
- Preimplantation genetic testing Aneuploidy (PGT-A) to detect chromosome abnormalities
- Hysteroscopy to diagnose and treat uterine abnormalities
- Hormonal or metabolic management to address underlying disorders
- Immunomodulatory therapy to address immunological factors
- Sperm DNA fragmentation testing and treatment, such as intracytoplasmic morphologically selected sperm injection (IMSI)
It is important to note that there is an ongoing debate about optimal conditions for successful IVF outcomes, and the implantation rate per embryo will vary depending on a patient’s age, and whether the embryos have had genetic testing prior to transfer. Therefore, it is important to work with your fertility specialist to determine the best treatment options for individual cases of RIF.