What is implantation failure (RIF) in IVF?

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1. What is implantation failure in IVF?

Over the past three decades, in vitro fertilization (IVF) has helped millions of women worldwide conceive healthy babies. Although IVF success rates are consistently improving, however, many IVF cycles end in disappointment in couples because the embryos appear normal at first, but after implantation the embryos do not. can implant and cannot develop into a fetus. When implantation failure occurs in multiple IVF cycles, the patient or couple is referred to as recurrent implantation failure (RIF).

Currently, obstetricians have not agreed on the definition of RIF. The most commonly used definition is failure after 3 embryo transfers with potentially high quality embryos. RIF includes cases where the embryo has been implanted but failed to implant, leading to failure, before the gestational sac could be detected by ultrasound. With the advent of pre-embryonic genetic testing for chromosomal abnormalities (PGT-A), the definition of miscarriage, recurrent stillbirth can be supplemented with cases including implantation failure. consecutively after three euploid embryo transfers, that is, the number of chromosomes in the cell is a multiple of n including the case of 2n, n, polyploidy.

2. What are the causes of implantation failure in IVF?

Many factors are known to contribute to implantation failure in IVF. Known factors include the age of the parents, genetic problems of the embryo, abnormalities of the uterus including birth defects, fibroids and polyps, chronic infections and inflammation of the fallopian tubes as well as tissue lining the inside of the uterus (endometrium), autoimmune factors, hormone abnormalities, obesity, and environmental toxins including maternal smoking, alcohol and drug use.

As women age, the number of eggs decreases and the proportion of eggs with genetic abnormalities increases. Implantation failure and biochemical pregnancy rates increase with maternal age, particularly in women 38 years of age and older. However, RIF can occur, even with embryos considered chromosomally normal, with age being only one contributing factor to RIF.

3. Directions for treatment of implantation failure in IVF

For any woman or couple with RIF, an evidence-based assessment should be done in both time and cost savings. By comprehensive assessment including medical and reproductive history of both parents, assessment of genetic, hormonal and immunological factors, detailed assessment of uterus, fallopian tubes and ovaries egg. Advanced sperm testing may be done in some cases of RIF.
Currently, there are many commonly used and combined treatment methods to help reduce implantation failure rates such as hormonal supplements, anticoagulants, treatment of uterine diseases or pelvic floor, antibiotic treatment and IVF combined with pre-implantation genetic testing (PGT) may be appropriate treatments for some couples.

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Reference source: Rbmojournal.com; Romanian.com