Repeated implantation failure

Uterine Fibroids

Translocation

Blastocyst - 2

Repeated Implantation Failure (RIF) is a condition characterized by the failure of an embryo to implant in the uterus after multiple cycles of in vitro fertilization (IVF) treatments. This condition is a significant challenge in the field of reproductive medicine, affecting a considerable number of couples seeking assistance for infertility.

Definition

Repeated implantation failure is typically defined after three or more unsuccessful attempts at embryo transfer, with the transfer of good quality embryos, in women under the age of 40. However, the exact definition can vary among fertility specialists and clinics.

Causes

The causes of RIF are multifactorial and can be divided into embryonic or uterine factors. Embryonic factors include issues related to the genetics of the embryo, while uterine factors involve abnormalities in the uterine environment that prevent successful implantation. These may include:

• Embryonic Factors: Chromosomal abnormalities in the embryo, poor embryo quality.
• Uterine Factors: Anatomical abnormalities of the uterus (such as fibroids or polyps), thrombophilias (blood clotting disorders), immunological factors, and hormonal imbalances.

Diagnosis

Diagnosing RIF involves a comprehensive evaluation of both partners. This includes a detailed medical history, physical examination, and various tests such as:

• Hysteroscopy and ultrasound to assess uterine abnormalities.
• Genetic screening of both partners.
• Assessment of embryo quality in previous IVF cycles.

Treatment

Treatment for RIF is tailored to the underlying cause(s) and may include:

• Surgical correction of uterine abnormalities.
• Use of preimplantation genetic testing (PGT) to select chromosomally normal embryos for transfer.
• Immunotherapy for suspected immunological issues.
• Adjustment of hormonal support during the embryo transfer cycle.

Prognosis

The prognosis for patients with RIF varies, depending on the identified causes and the effectiveness of targeted treatments. With appropriate intervention, many couples can achieve successful pregnancy.

Conclusion

Repeated implantation failure is a complex condition that requires a multidisciplinary approach for diagnosis and treatment. Advances in reproductive technologies and personalized treatment strategies offer hope to affected couples.