Recurrent Implantation Failure: Causes & Treatments
If you’ve struggled to become pregnant through IVF, you aren’t alone. You may be experiencing Recurrent Implantation Failure (RIF).
Implantation failure occurs when embryos don’t implant (attach to the uterine lining) after transfer. This can happen even when transferring several good quality embryos.
RIF is considered when 3 or more consecutive IVF cycles fail to result in pregnancy, despite using good quality embryos. Each case is unique, and fertility specialists consider a variety of factors when diagnosing and treating patients.
Related: Recurrent implantation failure is not the same as recurrent pregnancy loss (RPL). Learn about causes and treatments for RPL.
What Causes Recurrent Implantation Failure?
Successful implantation involves an interaction between a high-quality embryo and a receptive endometrial environment.
Because of this, there are many reasons why embryos may not implant during IVF. These reasons include:
Genetic factors: Sometimes an embryo may have chromosomal abnormalities that can prevent it from implanting. For example, aneuploidy (abnormal number of chromosomes in an embryo) can cause RIF.
Environmental factors: The health of the uterus is an important factor in IVF. Structural issues such as polyps or fibroids can make it difficult or nearly impossible for embryos to attach.
infection/inflammation: Chronic endometritis in the uterus can interfere with implantation.
Lifestyle factors: A person’s overall health also influences success with IVF. Smoking, stress, and diet can impact implantation chances.
How is Recurrent Implantation Failure Diagnosed?
Defining RIF can be challenging, as several factors are taken into account for diagnosis. These factors include embryo quality, whether embryos are fresh or frozen, maternal age, and the number of failed transfer attempts.
If your doctor believes you’re experiencing RIF, they may recommend testing to understand (and treat) the root cause. Tests include:
Genetic testing: You and your partner may be screened for genetic abnormalities such as balanced chromosomal translocation or your doctor may recommend screening the embryos for chromosomal aneuploidy.
Imaging: Pelvic ultrasound, hysteroscopy, or MRI may be recommended to evaluate the uterus more closely. These imaging tests can reveal anatomic issues like polyps or fibroids.
Blood tests: Your doctor may recommend bloodwork to check for hormonal imbalances or issues with your immune system. Bloodwork is also used for genetic testing.
Sperm testing: Sperm quality can be a factor in creation of a high quality embryo which may impact implantation success. Sperm DNA Fragmentation Tests check the integrity of sperm samples.
Treatment Options for Recurrent Implantation Failure
If RIF is impacting your fertility journey, there’s still hope that you can become pregnant.
Depending on the causes for RIF that are identified through your testing, there are several treatment options available to improve your chances of pregnancy:
Genetic interventions: If genetic factors are found, your doctor may recommend screening of the embryos through Preimplantation Genetic Testing (PGT). This screening can improve your chances of a successful pregnancy by ensuring that the embryos with the best potential for implantation are chosen to be transferred.
Surgical interventions: If structural issues (such as polyps or fibroids) are found during testing, surgery may be recommended. Removing these barriers can create a better environment for future embryo transfers.
Medication: If infections or immune issues are affecting implantation, medications can help. Your doctor may prescribe antibiotics to treat the issue and create better conditions for implantation.
Get Personalized Guidance and Fertility Care
RIF can be overwhelming, but advances in testing and treatment offer hope.
The best way to navigate these challenges is through a personalized approach. Consulting with a fertility specialist provides clarity and guidance for your specific situation. If you think you might be experiencing RIF, request a consultation with Dr. Lina Akopians.