Implantation Failure (IF) Causes and Treatment

Implantation Failure (IF) Causes and Treatment

Some infertile couples undergo multiple IVF cycles and produce high-quality embryos, yet the embryos consistently fail to implant. This is known as Implantation Failure (IF). The process of implantation involves two key components:

• A healthy embryo with the potential to implant.
• A receptive endometrium that enables implantation.

Maternal Causes of Implantation Failure

Inadequate Endometrial Receptivity (65% of IF cases):

Implantation failure may be due to undiagnosed uterine pathologies, such as hyperplasia, polyps, endometritis, synechiae, or fibroids. Decreased endometrial receptivity can also result from a thin uterine lining, altered expression of adhesive molecules, immunological factors, or thrombophilia.

Embryonic Causes of Implantation Failure

Genetic and Chromosomal Abnormalities (30% of IF cases):

High rates of chromosomal abnormalities in human embryos are responsible for IVF failure in many cases.

Multifactorial Causes of Implantation Failure

Endometriosis and Hydrosalpinx (5% of IF cases):

Patients with endometriosis have a decreased ovarian response, reduced embryo quality, and lower implantation & pregnancy rates, leading to implantation failure. Hydrosalpinx can also lower implantation and pregnancy rates through direct embryotoxicity or by negatively affecting the endometrium.

Investigation & Treatment for Implantation Failure

1. Improving Endometrial Receptivity

Studies show that hysteroscopic treatment of intrauterine pathologies improves pregnancy outcomes. The Endometrial Receptivity Array (ERA) test has made it possible to assess the endometrium’s receptivity status in natural and stimulated cycles. This molecular diagnostic tool analyzes 238 genes related to endometrial receptivity and helps personalize embryo transfer timing.

2. Selection of Good Quality Embryos

Time Lapse Imaging: Time Lapse Imaging allows selection of the optimal embryos for transfer based on the development timeline. An extended development time may indicate chromosomal abnormalities (aneuploidy), leading to a failed pregnancy.

PGS/PGD: Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD) are preventative measures used to detect chromosomal abnormalities in embryos, even when neither parent shows signs of genetic abnormalities.

Transferring embryos at the blastocyst stage is a more physiological approach since human embryos typically reach the endometrial cavity 5 days after fertilization. Proper embryo transfer technique is crucial in cases of implantation failure.

3. Multifactorial Treatment Options

Literature has shown that suppressing endometriosis prior to ART significantly increases pregnancy rates. Laparoscopic salpingectomy is recommended for women with hydrosalpinx before IVF treatment, especially in cases of implantation failure.

At Akanksha IVF Centre, we have successfully treated many patients with implantation failure referred from other centers. Our team of experienced specialists and embryologists is well-equipped to handle such cases with excellent outcomes.

Contact Akanksha IVF Centre

Akanksha IVF Centre, A-3/7, Janakpuri, New Delhi, India – 110058

Phone: +91-11-45682024

Mobile: +91-9810398765, +91-9810398767

Email: kdnayar@usa.net