Repeated Implantation Failure or Miscarriage in IVF-Why Does It Happen & What’s Next?
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It is Not your Fault!
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What is Repeated Implantation Failure & miscarriage in IVF?
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Which is the Culprit?—Possible Reasons why IVF Fails
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Investigations
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What’s Next? Can Implantation Failure be treated?
Treatment for infertile couples has been progressing immensely during recent years. Millions of ART cycles are being performed every year with the highest success of pregnancy and birth rates.
Sadly, not all fertility treatments result in a successful and healthy pregnancy and some couples have repeated implantation failure (RIF). And when implantation fails or a confirmed pregnancy ends in a miscarriage, understandably this could be an incredibly devastating experience for a couple.
Embryos looked perfect, yet they failed to implant—What’s gone wrong & Why did this happen?
These are the questions in the minds of women who undergo IVF failure and this becomes a particularly aching doubt when they face repeated or multiple IVF failures. Most women naturally think their uterus is defective or their body is unable to accept the embryos or their own body is not good enough to accept it or just kill it.
After all, fertilization happened in the laboratory, the embryo has grown well in vitro, and they even saw their embryo, most women undergoing IVF naturally conclude that good embryos are meant to implant.
In most cases, when an IVF attempt has been unsuccessful or a woman suffered a miscarriage in a natural pregnancy, the cause might be related to embryo quality, but this is not true in all cases. Many other factors are responsible for an implantation failure.
It is Not your Fault!
Sounds familiar? Low self-esteem caused due to infertility makes it easy to conclude that you have beaten up yourself. In addition, implantation failure or miscarriages is often made worse by relatives by their comments.
This article has been drafted to help you understand what are the possible causes for repeated implantation failures and contributing factors and are there any treatments or therapies available to treat implantation failure.
What is Repeated Implantation Failure or miscarriage in IVF?
When an egg and sperm combine an embryo is formed, (this event naturally takes place in the fallopian tube in your body and in IVF treatment it takes place in the lab in a petri dish that contains a special nourishing culture medium.
The embryo is thus formed and rapidly divides and reaches the uterus in the blastocyst stage (3-5 days of embryo development) and also manually transferred to the woman’s uterus on day3 or 5 during an IVF cycle.
In the uterus, the blastocyst starts communicating with the endometrium (uterine lining) by secreting protein molecules and if the endometrium is receptive and competent enough, this results in successful implantation
When a woman undergoes (2-6) IVF cycles and failed to achieve a conception. And implantation doesn’t happen even after transferring ten high-grade embryos were transferred to the uterus over many cycles, then the woman is said to have repeated implantation failure.
So what really causes implantation failure? Keep on reading!
Which is the Culprit?—Possible Reasons why IVF Fails
Embryonic loss or implantation failure occurs repeatedly after the ART or IVF cycles, maybe attributed to various factors. And these are grouped into three categories: embryonic defects, endometrial receptivity, and factors with combined effect.
Here are some assumed aetiologies or reasons for repeated implantation failure or Failed IVF:
Decreased endometrial receptivity
- Thin endometrium
- Uterine cavity abnormalities
- Immunological factors
- Altered expression of adhesive molecules
- Thrombophilias
Defective Embryonic Development
- Zona hardening
- Genetic abnormalities
- Suboptimal culture conditions
Multifactorial reasons
- Hydrosalpinges
- Endometriosis
- Suboptimal ovarian stimulation
Investigations & Suggestions
There is support for various treatment options for women with RIF-Recurrent Implantation failure. To devise treatment programs, there are some investigations listed below that can be carried out before commencing the treatment and also aid you to tailor treatment as per your needs.
If you would like to discuss your options after an implantation failure or a miscarriage, MotherToBe fertility Clinic in Hyderabad fertility specialists are here to help:
Creative image regarding Multiple IVF failures—
Maternal Blood Tests—
Clotting screen—Small clots in the blood have been identified as one of the possible causes for a pregnancy failing to progress.
Immune Screen—increased levels of white cells (uterine natural killer cells) and autoantibodies are also suggested as the cause for the repeated failure of IVF cycles.
Endometrial tests—
Endometrial scratch/Hysteroscopy & Endometrial Receptivity array tests are done to analyze the presence of fibroid or polyp inside the womb and furthermore, by planning the embryo transfer at the appropriate time to improve the chances of successful implantation.
Parental factors—
Sperm DNA Fragmentation—Assessing the sperm DNA helps identify couples that will benefit from ICSI treatment.
Embryo Factors
Genetic Screening—used to screen chromosomal abnormalities before implantation as well as to choose the most viable embryos that are more likely to implant.
Embryoscope—–(time-lapse imaging)—recording embryo information by time-lapsing photography to assess the subtle changes in embryo development.
Laser-assisted hatching—physical or chemical procedure carried out to break zona pellucida (embryo’s outer shell) to improve the chances of implantation.
What’s Next? Can Implantation Failure be treated?
It is obvious to grieve after an IVF failure or miscarriage, but you need to overcome this and seek the support of your fertility specialist, your partner before moving forward in your treatment for parenthood.
While deciding your next step, you can consider these options:
- Another Attempt of IVF—Discuss with your fertility doctor and determine whether any reliable adjustments to the IVF cycle need to be made. Based on the reason, to avoid prior IVF failure, PGT may be indicated.
- Test your AMH levels– if they are normal that means you have a good ovarian reserve and continue with ART procedures. (Third-party donor) If you have poor or diminished ovarian reserve or older than 40 years and also have suffered RIFs (repeated implantation failures), then you should consider using donor eggs.
- Go for add-ons—try IVF-ICSI, this could be a very successful treatment method. (this is in cases where an IVF cycle achieves a conception but the pregnancy does not develop to term).
- Go for mild ovarian stimulation protocols where you can produce superior quality eggs and embryos.
- Try Day-5 (Blastocyst) Transfer—if you have failed IVF many times by using day-3 embryo transfer, then try having a transfer with the day-5 embryo ( developing to blastocyst stage indicates that your embryos are good enough).
- Frozen Embryo Transfer (FET)—go for frozen transfer instead of a fresh embryo transfer. This is because high levels of estrogen during a fresh cycle could damage your uterine receptivity.
- Surrogacy— some women, for whatever reason, can’t carry a fertilized egg/embryo to term. This can result in embryo implantation failures or repeated miscarriages, even after the successful IVF. in such cases, women can go for a gestational carrier.
Had Previous IVF Failure or Miscarriage?
MotherToBe fertility center in Hyderabad specializes in the care and support for couples who have suffered repeated unsuccessful IVF cycles or recurrent miscarriages!
We provide a diagnosis through comprehensive screening and propose the best-tailored treatment pathway.
Our top fertility specialists and embryologists with 20+ years of combined expertise and experience, help you understand what’s going wrong and provide you with the answers and create treatment plans that possibly give you successful outcomes.
Personalized treatment as unique to your clinical history, genetics and health to resolve any issues and help you realize your parenthood dreams.
We are here to support you every step of your fertility journey!
Talk to our fertility experts!