Experiencing repeated implantation failures can be heartbreaking; it might feel like you’re so close to your dream of holding a baby in your arms, yet, so far.
Although it is a rare occurrence, about 5% of women are likely to suffer from repeated implantation failures. In this condition, good-quality embryos fail to conceive despite several IVF treatment cycles.
The below blog post discusses some more points to help you gain a better understanding:
- What is repeated implantation failure?
- What causes repeated implantation failure?
- What are the tests that help avoid repeated implantation failures?
- What next after repeated implantation failure?
What is repeated implantation failure?
Women who have failed three IVF attempts with good quality embryos are said to have experienced repeated implantation failure (RIF). Although the age factor plays a crucial role, the causes of recurrent implantation failures vary in each case, with the majority of factors related to maternal or embryonic causes.
What causes repeated implantation failure?
According to Dr. Narhari Malgoankar, Chief IVF consultant at Progenesis Fertility Center, “Repeated implantation failures can occur due to several factors, including the health of the uterus and embryo.” Along with this, poor lifestyle habits, low-quality gametes, advanced age, and reproductive issues are other factors to consider.”
The additional factors that contribute to the cause of repeated implantation failure are mentioned below:
1. The quality of the egg and sperm
A healthy embryo requires a high-quality egg and sperm that boosts the chances of embryo implantation in the womb. But unfortunately, some factors can reduce gamete quality and hamper the likelihood of implantation.
Dr. Malgonakar mentions, “egg quality typically declines in women after the age of 35, and the eggs collected in this case are less likely to successfully implant in the uterus.”
He further adds, “sperm abnormalities, on the other hand, also contribute to implantation failures. For instance, damage to the sperm’s genetic material – also known as DNA fragmentation can affect the development of an embryo leading to implantation failure.”
2. Chromosomal abnormalities in the embryo
Variations in the embryo’s chromosomes are another cause of recurrent implantation failures. As known, a healthy embryo contains 46 chromosomes in total, and even a minor discrepancy in this number can cause implantation failure.
While sharing his views Dr. Narhari Malgoankar adds, “embryos must be checked for chromosomal abnormalities in required cases before implantation. Also, keeping track of embryos in the development stage helps detect any variations in the number of chromosomes present along with the structural changes that affect chromosome size and structure of DNA within them.”
He further mentions, “no matter the type of error, chromosomal anomalies within the embryo are much less likely to result in an ongoing pregnancy.”
3. The uterine environment
For an embryo to implant successfully in the uterus, the endometrium (uterine lining) must undergo the necessary biological changes.
Inflammation and scarring, such as fibroids, polyps, adenomyosis, hydrosalpinx, and endometriosis, can affect the structure of the uterine environment making it more difficult for the embryo to implant.
4. Lifestyle factors and other medical conditions
Health and lifestyle factors relating to one or both parents can impact the success rates of embryo transfer.
Underlying medical issues in the mother, such as diabetes, thyroid disease, and other endocrine diseases, along with autoimmune and clotting disorders, can prevent the embryo from interacting with the endometrium.
In addition, alcohol consumption, smoking, and other modifiable lifestyle factors in both parents (including poor diet, exercise, and being overweight) contribute to repeated implantation failures by affecting the gamete quality and the health of the uterine environment.
What are the tests that help avoid repeated implantation failures?
Several tests and screenings are available to pinpoint the problems causing repeated implantation failures. Below are some of the various test options:
Uterine Evaluation/ Hysterosalpingogram
According to Dr. Narhari Malgoankar, “The evaluation of the uterus is necessary to be done before the first IVF cycle,” he further adds, “ HSG is the test of choice because it is the only test that looks into the uterus and the fallopian tubes.”
He further explains, “hydrosalpinx (blocked fallopian tube) reduces implantation by 50 percent, hence the test can help determine the tubal status before opting for IVF and help reduce the chances of implantation failure.”
Sperm DNA Fragmentation Test
Another test that can be beneficial is the sperm DNA fragmentation test, which examines the sperm’s DNA integrity.
“Abnormally high assay rates result in lower fertilization rates, lower implantation rates, and higher miscarriage rates”, states Dr. Malgoankar.
He also adds, “ sometimes, men with normal semen analysis findings can also have abnormal DNA fragmentation results. Thus, using sperm DNA fragmentation testing to evaluate male fertility rates is always a preferable alternative.”
Endometrial Receptivity Assay (ERA)
Endometrial receptivity assay is the test that helps determine whether the endometrium is receiving the embryo at the right time. During the test procedure, a biopsy of the endometrium is performed, and the expression of hundreds of genes is investigated to determine the receptivity of implantation.
The ERA test reveals if the endometrium is receptive on a particular day and further helps determine whether a future embryo transfer should be performed a day earlier or a day later than expected.
“The best thing about ERA is that it uses genetic markers instead of biochemical indicators as this technology helps see if the endometrial “implantation window” is open on the correct day of the cycle,” states Dr. Narhari Malgoankar.
He further mentions, “If not, you can freeze the embryos and transfer them in a protocol that adjusts the number of days of progesterone given before the transfer.”
Preimplantation Genetic Testing
One of the most common causes of repeated implantation failures is chromosomal abnormalities. Transferring abnormal embryos results in a failure to conceive, and increases the risk of miscarriages and abnormal births.
Conducting a PGT-A test can be beneficial in this case. During this technique, cells are taken from a growing embryo and their chromosomal content is examined.
According to Dr. Narhari Malgoankar, “PGT-A is a lot more of a logical approach than multiple embryo transfer”, he also adds, “PGT-A improves the ability to achieve pregnancy with single embryos, which helps reduce the risks of multiple IVF failures.”
What next after repeated implantation failures?
Despite all the science, all the expertise, and all the best efforts, unfortunately, implantation might not always occur in some cases. There are always abnormalities associated with implantation failure, hence, once they are recognized, other treatment options should be considered.
Along with the right treatment options, the right nutrition also plays an important role in increasing your chances of implantation.
Here are 5 of some common considerations for couples experiencing repeated implantation failures.
- If an inflammatory disorder such as endometriosis is an issue for you, consuming anti-inflammatory foods can help benefit
- Autoimmune diseases, such as coeliac disease or Type 1 diabetes may also cause chronic inflammation and prevent implantation. So, stick to a strict gluten-free diet, also, look into optimizing your glucose levels.
- Excess body obesity is another prevalent risk that might affect the uterine lining causing inflammation and hampering the process of implantation. In this case, a low-calorie, anti-inflammatory diet will prove effective.
- Anatomical abnormalities such as fibroids usually don’t cause any problems, but if they’re growing in the wrong place they can lead to multiple IVF failures. Hence, switching to a healthy diet can prove helpful.
- The odds of implantation increase when the uterine lining is thin. To boost the thickness of your uterine lining and your chances of implantation, eat a diet rich in whole grains.
Conclusion
Dispspite of major advances in science and IVF technologies, the dilemma of repeated implantation failure can be overwhelming; it is important to talk to your fertility specialist so that together you can overcome this challenge
Along with the advanced treatment options, the right tests and diagnosis with proper evaluation can definitely help overcome the problems with repeated implantation failures.
At Progenesis IVF, we have a team of experts to assist and guide you through all the treatment processes with assured success.
Our best centers in the cities of Thane, Pune, and Nashik utilize cutting-edge ART technology to provide you with the best fertility care.
Struggling with repeated implantation failures? Don’t give up on hope! Give us a call and we will help you in achieving your parenthood dream.