Implantation failure: definition, causes and solutions

Implantation failure

Implantation failure is when the pregnancy is not achieved after 3 cycles of IVF or IVF with egg donor in which good quality embryos were transferred. Although the embryos were good, there were no technical problems in carrying out the transfer to the uterus thanks to a good uterine receptivity, the pregnancy was not achieved due to implantation problem.

In case of embryo implantation failure, it is important understanding the cause in order to perform the treatment by applying a specific technique to increase the chances of pregnancy.

Why does implantation failure occur?

Several causes and factors are involved in the implantation failure such as: uterine and embryos causes as well as endometrial disorders. Problems related to the uterine environment may be due to inadequate development of the endometrium, fibroids, polyps, or alterations in endometrial receptivity due to anomalies in implantation window (period in which the endometrium allows implanting the embryo).

Regarding the embryo factor, even if the embryos are monitored in the laboratory, the embryo which is selected to be implanted may have genetic or chromosomal anomaly that may hinder the implantation.

Treatments to achieve the pregnancy after implantation failure

Make a correct diagnosis and understanding the causes of implantation failure are fundamental processes in order to choose the most appropriate treatment and technique to achieve the pregnancy. The techniques applied to face embryo problems:

  • Culture up to blastocyst stage: The transfer is performed in day 5 or 6 after the fertilization. In this way, the embryologist can detect any anomaly during the embryo development in the laboratory and select the one of higher quality and with more chances to implant.
  • Preimplantation Genetic Diagnosis (PGD): Before the embryo transfer in IVF cycle, PGD is applied. It is a prevention technique that helps detecting genetic disorders in embryo and allows selecting the healthy embryos.
  • Assisted Hatching: The oocytes are surrounded by the “zona pellucida”, the external layer, which is responsible for protecting the egg and the embryo from the fallopian tubes until they are implanted in the uterus. Occasionally, some embryos have a thicker zona pellucida which hampers the embryo to hatch of it. Thanks to Assisted Hatching a hole is made in the zona pellucida to help the embryo implantation.

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