Implantation Failure (RIF)
IVF or ICSI therapies, among all the different methods for treating infertility, offer the highest probability of a successful pregnancy. Success is not, however, guaranteed.
If transferring embryos does not succeed three times in a row, this is called “repeated implantation failure” or RIF.
There may be diverse reasons for this failure:
- Immunological Causes
One major focus in explaining RIF is in achieving a comprehensive diagnosis of the immune system. Please read further information on these issues, as well as options for diagnosis and treatment here >> - Organic Causes
Abnormalities in the uterus, constrictions of the uterine cavity, and endometrial polyps can all be responsible for an embryo’s failure to implant. These are not always easy to recognize on an ultrasound. The best way to diagnose such issues is through a uterine endoscopy (hysteroscopy). Often, the problem can even be resolved during this diagnostic examination. - Sperm Cell Quality
The embryo can only be as good as the egg and sperm cells that unite to form it. Many sperm cells have small collections of fluid in their heads (vacuoles) that can lead to a non-optimal embryo following fertilization. These cannot be seen under a “normal” microscope. They may only be identified using a specialized IMSI microscope. This tool can be used both diagnostically (MSOME sperm analysis) and therapeutically (IMSI therapy). - Chromosomal Causes
A genetic analysis of both the man and woman can also bring to light small faults which, while they may not represent any impairment in everyday life, can repeatedly lead to the creation of embryos which either do not implant or which cause early termination of the pregnancy following successful implantation. - Hormonal Causes
A hormonal imbalance can also prevent embryos from implanting. Besides a basic blood test, during which thyroid and other hormones are measured, the focus is primarily on ensuring a sufficiently high level of progesterone following transfer of the embryos. This level absolutely must be measured twice following transfer, so that the daily dose of progesterone can be adjusted if needed.