Most women feel frustrated and sad if they don’t get pregnant after their first IVF cycle. The feeling only gets worse when you go through several unsuccessful IVF cycles and learn you have recurrent implantation failure. But even this challenge doesn’t mean you reached the end of your journey.
As a reproductive and infertility expert, Fangyin Meng, MD, PhD, has helped many women overcome implantation failure with advanced diagnostic testing and customized treatments that help them have the baby they desire.
Here’s the information you need to know about recurrent implantation failure and its many possible causes.
Recurrent implantation failure defined
Implantation failure occurs during IVF when the embryo fails to attach to the inner uterine wall. Women who don’t get pregnant after several IVF cycles have recurrent implantation failure.
So, what is an IVF cycle? Your IVF cycle begins when you take fertility drugs to make several eggs mature. As soon as the eggs mature, we retrieve the eggs and fertilize them with sperm in our carefully controlled lab environment.
After the embryos grow for several days, we transfer them to your uterus. Finally, we schedule a pregnancy test 12-14 days later.
This entire process is considered one IVF cycle. A successful IVF cycle comes in the form of a positive pregnancy test.
Causes of recurrent implantation failure
The causes of recurrent implantation failure may involve the egg, sperm, embryo, uterus, the mother’s and father’s health, or any combination of these factors.
Within these broad categories, there are many possible causes to explore. For example, imbalances in a vast array of hormones and biochemicals, chronic infections, autoimmune antibodies, obesity, and immune system problems could play a role.
Gynecologic conditions such as endometriosis, ovarian cysts, and uterine fibroids often cause recurrent implantation failure. In most cases, we diagnose and treat these problems before starting IVF, but you may have other reproductive system conditions contributing to implantation problems.
However, the three most common issues affecting your IVF success include:
Endometrial receptivity
During every month that women menstruate, their uterus goes through a remarkable transformation, with the inner lining (endometrium) sloughing off and rebuilding again. To start a pregnancy, a healthy embryo must implant into a receptive endometrium.
The embryo can only attach to the endometrial tissues when the uterus executes a perfectly timed cascade of hormonal events. Additionally, there’s a short window of time when the endometrium is receptive to the embryo.
Recurrent implantation failure occurs when there’s a problem with endometrial receptivity. We can run several tests on the endometrial tissues to identify potential problems that interfere with implantation.
Chromosome abnormalities
Chromosome abnormalities (anomalies) represent one of the top causes of recurrent implantation failure. At the time the egg is fertilized and as the embryo develops, errors in cell division can change the chromosomes.
These changes may result in missing, extra, or irregular chromosomes. In some cases, the size of the chromosome or the DNA’s organization within the chromosome may change.
One of the most common problems, called aneuploidy, occurs when the embryo has extra chromosomes. For example, Down syndrome occurs when there are three copies of a specific chromosome rather than two.
We can perform preimplantation genetic testing to detect chromosomal abnormalities before transferring the embryo to your uterus.
Egg or sperm quality
Several factors affect the quality of the egg and sperm. These issues may not interfere with fertilizing the egg in the lab, but they prevent the embryo from implanting in the uterus.
Age plays an important role in egg and sperm quality. After the age of 35, the quality of a woman’s eggs declines, which may contribute to implantation failure.
Age may also cause damaged genetic material in the sperm. For example, DNA fragmentation in the sperm affects the embryo’s development, which in turn stops implantation.
While we don’t have tests to verify egg quality, we can analyze sperm to determine any genetic problems.
If you have questions about recurrent implantation failure, call Fangyin Meng, MD, PhD, or book a consultation online today.