The failure of the embryo to implant into the uterine wall following IVF treatment is known as repeated implantation failure. This occurs 6-7 days after embryo transfer. The upshot of this exchange of biochemical information between the embryo and the uterine lining is implantation. The embryo’s enzyme digests the endometrial lining, allowing the embryo to be embedded in the uterus and connected to maternal blood. An ultrasound can be used to observe the sac in which the baby grows inside the uterus to evaluate whether or not the implantation was successful.
Recurrent IVF failure and repeated implantation failure are not the same thing. Recurrent IVF failure is a considerably larger phrase that encompasses all repeated IVF failures. The term “repeated implantation failure” refers to repeated implantation failure.
A failed implantation can be caused by issues with either the mother or the embryo. It is critical that the mother and embryo communicate with each other during the pregnancy, and a lack of communication can result in an unsuccessful implantation and a subsequent unsuccessful pregnancy.
Being faced with one or more failed IVF cycles is painful and frustrating. When a couple fails to achieve pregnancy after numerous cycles of IVF utilising three excellent embryos, they are said to be experiencing recurrent or repeated implantation failure.
The following are the causes of repeated IVF failures:
Oocyte Quality Issues
A healthy egg produces a healthy embryo. Any chromosomally defective egg might result in a chromosomally aberrant embryo. After merging with sperm, the egg plays a significant role in cell division and chromosomal duplication to generate an embryo.
The spindle apparatus, or the mechanism responsible for chromosomal separation and equitable distribution, becomes more prone to breakdown as the oocyte or eggs age. This results in an aberrant or anomalous chromosomal distribution, resulting in the creation of a chromosomally malformed embryo.
The amount of free radicals or reactive oxygen species in a woman’s body grows as she ages. These free radicals in her ovaries react with her eggs, causing DNA damage and lowering egg quality.
Inadequate Sperm Quality
Unfertilized eggs can result from sperm abnormalities. A Sperm performs three key functions: it enters the fallopian tube, penetrates the egg’s outer membrane, and releases half of its genetic material, or sperm DNA, to make an embryo. For effective fertilisation, it is critical to select the best quality sperm under high magnification during IVF.
Even high-quality, chromosomally normal sperm may lack the enzymes needed to break through the egg’s zona pellucida, or outer shell. Low-quality, morphologically aberrant, and less motile sperm may be unable to reach and fertilise the egg.
Incorrect Embryo Selection
Embryo selection is critical to successful implantation. It is a typical function of the uterus to reject defective embryos. This signifies that the chromosomally defective embryo will die, resulting in implantation failure or miscarriage. Unfortunately, visually distinguishing chromosomally normal embryos from defective embryos is challenging. As a result, investigating embryo health is critical for a successful pregnancy.
The endometrial environment is also important for successful implantation. A healthy uterine environment is influenced by a variety of anatomical, hormonal, and immunological factors.
The irregular shape of the uterus, fibroids, polyps, scarring, tough cervix, and intrauterine adhesions are among structural uterine issues that can lead to implantation failure.
A thin endometrium caused by an early surge in progesterone before egg extraction in an IVF cycle is another major uterine concern.
Maternal and Paternal Health Concerns
The health of both the father and the mother is important in the success of an IVF pregnancy. Alcohol, smoking, and drug use can all cause difficulties during implantation and pregnancy.
IVF failures can also be caused by improper management of chronic conditions such as diabetes and hypertension, as well as an unhealthy body weight.
Miscarriages can be caused by autoimmune illnesses such as antiphospholipid syndrome and blood clotting abnormalities.
Issues with Embryo Transfer
The embryo transfer is a non-surgical process that is extremely delicate. Any changes to this method may result in the failure of an IVF cycle. It is critical that the embryos are implanted in the correct position in the uterus. It is difficult to establish the best spot for the embryo placement without doing a trial transfer.
What next if IVF fails?
Summary of a second IVF attempt:
- Get an honest assessment of your chances of success with a second IVF attempt from your IVF specialist.
- Consider modifying the medication strategy if there were complications with ovarian stimulation or a low number of eggs.
- If there were good-looking embryos for transfer but none implanted, try IVF again at the same or a different IVF facility.
- If there were severe egg and/or embryo quality difficulties, it was most likely due to an egg problem or an issue with IVF lab quality control. Consider switching to a programme with greater in vitro fertilisation success rates to discover if the problems were caused by egg quality – or a problem with ovarian stimulation – or a problem in the IVF lab.
- Donor sperm, donor eggs, or donor embryos may be considered in the future, but this is normally after one failed IVF cycle.
- The uterus can be the source of the disease, but this is uncommon. Almost always, implantation failure occurs because the transferred embryos are too weak to implant and continue normal development. Almost always, the uterus is amenable to embryo implantation.
Overall, second-try IVF success rates are only slightly lower than first-try IVF success rates. Couples with the best egg quality are more likely to become pregnant on their first try, but this is partially offset by potentially learning from the first failed cycle and making adjustments to maximise success for the second in vitro fertilisation effort. For successful IVF treatment call and schedule your appointment with Dr. Kaushiki Dwiveedi one of the best ivf doctor in Gurgaon.