Part 1: Why does recurrent implantation failure occur?
IVF is sought by many couples as an answer to their fertility woes. In fact, one child in every Australian classroom is born through IVF. Recurrent implantation failure (RIF) can be a devastating problem for many couples. There are many reasons why an embryo can repeatedly fail to implant in the uterus.
Embryo quality
IVF scientists identify embryos with a greater number of cells and a more regular appearance to have a greater chance of successfully implanting. The speed in which this occurs over a 72 hour period indicates quality. Embryos that have reached blastocyst stage are most desirable to transfer. These embryos are of course created from eggs and sperm. As we age, the quality of these individual components decline. Age also represents a decline in hormone function which can lead to a poor response in producing egg quantity as well as quality.
Thin endometrium
The endometrium (lining of the womb) should thicken to at least 8mm (although 11-12mm is optimal) thick by the time of ovulation. A thinner endometrium may be caused by hormonal irregularities, fibroids, uterine scarring or three or more consecutive months use the IVF medication, Clomid.
Immune problems
The immune system is designed to protect against infections and abnormal processes in the body. There is some research and theory to support that natural killer cells (NK cells) and antiphospholipid antibodies (APA’s) are a cause of RIF, recurrent miscarriage, pre-eclampsia and placental problems, however this is still treated as controversial.
Uterine scarring
Scarring from a previous caesarean section or dilation and curettage (D&C) procedure is a common cause of secondary infertility. This scarring may develop into adhesions in the pelvic cavity and/or uterus, Asherman’s syndrome (uterine scarring that often causes the front and back walls to adhere) or adenomyosis (the presence of endometrial glands and oestrogenic tissue occurring in the muscle wall of the uterus disrupting the flow of blood).
Sperm quality
Intracytoplasmic sperm injection (ICSI) can be employed where sperm quantity and quality are compromised. This method improved fertilisation rates and allows for a greater number of good quality embryos to choose from, indirectly increasing the potential for successful implantation.
More Information
- IVF & Natural medicine; Why does recurrent implantation failure occur?
- IVF & Natural medicine
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