Treatment and diagnosis for implantation failure

Index

1. What is implantation failure?
2. Tests to diagnose implantation failure
3. Causes of implantation failure
4. Treatments for implantation failure
5. Who treats implantation failure?

What is implantation failure?

For embryo implantation to occur, adhesion of the fertilized embryo to the endometrium is necessary. This is a complex but fundamental process for a successful pregnancy.

For this process to be successful, it is necessary that the embryo is suitable, the endometrium is in a receptive state and that there is integration between both parts. An implantation failure is a situation in which at least two cycles of in vitro fertilization (IVF) have been attempted without success.

Tests to diagnose implantation failure

There are a number of studies and tests that can be used to try to find out the reason or cause of implantation failure. The tests that can be performed are the following:

• 3D ultrasound
• Endometrial receptivity study
• Blood analysis
• Preimplantation Genetic Diagnosis

During pregnancy, implantation
implantation failure for various reasons

Causes of implantation failure

A percentage of women do not achieve pregnancy in spite of undergoing Assisted Reproduction treatments. Failure to achieve pregnancy may be caused by a failure of the embryo to implant in the endometrium at the receptive stage.

Depending on each particular case, the causes may be one of the following:

• Chromosomal abnormalities of the embryo.
• Chromosomal abnormalities on the part of the parents.
• The receptivity of the endometrium: an endometrium is in a receptive state when it is ready to receive the embryo. In this case, the optimal time is between day 19 and day 21 of the menstrual cycle, i.e. between days five and six days post-ovulation. However, each case must be analyzed individually, since the cycle is not the same for all women.
• There are pathologies in the female genitalia and female reproductive system: in this case there are many existing possibilities, but the most important would be endometriosis, genital tuberculosis, the presence of polyps in the female urogenital system, uterine fibroids…
• Lifestyle: lifestyle habits, such as smoking, can produce hormonal alterations and affect the woman’s ovarian reserve.
• Overweight: it can produce some alterations in the endocrine system.
• Thrombophilias: this is another factor that can reduce the receptive capacity of the endometrium. In this case, the thrombi produced prevent proper blood flow, thus hindering the endometrial tissue from thriving.
• Age: if the woman’s age is too high.

Treatments for implantation failure

A first option would be to carry out a genetic study of the progenitors. Thanks to this test it is possible to identify the existence of possible problems in the parents’ genes.

On other occasions, Preimplantational Genetic Diagnosis (PGD) can be performed. However, the patient must be well selected, as this is an aggressive technique that affects the embryo’s environment. PGD is a technique that enables the genetic study of the embryo before it is transferred to the mother’s uterus.

There are a number of treatments that can be performed in these cases. However, in order to choose one or the other, it is necessary to know exactly what is causing the implantation failure. Along these lines, if the problem were the presence of an anatomical factor, such as a polyp, surgical hysteroscopy would allow it to be resected. If there were thyroid problems, drugs would be an appropriate treatment, as in cases of thrombus formation and blood clotting.

Who treats implantation failure?

The person in charge of treating and diagnosing implantation failure is the specialist in Assisted Reproduction.