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How can you promote implantation?

After successful fertilisation of the egg, the merged cells divide further, and the embryo develops. This will implant itself in the uterine lining, so that a pregnancy can develop. In order to promote this implantation, there are several options available to patients wanting to have children.

When several artificial insemination procedures have already taken place and no pregnancy has occurred, this is called recurrent implantation failure (RIF). The term is used to indicate that more than four good-quality embryos were transferred into the uterus during at least three cycles in a woman younger than 40. If RIF has occurred, various tests can help find the cause and then initiate targeted supportive measures. In addition, it is of course important to create good general conditions for implantation.

Good conditions for implantation

There is evidence that a well-built-up uterine lining is beneficial for implantation. This means it matters how thick the uterine lining is and how it is constructed. An optimally constructed mucosa exhibits a three-line structure in ultrasound, which depicts the boundary lines of the two layers of mucosa – that between the two layers and those between them and their surroundings (trilaminar structure). Most important, however, is that the mucosa is at least 7 millimetres thick – ideally, 8 millimetres or more. Values above this have no positive or negative impact on implantation. Since a uterine lining that is too thin is attributed to insufficient blood circulation, measures to improve blood circulation can improve the thickness of the uterine lining. And thus the chances of implantation after ovulation and fertilisation, and, as a result, of a baby.

What to do if the uterine lining is too thin?

There are various factors that positively or negatively affect the strength of the uterine lining. In order to support fertility treatment, patients can resort to supplementary measures and should avoid harmful behaviours, so as to increase the chances of the woman becoming pregnant. However, all measures that involve ingestion of a substance should only be undertaken after consulting the doctor.

What you should definitely avoid

Smoking: Nicotine can generally have a negative impact on fertility. Smoking is also suspected of resulting in a thinner uterine lining, for example, as it has been shown to severely impair blood circulation. Since smoking should in any case be stopped altogether once a woman is pregnant, as it is harmful to the unborn baby, the beginning of fertility treatment is a good time to give up nicotine.

For those who would like to have further tests done, the following are available:

Genetic analysis: If one's dream of having a child has also not yet been fulfilled by IVF, the next diagnostic step is usually genetic testing. The genetic counselling provided by our experts informs you comprehensively and individually about all genetic issues and discusses the options available for pre-implantation diagnostics in each individual case.

NK cells and plasma cells: In women who have suffered repeated unsuccessful implantations or multiple miscarriages, increased levels of NK cells are detected in both the blood and the uterine lining. If a patient has already had several unsuccessful implantation attempts or has suffered repeated miscarriages without there being any other obvious causes for this, our doctors recommend the woman undergo immunological testing. This involves a piece of the uterine lining being biopsied between the 19th and 21st days of the cycle and then tested with respect to its concentration of NK cells and plasma cells in a specialist laboratory.

ERA test: An ERA test allows precise determination of the so-called implantation window: genetic testing of the uterine lining is used to determine its "receptivity". The endometrial receptivity array (ERA) examines a group of 238 genes in the uterine lining. The state of these genes provides information about the receptivity of the mucosa, i.e., its ability to facilitate successful implantation, on the day of the test. It is thus possible to determine on exactly which day of one's cycle the endometrium is ready for implantation or nidation.

Trophectoderm biopsy: While in polar body diagnosis (PCD) only the polar bodies of the egg are removed for genetic analysis, in a TEB, the embryos are examined. It is not the cells the child later develops from (the so-called embryoblasts) that are biopsied, but rather those which are involved in the formation of the placenta. The genetic makeup of these trophoblasts is usually identical to that of the embryoblasts. In this way, a comprehensive diagnosis of chromosomal maldistribution is possible at a very early stage of pregnancy, without manipulating the embryoblasts.