Implantation failure

There is support for several treatment options for women with “recurrent implantation failure” (defined as two or more failed embryo transfers in IVF/ICSI treatment cycles).

Listed below are options we can talk about in a follow-up appointment in the upsetting event of a failed implantation or miscarriage.

Maternal blood tests

• Clotting (thrombophilia) screen – Small clots in the blood have been identified as a possible cause for pregnancies failing to progress. In some cases, this can be treated with aspirin or heparin injections to thin the blood.

  
  

• Immune screen – Increased levels of uterine natural killer cells (white cells) and autoantibodies (antibodies attacking specific organs) have also been suggested as a cause for the repeated failure of cycles. The use of steroids and other drugs to suppress the immune system and to help a pregnancy develop are controversial as some of the drugs used in these treatments have side effects for both a mother and her developing baby. It’s important to understand these risks before deciding with your doctor whether testing or treatment is recommended.

Endometrial tests

• Hysteroscopy or endometrial scratch – We may suggest a hysteroscopy (passing a flexible telescope into the womb under general anaesthetic) if we suspect scar tissue formation or the presence of a fibroid or polyp inside the womb which needs to be removed. There is some evidence that this procedure itself, or performing an endometrial scratch, can increase implantation rates.

Paternal factors

• Sperm DNA fragmentation – Assessing the degree of damage to sperm DNA can help identify those couples that would benefit from ICSI treatment.

Embryo factors

• Genetic screening – We can use genetic screening to learn more about embryos before they are implanted, which helps us select the best embryos most likely to implant.

  
  

• Embryoscope™ (Time-lapse imaging) – Recording information by time-lapse photography allows us to assess more subtle changes seen during embryo development and identify the best embryos for transfer.