Implantation Failure

Failure to become pregnant even after 2-3 attempts of IVF on which fairly good quality embryos were transferred is known as implantation failure.

Q. 1. What are the reasons of implantation failure?

Implantation failure can be due to:

  • Problems with the embryos.

  • Problems with uterus.

  • Problems in the mutual action between embryo and uterus.

These may be due to:

  • Decreased endometrial receptivity.

  • Embryonic defect.

  • Combination of above factors.

Q. 2. How can we determine the problems within the sperms?

Problems within the sperm if not diagnosed by the standard attributes of semen analysis, can be discovered by: -

  • Sperm function tests.

  • sperm DNA integrity assay [SDla].

  • Y chromosome micro deletion assay.

Q. 3. How can we know the problems with the egg?

Problems within the egg can be demonstrated clinically as vitiated ovarian reserve or premature ovarian failure. Diagnostic tests useful for identifying individuals at greater risk for vitiated ovarian reserve or premature ovarian failure comprise of

  • Hormonal study for Follicle Stimulating Hormone [FSH], Estradiol and Inhibin.

  • Antiovarian antibodies [AOA].

  • Antimillerian hormone (AMH).

Problems within the environment where the embryo implants and grows may be anatomic, hormonal and immunologic by:

Q. 4. How can we find out the anatomic problems within the uterus?

  • Hysterosonosalpingography (ultrasound evaluation of the uterus after fluid is injected) or

  • Hysterosalpingography (X-ray after instillation of dye into the uterus and fallopian tubes)

  • Hysteroscopy (telescopic evaluation of the uterine cavity).

Q. 5. How can we find the problems in hormonal response of uterus?

Hormonal response of the uterus can be examined with the help of ultrasound.

  • Transvaginal ultrasound monitoring of the lining of the uterus at the time of ovulation

  • Color Doppler flow studies to analyze blood flow to the lining of the uterus

Q. 6. How to treat recurrent pregnancy loss?

Pregnancy loss is a devastating experience. It is especially more distressing when the losses are repetitive. Loss of pregnancy is both physically and emotionally challenging. Until recently, couples could not do much, but with the new researches coming up, more information may now be available on the causes of unexplained pregnancy losses resulting in availability of treatment that might enable women to carry their pregnancies to term.