Recurrent (Repeated) Implantation Failure (RIF)

RIF Recurrent Implantation Failure 1

What is Recurrent Implantation Failure (RIF) or repeated implantation failure?

Recurrent Implantation failure is when the good embryos fails multiple times (at least 3 IVF cycles) to implant (attach) on the endometrium (uterus wall).

Approximately about 10% of women suffer from Repeated Implantation Failure.

What are the causes of recurrent implantation failure?

Recurrent implantation failure is caused by various factors including:

  • Poor quality of Egg & sperm – Embryo is formed when sperm enters the egg, but when quality of the egg or sperm or both are not good, the embryo formed is not of a good quality reducing the implantation chances
  • Chromosomal abnormality – The embryo may have chromosomal abnormality which may fail to implant (At Akruti IVF we advise PGT – Preimplantation genetic testing which can help overcome this issue).
  • Uterine environment & factors – Structural issues of the uterus or Abnormalities in uterus like
    • Sub mucous fibroids
    • endometrial polyps
    • Adhesions
    • Adenomyosis
    • Endometriosis
    • Other endometrial receptivity issues
  • Hormonal Factors – Hormonal imbalance, thyroid disorder, diabetes can cause RIF
  • Lifestyle & environmental factors – Health & lifestyle factors can cause RIF for example
    • Smoking or substance abuse
    • Alcohol consumption
    • Poor or improper diet & malnutrition.
    • obesity
    • Mental stress & excessive physical stress
    • Endocrine diseases or disorders
    • Autoimmune and clotting disorders
  • Microbiome/ Microorganisms/ Bacteria/ Viruses – Reduction is the Microbes (good Bacteria) which are present in female reproductive tract (from vagina to fallopian tubes) or change in microbiome in vagina can result in inflammation causing RIF.

How to test or diagnose & treat recurrent implantation failure?

A comprehensive evaluation is required for both husband & wife to diagnose recurrent implantation failure that includes;

  • Uterine Evaluation – The experienced Gynecologist will examine the Female uterus with
  • Ultrasound (sonography) to check any fibroid, polyps etc
  • HSG (hysterosalpingography) – to check fallopian tube blockage.
  • Hysteroscopy – the gold standard worldwide to identify and treat uterine cavity lesions or any sort of infections present inside.
  • Endometrial Biopsy or Endometrial receptivity test – This test helps in determining whether the endometrium is receiving the embryo at the right time, a small part of the endometrium is sent to genetic laboratory for evaluation to identify the right date of embryo transfer.
  • Pre-Implantation Genetic Testing (PGT) – Chromosomal abnormality is one of the common causes of implantation failure & miscarriages. In Pre-Implantation Genetic Testing (PGT) a small part of the Embryo is taken by the expert & sample is sent to Genetic Laboratory for genetic analysis. The results can provide an insight & identification of the abnormal embryos so that the healthy ones can be transferred.
  • Advance semen analysis & DNA fragmentation test – Both advance semen analysis & DNA fragmentation test for sperm can help identify the issues in male sperm sample which may be the cause of repeated failure.
  • Therapeutic treatment – Some new innovative approaches are available which can help that includes;
    • Endometrial PRP (Platelet rich Plasma) – Platelet rich Plasma is segregated from the blood sample of the patient & transferred to the patient endometrium which helps in increasing the endometrium thinness & its  health.
    • Endometrial preparation – Providing hormonal medications to prepare a better endometrium which can improve implantation.
    • Gut Micro biome improvement – Improving the Gut (stomach) health by providing good bacteria specially designed to improve the fertility health.
    • Lifestyle changes / modification – opting for Better balance & nutritive diet, regular exercise, managing & reducing mental and physical stress.