Recurrent Implantation Failure: The Role of Anatomical Causes

Abstract

Recurrent implantation failure (RIF) is one of the great challenges of current reproductive medicine. The term refers to the failure of repeated transfers of embryos of good morphological quality. Embryo implantation is a crucial moment in in vitro fertilization (IVF) treatments. A successful pregnancy depends on a synchronized interaction between a good quality embryo and a receptive endometrium. Its failure may be a consequence of embryo quality, anatomical or immunological factors. The anatomic causes constitute an important factor for RIF, although they are usually manageable. Fibroids, polyps and adhesions that develop after a surgical procedure or infection can hamper the embryo - endometrium attachment process. In addition, Mullerian abnormalities and hydrosalpinx can cause a negative impact on implantation rates and should also be taken into account in patients with RIF. In this chapter, we will address the main anatomical causes that may impact the implantation rates of patients undergoing IVF, as well as recommendations on management and its treatment.

Omics insights into extracellular vesicles in embryo implantation and their therapeutic utility

“…Perturbation of this process results in implantation failure [4–6], which accounts for ∼75% of unsuccessful pregnancies [7–9] and a miscarriage rate of 10% [7, 10]. The aetiology of implantation failure, however, is highly complex and can be attributed to causes including maternal (uterine anatomic abnormalities [11], thrombophilia [12], non‐receptive endometrium [13, 14], and immunological factors [15]) and embryonic (genetic abnormalities [16–18], impaired ability to develop in utero, hatch, or attach/implant [19, 20]) (reviewed [21–23]). A fundamental pre‐requisite of implantation success is therefore development of an implantation‐competent blastocyst, and hormonal priming to achieve a receptive endometrium.…”

“…Created with BioRender accounts for ∼75% of unsuccessful pregnancies [7][8][9] and a miscarriage rate of 10% [7,10]. The aetiology of implantation failure, however, is highly complex and can be attributed to causes including maternal (uterine anatomic abnormalities [11], thrombophilia [12],…”