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Recurrent implantation failure (RIF)

recurrent ivf failure

Recurrent implantation failure (RIF) refers to cases in which women have had three Vitro fertilization (IVF) failed attempts with good quality embryos in women <37 years or 2 failed attempts in women >37 years. 

There are many reasons for RIF. The causes of RIF should be investigated diagnosed and treated before the next attempt of IVF.

Reasons for RIF

Female Factors

  • Advanced Maternal Age.
  • Uterine pathology – chronic endometritis infection, uterine polyps, fibroids, uterine septum, abnormal endometrial receptivity.
  • Smoking, obesity, increased stress
  • Immunological cause – autoantibodies, autoimmune diseases.

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Malefactors

  • Poor sperm morphology
  • Azoospermia with a chromosomal abnormality

Embryo Factors

  • Poor quality embryos
  • Embryos aneuploidy

IVF Protocol

  • In our hospital, we do investigate, the reason for RIF by doing tests.  Depending upon the cause treatment is given.

In Our hospital, we do investigate the reason for RIF by doing tests. Depending upon the cause treatment is given.

  1. Complete blood checkup, autoantibody assay.
  2. Laparoscopy and hysteroscopy (This is done, to correct Intra uterine pathologies like polyp, septum, and fibroids, salpingectomy in hydrosalpinx)
  3. Endometrial biopsy is done for TB endometrium and other infections.
  4. Male chromosomal analysis.
  5. Pre-Implantation genetic testing, Blastomere biopsy is done to rule out aneuploidy.
  6. Endometrial receptive array

Treatment is done depending upon the cause

  1. Weight reduction
  2. Healthy lifestyle
  3. Quit smoking
  4. Anxiolytics to decrease anxiety
  5. In case of intrauterine pathology, the patient might undergo polypectomy, septal resection, myomectomy adhesiolysis, salpingectomy depending upon the cause.
  6. In case of uterine infection, the patient is treated with appropriate antibiotics depending upon the endometrial receptivity testing, embryo transfer is done during the window of implantation.
  7. Genetically normal embryos are transferred.
  8. To improve the endometrial receptivity autologous PRP treatment, and other drugs are given.
  9. Immunotherapy is given RIF is due to autoantibodies of thrombophilic

In our hospital, we have a very good success rate for recurrent IVF failures

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