Recurrent implantation failure (RIF)
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 next attempt of IVF.
Reasons for RIF
- Advanced Maternal Age.
- Uterine pathology – chronic endometritis infection, uterine polyps, fibroids, uternine septum, abnormal endometrial receptivity.
- Smoking, obesity, increased stress
- Immnological cause – auto antibodies, auto immune diseases.
- Poor sperm morphology
- Azoospermia with chromosomal abnormality
- Poor quality embryos
- Embryos aneuploidy
In Our hospital we do investigate the reason fro RIF by doing tests. Depending upon the cause treatment is given.
- Complete blood checkup, auto antibody assay.
- Laproscopy and hysteroscopy (This is done, to correct intra uterine pathologies like polyp, septum and fibroids, salphinpectomy in hydrosalphinx)
- Endometrial bipsy is done for TB endometrium and other infection.
- Male chromosomal analysis.
- Pre-Implantation genetic testing, Blastomere biopsy is done to rule out aneuploidy.
- Endometrial receptive array
Treatment is done depending upon the cause
- Weght reduction
- Healthy life style
- Quit smoking
- Anxiolytics to decrease anxity
- Incase of intra uterine pathology, patient might undergo polypectomy, septal resection,myomectomy adhesiolysis, salphingectomy depending upon the cause.
- Incase of uterine infection, patient is treated with appropriate antibiotics depending upon the endometrial receptivity testing, embryo transfer is done during window of implantation.
- Genetically normal embryos are transfered.
- To improve the endometrial receptivity autologus PRP treatment, and other drugs are given.
- Immunotherapy is given RIF is due to auto antibodies of theombophillic