I-24: Recurrent Implantation Failure

Recurrent implantation failure (RIF) has many definitions, but usually authors consider RIF, the failure to achieve a pregnancy fallowing 2-6 IVF cycles in which more than 10 high grade embryos were transferred to the uterus. There are a lot of causes for RIF but two main causes of that are related to embryo and endometrium. Chromosomal abnormalities, zona hardening and problems in culture media are causes of RIF due to embryo development.And the factors such as polyps, fibroids, endometriosis and thin endometrium can affect implantation related to endometrium. The relationship between ART failure and thrambophilia remain largely inconclusive. The exact mechanism by which thromobophilia can cause implantation failure is not fully understand, But many Theories are affected such as: impaired vascularization, impairment of trophoblast function and immunologic mechanism, other causes of RIF may related to presence of hydrosalpinx, endometriosis, adenomyosis. About the treatment of RIF, there are controversies. The aim of all infertility specialists is to provide an evidence bored treatment for these patients.Removing or occlusion of hydrosalpinx and doing hysteroscopy before any additional treatment, and injury of endometrium just before COH, assisted hatching, blasto cyst transfer, zift, PGD, treatment by heparin in thrombophilia and co - culture, … but all of them need more research for approval.