I-16: The Immunological Aspect of Implantation Failure

The success of reproduction, although gradually increasing over the years, many couples also had been left frustrated following repeated failed attempts. Clinicians who treated unsuccessful couples often face a challenge. The probable causes of repeated IVF failures classified as: reduced endometrial receptivity, embryonic defects or multifactorial causes. Intrauterine and endometrial integrity abnormalities such as thin endometrium, altered expression of adhesive molecules and immunological factors like anti sperm (ASA), Anticardiolipin (aCL), Lupus anticoagulant (LA), anti-phosphatidylserine (aPS) , anti-phosphatidylethanolamine (aPE), and antinuclear antibody (ANA), anti DNA, anti zona and anti ovarian (AOA) antibodies, thrombophilia, decreased expression of endometrial integrins, increase of natural killer cells activities and imbalance of cytokine networks (balance between IL-12 and IL-18) , may decrease endometrial receptivity, whereas chromosomal and genetic abnormalities of the male sperm or female ovarian defects, embryonic aneuploidia or zona hardening are embryonic reasons for the failure of implantation. By the way Endometriosis, non fixed stimulation protocols and hydrosalpinges may adversely influence both . It will be discussed all aspects of implantation failure specially endometrial and immunological reason .