Recurrent Implantation Failure
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RECURRENT IMPLANTATION FAILURE mivf.com.au | 1800 111 483 Failure to achieve a The Egg The Sperm pregnancy following The quality of a woman’s eggs is The main function of the sperm is to several cycles of IVF important in creating a healthy move and transmit healthy DNA into embryo. As maternal age advances, the oocyte to make a healthy embryo. where three good the percentage of chromosomally Clearly, the fact that an embryo is quality embryos have abnormal eggs increases, reducing forming in the first place indicates that the chance of creating a healthy the sperm are at least fertilising the been transferred is embryo naturally. Additionally, egg. However, even beyond this point, defined as Recurrent low ovarian reserve or a history of problems in the sperm quality may still endometriosis and ovarian surgery, contribute to recurrent implantation Implantation Failure. may also reduce egg health and failure. In some men, this may due to Recurrent Implantation Failure quantity. advancing age or medical conditions, is an expected, if sad, reality of such as diabetes or cigarette smoking, Investigations into egg health human reproduction, but it is resulting in damaged sperm DNA. include: important to recognise that not all • An AMH test which is a blood test The normal first investigation for embryos are meant to implant. that measures a woman’s ovarian a man is a semen analysis which Up to 70% of embryos created, reserve (the number of eggs left measures the number, movement and either via natural conception or in the ovary) shapes of the sperm as well as the IVF are lost before birth, usually • Measuring the number of eggs volume and consistency of the semen within the first three months of seen on ultrasound (the antral sample. This test, however, does not pregnancy and most of these even follicle count). provide much information about the before implantation. • Observing the capacity of an contribution of the sperm to recurrent embryo to grow to the blastocyst implantation failure. In our experience, through stage during the IVF process persistence, investigation and A measurement of sperm DNA taking different approaches, most There is no medical treatment that fragmentation may, in some cases, patients can eventually achieve a has been shown to improve the provide useful information about pregnancy. health of eggs. Approaches that the contribution of the sperm to the have been tried, but where the health of the embryo. evidence is still uncertain, include: What are the • Using antioxidants such as CoQ10 It is also important to check the male causes of Recurrent and melatonin partner’s chromosomes to ensure • Stimulating drugs to obtain more that there is no chromosomal variation Implantation Failure? eggs underlying the problem. Causes of recurrent implantation • The addition of adjuvant hormones such as low dosages What can be done to improve the failure may be varied and involve: health of the sperm • the egg of male hormone and growth • the sperm hormones in patients who are It is important for a prospective • the embryos created defined as poor responders father to be as healthy as he can be. • the woman’s uterus • Use of pre implantation genetic Problems such as excessive weight, • material & paternal health, or testing of the embryos to lack of exercise, cigarette smoking • a combination of these factors identify the embryos which have or alcohol overuse can affect sperm normal chromosomes prior to quality as can medical conditions such implantation. as diabetes. It is an important first step for men to look after their own health and thereby improve the health of their sperm. VH-MKT-PI-040H-VIC | 1AUGUST2018 VH-MKT-PI-040H-VIC RECURRENT IMPLANTATION FAILURE There is no medical treatment not exclude all genetic problems in • Surgery for Intrauterine adhesions that has been shown to improve an embryo that could contribute to • Medications such as clexane the health of sperm. Approaches recurrent implantation failure. to assist where there are blood that have been tried, but where the clotting problems. evidence is still uncertain, include: The Uterus • Immune therapies to deal with • The use of antioxidants such as immune disorders. zinc to improve sperm quality Embryo implantation depends • Frequent ejaculation to limit the on both embryo quality and the General maternal and time that sperm are exposed to endometrial environment. The endogenous free oxygen radicals uterus may be affected by either paternal health that could damage the sperm structural, hormonal or immunological The factors in both maternal and DNA. conditions. Some of the conditions paternal health that could be • IVF including ICSI to isolate the that may cause difficulties with contributing to recurrent implantation healthiest sperm for injection into successful implantation include failure include: the egg. • Gynaecological disorders of the • Body weight: a balanced lifestyle • We can also use a special pelvis such as fibroids (muscular of healthy eating and exercise is technique using digital high swellings in the uterus), polyps recommended for patients with magnification to select the best (small fleshy lumps in the lining weight problems. For underweight quality sperm of the uterus), adenomyosis patients a review by dietician is • Testicular biopsies which may (abnormal glandular tissue within needed. yield sperm that has a lower the wall of the uterus) • Smoking: should be stopped degree of DNA damage, but the • Scarring inside the uterus, possibly • While a low intake of coffee or technique is invasive and still, related to past uterine curettage. alcohol does no harm, excessive essentially, unproven • Genetic abnormalities in the shape alcohol and coffee intake should be of the uterus. reduced. • Metabolic problems in the mother, The Embryo • Systemic diseases such as diabetes such as mild diabetes or glucose need to be managed adequately by One of the most common intolerance, the treating physician explanations for why IVF is • Known immune problems such • Blood clotting disorders unsuccessful, or why implantation as lupus or the presence of and autoimmune disorders failure or miscarriages can occur, anti•cardiolipin antibodies. anti•phospholipid syndrome may is chromosomal variations in the • Deficiencies in the specific immune affect miscarriage rates simple embryo. These variations mean reactions in the uterus, involving immune therapy such as heparin that while the embryo may start to the natural killer cells in the uterus injections may be indicated. implant, the genetic constitution that are necessary for successful • Thyroid dysfunction of the embryo means that a viable implantation. This area remains • Impaired Glucose tolerance: should pregnancy is either unlikely or complex but is a growing area of be treated with metformin and a impossible. investigation. suitable diet. Chromosomal testing It is also, however, important to • Stress is, understandably, a natural (preimplantation testing) of the remember that these problems are part of fertility treatment. The role embryo not always the cause of recurrent of stress in implantation problems implantation failure. There are many remains unclear. It is, however, It is possible to test the conditions, such as some fibroids, always a healthy approach to chromosomes in a human embryo which, although present, may not be maintain your mental health as well prior to replacement of the embryo affecting implantation. as your physical health. into the uterus. This testing ensures that embryos with a healthy Treatments for uterine problems chromosome constitution can include: be identified and replaced into • Surgery to treat fibroids and polyps the embryo. However, testing the • Laparoscopy for endometriosis chromosomes in an embryo does .