Recurrent implantation failure
Unfortunately some women suffer from repeated failures of IVF cycles, either never achieving a positive result or an early pregnancy failing to progress. We offer comprehensive investigations and tailor your treatment cycle accordingly.
Maternal blood tests
- Clotting (thrombophilia) screen – small clots in the blood have been identified as a possible cause for a pregnancy to fail to progress. In some cases this can be treated with aspirin or heparin injections to thin the blood.
- Immune screen – increased levels of natural killer cells (white blood cells) and autoantibodies (antibodies attacking specific organs) have also been suggested as a cause for repeated failure of cycles. The use of steroids, intralipids and other drugs to suppress the immune system and to help a pregnancy develop are controversial. More clinical trials are needed to understand the ways in which the immune system affects pregnancy. Some of the drugs used in these treatments have side effects to both a mother and her developing baby and it is important to understand these risks before deciding with your doctor whether testing or treatment are recommended.
- 3D ultrasound can examine the cavity of the womb to ensure there is no structural abnormality preventing a pregnancy from implanting.
- Hysteroscopy/endometrial scratch - we may suggest a hysteroscopy (passing a flexible telescope in to the womb under general anaesthetic) if we suspect scar tissue formation or the presence of a fibroid or polyp inside the womb which needs to be removed. There is some evidence that this procedure itself, or performing an endometrial scratch, can increase implantation rates.
- Endometrial Receptivity Array –a small amount of tissue from the womb lining (endometrium) can be sampled and analysed for the presence of over 200 genes known to be associated with implantation.
- Sperm DNA fragmentation – assessing the degree of damage to sperm DNA help identify those couples that would benefit from ICSI treatment.
- CGH (comparative genomic hybridisation) (see PGD/PGS/CGH)
- Embryoscope – recording information by time-lapse photography allows us to assess more subtle changes seen during embryo development and identify the best embryos for transfer.