What is What is Implantation Failure?
💡 Implantation failure is the inability of a transferred embryo to attach to the endometrium after IVF — the most common cause of IVF cycle failure. Causes: embryo chromosomal abnormality (50–60%), endometrial factors (thin lining, displaced window of implantation), uterine abnormalities, and immunological factors.
Implantation failure occurs when a transferred embryo fails to successfully attach to and invade the uterine lining after IVF, resulting in a failed cycle. It is the most common cause of IVF cycle failure and occurs even with morphologically graded good-quality embryos.
🇮🇳 India Context: What is Implantation Failure is widely assessed and treated across major Indian fertility centres including Chennai, Mumbai, Bangalore, Delhi, and Hyderabad.
What are the key characteristics of What is Implantation Failure?
- Most common cause: embryo chromosomal aneuploidy — responsible for 50–60% of implantation failures in unscreened embryos
- Endometrial factors: thin endometrium (<7mm), absent trilaminar pattern, displaced window of implantation (ERA test)
- Uterine cavity factors: submucosal fibroids, endometrial polyps, intrauterine adhesions, uterine septum
- Immunological factors: elevated uterine natural killer (NK) cells, antiphospholipid syndrome, inherited thrombophilia
- Recurrent implantation failure (RIF): failure of ≥3 good-quality embryo transfers or ≥2 blastocyst transfers
- ERA test: identifies displaced window of implantation in 20–25% of RIF cases — personalises transfer timing
- Chronic endometritis: low-grade uterine infection found in 30–60% of RIF patients — treated with antibiotics
- PGT-A: genetic testing of embryos reduces implantation failure by selecting chromosomally normal embryos for transfer
How does What is Implantation Failure work?
Why does What is Implantation Failure matter in fertility?
Implantation failure is the key bottleneck in IVF — even with high fertilisation rates (70–80%), implantation per transferred embryo is 30–65% at the best centres. PGT-A significantly reduces failure by selecting euploid embryos. For recurrent implantation failure, a systematic investigative protocol (ERA, hysteroscopy, chronic endometritis biopsy, NK cell testing, thrombophilia screen) is essential before further transfers. In India, investigation of implantation failure is underutilised — many couples undergo repeated transfers without systematic workup, delaying effective intervention.
What are related terms to What is Implantation Failure?
Recurrent Implantation Failure
Recurrent implantation failure (RIF) is the repeated absence of implantation aft…
Embryo Transfer
Embryo Transfer is the final step of the IVF process. A laboratory-cultured embr…
Endometrial Preparation
Endometrial preparation is the hormonal or natural-cycle process of conditioning…
FAQs about What is Implantation Failure
What is implantation failure?
Implantation failure occurs when a transferred embryo fails to attach to the uterine lining after IVF, resulting in a failed cycle. It is the most common cause of IVF failure. Causes include embryo chromosomal abnormality (50–60%), endometrial factors, uterine abnormalities, and immunological factors.
What causes implantation failure in IVF?
Most common cause: embryo chromosomal aneuploidy (50–60% of failures). Other causes: thin endometrium (<7mm), displaced window of implantation (ERA test), uterine abnormalities (polyps, fibroids, adhesions, septum), chronic endometritis (30–60% of RIF patients), and immunological factors (NK cell hyperactivity, thrombophilia).
How do I know if I have implantation failure vs recurrent implantation failure?
Implantation failure refers to any single cycle where the embryo does not implant. Recurrent implantation failure (RIF) is defined as failure of ≥3 good-quality embryo transfers or ≥2 blastocyst transfers. RIF triggers a systematic investigative workup (ERA, hysteroscopy, endometritis biopsy, PGT-A).
Does PGT-A help implantation failure?
Yes. PGT-A (preimplantation genetic testing for aneuploidy) selects chromosomally normal (euploid) embryos for transfer. This reduces implantation failure rates from ~50% to ~20–30% per transfer — significantly improving outcomes in women with recurrent implantation failure or advanced maternal age.
What is ERA testing for implantation failure?
ERA (endometrial receptivity array) is an endometrial biopsy test that identifies whether the endometrium is receptive, non-receptive, or pre-/post-receptive at the expected window of implantation. In 20–25% of RIF patients, the window is displaced — ERA-guided personalised transfer timing corrects this.
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