It is defined as a failed attempt to achieve a viable pregnancy by means of IVF. That is, it encompasses both those patients who fail to become pregnant and those patients who become pregnant but have an early miscarriage.
It is a challenge to answer this question because we are unaware of many processes that result in a successful embryo implantation.
To begin with, it must be kept in mind that the cause cannot be attributed to a single patient (the mother) but to THREE: her, him and the embryo.
True, we know that some causes are related to the mother, but most of them have to do with the embryo, and they cannot always be diagnosed or treated satisfactorily. Hence the patient’s high degrees of uncertainty and anxiety when doctors cannot find them.
Nevertheless, great progress has been made in this field over the last years.
An accurate study of implantation failure requires a multidisciplinary assessment. For this reason, a working group that specializes in these disorders was created at INSTITUTO BERNABEU. This group includes gynecologists, endocrinologists, molecular biologists, geneticians and embryologists.
It is necessary to assess the FEMALE FACTOR. Essentially, the study includes hysteroscopy, endometrial biopsy and/or culture transfer procedures; analysis of congenital or acquired thrombophilias; hormonal considerations, thyroid and karyotype functions. A complementary study may be necessary in certain cases.
THE MALE FACTOR is studied by karyotype, DNA fragmentation, and andrological examination and chromosome assessment.
But it is undoubtfully the EMBRYO FACTOR where the greatest advances have been made.
Indeed, these days molecular and genetic biology techniques make it possible to analyze all of the embryo’s chromosomes, as the most common cause for implantation failure and early miscarriage is an anomalous number and constitution of embryo chromosomes.
The transfer of chromosomally normal embryos makes pregnancy rates remain the same regardless of the mother’s age. At the same time, miscarriage risks decrease dramatically. In other words, whenever embryos that are free from chromosomal abnormalities are transferred, patients will always have the same expectancy for success regardless of their age.
This technique, known as CCS (Comprehensive Chromosomal Screening), is used around the fifth day of the embryo’s development and is proving to be greatly effective to answer the most relevant questions for patients and for the doctors that take care of them.
Why do embryos fail to implant?
Why do they miscarry?
Is the treatment worth repeating?
Is it time to leave it or change it?
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