What is Repeated implantation failure (RIF)?
Repeated implantation failure (RIF) is a term used when a woman fails to achieve a viable pregnancy even after two or three IVF cycles with good quality embryos and a normal uterus.
What is the reason for RIF?
There are 6 main reasons for RIF
- Poor egg quality: This may be due to advanced maternal age/ genetic conditions/ chronic smoking or alchohol consumption
- Poor sperm quality: This may be due to obesity/ chronic smoking or alchohol consumption/
- Genetic defects in the embryo
- Immune problems: Autoimmune disorders etc
- Problems in the uterus: structural abnormalities/ infections/ uterine scarring etc
- Hormonal imbalances
How do we diagnose RIF?
Diagnosis and Treatment of RIF can be potentially challenging. We need to first take a detailed medical history and examine the patient. We need to do some blood investigations and a detailed ultrasound which includes a 3D scan and a hysteroscopy.
How do we treat RIF?
If we know the underlying reason for RIF we can treat it directly. But in most of the cases the reason is unexplained. Then the potential treatment options may include personalised treatment protocols,
using donor eggs/ donor sperms, embryo testing for genetic abnormalities (PGT A), doing ERA test, immunotherapy or using alternative treatment options like surrogacy or adoption
Symptoms and impact of RIF
RIF can have an emotional and financial impact on the couples undergoing treatment. RIF may also impact treatment success rates if the couples go for further IVF cycles and the underlying causes are not treated. These couples should go to a qualified fertility specialist for detailed evaluation and to know their treatment options.
If you are facing RIF issue, here are the possible next steps: