Experiencing multiple failed IVF cycles despite transferring high-quality embryos is an emotionally devastating barrier for couples. Medically, this condition is known as Recurrent Implantation Failure (RIF). When standard protocols do not result in pregnancy, a deep, systematic diagnostic review becomes vital. Prof. (Dr.) Abha Majumdar utilizes a multi-layered investigative checklist to identify hidden maternal and embryonic factors, paving a clear, predictable pathway for subsequent cycle success.
There is no single universally agreed-upon definition for Recurrent Implantation Failure (RIF). However, the latest consensus among leading fertility organizations, including the European Society of Human Reproduction and Embryology (ESHRE), generally defines RIF using the following criteria:
Furthermore, implantation is a complex biochemical dialogue between a competent embryo and a receptive endometrial lining. If either side displays structural or genetic irregularities, the attachment process terminates immediately. Therefore, we break our investigative framework down into distinct biological categories to isolate the root cause effectively.
Professor’s Medical Insight: Do not lose hope after failed transfers. Many patients assume their body is rejecting the baby permanently. In reality, fine-tuning the uterine microenvironment or correcting subtle blood clotting profiles frequently resolves long-standing implantation barriers.
Our advanced tertiary centre at Sir Ganga Ram Hospital addresses RIF through a structured, step-by-step diagnostic strategy:
| Investigative Area | Advanced Diagnostic Tests | Target Clinical Goal |
|---|---|---|
| Anatomical Factors | 3D Pelvic Ultrasound, Diagnostic Hysteroscopy. | Detects hidden sub-mucosal fibroids, uterine septums, or intrauterine adhesions. |
| Endometrial Receptivity | Endometrial Receptivity Analysis (ERA), endometrial biopsy to rule out chronic endometritis (CD138 Immunostaining.) | Identifies a displaced window of implantation or chronic endometritis. |
| Thrombophilia Screening | Antiphospholipid Antibody (APLA) Panel, Lupus Anticoagulant, Protein S/C metrics. | Detects hypercoagulable blood disorders that cause micro-clots at the implantation site. |
| Embryonic/Genetic | Preimplantation Genetic Testing (PGT-A), Parental Karyotyping. | Conforms normal chromosomal # in embryo biopsy. Excludes parental structural anomalies |
Once your checklist identifies the possible biological barrier, our medical team alters subsequent treatment protocols:
