Implantation Failure Management (Pages: 0-0)

Taheripanah R *,


Introduction: The purpose of this review is to evaluate the management of implantation failure following ART cycles. The main limitation of the successful IVF-ET cycle is the low implantation rate of the in vitro embryos that reduce success rate from the more than 90% embryo transfer to less than 30% pregnancy per started cycles. It is suggested that unknown processes occur in the black box of the uterus and for this reason the most investigation in the art field are done in this part of the treatments. Embryo endometrial receptivity and systemic condition are the most important factors in implantation. Nowadays many clinical trials have been done to improve the success rate and overcome of the implantation failure. Materials and Methods: Medline and Cochrane research. Results: Preimplantation genetic diagnosis is one of ways that it is very useful for the patients specially older women. Aneuploidiy of the gametes and embryos is very common and it related to the maternal age. Assisted zona hatching may be overcome zona hardening in older women. Uterine cavity abnormalities and endometrial polyp disturbe the implantation. So hysteroscopic evaluation of the endometrial cavity even without any pathological finding increases the implantation rate by stimulation of the endometrial gland secretion and lymphokines. In this process endometrial injury has positive effect on ART outcomes. Thrombophilia is associated with lower success and implantation rate. Although anti-thrombotic treatment such as low dose aspirin heparin suppress the immunological activities but no significant benefits is shown in some of the clinical trials and it is controversial. Conclusion: PGD correction of anatomical defect and increasing endometrial receptivity are the most important factors that can overcome on implantation failure and increase the success rate in ART cycles.