What exactly do we mean by ‘recurrent implantation failure’? A systematic review and opinion

Polański, Łukasz; Baumgarten, Miriam; Quenby, Siobhán; Brosens, Jan J.; Campbell, Bruce; Raine‐Fenning, N.

doi:10.1016/j.rbmo.2013.12.006

Cited by 223 publications

(175 citation statements)

References 153 publications

(255 reference statements)

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“…RIF may simply be defined as two or more continuous implantation failures (2); however, researchers now prefer to define RIF as the failure to maintain a clinical pregnancy following three cycles of ET (3,4). Several causes of RIF have been reported, including embryo, uterine and immunological factors, as well as thrombophilic conditions, however, the genetic mechanisms underlying RIF remain unclear (1).…”

Section: Introductionmentioning

confidence: 99%

Association between vascular endothelial growth factor promoter polymorphisms and the risk of recurrent implantation failure

et al. 2017

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Abstract. The objective of the present study was to investigate the association between recurrent implantation failure (RIF) and vascular endothelial growth factor (VEGF) gene polymorphisms that are associated with various female infertility disorders. A total of 116 women diagnosed with RIF and 218 control subjects were genotyped for the VEGF -2578C>A, -1154G>A, -634C>G and 936C>T polymorphisms using a polymerase chain reaction-restriction fragment length polymorphism assay. The VEGF -2578AA genotype was associated with an increased prevalence (≥4) of RIF [adjusted odds ratio (AOR)=2.77; 95% confidence interval (CI)=1.10-7.02; P=0.031], whereas the VEGF -634CG+GG genotype was associated with an increased incidence of total RIF (AOR=2.03; 95% CI=1.02-4.05; P=0.044) and ≥4 RIF (AOR=3.16; 95% CI=1.19-8.37; P=0.021). The results of the haplotype analysis indicated that -2578A/-1154A/-634G/936C (AOR=1.76; 95% CI=1.03-3.00; P=0.040 for total RIF and AOR=2.11; 95% CI=1.12-3.97; P=0.021 for ≥4 RIF) was associated with the occurrence of RIF. In addition, it was revealed that there was a significant difference in serum prolactin level associated with the VEGF -634C>G polymorphism (P=0.013). Therefore the findings of the present study indicate that the VEGF -2578AA genotype, -634G allele and -2578A/-1154A/-634G/936C haplotype may be genetic markers for susceptibility to RIF. However, further studies on VEGF promoter polymorphisms that include an independent randomized-controlled population are required to confirm these results.

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Section: Introductionmentioning

confidence: 99%

Association between vascular endothelial growth factor promoter polymorphisms and the risk of recurrent implantation failure

et al. 2017

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“…As this study was retrospectively designed, institutional review board approval was not obtained. RIF was defined as two or more unsuccessful ART/embryo transfer cycles despite the availability of good quality embryos (7). According to the ART center's policy, all women with a history of RIF were suggested to undergo an oHS procedure preceding a new ovarian stimulation cycle despite normal vaginal sonography (TVS) or hysterosalpingography (HSG).…”

Section: Methodsmentioning

confidence: 99%

Impact of office hysteroscopy in repeated implantation failure: Experience of a single center

Pabuçcu¹,

Yalçın²,

Bodur³

et al. 2016

J Turkish German Gynecol Assoc

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Objective: Repeated implantation failure (RIF) is a clinical entity affecting many couples undergoing assisted reproductive technology (ART).Various intrauterine pathologies contribute to RIF. Nevertheless, vaginal sonography and hysterosalpingography, which are the common diagnostic tools for the initial follow-up, have limited sensitivities. In this context, we aimed to evaluate the impact of office hysteroscopy (oHS) on live birth rates (LBRs) when performed prior to subsequent ART cycles in women with a history of RIF. Material and Methods:The database of an assisted reproduction center was retrospectively reviewed to detect eligible cases. A total of 363 women out of 2875 admissions were consecutively included in the analysis, of which 119 formed the oHS group and 244 formed the non-oHS group prior to a new ART cycle. Women in the oHS arm were examined during their early follicular phase via a vaginoscopic approach 1-6 months before the beginning of a new cycle. The standard in-vitro fertilization-intracytoplasmic sperm injection (IVF/ICSI) cycle was applied to all the women. Results:In the oHS group (n=119), 61 patients had intrauterine abnormalities, with an overall abnormality rate of 51.2%. Implantation, pregnancy, and LBRs of the groups were statistically similar. LBRs of the women with abnormal oHS findings (15/61, 24.5%), with normal oHS findings (14/58, 24.1%), and without oHS (39/244, 16%) were statistically similar (p=0.41). Conclusion:Unrecognized intrauterine pathologies can be easily detected and concurrently treated during oHS with high success rate. However, a beneficial impact depends on the extent of the pathology and thus, routine application to enhance reproductive outcomes is still not warranted. (J Turk Ger Gynecol Assoc 2016; 17: 197-200) Keywords: Endometrium, in-vitro AbstractSubjects who underwent the procedure formed the oHS group, whereas the remaining subjects formed the non-oHS group. All included patients were between 18 and 40 years of age and had follicle-stimulating hormone (FSH) levels of <15 IU/mL. The exclusion critertia were 1) poor ovarian response according to the Bologna criteria (8) or women with premature ovarian failure; 2) male subjects with severe oligozoospermia, oligoasthenozoospermia, or azoospermia; 3) preimplantation genetic screening and cryopreserved/thawed embryo transfer cycles; 4) women with confirmed endometriosis; 5) women with hypothalamic amenorrhea; and 6) women who underwent oHS more than 6 months prior to a new cycle.Office hysteroscopy procedure All patients were examined during their early follicular phase, 1-6 months before the start of a new ART cycle, via the vaginoscopic approach as previously described (9). No routine preoperative analgesia, antibiotics, sedation, or cervical preparation was used. Briefly, a rigid hysteroscope (continuous flow; 30° forward oblique view) with an outer diameter of 4 mm using 0.9% normal saline was used. Following adequate distension of the uterine cavity, systematic inspection was performed. Standard g...

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“…Despite many publications on this topic, no unanimous de- Polanski has defined RIF in an expert opinion based on the available literature as the "absence of implantation after two consecutive IVF cycles where the cumulative number of transferred embryos was no less than four for cleavage-stage embryos and no less than two for blastocysts, with all embryos being of good quality and of appropriate developmental stage" [14].…”

Section: Recurrent Implantation Failure (Rif)mentioning

confidence: 99%

Recurrent Implantation Failure and Low Molecular Weight Heparin

Khalife¹,

Ghazeeri²

2018

OJOG

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Implantation of the embryo into the endometrium is the first step in the establishment of pregnancy. This process is complex, and depends on many factors. Recurrent implantation failure is a source of distress to patients and specialists. It is defined as failure to achieve a viable pregnancy, following ">3 embryo transfers with high quality embryos or the transfer of ≥ 10 embryos in multiple transfers". Thrombophilic conditions that contribute to recurrent implantation failure are the main concern in this review. The mechanism of implantation failure is believed to be due to decreased blood flow to the endometrium and placenta which can hinder normal endometrial receptivity leading to miscarriage. Defects in early placentation resulting in pregnancy failure, have focused attention on the therapeutic potential of low molecular weight heparin in the implantation process. Heparin has a role at all stages of implantation to improve pregnancy outcomes. There are controversies in literature regarding the association between thrombophilia and recurrent implantation failure and available literature regarding this issue is very heterogeneous. Various investigators, have shown that women with RIF are more likely to have a thrombophilia disorder, yet a clear cause cannot be acknowledged from these studies. Heparin treatment has been evaluated in several studies, showing conflicting evidence. However, several studies have pointed out that it may play a role in a subset of patients who presents a thrombophilia mutation, thus the group of patients that might benefit is needed to be identified. This review is dedicated to evaluate the published literature about the role of low molecular weight heparin in case of recurrent implantation failure with or without the presence of thrombophilia.

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What exactly do we mean by ‘recurrent implantation failure’? A systematic review and opinion

Cited by 223 publications

References 153 publications

Association between vascular endothelial growth factor promoter polymorphisms and the risk of recurrent implantation failure

Association between vascular endothelial growth factor promoter polymorphisms and the risk of recurrent implantation failure

Impact of office hysteroscopy in repeated implantation failure: Experience of a single center

Recurrent Implantation Failure and Low Molecular Weight Heparin

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