You have followed all the stages and times of the fertility treatment. You have followed your doctor’s instructions to the letter. The embryos were of good quality and your condition was ideal. However, you are not able to get pregnant… What could be wrong?
The last phase of the assisted reproduction process is the transfer of the embryo. Its attachment to the endometrium is a decisive episode in gestation, so if it does not occur correctly, pregnancy will not occur. If this is repeated after three IVF-ICSI cycles or after the transfer of more than four embryos, we would be facing what is known as implantation failure.
Let’s review the most common factors that may be at the origin of this problem and their possible solutions.
- Chromosomal defects in the embryo
Sometimes embryos carry genetic abnormalities that make implantation impossible. A karyotype of both the mother and the father is required to detect hereditary factors that lead to these chromosomal defects that are hindering pregnancy. It is also possible to carry out Preimplantation Genetic Diagnosis of the embryos to discard those that due to genetic defects will not be able to implant in the mother’s uterus.
- Uterine complications
The presence of pathologies such as endometrial polyps, fibroids or hydrosalpinx (the accumulation of fluid in the fallopian tubes) can prevent the embryo from implanting and surviving in the uterus. These problems are detected by hysteroscopy or other specific tests (such as hysterosalpingography) and, if possible, are solved by surgery.
- Age of the woman
It is a fact that a woman’s age affects oocyte quality, especially after the age of 35, which makes it difficult to obtain quality embryos. However, the state of the endometrium can also be compromised by age, making it less receptive to implantation.
- Endometritis
It is an infection (often bacterial) that causes inflammation of the endometrium. It often goes unnoticed because it normally occurs without symptoms or with non-specific symptoms: occasional pelvic pain, fever, uterine bleeding, etc. The way to diagnose it is by biopsy or endometrial culture. It is treated with antibiotics.
- Increased blood clotting
Blood clotting disorders can cause blood clots that prevent proper blood flow from the placenta to the embryo. These problems, which are detected by a blood test, are treated with anticoagulant medications.
- Antiphospholipid syndrome
This is an autoimmune disease that causes the woman’s immune system to identify the embryo as a harmful external agent and attack its cells, causing rejection. It is detected with a specific blood test. Its treatment is based on anticoagulant medication.