Assisted implantation
Implantation is the process of attaching the developing embryo to the uterine wall. It is an extremely complicated process in which a completely foreign organism – the embryo – forms a bond with the mother’s body in order to absorb all the substances necessary for its development and to excrete waste products. Pregnancy begins the moment the embryo implants.
Even though the embryo is an extremely efficient parasite, we humans are not exactly the great success story of natural reproduction (according to Wilcox AJ et al. Preimplantation loss of fertilized human ova: estimating the unobservable. Hum Reprod. 2020. 35(4): 743-750):
- Up to 60% of fertilized eggs are lost before implantation.
- Another 30% of implanted embryos are lost during early pregnancy.
Natural selection is one of nature’s most powerful forces and favors the birth of genetically unencumbered, well-viable organisms. The implantation of an embryo is a particularly central time for (natural) embryonic selection, which is why there seems to be large embryonic losses before, during and shortly after implantation.
There are two specific groups of patients who have problems when trying to conceive beyond naturally expected implantation rates. In the first group, implantation does not occur (implantation failure). The other achieves implantation but is unable to maintain an early pregnancy (repeated miscarriages).
Unfortunately, our knowledge of implantation and early pregnancy is far from satisfactory: the cause of implantation failure or repeated miscarriages currently remains unknown in up to 70% of cases.
If you have implantation problems or have suffered two or more recurrent miscarriages after IVF/ICSI treatment, we will treat you with special attention at ReproCreate Fertility Clinic. We will do our best to determine the cause of your problem and, if possible, to tailor your treatment to the individual.
If the cause of the failed implantation or recurrent miscarriage remains unclear, we will analyze all available options and then decide together which treatment is best for your situation.
Note: The proposed treatments for implantation failure/recurrent miscarriage are still under development, and there may be conflicting data in the literature. We cannot guarantee a solution to the problem of implantation or .dem preservation of pregnancy.
Please note: Treatments for implantation failure/recurrent miscarriage are associated with additional costs. If you are interested in such treatment, we will be happy to take the time to provide you with the necessary information for your informed consent and to answer all your questions in the best possible way.
The additional treatments that can be applied in case of implantation failure/recurrent miscarriage include:
- Assisted hatching: “assisted hatching”, in which a small hole is made in the shell of the embryo by means of a laser to facilitate the hatching process;
- EmbryoGlue: “embryo glue”, a special medium for embryo transfer, designed to facilitate implantation;
- PICSI: physiological ICSI, a modified ICSI fertilization method in which spermatozoa are tested and the most functional ones are selected;
- Timing of embryo transfer after ERA test: “Endometrial Receptivity Array”, testing of the receptivity of the endometrium to determine the optimal implantation window for embryo transfer;
- Scratching: “scratching” the endometrium (lining of the uterus) to improve the likelihood of implantation;
- optimization of the endometrial microbiome;
- HCG Flushing: irrigation of the uterus with the pregnancy hormone HCG;
- Diagnosis and treatment of possible chronic inflammation of the cervius (endometritis);
- Confirmation and treatment of endometrial NK cells (natural killer cells);
- Intralipid infusion to suppress the activity of natural killer cells;
- IVIG infusion: “passive immune treatment” by infusion of immunoglobulins
We will be happy to explain further details and possibilities to you in a detailed initial consultation.
