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Recurrent implantation failure (RIF) is a complex distressing challenge that many couples face when they undergo IVF and other assisted reproductive treatments. It is generally defined as the failure to achieve a clinical pregnancy after at least three high-quality embryos are transferred across multiple IVF cycles.
Couples struggling with RIF often consult with the best infertility clinic in Kolkata to explore deeper causes, including genetic issues.
RIF has various possible causes, but the role of genetic abnormalities is one critical area that is often overlooked. The abnormalities might be in the prospective parents or within the embryos. It is very important to understand this connection, to guide future treatment and improve outcomes.
It is essential not to view implantation as a simple biological event. It demands a proper interplay between a healthy embryo, hormonal balance, a receptive endometrium and effective immune regulation. If there is a failure in any part of this system, implantation may fail.
In cases of RIF, a hidden but major role is often played by genetics. It can affect either the environment where the implantation is supposed to occur or the viability of the embryo itself.
This is why many patients are advised to undergo comprehensive evaluations at a high risk pregnancy treatment center for advanced reproductive assessment.
Chromosomal abnormality in the embryo is among the commonest genetic factors associated to RIF. Embryos might appear to be normal under the microscope but these may have an improper number of chromosomes. In such cases, there may be a failure of embryo implantation or the risks of early miscarriage. With increasing maternal age, the risks of chromosomal abnormalities can increase. However, it can also be seen in younger women due to sperm or egg quality.
With the help of a technique known as Preimplantation Genetic Testing for Aneuploidy (PGT-A), embryos can be screened for chromosomal abnormalities even before transfer. This method can help to identify and choose only chromosomally normal embryos. It can significantly improve the chances of implementation and success of pregnancy in couples with RIF.
Fertility centers often use support diagnostics from trusted ultrasound centres in Kolkata to ensure embryo placement aligns with uterine receptivity.
There are times when the problem lies in the chromosomes of the parents and not in the embryo itself. Structural chromosomal abnormalities like inversions or translocations in any of the partners, or both of them, may be passed on to embryos. This can lead to unbalanced genetic material. Such kinds of embryos often fail to implant or develop.
With the help of a simple blood test known as Parental karyotyping, such types of structural rearrangements can be detected. If doctors find abnormalities, they can carry out Preimplantation Genetic Testing for Structural Rearrangements (PGT-SR) to detect embryos with balanced chromosomes that can have higher chances of successful implantation and the potential for ensuring healthy pregnancies.
Advanced clinics may also integrate genetic screening with procedures whose success relies on minimal invasion, keeping in mind the cost of laparoscopic surgery in Kolkata for affordability planning.
With the help of traditional semen analysis, semen count, morphology and motility can be assessed properly. But the genetic quality of sperm cannot be evaluated. However, if there are high levels of sperm DNA fragmentation, embryo development can be affected significantly, even if fertilization happens. DNA fragmentation can occur with age, infections, oxidative stress or lifestyle factors.
Such issues can be detected with the help of tests like Sperm DNA Fragmentation Index (DFI). The treatment options for such problems may include using surgically retrieved sperm that may have better DNA integrity, antioxidant therapy or lifestyle changes.
These interventions are typically overseen by a top gynecologist in Kolkata, in coordination with fertility specialists for tailored outcomes.
The presence of some genetic conditions on the maternal side can interfere with implantation. Hereditary clotting disorders like thrombophilia, which can impair flow of blood to the uterus, is one such condition. Mutations like prothrombin gene mutations or Factor V Leiden can also lead to a hostile environment in the uterus, resulting in failure of implantation or early pregnancy loss.
Women who have such mutations are often recommended blood thinners like heparin or low-dose aspirin during IVF and early pregnancy. Studies have revealed that these actually manage to improve outcomes by increasing flow of blood and reducing clot formation within the uterus.
In some cases, patients who’ve undergone gynecology cosmetic surgery in Kolkata are also monitored for any genetic complications that could impact future conception.
Implantation success also depends on how receptive the endometrial lining is to an embryo. The endometrial lining of some women with RIF seems to be normal on ultrasound scans. On a molecular level, however, it might be out of sync. Due to this misalignment, even healthy embryos may be prevented from getting implanted.
The gene expression profile of the uterine lining can be examined with the help of ERA and other emerging tests, which can determine the best time for embryo transfer. In some cases of RIF, personalized embryo transfer – based on ERA results – has been found to be useful.
When it comes to recurrent implantation failure, genetic abnormalities are an important factor that is usually not explored much. Whether the problem lies in maternal genetics, sperm, embryo or the interaction between all these, such factors can prevent the success of even the most promising IVF cycles.
The best way to overcome RIF is to go for comprehensive genetic evaluation and a personalized treatment approach. By understanding genetics better and going for advanced reproductive technologies, many couples have been found to achieve healthy pregnancy, despite having experienced recurrent implantation failures in the past.
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