Recurrent Implantation Failure
If you’re facing recurrent implantation failure (RIF), you’re already familiar with the hopes and heartbreak that accompany each IVF cycle.
The emotional toll deepens with each negative pregnancy test, especially when there’s no obvious explanation. Your doctors, friends and family may encourage you to keep trying, suggest that you use a donor or tell you that it’s time to give up.
How do we handle RIF at Demeter Fertility? We pause and ask, “Why does this keep happening?” Careful investigation may open the door to new insights and more personalised treatment approaches.
What is recurrent implantation failure?
Recurrent implantation failure (RIF) refers to the absence of a successful pregnancy after several IVF attempts involving high-quality embryos in a patient/couple who could reasonably be expected to conceive.
‘Struggling with fate’
Anyone experiencing RIF has already endured a long journey of trying to conceive through natural means and then repeated IVF cycles.
You might be feeling grief, misplaced guilt, disappointment, helplessness, shock and loneliness. All of these emotions (and more) were listed by RIF patients in a Swiss study. Patients also said they felt like they were ‘struggling with fate’ or living on an ‘emotional rollercoaster.’
Possible causes of recurrent implantation failure
Each stage of the IVF process can potentially influence RIF, including any issues with:
Egg or sperm quality
Embryos
The mother’s and father’s general and reproductive health*
A combination of those factors.
*including metabolic issues, microbiome factors, chronic inflammation, lifestyle factors or uterine polyps or fibroids
Investigating recurrent implantation failure
At Demeter Fertility, we take recurrent implantation failure seriously and we dedicate time to a thorough investigation.
A personalised diagnostic workup may include:
- Full medical and fertility history review
- Blood tests such as AMH, FSH, thyroid function, immune and clotting profiles
- Ultrasound and hysteroscopy to assess the uterus
- Endometrial receptivity analysis (ERA) to determine the optimal time for embryo transfer
- Genetic testing of embryos (PGT-A) or parental karyotyping in some cases.
Potential treatment approaches
There is no one-size-fits-all solution to RIF. Your treatment plan will be tailored to your circumstances and may include:
- Personalised embryo transfer timing, using ERA results
- Pre-implantation genetic testing (PGT-A) to help select embryos with the correct number of chromosomes
- Endometrial support, including hormone treatments or other medications
- Management of chronic inflammation or infection
- Assisted hatching to help embryos implant in specific cases
- Optimising your overall health, including lifestyle changes to manage weight, sleep, stress and any underlying conditions.
A respectful and evidence-informed approach
Demeter Fertility approaches RIF with both compassion and clinical insight. We recognise that every individual’s experience is different, and we will:
- Take the time to listen and understand your full medical and fertility history
- Offer diagnostic testing that is evidence-informed and appropriate to your case
- Support you emotionally as well as medically
- Provide transparency around treatment options, costs and likelihood of success.
When you're ready to talk
If you’ve experienced multiple unsuccessful embryo transfers, you deserve a thorough, respectful evaluation without pressure.
Disclaimer: All information is general and not intended as a substitute for professional advice. Any surgical or invasive procedure carries risks.
References
- Human Reproduction Open, ESHRE good practice recommendations on recurrent implantation failure, https://academic.oup.com/hropen/article/2023/3/hoad023/7198324, [Accessed 19 June 2025]
- Citation: Meier M, di Giacopo SCM, Stucki P, Birchler K, Leeners B (2024) Women’s Experiences and Coping Strategies for Dealing with Recurrent Implantation Failure in IVF/ICSI – An Interview Study. Gynecol Obstet Open Acc 8: 226. https://doi.org/10.29011/2577-2236.1002266, [Accessed 19 June 2025]