Recurrent Implantation Failures in ART: Myth or Reality?Classically, implantation failures in ART were believed to result from alterations in embryo or endometrium quality. The advent of PGT-A has allowed for the transfer of only genetically normal embryos. However, not all euploid embryos implant, which leads us to question the role played by the endometrium. Several tests have been designed to assess receptivity, but none are fully validated.
In light of this, Pirtea, et al. from Richard Scott’s team in Basking Ridge, New Jersey designed a large retrospective study to assess whether women who previously failed a euploid embryo transfer were at greater risk of implantation failure on the occasion of the second and third frozen euploid blastocyst transfers. Results from 4,429; 784; and 131 successive frozen euploid embryo transfers showed practically no reduction in sustained implantation chances with successive transfers.
Ultimately, the cumulative sustained implantation and live birth rates after three successive frozen euploid blastocysts transfers (the definition of recurrent implantation failure) were 95.2% and 93.7%, respectively. These results therefore indicate that the role played by the endometrium in implantation failures is probably minimal.
DiscussantsDr. Danilo Cimadomo, PhD, MSc
Dr. Cimadomo is Science and Research Manager of GeneraLife IVF Centers. His research is focused on the strategies to outline embryo competence in IVF and their clinical application. He is reviewer or associate editor of several international journals in the field of reproductive medicine, a member of the Executive Committee of SIERR (Italian Society of Embryology, Research and Reproduction), and basic science officer of the ESHRE special interest group (SIG) in “implantation and early pregnancy”. He is author or co-author of more than 60 papers in peer-reviewed journals and book chapters, along with several abstracts at national and international meetings.
Dr. Paul Pirtea
Dr. Pirtea is Junior Attending in the Division of Reproductive Endocrinology and Infertility at Hospital Foch, Universite de Paris Ouest (UVSQ). He worked as a research fellow at the RMA campus in Basking Ridge, NJ while conducting the present study. Dr. Pirtea has authored more than 30 papers indexed in PubMed. His interests range across the field of infertility care and include ART and endometriosis management.
Zev Williams, MD, PhD
Dr. Williams is the Wendy D. Havens Associate Professor in Women's Health, Chief of the Division of Reproductive Endocrinology and Infertility, at Columbia University Irving Medical Center, and Director of Columbia University Fertility Center (CUFC). He received his MD and PhD from the Mount Sinai School of Medicine, his residency training in Obstetrics and Gynecology at the Brigham and Women's Hospital/Massachusetts General Hospital, his fellowship training in Reproductive Endocrinology and Infertility at Weill Cornell, and his postdoctoral training at the Rockefeller University. Dr. Williams is an NIH-funded researcher with a particular focus in early pregnancy.
HostRichard Scott, Jr., MD, HCLD/ALD
Dr. Scott is double board certified in obstetrics/gynecology and REI. He is a founding partner of IVIRMA Global. Additionally, he is the Clinical Director, Andrology and Endocrinology Laboratory Director, and Embryology Director of RMANJ; Embryology Laboratory Director for IVI Florida in Orlando; Fellowship Director for the Jefferson- RMANJ fellowship at Thomas Jefferson University; and the Director of the Division of Reproductive Endocrinology at Robert Wood Johnson Medical School of Rutgers University. He is the recipient of many awards.
ModeratorsDominique de Ziegler, MD
Dr. de Ziegler is a U.S-trained (UCLA) Reproductive Endocrinologist who now works as University Consultant at Foch Medical Center, Universite de Paris - Ouest (UVSQ).
Kurt Barnhart, MD, MSCE
Dr. Barnhart is Associate Chief, Penn Fertility Care, Director, Women's Health Clinical Research Center, Vice Chair for Clinical Research, William Shippen, Jr. Professor of Obstetrics and Gynecology, and Professor of Epidemiology in Biostatistics and Epidemiology at the University of Pennsylvania. He serves as Video and New Media Editor of Fertility and Sterility.