Embryonic Factors Associated with Recurrent Implantation Failure

  • Daniel J. Kaser
  • Catherine Racowsky


Recurrent implantation failure (RIF) is a frustrating clinical scenario for the patient, physician, and embryology team alike. When seemingly “good-quality embryos” fail to implant in a normal uterus following multiple embryo transfers, there is often no immediate obvious reason. Despite considerable improvements in both clinical protocols and laboratory technologies over the last 30 years of assisted reproduction, the question remains as to how best to select the most developmentally competent embryo from a given cohort. The purpose of this chapter is not to provide a comprehensive review of the normal developmental kinetics or morphologic scoring systems of the human preimplantation embryo (reviewed by Matchinger and Racowsky (Reprod Biomed Online 26:210–21, 2013)). Rather, this chapter will (1) focus on embryonic factors associated with implantation in general and RIF specifically and (2) identify interventions in the IVF laboratory at the cleavage and blastocyst stages that may optimize pregnancy rates in this challenging patient population.


Assisted hatching Blastocyst transfer Developmental kinetics Extended culture Freeze all IVF Preimplantation genetic testing Recurrent implantation failure Time-lapse imaging 



Abnormal cleavage


Assisted hatching


Clinical pregnancy rate


Fluorescence in situ hybridization


Hours post-insemination


Inner cell mass


Implantation rate


Live birth rate


Next-generation sequencing


Preimplantation genetic testing for aneuploidy




Time-lapse imaging


Reverse cleavage


Randomized controlled trial


Recurrent implantation failure


Zona pellucida


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Sidney Kimmel Medical CollegeThomas Jefferson University PhiladelphiaPhiladelphiaUSA
  2. 2.IVI-RMA of New JerseyBasking RidgeUSA
  3. 3.Department of Obstetrics and GynecologyBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA

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