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Embryonic Factors Associated with Recurrent Implantation Failure

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Recurrent Implantation Failure

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Abstract

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.

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Abbreviations

AC:

Abnormal cleavage

AH:

Assisted hatching

CPR:

Clinical pregnancy rate

FISH :

Fluorescence in situ hybridization

HPI:

Hours post-insemination

ICM:

Inner cell mass

IR:

Implantation rate

LBR:

Live birth rate

NGS:

Next-generation sequencing

PGT-A:

Preimplantation genetic testing for aneuploidy

TE:

Trophectoderm

TLI:

Time-lapse imaging

RC:

Reverse cleavage

RCT:

Randomized controlled trial

RIF:

Recurrent implantation failure

ZP:

Zona pellucida

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Authors and Affiliations

  1. Sidney Kimmel Medical College, Thomas Jefferson University Philadelphia, Philadelphia, PA, USA

    Daniel J. Kaser MD

  2. IVI-RMA of New Jersey, Basking Ridge, NJ, USA

    Daniel J. Kaser MD

  3. Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Catherine Racowsky PhD, HCLD

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  1. Daniel J. Kaser MD
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  2. Catherine Racowsky PhD, HCLD
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Correspondence to Catherine Racowsky PhD, HCLD .

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Editors and Affiliations

  1. Reproductive Medicine Associates of NJ, Thomas Jefferson University, Basking Ridge, New Jersey, USA

    Jason M. Franasiak

  2. Reproductive Medicine Associates of NJ, Thomas Jefferson University, Basking Ridge, New Jersey, USA

    Richard T. Scott Jr.

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Kaser, D.J., Racowsky, C. (2018). Embryonic Factors Associated with Recurrent Implantation Failure. In: Franasiak, J., Scott Jr., R. (eds) Recurrent Implantation Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-71967-2_4

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