Management strategies following implantation failure of euploid embryos
Abstract Background Euploid blastocyst implantation failure may result from embryonic factors undetectable by preimplantation genetic testing for aneuploidy (PGT‐A); however, various nonembryonic factors can also intricately interfere with implantation. This review seeks to clarify evidence‐based te...
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-01-01
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| Series: | Reproductive Medicine and Biology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rmb2.12576 |
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| Summary: | Abstract Background Euploid blastocyst implantation failure may result from embryonic factors undetectable by preimplantation genetic testing for aneuploidy (PGT‐A); however, various nonembryonic factors can also intricately interfere with implantation. This review seeks to clarify evidence‐based testing and treatments for implantation failure after euploid embryo transfer. Methods We conducted a review of the literature on implantation failure after euploid embryo transfer or multiple embryo transfer cycles, which mainly included systematic reviews and meta‐analyses. Results The recommended tests for implantation failure include (1) hysteroscopy, (2) endometrial CD138 immunohistochemistry and bacterial culture, (3) serum 25‐hydroxyvitamin D3, and (4) thrombophilia screening. Based on diagnostic findings, the following treatments have been recommended: (1) antibiotics for chronic endometritis, (2) vitamin D replacement, (3) lifestyle modification, and (4) low‐dose aspirin starting from the postimplantation period for thrombophilia. Moreover, frozen–thawed single euploid blastocyst transfer using assisted hatching and hyaluronan‐enriched transfer medium may support embryo implantation. Conclusion To ensure a successful pregnancy in subsequent embryo transfers, simple, inexpensive, and evidence‐based tests and treatments should be selected. |
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| ISSN: | 1445-5781 1447-0578 |