Answer from: Raúl Olivares, MD
This is a million-dollar question. When we transfer the embryos, we basically lose control of what’s going on. There could be different reasons why the embryo does not implant. It could be that the initially good embryo stops developing because of some genetic condition, abnormal development of the cells and the embryo is no longer viable, and it does not implant. It could also happen that the dialogue that takes place between the embryo and the endometrium does not take place properly. The embryo cannot really implant as it should and that at some stage, the embryo may lack the necessary things to keep on growing. This may also end up in a negative.
It could also be that there is something wrong on the patient’s side, on the endometrium level, antibodies, coagulation issues, for example, that may make it more difficult for the embryo to implant. If we transfer the embryos, and we won’t get single implantation even if we think that the embryos were of good quality, it’s going to make sense to carry out some studies to see if there is anything wrong on the mother’s side.
Answer from: Zane Vitina, MD
To achieve pregnancy, we need good quality embryos. We also need a healthy uterus, healthy endometrium, which is the internal part of the uterus. Usually, implantation occurs according to women’s menstrual cycle. The period when the endometrium is ready to implant the embryo is called the implantation window. It usually lasts for 24 hours to implant the embryo. It is necessary to coordinate women’s menstrual cycle after ovulation and embryo stage.
Usually, on the 5 -day embryo, the blastocyst is available for the uterus on day-5 after a progesterone intake, but sometimes this implantation window deviated to the right or left side. An ERA test or endometrial receptivity test can help us with detecting the implantation period. The implantation is based on 239 gene expression in the endometrium, not only in endometrial and morphological changes.
What are the reasons that embryos don't implant?
How does embryo quality impact successful implantation? Why do chromosomally normal embryos not implant? What may be the cause?