Chapter 22 - Implantation failure:

Summary

Failed implantation is one of the most difficult challenges for clinicians and embryologists involved in assisted reproductive technologies (ART). This chapter considers how far genetic abnormalities or morphological characteristics may impair or favor implantation. It reviews the strategies such as blastocyst transfer, assisted hatching, transfer media, co-cultures, cytoplasmic transfer and zygote intra-fallopian transfer aimed at overcoming implantation failure. The chapter presents new approaches for non-invasive embryo quality assessment as perspectives, since they need clinical validation. Proteomic analysis was applied at the level of the embryo itself as well as its own environmental medium in the studies with perspectives to relate a protein profile in the medium with embryo viability in a non-invasive manner. Alternatives to recurrent implantation failure like oocyte or sperm donation may be proposed to patients, keeping in mind that with the exception of identified genetic abnormalities, developmental or implantation failure may involve the male or female partner.