Management of Recurrent Implantation Failure

Diagnostic Approach and Treatment Recommendations

• The American Society for Reproductive Medicine recommends continuing with single embryo transfer (eSET) as the standard procedure, as there is no evidence showing that cumulative live birth rate with eSET is inferior to double embryo transfer (DET) 1, 2
• Blastocyst transfers should be done as single embryo transfers due to higher monozygotic twin potential and increased risk of complications with multiple embryos 1, 3
• For patients with normal ovarian reserve, routine stimulation protocols can be used to obtain more oocytes for testing and transfer, while alternative protocols such as natural cycle, minimal ovarian stimulation, or luteal phase stimulation can be considered for poor responders 4
• Transferring more than one embryo as a solution to RIF should be avoided, as this increases risks of multiple pregnancy, ectopic pregnancy, and other complications 2, 5