Recurrent Implantation Failure: History, Etiology, Advances and Ongoing Challenges


Authors : Sheron K George

Volume/Issue : Volume 10 - 2025, Issue 3 - March


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DOI : https://doi.org/10.38124/ijisrt/25mar1152

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Abstract : Infertility is the inability to conceive even after unprotected intercourse for more than 12 months. In India, the prevalence of infertility has been growing to the extent that 10-15 percent of couples experience this condition. Recurrent implantation failure (RIF) is a complex medical condition in which implantation becomes unsuccessful despite the advancements in Assisted Reproductive Technologies (ART). We lack a clear understanding of the definition and standardisation of RIF protocols. The etiology behind RIF is multifactorial, comprising both maternal and embryonic factors. Maternal factors include endometrial abnormalities, environmental exposure, physical aspects, and dysregulation of the immune system. Chromosomal aberrations such as aneuploidy are embryo-born factors that impede implantation. The latest studies have shed light on the novel mechanisms of RIF. Recent research has identified miRNA that can hinder the implantation processes, opening the door to many more avenues for targeted therapies, gene knockdown, and immune modulation. This review is a comprehensive overview of the history, causes, advancements, and challenges related to RIF.

Keywords : Recurrent Implantation Failure, Assisted Reproductive Technology, Endometrial Receptivity Assay, Infertility.

References :

  1. 1. A., F., A., F., R., F., R., T., Y., W., A., H., & H., S. (2017). NK cells and reproduction our progress in NK cell study. American Journal of Reproductive Immunology, 78.
  2. Bashiri, A., Halper, K. I., & Orvieto, R. (2018a). Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions. In Reproductive Biology and Endocrinology (Vol. 16, Issue 1). https://doi.org/10.1186/s12958-018-0414-2
  3. Bashiri, A., Halper, K. I., & Orvieto, R. (2018b). Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions 11 Medical and Health Sciences 1114 Paediatrics and Reproductive Medicine. Reproductive Biology and Endocrinology, 16(1).
  4. Bellelis, P., Barbeiro, D. F., Rizzo, L. V., Baracat, E. C., Abrão, M. S., & Podgaec, S. (2013). Transcriptional changes in the expression of chemokines related to natural killer and T-regulatory cells in patients with deep infiltrative endometriosis. Fertility and Sterility, 99(7). https://doi.org/10.1016/j.fertnstert.2013.02.038
  5. Bellver, J., Soares, S. R., Álvarez, C., Muñoz, E., Ramírez, A., Rubio, C., Serra, V., Remohí, J., & Pellicer, A. (2008). The role of thrombophilia and thyroid autoimmunity in unexplained infertility, implantation failure and recurrent spontaneous abortion. Human Reproduction, 23(2). https://doi.org/10.1093/humrep/dem383
  6. Benkhalifa, M., Montjean, D., Corsi-Cauet, H., Copin, H., Bach, V., Miron, P., & Cabry, R. (2023). O-091 The impact of endocrine disruptors on early pregnancy and clinical outcomes in IVF. Human Reproduction, 38(Supplement_1). https://doi.org/10.1093/humrep/dead093.110
  7. Benner, M., Ferwerda, G., Joosten, I., & van der Molen, R. G. (2018). How uterine microbiota might be responsible for a receptive, fertile endometrium. Human Reproduction Update, 24(4). https://doi.org/10.1093/humupd/dmy012
  8. Boniface, C., & Esfandiari, N. (2024). Immunology Updates in Recurrent Implantation Failure in In Vitro Fertilization. Current Obstetrics and Gynecology Reports, 13(1). https://doi.org/10.1007/s13669-024-00375-0
  9. Boucher, A., Brichant, G., Gridelet, V., Nisolle, M., Ravet, S., Timmermans, M., & Henry, L. (2022). Implantation Failure in Endometriosis Patients: Etiopathogenesis. In Journal of Clinical Medicine (Vol. 11, Issue 18). https://doi.org/10.3390/jcm11185366
  10. Carvalho, F. M., Aguiar, F. N., Tomioka, R., De Oliveira, R. M., Frantz, N., & Ueno, J. (2013). Functional endometrial polyps in infertile asymptomatic patients: A possible evolution of vascular changes secondary to endometritis. European Journal of Obstetrics and Gynecology and Reproductive Biology, 170(1). https://doi.org/10.1016/j.ejogrb.2013.05.012
  11. Catherino, W. H. (2011). Stress relief to augment fertility: The pressure mounts. Fertility and Sterility, 95(8). https://doi.org/10.1016/j.fertnstert.2011.05.067
  12. Celik, O., Koc, O., Yurci, A., Ersahin, A., Celik, N., Tanilir, F., Gurkan, N., Ozyurt, R., Ozcil, M. D., Duran, B., & Unlu, C. (2022). Receptivity-based uterine fibroid surgery: an updated systematic review of the evidence. In Clinical and Experimental Obstetrics and Gynecology (Vol. 49, Issue 5). https://doi.org/10.31083/j.ceog4905114
  13. Coughlan, C., Ledger, W., Wang, Q., Liu, F., Demirol, A., Gurgan, T., Cutting, R., Ong, K., Sallam, H., & Li, T. C. (2014). Recurrent implantation failure: Definition and management. In Reproductive BioMedicine Online (Vol. 28, Issue 1). https://doi.org/10.1016/j.rbmo.2013.08.011
  14. Coughlan, C., Yuan, X., Nafee, T., Yan, J., Mariee, N., & Li, T. (2013). The clinical characteristics of women with recurrent implantation failure. Journal of Obstetrics and Gynaecology, 33(5). https://doi.org/10.3109/01443615.2013.782280
  15. Coutifaris, C. (2004). Histological dating of secretory endometrium: What controversy? Fertility and Sterility, 82(5). https://doi.org/10.1016/j.fertnstert.2004.07.929
  16. Critchley, H. O. D., Maybin, J. A., Armstrong, G. M., & Williams, A. R. W. (2020). Physiology of the endometrium and regulation of menstruation. In Physiological Reviews (Vol. 100, Issue 3). https://doi.org/10.1152/physrev.00031.2019
  17. Daya, S. (2009). Luteal support: Progestogens for pregnancy protection. Maturitas, 65(SUPPL. 1). https://doi.org/10.1016/j.maturitas.2009.09.012
  18. de la Cruz Borthiry, F. L., Schander, J. A., Cella, M., Beltrame, J. S., Franchi, A. M., & Ribeiro, M. L. (2022). Maternal exposure to an enriched environment promotes uterine vascular remodeling and prevents embryo loss in mice. Reproduction, 163(2). https://doi.org/10.1530/REP-21-0297
  19. Demirel, E., Kelekçi, S., Aydoʇmuş, S., Kiziltuʇ, N., & Eriş, S. (2015). Endometriosis and implantation failure: Review. In Turkiye Klinikleri Jinekoloji Obstetrik (Vol. 25, Issue 2). https://doi.org/10.5336/gynobstet.2013-38162
  20. Devesa-Peiro, A., Sebastian-Leon, P., Pellicer, A., & Diaz-Gimeno, P. (2021). Guidelines for biomarker discovery in endometrium: Correcting for menstrual cycle bias reveals new genes associated with uterine disorders. Molecular Human Reproduction, 27(4). https://doi.org/10.1093/molehr/gaab011
  21. Donaghay, M., & Lessey, B. A. (2007). Uterine receptivity: Alterations associated with benign gynecological disease. In Seminars in Reproductive Medicine (Vol. 25, Issue 6). https://doi.org/10.1055/s-2007-991044
  22. Ehrlich, S., Williams, P. L., Missmer, S. A., Flaws, J. A., Berry, K. F., Calafat, A. M., Ye, X. Y., Petrozza, J. C., Wright, D., & Hauser, R. (2012). Urinary bisphenol A concentrations and implantation failure among women undergoing in vitro fertilization. Environmental Health Perspectives, 120(7). https://doi.org/10.1289/ehp.1104307
  23. Elnafarawi, M. A., Elsherbiny, M. F., Tawfik, W. M., & EIbrahim, D. M. (2022). The Role of Platelets Rich Plasma (PRP) in Recurrent Implantation Failure (RIF). Benha Journal of Applied Sciences, 7(5). https://doi.org/10.21608/bjas.2022.244603
  24. Fabregues, F., Antonio García-Velasco, J., Llácer, J., Requena, A., Ángel Checa, M., Bellver, J., & José Espinós, J. (2023). The role of thrombophilias in reproduction: A swot analysis. In European Journal of Obstetrics and Gynecology and Reproductive Biology (Vol. 280). https://doi.org/10.1016/j.ejogrb.2022.10.024
  25. Fatemi, H. M., & Popovic-Todorovic, B. (2013). Implantation in assisted reproduction: A look at endometrial receptivity. In Reproductive BioMedicine Online (Vol. 27, Issue 5). https://doi.org/10.1016/j.rbmo.2013.05.018
  26. Fitzgerald, H. C., Schust, D. J., & Spencer, T. E. (2021). In vitro models of the human endometrium: Evolution and application for women’s health+. In Biology of Reproduction (Vol. 104, Issue 2). https://doi.org/10.1093/biolre/ioaa183
  27. Freitag, N., Pour, S. J., Fehm, T. N., Toth, B., Markert, U. R., Weber, M., Togawa, R., Kruessel, J. S., Baston-Buest, D. M., & Bielfeld, A. P. (2020). Are uterine natural killer and plasma cells in infertility patients associated with endometriosis, repeated implantation failure, or recurrent pregnancy loss? Archives of Gynecology and Obstetrics, 302(6). https://doi.org/10.1007/s00404-020-05679-z
  28. Fukui, A., Kamoi, M., Funamizu, A., Fuchinoue, K., Chiba, H., Yokota, M., Fukuhara, R., & Mizunuma, H. (2015). NK cell abnormality and its treatment in women with reproductive failures such as recurrent pregnancy loss, implantation failures, preeclampsia, and pelvic endometriosis. Reproductive Medicine and Biology, 14(4). https://doi.org/10.1007/s12522-015-0207-7
  29. Gabrielsen, J. S., & Tanrikut, C. (2016). Chronic exposures and male fertility: the impacts of environment, diet, and drug use on spermatogenesis. In Andrology (Vol. 4, Issue 4). https://doi.org/10.1111/andr.12198
  30. Gao, X., Louwers, Y. V., Laven, J. S. E., & Schoenmakers, S. (2024). Clinical Relevance of Vaginal and Endometrial Microbiome Investigation in Women with Repeated Implantation Failure and Recurrent Pregnancy Loss. In International Journal of Molecular Sciences (Vol. 25, Issue 1). https://doi.org/10.3390/ijms25010622
  31. Garneau, A. S., & Young, S. L. (2021). Defining recurrent implantation failure: a profusion of confusion or simply an illusion? In Fertility and Sterility (Vol. 116, Issue 6). https://doi.org/10.1016/j.fertnstert.2021.10.023
  32. Gellersen, B., & Brosens, J. J. (2014). Cyclic decidualization of the human endometrium in reproductive health and failure. In Endocrine Reviews (Vol. 35, Issue 6). https://doi.org/10.1210/er.2014-1045
  33. Gingold, J. A., Lee, J. A., Rodriguez-Purata, J., Whitehouse, M. C., Sandler, B., Grunfeld, L., Mukherjee, T., & Copperman, A. B. (2015). Endometrial pattern, but not endometrial thickness, affects implantation rates in euploid embryo transfers. Fertility and Sterility, 104(3). https://doi.org/10.1016/j.fertnstert.2015.05.036
  34. Glujovsky, D., Lattes, K., Miguens, M., Pesce, R., & Ciapponi, A. (2023). Personalized embryo transfer guided by endometrial receptivity analysis: a systematic review with meta-analysis. Human Reproduction, 38(7). https://doi.org/10.1093/humrep/dead098
  35. Goharitaban, S., Hamdi, K., Khazaei, M., Esmaeilivand, M., & Niknafs, B. (2022). Study of LIF, NR3C1, BCL6, miR-494, and miR-30d in Endometrial Epithelial Cells of Repeated Implantation Failure and Healthy Women Treated with Calcitriol and Letrozole in a Fibrin Scaffold. ImmunoAnalysis, 2. https://doi.org/10.34172/ia.2022.12
  36. Guerif, F., Bidault, R., Gasnier, O., Couet, M. L., Gervereau, O., Lansac, J., & Royere, D. (2004). Efficacy of blastocyst transfer after implantation failure. Reproductive BioMedicine Online, 9(6). https://doi.org/10.1016/S1472-6483(10)61773-7
  37. Guo, S., Li, Z., Yan, L., Sun, Y., & Feng, Y. (2018). GnRH agonist improves pregnancy outcome in mice with induced adenomyosis by restoring endometrial receptivity. Drug Design, Development and Therapy, 12. https://doi.org/10.2147/DDDT.S162541
  38. Hortal, M., Lledo, B., Ortiz, J. A., Fabregat, A., Moliner, B., Bernabeu, A., & Bernabeu, R. (2023). O-261 The relationship of abnormal vaginal microbiome (dysbiosis of vaginal microbiome) and proinflammatory cytokines in recurrent implantation failure patients. Human Reproduction, 38(Supplement_1). https://doi.org/10.1093/humrep/dead093.315
  39. Horton, J., Sterrenburg, M., Lane, S., Maheshwari, A., Li, T. C., & Cheong, Y. (2019). Reproductive, obstetric, and perinatal outcomes of women with adenomyosis and endometriosis: A systematic review and meta-analysis. Human Reproduction Update, 25(5). https://doi.org/10.1093/humupd/dmz012
  40. Huang, J., Qin, H., Yang, Y., Chen, X., Zhang, J., Laird, S., Wang, C. C., Chan, T. F., & Li, T. C. (2017). A comparison of transcriptomic profiles in endometrium during window of implantation between women with unexplained recurrent implantation failure and recurrent miscarriage. Reproduction, 153(6). https://doi.org/10.1530/REP-16-0574
  41. Ifenatuoha, C., & Okewale, B. (2022). Zooming in on the endometrial factor of recurrent implantation failure. In Human Fertility (Vol. 25, Issue 5). https://doi.org/10.1080/14647273.2021.1925976
  42. Juárez-Barber, E., Corachán, A., Carbajo-García, M. C., Faus, A., Vidal, C., Giles, J., Pellicer, A., Cervelló, I., & Ferrero, H. (2024). Transcriptome analysis of adenomyosis eutopic endometrium reveals molecular mechanisms involved in adenomyosis-related implantation failure and pregnancy disorders. Reproductive Biology and Endocrinology, 22(1). https://doi.org/10.1186/s12958-023-01182-7
  43. Kim, K.-R., Kim, H.-K., Chun, E.-K., Chun, S., & Min, W.-K. (2014). Urinary concentrations of bisphenol a and their association with indicators of implantation in IVF couples. Fertility and Sterility, 102(3). https://doi.org/10.1016/j.fertnstert.2014.07.071
  44. Kliman, H. J. (2020). Noyes, Hertig, and Rock revisited. In F and S Reports (Vol. 1, Issue 1). https://doi.org/10.1016/j.xfre.2020.04.004
  45. Klimaszyk, K., Nielsen, H. S., Wender-Ozegowska, E., & Kedzia, M. (2023). Chronic endometritis — is it time to clarify diagnostic criteria? Ginekologia Polska, 94(2). https://doi.org/10.5603/GP.a2022.0147
  46. Koot, Y. E. M., Van Hooff, S. R., Boomsma, C. M., Van Leenen, D., Koerkamp, M. J. A. G., Goddijn, M., Eijkemans, M. J. C., Fauser, B. C. J. M., Holstege, F. C. P., & Macklon, N. S. (2016). An endometrial gene expression signature accurately predicts recurrent implantation failure after IVF. Scientific Reports, 6. https://doi.org/10.1038/srep19411
  47. Kosova, G., Stephenson, M. D., Lynch, V. J., & Ober, C. (2015). Evolutionary forward genomics reveals novel insights into the genes and pathways dysregulated in recurrent early pregnancy loss. Human Reproduction, 30(3). https://doi.org/10.1093/humrep/deu355
  48. Krey, G., Frank, P., Shaikly, V., Barrientos, G., Cordo-Russo, R., Ringel, F., Moschansky, P., Chernukhin, I. V., Metodiev, M., Fernández, N., Klapp, B. F., Arck, P. C., & Blois, S. M. (2008). In vivo dendritic cell depletion reduces breeding efficiency, affecting implantation and early placental development in mice. Journal of Molecular Medicine, 86(9). https://doi.org/10.1007/s00109-008-0379-2
  49. Kuroda, K., Nakagawa, K., Horikawa, T., Moriyama, A., Ojiro, Y., Takamizawa, S., Ochiai, A., Matsumura, Y., Ikemoto, Y., Yamaguchi, K., & Sugiyama, R. (2021). Increasing number of implantation failures and pregnancy losses associated with elevated Th1/Th2 cell ratio. American Journal of Reproductive Immunology, 86(3). https://doi.org/10.1111/aji.13429
  50. Kwak-Kim, J. (2022). Immunology of Recurrent Pregnancy Loss and Implantation Failure: Volume 3. In Immunology of Recurrent Pregnancy Loss and Implantation Failure: Volume 3 (Vol. 3). https://doi.org/10.1016/C2020-0-02333-9
  51. Lamb, E. J., Colliflower, W. W., & Williams, J. W. (1972). Endometrial histology and conception rates after clomiphene citrate. Obstetrics and Gynecology, 39(3).
  52. Large, M. J., & DeMayo, F. J. (2012). The regulation of embryo implantation and endometrial decidualization by progesterone receptor signaling. In Molecular and Cellular Endocrinology (Vol. 358, Issue 2). https://doi.org/10.1016/j.mce.2011.07.027
  53. Lédée, N., Petitbarat, M., Chevrier, L., Vitoux, D., Vezmar, K., Rahmati, M., Dubanchet, S., Gahéry, H., Bensussan, A., & Chaouat, G. (2016). The Uterine Immune Profile May Help Women With Repeated Unexplained Embryo Implantation Failure After In Vitro Fertilization. In American Journal of Reproductive Immunology (Vol. 75, Issue 3). https://doi.org/10.1111/aji.12483
  54. Li, F., Zhang, M., Zhang, Y., Liu, T., & Qu, X. (2015). GnRH analogues may increase endometrial Hoxa10 promoter methylation and affect endometrial receptivity. Molecular Medicine Reports, 11(1). https://doi.org/10.3892/mmr.2014.2680
  55. Li, N., Guan, Y., Liu, J., Ren, B., Du, Y., Wang, K., Zhang, Y., & Lou, H. (2022). History of Recurrent Implantation Failure is Associated With the Incidence of Adverse Perinatal Outcomes in Singleton Live Births Following Frozen-Thawed Embryo Transfer Cycles. Frontiers in Endocrinology, 12. https://doi.org/10.3389/fendo.2021.774646
  56. Li, Q., Liu, A., Shen, H., & Zhang, X. (2022). Endometrial compaction after human chorionic gonadotrophin administration reduces ectopic pregnancy rate following fresh embryo transfer in vitro fertilization/intracytoplasmic sperm injection cycles in patients with non-thin endometrium: a retrospective cohort study. Reproductive Biology and Endocrinology, 20(1). https://doi.org/10.1186/s12958-022-01020-2
  57. Likhachov, V. K., & Taranovska, O. O. (2023). Changes in levels of pro- and anti-inflammatory cytokines in women with chronic endometritis and and the possibility of medically correcting these levels at the preconception stage. Ukrainian Journal of Perinatology and Pediatrics, 96(4). https://doi.org/10.15574/PP.2023.96.71
  58. Lozano, F. M., Lledó, B., Morales, R., Cascales, A., Hortal, M., Bernabeu, A., & Bernabeu, R. (2023). Characterization of the Endometrial Microbiome in Patients with Recurrent Implantation Failure. Microorganisms, 11(3). https://doi.org/10.3390/microorganisms11030741
  59. Ma, J., Gao, W., & Li, D. (2023). Recurrent implantation failure: A comprehensive summary from etiology to treatment. In Frontiers in Endocrinology (Vol. 13). https://doi.org/10.3389/fendo.2022.1061766
  60. Mahajan, N., Kaur, S., & Alonso, M. R. (2018). Window of implantation is significantly displaced in patients with adenomyosis with previous implantation failure as determined by endometrial receptivity assay. Journal of Human Reproductive Sciences, 11(4). https://doi.org/10.4103/jhrs.JHRS_52_18
  61. Makrigiannakis, A., Petsas, G., Toth, B., Relakis, K., & Jeschke, U. (2011). Recent advances in understanding immunology of reproductive failure. Journal of Reproductive Immunology, 90(1). https://doi.org/10.1016/j.jri.2011.03.006
  62. Mrozikiewicz, A. E., Ożarowski, M., & Jędrzejczak, P. (2021). Biomolecular markers of recurrent implantation failure— a review. In International Journal of Molecular Sciences (Vol. 22, Issue 18). https://doi.org/10.3390/ijms221810082
  63. Murata, H., Tanaka, S., & Okada, H. (2022). The Regulators of Human Endometrial Stromal Cell Decidualization. In Biomolecules (Vol. 12, Issue 9). https://doi.org/10.3390/biom12091275
  64. Murtinger, M., Wirleitner, B., Spitzer, D., Bralo, H., Miglar, S., & Schuff, M. (2022). Diagnosing chronic endometritis: When simplification fails to clarify. Human Reproduction Open, 2022(3). https://doi.org/10.1093/hropen/hoac023
  65. Nakagawa, K., Kwak-Kim, J., Ota, K., Kuroda, K., Hisano, M., Sugiyama, R., & Yamaguchi, K. (2015). Immunosuppression with tacrolimus improved reproductive outcome of women with repeated implantation failure and elevated peripheral blood th1/th2 cell ratios. American Journal of Reproductive Immunology, 73(4). https://doi.org/10.1111/aji.12338
  66. NCT03267797. (2017). The Effects of Lymphocyte Therapy on Pregnancy Rate of Patient With Recurrent Implantation Failure. Https://Clinicaltrials.Gov/Show/NCT03267797.
  67. Neykova, K., Tosto, V., Giardina, I., Tsibizova, V., & Vakrilov, G. (2022). Endometrial receptivity and pregnancy outcome. In Journal of Maternal-Fetal and Neonatal Medicine (Vol. 35, Issue 13). https://doi.org/10.1080/14767058.2020.1787977
  68. Noyes, R. W., Hertig, A. T., & Rock, J. (1950). Dating the endometrial biopsy. Obstetrical and Gynecological Survey, 5(4). https://doi.org/10.1097/00006254-195008000-00044
  69. Noyes, R. W., Hertig, A. T., & Rock, J. (2019). Reprint of: Dating the Endometrial Biopsy. Fertility and Sterility, 112(4). https://doi.org/10.1016/j.fertnstert.2019.08.079
  70. Okada, H., Tsuzuki, T., & Murata, H. (2018). Decidualization of the human endometrium. In Reproductive Medicine and Biology (Vol. 17, Issue 3). https://doi.org/10.1002/rmb2.12088
  71. P78: Influence of Granulocyte colony‐stimulating factor on immune pattern of endometrium of patients with recurrent implantation failures in assisted reproduction cycles. (2019). American Journal of Reproductive Immunology, 81(S1). https://doi.org/10.1111/aji.76_13120
  72. Rageh, K., Barakat, A., Ahmed, K., & Ahmed, A. (2020). PRP in recurrent implantation failure, hope or hype? A Prospective randomized controlled study. Evidence Based Women’s Health Journal, 10(1). https://doi.org/10.21608/ebwhj.2019.17936.1039
  73. Raziel, A., Friedler, S., Schachter, M., Kasterstein, E., Strassburger, D., & Ron-El, R. (2002). Increased frequency of female partner chromosomal abnormalities in patients with high-order implantation failure after in vitro fertilization. Fertility and Sterility, 78(3). https://doi.org/10.1016/S0015-0282(02)03298-3
  74. Ricci, E., Al Beitawi, S., Cipriani, S., Candiani, M., Chiaffarino, F., Viganò, P., Noli, S., & Parazzini, F. (2017). Semen quality and alcohol intake: a systematic review and meta-analysis. In Reproductive BioMedicine Online (Vol. 34, Issue 1). https://doi.org/10.1016/j.rbmo.2016.09.012
  75. Rokhsartalab Azar, P., Karimi, S., Haghtalab, A., Taram, S., Hejazi, M., Sadeghpour, S., Pashaei, M. R., Ghasemnejad-Berenji, H., & Taheri-Anganeh, M. (2024). The role of the endometrial microbiome in embryo implantation and recurrent implantation failure. In Journal of Reproductive Immunology (Vol. 162). https://doi.org/10.1016/j.jri.2024.104192
  76. Rubio, C., Bellver, J., Rodrigo, L., Bosch, E., Mercader, A., Vidal, C., De Los Santos, M. J., Giles, J., Labarta, E., Domingo, J., Crespo, J., Remohí, J., Pellicer, A., & Simón, C. (2013). Preimplantation genetic screening using fluorescence in situ hybridization in patients with repetitive implantation failure and advanced maternal age: Two randomized trials. Fertility and Sterility, 99(5). https://doi.org/10.1016/j.fertnstert.2012.11.041
  77. Sahar, N., Mujihartini, N., Pudjianto, D. A., Pradhita, A. D., Thuffi, R., & Kusmardi, K. (2019). Increased progesterone on the day of administration of hCG in controlled ovarian hyperstimulation affects the expression of HOXA10 in primates’ endometrial receptivity. Biomedicines, 7(4). https://doi.org/10.3390/biomedicines7040083
  78. Sebastian-Leon, P., Garrido, N., Remohí, J., Pellicer, A., & Diaz-Gimeno, P. (2018). Asynchronous and pathological windows of implantation: Two causes of recurrent implantation failure. Human Reproduction, 33(4). https://doi.org/10.1093/humrep/dey023
  79. Shapiro, B. S., Daneshmand, S. T., Garner, F. C., Aguirre, M., & Hudson, C. (2014). Clinical rationale for cryopreservation of entire embryo cohorts in lieu of fresh transfer. In Fertility and Sterility (Vol. 102, Issue 1). https://doi.org/10.1016/j.fertnstert.2014.04.018
  80. Sharfi, Y. N. (2013). Cytokines and growth factors as markers of endometrium implantation capacity in IVF. Journal of Obstetrics and Woman Disease, 62(4). https://doi.org/10.17816/jowd62488-96
  81. Sheikhansari, G., Pourmoghadam, Z., Danaii, S., Mehdizadeh, A., & Yousefi, M. (2020). Etiology and management of recurrent implantation failure: A focus on intra-uterine PBMC-therapy for RIF. In Journal of Reproductive Immunology (Vol. 139). https://doi.org/10.1016/j.jri.2020.103121
  82. Shihabudeen, T. (2022). The effect of intrauterine human chorionic gonadotrophin injection before embryo transfer on the implantation and pregnancy rate in infertile patients: a retrospective study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 12(1). https://doi.org/10.18203/2320-1770.ijrcog20223478
  83. Stern, C., Pertile, M., Norris, H., Hale, L., & Baker, H. W. G. (1999). Chromosome translocations in couples with in-vitro fertilization implantation failure. Human Reproduction, 14(8). https://doi.org/10.1093/humrep/14.8.2097
  84. Summers, G. K., Gustin, S., & Swartz, T. L. (2020). DOES GnRH DOWN REGULATION AMONGST WOMEN WITH ABNORMAL BCL6 AND/OR BETA 3 INTEGRIN EXPRESSION IMPROVE IMPLANTATION RATES? AN INTERIM ANALYSIS. Fertility and Sterility, 114(3). https://doi.org/10.1016/j.fertnstert.2020.08.588
  85. Szekeres-Bartho, J., & Balasch, J. (2008). Progestagen therapy for recurrent miscarriage. Human Reproduction Update, 14(1). https://doi.org/10.1093/humupd/dmm035
  86. Tamura, I., Shiroshita, A., Fujimura, T., Tanaka-Doi, Y., Shirafuta, Y., Maekawa, R., Taketani, T., Sato, S., & Sugino, N. (2023). Genome-wide analysis of histone modifications that underlie the dynamic changes in gene expression during decidualization in human endometrial stromal cells. In Molecular Human Reproduction (Vol. 29, Issue 7). https://doi.org/10.1093/molehr/gaad019
  87. Teh, W. T., Chung, J., Holdsworth-Carson, S. J., Donoghue, J. F., Healey, M., Rees, H. C., Bittinger, S., Obers, V., Sloggett, C., Kendarsari, R., Fung, J. N., Mortlock, S., Montgomery, G. W., Girling, J. E., & Rogers, P. A. W. (2023). A molecular staging model for accurately dating the endometrial biopsy. Nature Communications, 14(1). https://doi.org/10.1038/s41467-023-41979-z
  88. Tomassetti, C., Meuleman, C., Pexsters, A., Mihalyi, A., Kyama, C., Simsa, P., & D’Hooghe, T. M. (2006). Endometriosis, recurrent miscarriage and implantation failure: Is there an immunological link? Reproductive BioMedicine Online, 13(1). https://doi.org/10.1016/S1472-6483(10)62016-0
  89. Tomic, V., Kasum, M., & Vucic, K. (2020). Impact of embryo quality and endometrial thickness on implantation in natural cycle IVF. Archives of Gynecology and Obstetrics, 301(5). https://doi.org/10.1007/s00404-020-05507-4
  90. Tong, J., Lv, S., Yang, J., Li, H., Li, W., & Zhang, C. (2022). Decidualization and Related Pregnancy Complications. Maternal-Fetal Medicine, 4(1). https://journals.lww.com/mfm/fulltext/2022/01000/decidualization_and_related_pregnancy.5.aspx
  91. van Hoogenhuijze, N. E., Torrance, H. L., Mol, F., Laven, J. S. E., Scheenjes, E., Traas, M. A. F., Janssen, C., Cohlen, B., Teklenburg, G., de Bruin, J. P., van Oppenraaij, R., Maas, J. W. M., Moll, E., Fleischer, K., van Hooff, M. H., de Koning, C., Cantineau, A., Lambalk, C. B., Verberg, M., … Broekmans, F. J. M. (2017). Endometrial scratching in women with implantation failure after a first IVF/ICSI cycle; does it lead to a higher live birth rate? The SCRaTCH study: A randomized controlled trial (NTR 5342). BMC Women’s Health, 17(1). https://doi.org/10.1186/s12905-017-0378-y
  92. Von Woon, E., Greer, O., Shah, N., Nikolaou, D., Johnson, M., & Male, V. (2022). Number and function of uterine natural killer cells in recurrent miscarriage and implantation failure: a systematic review and meta-analysis. In Human Reproduction Update (Vol. 28, Issue 4). https://doi.org/10.1093/humupd/dmac006
  93. Wang, W., Feng, D., & Ling, B. (2022). Biologia Futura: endometrial microbiome affects endometrial receptivity from the perspective of the endometrial immune microenvironment. In Biologia Futura (Vol. 73, Issue 3). https://doi.org/10.1007/s42977-022-00134-3
  94. Wei, L., Zhang, Y., Tian, W., Lyu, Y., Zhang, J., Song, X., & Bai, X. (2023). Management of the uterine abnormalities on the reproductive outcomes in women with repeated implantation failure. Chinese Journal of Reproduction and Contraception, 43(9). https://doi.org/10.3760/cma.j.cn101441-20221001-00429
  95. Wilton, L., Voullaire, L., Sargeant, P., Williamson, R., & McBain, J. (2003). Preimplantation aneuploidy screening using comparative genomic hybridization or fluorescence in situ hybridization of embryos from patients with recurrent implantation failure. Fertility and Sterility, 80(4). https://doi.org/10.1016/S0015-0282(03)01162-2
  96. Yu, P. H., Wu, Y. H., Chen, T. S., Kuo, T. C., & Wu, M. H. (2023). Segmentation of in vitro fertilization with high-intensity focused ultrasound in repeated implantation failure with adenomyosis. Gynecology and Minimally Invasive Therapy, 12(2). https://doi.org/10.4103/gmit.gmit_95_22
  97. Zhang, D., Yu, Y., Duan, T., & Zhou, Q. (2022). The role of macrophages in reproductive-related diseases. In Heliyon (Vol. 8, Issue 11). https://doi.org/10.1016/j.heliyon.2022.e11686
  98. Zhao, H., Hu, S., Qi, J., Wang, Y., Ding, Y., Zhu, Q., He, Y., Lu, Y., Yao, Y., Wang, S., Du, Y., & Sun, Y. (2022). Increased expression of HOXA11-AS attenuates endometrial decidualization in recurrent implantation failure patients. Molecular Therapy, 30(4). https://doi.org/10.1016/j.ymthe.2022.01.036
  99. Zhu, L. H., Sun, L. H., Hu, Y. L., Jiang, Y., Liu, H. Y., Shen, X. Y., Jin, X. Y., Zhen, X., Sun, H. X., & Yan, G. J. (2013). PCAF impairs endometrial receptivity and embryo implantation by down-regulating β3-integrin expression via HOXA10 acetylation. Journal of Clinical Endocrinology and Metabolism, 98(11). https://doi.org/10.1210/jc.2013-1429

Infertility is the inability to conceive even after unprotected intercourse for more than 12 months. In India, the prevalence of infertility has been growing to the extent that 10-15 percent of couples experience this condition. Recurrent implantation failure (RIF) is a complex medical condition in which implantation becomes unsuccessful despite the advancements in Assisted Reproductive Technologies (ART). We lack a clear understanding of the definition and standardisation of RIF protocols. The etiology behind RIF is multifactorial, comprising both maternal and embryonic factors. Maternal factors include endometrial abnormalities, environmental exposure, physical aspects, and dysregulation of the immune system. Chromosomal aberrations such as aneuploidy are embryo-born factors that impede implantation. The latest studies have shed light on the novel mechanisms of RIF. Recent research has identified miRNA that can hinder the implantation processes, opening the door to many more avenues for targeted therapies, gene knockdown, and immune modulation. This review is a comprehensive overview of the history, causes, advancements, and challenges related to RIF.

Keywords : Recurrent Implantation Failure, Assisted Reproductive Technology, Endometrial Receptivity Assay, Infertility.

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