This unique text discusses the wide range of causes and pathophysiologic conditions contributing to recurrent implantation failure (RIF) and the current treatment approaches to best approach this challenging patient population. Beginning with a presentation of the mechanism of normal implantation, the physiologic synchrony between embryo and endometrium, and the roles of both gametes and embryos in RIF, the book then examines the various genetic, immune and environmental factors involved. Abnormalities of the hematologic and endocrine system, as well as those of the anatomy and microbiome, are described in detail. Last but no less important, the psychological stress and treatment of patients experiencing RIF is discussed. Assisted reproductive technology (ART) success has increased substantially over the past three decades. However, despite these advances, recurrent implantation failure is still a common issue confronting patients and clinicians, and RIF represents one of the greatest challenges in ART and remains a source of frustration and disappointment for patients, clinicians, and researchers involved in the process. Providing an in-depth investigation into the pathophysiology and biological mechanisms of RIF and its clinical management, this will be an excellent resource for reproductive endocrinologists and infertility specialists.

Implantation is a complex phenomenon, still not thoroughly understood, involving the embryo and the endometrium. Successful implantation is considered to stem from an efficient combination of various embryo and/or maternal factors. Repeated failure of any of these factors or of their combination might decrease the chance of implantation and eventually lead to recurrent implantation failure. Despite technological advances, only about a quarter of In Vitro Fertilization procedures will result in live birth, leading many couples to experience multiple failures. This text from international experts explores the various factors at play and offers a helpful summary of the state of knowledge to help guide clinicians in their management of this complex and important problem. Contents: What is Recurrent Implantation Failure? * The psychosocial aspects of recurrent implantation failure * The role of life-style factors in RIF * Endocrine causes of recurrent implantation failure * Congenital uterine anomalies and recurrent implantation failure * Immunological causes of recurrent implantation failure * Acquired uterine conditions, reproductive surgery, and RIF? * Thrombophilia: diagnosis and management in women with recurrent implantation failure * Andrological causes of RIF * Diagnostic evaluation of RIF? (Modalities and algorithm) * Optimizing embryo culture for RIF? * Optimizing endometrial receptivity for patients with recurrent implantation failure: The role of progesterone on the day of triggering final oocyte maturation * Is there a role of follicular phase LH and E2 on the day of triggering final oocyte maturation for embryo implantation? * Manipulating the endometrium: Can RIF be managed by inducing endometrial inflammation or by the use of novel research therapies * The embryo in RIF: Genetic selection and strategies for improving its implantation potential * Is oocyte donation efficient in patients with RIF? * Sperm donation and RIF? * Optimizing embryo transfer technique for RIF management * Proposed management of patients with recurrent implantation failure and directions for future research * When should patients abandon treatment?

This book offers a highly informative guide to treating unexplained infertility and recurrent miscarriage (RM). In particular, it provides detailed treatment strategies for infertility or RM derived from uterine circumstance such as chronic endometritis and perturbation of endometrial decidualization, as well as maternal immunological rejection of an embryo as semi-allograft. Unexplained infertility refers to those types that cannot be detected by the general screening test. The causes are sometimes detected in the course of treatment with assisted reproductive technology including IVF. However, some unexplained infertility is intractable even after intracytoplasmic sperm injection or repeated implantation of morphologically suitable embryos. Patients with unexplained RM also have a high likelihood of undetectable risk factors of miscarriage. As a result, gynecologists often repeatedly provide these couples with general treatments for infertility and miscarriage or even discontinue treatment because they cannot detect the reason, which places serious financial, physical and mental burdens on the couples affected. This book offers gynecologists essential insights into the pathological condition of unexplained infertility and RM, equipping them to identify it, explain it to patients, and consider further examinations and more aggressive fertility treatments.

Immunology of Recurrent Pregnancy Loss provides doctors and immunologists with the information they need to help couples who experience recurrent pregnancy losses. Sections cover unexplained infertility, repeated in vitro fertilization, embryo transfer failures, history of second or third trimester pregnancy losses of unknown cause, or pregnancy with a history of or active autoimmune and/or alloimmune disease. Reproductive failure (RF), including recurrent pregnancy losses (RPL) and repeated implantation failures (RIF) is rather a syndrome than a disease caused by multiple etiologies, such as anatomical, endocrine, genetic, infectious, immunological, thrombotic and unexplained etiologies, hence this book strives to present the latest information. In 27 chapters, divided in 5 sections, the book introduces the current update of reproductive immunology topics in RF and provides systematic diagnostic guidelines, systemic and immune etiologies and therapeutic approaches. Provides detailed immunological background for understanding the etiology and management of reproduction failure Evaluates various immunological factors involved in the pathogenesis and management of reproduction failure Gives insights into various immunological and therapeutic approaches for reproduction failure

This new volume in the Reproductive Medicine for Clinicians series focuses on the practical clinical impact of problems linked to infertility, discussing topics such as luteal support in ART cycles, ovulation induction using pulsatile administration of GnRH, how to deal with the metabolic changes in PCOS, treatment to restore fertility in endometriosis and how to improve implantation, which are common aspects of daily clinical practice. It also addresses significant novel areas like the biological clock in human reproduction, reproduction at advanced parental age and medical and social egg freezing, offering valuable insights for patients and their doctors. Further, the book covers various areas of growing importance, such as how to access the uterine cavity; the future of imaging in reproduction; non-invasive prenatal testing; ART and male infertility; as well as breast cancer and fertility preservation. Last but not least, it examines the medical, ethical and legal aspects of a number of challenges for current and future reproductive medicine, including uterine transplantation and human genetic modification. Bringing together updates on some of the most important problems in reproductive medicine and also covering ethical and legal bases, this book offers an overview of potential treatments for infertility. As such, it is a valuable resource for gynecologists, obstetricians, endocrinologists and all specialists dealing with reproductive health.

This book covers in detail contemporary hypotheses and studies related to the immunology of implantation and provides a practical approach for the application of basic reproductive immunology research to pregnancy complications such as preeclampsia, pre-term labor and IUGR. Provides complete and up to date review of current knowledge of the role of the immune system during pregnancy and the interactions between the placenta and the maternal immune system.

Novel topics compiled in this one-of-a-kind volume provide tantalizing hints for clinical application through future translational research. Only recently have we come to ask what role the male might play in pregnancy loss and embryo implantation failure, beyond contributing an abnormal set of paternal chromosomes at fertilization. This volume explores the recent evidence that these conditions might also be related to the transmission of previously unrecognized chromosomal micro-deletions and duplications, or via the epigenetic dysregulation of early embryonic gene function by spermatozoal microRNAs or alterations in sperm DNA methylation patterning, or by DNA damage secondary to either reactive oxygen species or environmental toxicants. In addition, the composition of seminal plasma has been found to be highly complex, containing many factors that play important roles in altering the uterine environment and the female immune system permissive of embryo implantation and trophectoderm outgrowth leading to successful pregnancy. Coverage includes an examination of both spermatozoa and seminal fluid component factors.