Recently, Dr Makrakis published in the scientific Journal ‘Topics on Obstetrics and Gynecology’ a review article on repeated IVF failures (RIF), a condition that represents one of the most upsetting problems in current assisted reproductive technologies. According to the author, various factors have been associated with RIF, like undiagnosed pathology of the uterine cavity, persistently thin endometrium, local dysregulation of the expression or action of endometrial cytokines, immunological or thrombophilic factors, chromosomal abnormalities of parents, gametes or embryos, absence of synchronization between receptive endometrium and developing embryo, difficulty in hatching of the zona pellucida, presence of hydrosalpinges, etc. Various treatments for RIF have been proposed but many of them have been reported in studies with small statistical power. Among them, strategies or treatments that seem more appropriate include the following: application of hysteroscopy and hysteroscopic correction of endometrial cavity anomalies, embryotransfer at the blastocyst stage, assisted hatching of the embryos before embryotransfer especially in women of advanced age, salpingectomy in the presence of hydrosalpinges, optimization of embryotransfer technique, application of IMSI technique (which is available in our Unit) in cases with specific sperm abnormalities like high DNA fragmentation Index and teratozoospermia. Finally preimplantation genetic screening (PGS) and parental karyotyping can be useful for genetic counseling. Nevertheless, it has to be highlighted that the crucial point in couples experiencing multiple IVF failures is to spend adequate time in order to carefully study every single case individually, to find out what has or has not been done, and what may be helpful. Just repeating similar attempts does not really help. The ideal strategy for such couples is to draw the strategy. Current research regarding RIF is intense, and we hope that in the near future we will be able to offer more to these couples.

« back