In order for a pregnancy to occur, a fertilized egg needs to implant in the endometrium of the uterus. A successful implantation is actually a complex process, and there are a number of reasons why implantation may fail to take place.
What Is Implantation Failure?
The embryo must make contact with the endometrium in order to implant; however, the endometrium must offer the 'right conditions' for implantation as well. Implantation failure is when an embryo (at the blastocyst stage) does not implant in the endometrium of the uterus and you are unable to achieve pregnancy. There are a number of reasons why this may happen.
Causes of Implantation Failure
Possible causes of implantation failure include the following.
Problems With the Uterus
The following uterine issues may cause problems with implantation.
- Fibroids are benign growths that can be found anywhere in or on the uterus and can range in size from small to quite large. Fibroids may be in the way and interfere with implantation.
- Polyps are typically benign growths found in the endometrium of the uterus and can cause infertility and prevent implantation.
- Endometriosis is a condition that occurs when the endometrial tissue grows outside the uterus. This can cause inflammation and scarring in the uterus and may affect the endometrium's receptivity of an embryo, therefore affecting implantation.
- Adenomyosis is a condition when the endometrial tissue grows into the muscular tissue of the uterus and could cause problems with infertility and implantation.
- Adhesions can form in the uterus from the build up of scar tissue from previous medical procedures and can cause infertility.
- Congenital uterine anomalies such as a bicornuate uterus or septate uterus can prevent implantation and pregnancy.
Problems With the Embryo
If there is a problem with the embryo, such as genetic abnormalities, it may not implant. However, if implantation does happen, the embryo is unlikely to develop normally in the uterus, and miscarriage will most likely occur.
Other Potential Causes of Implantation Failure
There are a few other reasons for implantation failure.
- Fallopian tubes, which are connected to the uterus, can become damaged or blocked due to endometriosis, adhesions or infection. This can prevent the fertilized egg from passing into the uterus, therefore preventing implantation.
- PCOS or polycystic ovary syndrome is a hormone disorder that can affect women's fertility in various ways. One way is that the imbalance of female hormones may prevent the endometrium from developing as it should in order to prepare for implantation of an embryo.
- Thrombophilia is a hereditary condition that causes abnormalities in blood coagulation and increases the risk of developing blood clots. Thrombophilia can cause decreased blood flow to the endometrium which can affect the receptivity of the endometrium to an embryo, therefore preventing implantation.
- Stress may affect the release of LH which is the luteinizing hormone that is important in reproduction. LH is key in helping the progesterone get the uterus ready for pregnancy. This can interfere with the implantation of an embryo if the release of LH is interrupted.
What Can Help With Implantation
There are a few common sense approaches that may help with implantation. These include:
Questioning Your Fertility
If you are having fertility issues and suspect it could be related to implantation failure, discuss this with your OB/GYN doctor. Your doctor will most likely run various tests that will help him diagnose the issue. There is also the chance your doctor may refer you to a reproductive endocrinologist. This is a doctor who is a fertility specialist. Once you are appropriately diagnosed the doctor can then proceed with treatment (if necessary) in order to help you achieve pregnancy.