Management of recurrent implantation failure: British Fertility Society policy and practice guideline

Abstract

Recurrent implantation failure (RIF) is defined as the absence of a positive pregnancy test after three consecutive transfers of good quality embryos. There remains significant variation in clinical practice in the management of RIF. This British Fertility Society (BFS) Policy and Practice guideline analyses the evidence for investigations and therapies that are employed in RIF and provides recommendations for clinical practice and for further research. Evidence for investigations of sperm and egg quality, uterine and adnexal factors, immunological factors and thrombophilia, endocrine conditions and genetic factors and for associated therapies have been evaluated. This guideline has been devised to assist reproductive medicine specialists and patients in making shared decisions concerning management of RIF. Finally, suggestions for research towards improving understanding and management of RIF have also been provided.

Keywords:

• Recurrent implantation failure
• IVF
• British Fertility Society
• investigations
• treatment

Author contributions

The scope of the article was prepared, and authors identified, by HMB. Evidence was critically appraised and graded by authors for each section (MM for investigations into oocyte and genetic factors, immunological factors and thrombophilia and management of lifestyle factors, embryo transfer factors, donor gametes and surrogacy, and empirical treatments, YJ for investigation into uterine and adnexal factors and reproductive surgeries, LP for investigation and management for endocrine factors, management of ART protocols and empirical treatments, AS for investigations and management of sperm factor and management of embryo factors). The overall paper was then compiled by MM and HMB, after multiple rounds of discussion with YJ, LP, AS and EY with EY providing critical input. The final paper including the evidence grading was approved by all the authors with any disagreements resolved through discussion with final decision made by MM, HMB and EY.

Disclosure statement

No potential conflict of interest was reported by the author(s).