A review of the pathophysiology of recurrent implantation failure

Jason M. Franasiak*, Diana Alecsandru, Eric J. Forman, Laura C. Gemmell, Jeffrey M. Goldberg, Natalia Llarena, Cheri Margolis, Joop Laven, Sam Schoenmakers, Emre Seli

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

76 Citations (Scopus)


Implantation is a critical step in human reproduction. The success of this step is dependent on a competent blastocyst, receptive endometrium, and successful cross talk between the embryonic and maternal interfaces. Recurrent implantation failure is the lack of implantation after the transfer of several embryo transfers. As the success of in vitro fertilization has increased and failures have become more unacceptable for patients and providers, the literature on recurrent implantation failure has increased. While this clinical phenomenon is often encountered, there is not a universally agreed-on definition—something addressed in an earlier portion of this Views and Reviews. Implantation failure can result from several different factors. In this review, we discuss factors including the maternal immune system, genetics of the embryo and parents, anatomic factors, hematologic factors, reproductive tract microbiome, and endocrine milieu, which factors into embryo and endometrial synchrony. These potential causes are at various stages of research and not all have clear implications or immediately apparent treatment.

Original languageEnglish
Pages (from-to)1436-1448
Number of pages13
JournalFertility and Sterility
Issue number6
Early online date19 Oct 2021
Publication statusPublished - 1 Dec 2021

Bibliographical note

Funding Information:
E.S. reports grants and personal fees from the Foundation for Embryonic Competence, outside the submitted work. J.M.F. has nothing to disclose. D.A. has nothing to disclose. E.J.F. has nothing to disclose. L.C.G. has nothing to disclose. J.M.G. has nothing to disclose. N.L. has nothing to disclose. C.M. has nothing to disclose. J.L. has nothing to disclose. S.S. has nothing to disclose.

Publisher Copyright:
© 2021 American Society for Reproductive Medicine


Dive into the research topics of 'A review of the pathophysiology of recurrent implantation failure'. Together they form a unique fingerprint.

Cite this