Tony Gordon: How Often Does Repeat Implantation Failure Really Occur?

Tony Gordon, Senior Director of Clinical Strategy and Market Development at CooperSurgical Fertility Solutions, shared on LinkedIn:

“How often does repeat implantation failure really occur, and what is the probability of a live birth after multiple euploid transfers?

These are two of the key questions answered by the recent Fertility and Sterility paper of Claudia Durbin et al., Cumulative probability of a live birth after up to six sequential single euploid embryo transfers. Jamie Grifo, Caroline McCaffrey, and Frederick Licciardi report,

‘Among 5811 patients undergoing 7763 euploid SETs attempts, the estimated cumulative probability of a LB increased from 63.1% after one SET to 92.0% after three, 98.3% 116 after five, and 98.8% after six SETs’.

These are some very encouragingly high live birth rates for euploid embryo transfers.

Of course, finding even one euploid embryo for transfer can be a challenge with advanced maternal age. Also, undergoing multiple embryo implantations, even more so when they are unsuccessful, are physically, emotionally, and financially challenging. You can see this with the number of transfers in this study diminishing with more cycles: n=5811 first transfers, n=392 third transfers, and n=7 sixth transfers.

The other striking observation is that after the first euploid transfer, which per implantation is the most successful single transfer (possibly due to the best quality embryo being transferred first), each subsequent transfer has approximately the same probability of resulting in a live birth.

The data show that real RIF is rare. Less than 5% after 5 euploid transfers, and even with 6 euploid transfers, implantation RIF is at ~2%.

Science is always most reliable when independent studies agree, and the data here from Durbin et al. is very similar (a remarkably consistent 92% probability of live birth after 3 euploid transfers) to the studies of Paul Pirtea et al. 2021 and Pavan Gill et al. 2024. Showing consistent results across three large studies.

Check out the publications and LinkedIn post from Paul Pirtea, who has published on this subject too.

Durbin et al. sum up the impact of their study very concisely: ‘These findings support continued sequential transfer of euploid embryos as the primary management strategy after transfer failure.’... if you can find those euploid embryos for transfer!

Of course, great to see how Coopersurgical PGT-A is being used by NYU Langone IVF to help so many patients get to a live birth.”

Title: Cumulative probability of a live birth after up to six sequential single euploid embryo transfers

Authors: Claudia Durbin, Carlos M. Parra, Jennifer K. Blakemore, Shannon DeVore, Brooke Wertz, M. Elizabeth Fino, Frederick Licciardi, Alan Berkeley, Caroline McCaffrey, James A. Grifo

You can read the Full Article in Fertility and Sterility.

Title: Rate of true recurrent implantation failure is low: results of three successive frozen euploid single embryo transfers

Authors: Paul Pirtea, Dominique De Ziegler, Xin Tao, Li Sun, Yiping Zhan, Jean Marc Ayoubi, Emre Seli, Jason M. Franasiak, Richard T. Scott Jr.

You can read the Full Article in Fertility and Sterility.

Title: Does recurrent implantation failure exist? Prevalence and outcomes of five consecutive euploid blastocyst transfers in 123 987 patients

Authors: Pavan Gill, Baris Ata, Ana Arnanz, Danilo Cimadomo, Alberto Vaiarelli, Human M Fatemi, Filippo Maria Ubaldi, Juan A Garcia-Velasco, Emre Seli

You can read the Full Article in Human Reproduction.

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