The three main causes for implantation failure include:

• Embryo quality – embryos may be genetically abnormal or of poor quality
• Unfavorable uterine environment – quality of endometrium in terms of thickness or receptivity may be inadequate
• Immunological abnormalities – involving antigen – antibody reactions which hinder implantation of embryo.

The tests which may help include:

• Diagnostic hysteroscopy – to rule out any abnormality inside the uterus which hinders implantation.
• Endometrial receptivity array – analysis the proteins in the uterine lining and helps in personalized embryo transfer at the right time of the cycle, based on the results.
• Nk cell assessment in the uterus / blood – to rule out immunological abnormalities

Some treatments which can be offered include:

• Intralipid infusion prior to embryo transfer
• Injection of PRP or GCSF inside the uterus
• Preimplantation genetic testing/ PGTa to test the chromosomal make-up of embryo prior to transfer
• Assisted hatching to aid implantation