Causes & Treatment

Understanding embryo implantation failure: answers from a fertility clinic

Emma Harpham in partnership with Vida Fertility  |   2 Jul 2023

Embryo implantation failure in the context of IVF creates a difficult reality where the hope of becoming a parent collides with profound heartbreak. Implantation failure can occur in isolation, or as recurrent implantation failure (RIF) where three or more IVF transfers fail. If it’s happened to you, the first question you’ll have asked yourself is – why?

Tapping into in-depth expertise from Dr Héctor Izquierdo from Vida Fertility, we’re covering some of the symptoms and causes of embryo implantation failure, as well as running through the treatments available.

With around 90 per cent of their patients coming from abroad, Vida Fertility see many patients who’ve already faced multiple failed IVF treatments in their home country before coming to their clinic in Spain.

Keen to chat through advanced testing and treatment options? Book a consult with Vida Fertility here.

What are the symptoms of failed implantation?

Failed implantation symptoms can be tricky to spot. In fact, embryo implantation failure usually doesn’t present any symptoms at all, and even symptoms that may feel worrying, like spotting, can actually be a positive sign that you’ve had a successful embryo implantation.

“This is why patients should always inform their clinic about the symptoms they are experiencing but never stop taking medication by themselves without any input from their fertility doctor.”, Dr Izquierdo explains.

He advises, “The only real symptom of failure would usually be an important bleeding like getting your period; the facts are normally revealed through testing bHCG levels, or an ultrasound showing there is no pregnancy developing.” 

Our bodies are all different, and each instance should be tackled on a case-by-case basis. But what can cause an embryo to fail to implant in the first place?

Implantation failure causes

If it’s happened to you, you’ll certainly wonder why. And maybe more specifically, why me? Finding answers to these questions can be challenging, as the causes of embryo implantation failure can be multiple and sometimes complex.

Embryo-related causes

According to Dr Izquierdo, embryo quality is usually considered the main cause of implantation failure. This can in many cases be due to diminished egg or sperm quality related to age, or lifestyle factors like smoking or diet. Poor gamete quality can also lead to embryos with genetic abnormalities, which can prevent implantation.

Your unique fertility profile

Like so many in our community, your unique fertility profile can also affect embryo implantation. Here are some important causes to chat through with your doctor.

  • Thin endometrium
  • Adenomyosis
  • Myomas
  • Fibroids
  • Lack of blood flow to the uterus
  • Blood clotting issues
  • Immunological issues

Getting support here is so key, and the good news is that so many of these important causes can be treated and managed with the help of a fertility specialist.

According to Dr Izquierdo, “Implantation failure is always a challenging diagnosis because it usually involves multiple causes, and you cannot treat only one. The key is to have an individualized diagnosis that covers all the particular characteristics of every woman”.

Embryo implantation failure treatment

Encouragingly, treatments for embryo implantation failure are wide-ranging, and will always depend on the individual cause ascertained by your doctor.

When it comes to embryo quality, Dr Izquierdo recommends that clinics use day 5 or day 6 high-quality blastocysts for transfer. If there is male factor and sperm is the cause, treatment prior to fertilization with the right fertilization technique is crucial. If age is a factor in embryo quality, simple lifestyle changes like stopping smoking and moving towards a healthy diet and lifestyle can help.

“We can also help with preimplantation genetic testing (PGT-A) where we analyse the karyotype of the embryo and check its number of chromosomes before the transfer. This is because an embryo with an incorrect chromosome number (aneuploid embryo) will end up in an implantation failure, a miscarriage or an unhealthy baby”, he explains.

Improving egg quantity/quality through PRP treatment can also sometimes be helpful. This particular procedure can also improve uterine lining thickness before an embryo transfer. If embryo quality cannot be improved enough for achieving a pregnancy, egg and/or sperm donation can become the best option for prospective parents.

When it comes to treating endometrium issues, corrective surgeries can be done to address uterine abnormalities. Medication to help blood circulation or to increase the endometrium lining can be easily prescribed, and receptivity and immunology tests in order to adapt the treatment to the patient’s womb is also an avenue that can be explored. Sometimes, simply changing the transfer date or adding the right immunotherapy can make a difference.

Finally, as hard as it feels, it’s important to remember that it’s not your fault. Being kind to yourself and reminding yourself that it’s not your failure. Dr Izquierdo explains that, like in a natural pregnancy, an IVF cycle can fail, and it doesn’t mean that you’ve done anything wrong. “Here, communication with your doctor is key because it’s not just about medical treatment. There are personal, emotional and financial aspects too, specific to each patient, that must be discussed and included in the road to parenthood” he says.

Vida Fertility understands the frustration and worry a failed transfer can bring, and offer stress-free, tailored support with a wellbeing focus. Click here to book a consult with them today.


Héctor studied medicine in Columbia and Germany. He finished his residency in gynaecology and obstetrics in Würzburg (Germany) and specialised in Human Reproduction in Salamanca (Spain).

Thanks to his experience with international patients, he specialised in immunology issues, recurrent implantation failure and miscarriages. Héctor is now Medical Director of Vida Fertility Alicante. He is fluent in German, English and Spanish. As a former fertility patient himself, he establishes a very human rapport with his patients.

Vida Fertility Doctor Hector

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