Evidence-based Update: Immunological Evaluation of Recurrent Implantation Failure

Abstract

Recurrent implantation failure (RIF) is generally defined as the failure to achieve clinical pregnancy after the transfer of at least 6 good quality embryos in fresh or frozen IVF cycles or of at least 4 embryos in two egg donations. Patients with RIF represents an heterogeneous group in which diverse immunological or inflammatory factors have been described, representing globally the more frequent known causes, including antiphospholipid syndrome or autoimmune thyroid disease, among others. However, there is a lack of evidence-based reviews focusing on inflammatory RIF (iRIF). We performed a systematic review of the published literature on iRIF from 1988 to July 2016, in order to build an updated evidence-based classification of immunological diagnostic tests and assigned recommendations accordingly. This review intends to offer a useful immunological workout of women suffering RIF from a multidisciplinary approach.