On the way to IVF, some patients still have no “pregnancy” after three or even more IVF attempts, in which case, the patient’s mood is very bad, because embarking on this path of IVF is the last choice of seeking a child for the patient… …In fact, it is not easy for doctors either, because they have encountered one of the most prominent problems in the field of assisted reproductive technology, which is medically known as “repeated IVF failure”. “Repeated IVF failures” can occur in a variety of ways, such as cancellation of treatment cycles due to poor ovarian response; cancellation of treatment cycles due to low ovarian response; cancellation of treatment cycles in which no embryos are available due to failure of fertilization of the retrieved eggs; failure of implantation of embryos after repeated transfers; or repeated miscarriages after a pregnancy has occurred. The following are some examples of repeated implantation failures. Let’s take repeated implantation failure as an example. There is no consistent standard for repeated implantation failure. Previously, repeated IVF treatment for more than 3 cycles; or a cumulative total of more than 10 highly rated embryos failed to conceive is considered repeated implantation failure. In recent years, with the improvement of embryo culture technology and the popularization of blastocyst culture and single embryo transfer, it is now considered that repeated implantation failure can be diagnosed if the cumulative transfer of 4-6 high-rating embryos or 2-3 blastocysts still fails to achieve pregnancy. Possible reasons for repeated implantation failure include: poor developmental potential of the embryo, meaning that it is difficult for the seed (embryo) to germinate or grow; decreased receptivity of the endometrium or abnormal dialog between the embryo and the endometrium, which is a bit of a tongue twister, or in layman’s terms, something is wrong with the land where life is nurtured. These are all theoretical problems in reproductive medicine, but in reality, why did this patient fail to conceive with repeated embryo transfers? What are the reasons? It is extremely difficult for doctors to determine this objectively, so what can be done? At present, the embryo quality evaluation standard used in the laboratories of reproductive centers is the same, and we all know that there are first, second and third level embryos, and some patients who have done their homework well also know that there are a few cells, however, these high quality embryos with high “value” and standard under the laboratory doctor’s microscope cannot truly and fully reflect the quality of the embryo and its implantation. The quality of the embryo and its ability to be implanted is not a true and complete reflection of the quality of the embryo. In other words: a seemingly normal embryo may not necessarily be normal, the probability of abnormality is around 50%, and this probability increases with age, which explains why the success rate of women over 38 years of age falls off a cliff, and the success rate of women over 45 years of age is only around 2%. What to do? Doctors suggest: 1. If considering the embryo cause, then patients who still can not get pregnant after multiple transfers of high scoring embryos can consider further screening embryos through blastocyst culture (of course, the pros and cons of blastocyst culture can not be said in one or two sentences, and you need to make a decision after in-depth communication with your fertility doctor). For patients with recurrent poor embryo morphology score, or by trying microstimulation or natural cycle, the dose of ovulation stimulation drugs can be reduced, which may result in fewer eggs but may improve the quality of eggs and embryos. 2. The most normal embryos are selected for transfer by observing the growth rate and temporal phases of the embryos, but this requires a dynamic observation microscope system for 24 hours of continuous observation during embryo development. It is not yet widely available. 3, embryo chromosome abnormality (embryo chromosome aneuploidy) is one of the reasons for repeated embryo implantation failure, for some patients of advanced age, repeated implantation failure, repeated spontaneous abortion patients, can also be considered for preimplantation genetic screening for screening, which is another topic. The uterus is indispensable and important. Just as you need fertile and soft soil for planting, the process of embryo implantation requires a suitable uterus and endometrium. Abnormalities of the uterus, such as uterine polyps, submucosal fibroids, adhesions in the uterine cavity, endometritis, and other pathologies, can reduce the likelihood of implantation, and will need to be addressed at the discretion of the doctor prior to the transfer. But what about the patient whose uterine cavity looks normal but has repeated implantation failures? Doctors sometimes perform one or more endometrial scratching procedures when appropriate (e.g., in preparation for frozen embryo transfer). This mechanical trauma can stimulate the endometrium to undergo a number of beneficial inflammatory and immune responses, and to secrete a series of cytokines, growth factors, and chemokines, etc., which are beneficial for tissue remodeling and vascularization, and which may improve and increase the receptivity of the endometrium, leading to embryo implantation and implantation. receptivity and promote embryo implantation. To draw an analogy, farmers still need to turn over the soil for planting, so that the land will be soft and conducive to the germination and rooting of the seeds, and the doctor is like doing the preparation before planting. Of course, there are many other reasons affecting the failure of IVF, such as tubal factors, immune factors, coagulation factors and invisible psychological factors, each of which will cause failure if they appear abnormally and are magnified, and all of which require the doctor’s careful attention and the patient’s cooperation and joint efforts to seek an individualized treatment plan to improve the success rate of IVF.