Reproductive healthLecture
Why euploid embryos fail to implant?
The failed implantation of a euploid blastocyst is a clinical problem that bridges two schools of thought: «embryo-centric» and «endometrium-centric». The concept of the endometrium as a biosensor explains why, with embryos of average quality, endometrial receptivity and selectivity determine the outcome. A review of current evidence and the clinical grading of RIF (recurrent implantation failure) per the ESHRE 2023 consensus.
Audio: MultiSubtitles: EN · UA · RU40 min
Nick Macklon
Professor, MD, PhD
Professor and Medical Director of the London Women's Clinic and Co-Chief Editor of Reproductive BioMedicine Online. Internationally recognized for his research on ovarian stimulation, endometrial receptivity and periconception. Author of more than 200 scientific papers.
London, United KingdomLinkedIn →
The failed implantation of a euploid blastocyst is one of the most demanding clinical scenarios in ART. The contemporary approach reconciles two schools of thought — embryo-centric and endometrium-centric — into a unified framework that explains why, when the embryo is of average quality, the endometrium becomes the rate-limiting factor.
Embryo quality as a continuum, not on/off
A morphologically excellent blastocyst is not always cytologically perfect. Current research shows that a substantial proportion of good-looking blastocysts carry mosaic changes in at least one cell — a finding that reshapes how clinicians counsel patients and prompts reconsideration of what «ideal embryo» means in clinical practice.
