Immunological interventions in recurrent implantation failure: a systematic review and SWOT analysis

Area of Science:

• Reproductive Medicine
• Immunology in Reproduction

Background:

• Recurrent implantation failure (RIF) is defined as failed pregnancy after multiple embryo transfers.
• Lack of standardized diagnostic criteria complicates RIF management, leading to varied interventions.
• Immunological treatments are often used in RIF without robust evidence.

Purpose of the Study:

• To review existing research on interventions for RIF patients undergoing in vitro fertilization (IVF).
• To assess the impact of immunological treatments on IVF outcomes in RIF.
• To provide an overview of current research characteristics.

Main Methods:

• Systematic bibliographic search conducted up to November 2024.
• Focused on studies evaluating immunological treatments in RIF cases.
• Compared IVF outcomes between case and control groups.

Main Results:

• 77 studies were included in the review.
• Heterogeneous diagnostic criteria for RIF were observed; only 47% defined it as 3+ failed transfers.
• Most studies featured small sample sizes, limiting statistical power.

Conclusions:

• Insufficient evidence exists to recommend routine immunological interventions for RIF in clinical practice.
• Methodological inconsistencies in current research hinder result reliability and generalizability.
• Further high-quality studies with standardized criteria are necessary.