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Elizabeth Barbieri of Oregon Reproductive Medicine helps explain the leading causes of failed transfers and miscarriages in IVF treatments.

A failed transfer is understandably an emotionally difficult time for patients. Multiple failed transfers compound this stress and can be extremely costly as well. When a failed transfer occurs, patients are left questioning "Why didn’t it work?" "Is something wrong with me?" and looking for answers.

Where to Look After a Failed Transfer?

To try and develop a treatment strategy that has the best chance of success on a subsequent attempt, we need to look for answers in the right places. I often hear questions about the role of Natural Killer cells and role of a good uterine lining in the context of failed transfers, so it is important to address these concerns. However, the most common reason an embryo fails to implant is that the embryo is chromosomally abnormal i.e. is missing a chromosome or has an extra chromosome and cannot develop into a viable pregnancy and a healthy baby.

Natural Killer Cells are white blood cells that play an essential role in the body’s immune system by targeting and destroying foreign cells. They are present in the blood and also in the uterine lining. It has been suggested that Natural Killer cells play a part in pregnancy and that elevated levels may cause miscarriage by rejecting an embryo. While some physicians and clinicians subscribe to this theory and point to some studies as evidence, a detrimental role for elevated Natural Killer cell levels has yet to be conclusively demonstrated and there is evidence that Natural Killer cells in the uterus operate differently to those in the rest of the body. Complicating matters is that there is no standardised way to measure Natural Killer cell levels or agreement on what comprises elevated levels.

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