Recurrent Miscarriage & Repeated Implantation Failure

Even though there is no obvious cause, attempts to pregnant may not lead to pregnancy, including repeated embryo transfers.
In the case of unexplained infertility or recurrent implantation failure, there may be a chromosomal abnormality in the embryo or some abnormality in the patient.
In such cases, it is necessary to investigate.

Causes and Examinations for Repeated Implantation Failure

There are abnormalities in the uterine cavity, immune disorders, and vitamin and mineral abnormalities that are closely related to pregnancy.

IFCE (Implantation Failure Test)

In IFCE, we will check with a hysteroscope for abnormalities in the uterus (polyps, fibroids, adhesions, etc.) and chronic endometritis (micropolyps, redness, edema, etc.)

Allogeneic Immune Abnormality Test

One of the causes of recurrent implantation failure and recurrent miscarriage is abnormal functioning of the immune system.
In this abnormal situation, the immune system sees the embryo and fetus as foreign bodies and tries to eliminate them from the body (allogeneic immune abnormalities) resulting in abnormal pregnancy and discontinued pregnancy.
Tests for allogeneic immunological abnormalities include the following to check for any reaction from the body to eliminate transplanted embryos or fetus as foreign bodies.

• Peripheral Blood NK (Natural Killer) Activity

NK cells (natural killer cells) are involved in the immune tolerance needed to maintain pregnancy.
Excessive NK cell activity impairs the induction of angiogenesis and causes miscarriage by trying to eliminate the fetus as a foreign body.
Peripheral blood NK cell activity is often high in patients with infertility and recurrent miscarriage, and it patients who have experienced recurrent miscarriage may have levels significantly higher than those who have no history of miscarriage.

• Th 1 /Th 2

mmunity includes cell-mediated immunity and humoral immunity. Th 1 plays a central role in cell-mediated immunity, and Th 2 plays a central role in humoral immunity.
In recent years, Th 1 /Th 2 balance has been attracting attention as an immunological pregnancy maintenance mechanism.
Essentially, a pregnancy is maintained because Th 1 decreases and Th 2 increases.
One immunological cause of recurrent miscarriage may be autoantibodies such as antiphospholipid antibodies and mechanisms similar to the rejection of organ transplantation, both of which suggest that the Th 1 /Th 2 balance is disrupted.
If the balance is tilted too far toward Th 1 , the mother will recognize the fetus as a foreign body, causing rejection, implantation problems and miscarriage.
If you lean too much toward Th 2 , antibody production will become more active, and autoantibodies such as antiphospholipid antibodies will be produced, causing miscarriage.
The balance itself is important.

Blood Test of Substances Related to Pregnancy

This test will Judge whether the patient’s levels of substances (vitamin D, copper, zinc) that play an important role in the implantation environment and pregnancy are appropriate or need adjustment.

• Vitamin D

Vitamin D is best known for its role in calcium and bone metabolism, but it is also related to immunity, cancer, and allergies.
It has a very important role in pregnancy, and is related to the environment of the endometrium and implantation.
Women with higher vitamin D have a higher pregnancy rate for in vitro fertilization, and vitamin D deficiency increases the risk of early miscarriage.
In addition, it is said that the higher the blood vitamin D, the higher the AMH, that is, vitamin D deficiency leads to a decrease in ovarian reserve.
Vitamin D is taken from the diet and exposure to sunlight.
In recent years, vitamin D has become deficient in the general population due to reduced exposure to sunlight, making it extremely difficult to maintain sufficient levels with dietary intake alone.
Those who are reluctant to be exposed to sunlight should take supplements. (In food, it is abundant in herring, mackerel, sardines, tuna, shirasu, salmon, oocytes, mushrooms, etc.)

• Zinc / copper

Zinc is an important mineral for pregnancy.
Zinc promotes cell division in fertilized oocytes and regulates the environment in the uterus.
Copper, on the other hand, has the function of inhibiting implantation.
In other words, zinc deficiency allows more copper to be absorbed into the body, making implantation problems due to excess copper more likely.
In modern people's eating habits, retort pouch foods, frozen foods, processed foods such as snack foods, and vegetable-based diets make it harder to ingest zinc, which is abundant in meat and fish. Additives that are abundant in processed foods have the effect of inhibiting the absorption of zinc, and many people are zinc-deficient.
By supplementing zinc, the absorption of copper is suppressed, and it is possible to create a good environment for pregnancy.
Zinc is abundant in beef, pork, shellfish, crustaceans, peanuts and legumes.