Recurrent implantation failure in Dubai
Good embryos that do not implant, cycle after cycle, are among the hardest things in fertility medicine, for the couple and for the doctor. It is one of Dr. Shami's main areas of interest, and she approaches it as a case to be investigated, not a cycle to be repeated.
What it means
Implantation failure is usually called recurrent when good-quality embryos have been transferred over several cycles without a pregnancy. There is no single cause, and often more than one factor is involved. The four questions Dr. Shami asks are: was the embryo really what it seemed, is the uterus ready to receive it, is something in the body working against it, and was the cycle itself designed well?
Who it is for
- Couples who have had two, three or more embryo transfers without a pregnancy, here or elsewhere
- Couples with repeated early losses after IVF (chemical pregnancies)
- Anyone told that their embryos were “fine” but who has never been given a reason for the failures
- Couples considering another cycle who want the plan reviewed before spending more money and hope
What the review looks at
The embryo. Embryo grading, the laboratory's culture conditions, and whether PGT-A was used or should be. An embryo that looks perfect can still be chromosomally abnormal, particularly with age.
The uterus. A detailed ultrasound, often a hysteroscopy, to look for polyps, fibroids, adhesions, a septum, chronic inflammation of the lining (chronic endometritis), or fluid in the tubes that can wash back into the cavity. Some of these are easily treated and are missed surprisingly often.
The body. Thyroid, prolactin and metabolic health, clotting and immune tests where the history justifies them, and conditions such as endometriosis or adenomyosis that quietly change the environment.
The cycle. The stimulation protocol, the timing of the transfer relative to the lining's receptive window, the type of luteal support, and whether a frozen transfer with careful preparation of the lining would give the embryo a better chance.
How Dr. Shami approaches it
- 1
She reads your whole file
Previous protocols, egg numbers, embryo reports and transfer notes are reviewed before you meet, whichever clinic they came from.
- 2
Tests with a purpose
Only investigations that could change the plan are ordered. Long panels of tests without consequences are not.
- 3
Something must change
The next cycle is deliberately different from the last: a corrected uterus, a tested embryo, a different protocol or timing. Repeating the same plan and hoping is not a strategy.
- 4
A clear-eyed conversation
If the evidence points to a limit that cannot be changed, she will say so, and talk through every option with you.
Dr. Ghina Shami
Questions patients ask
After how many failed transfers should we look deeper?
Many specialists use the threshold of three transfers of good embryos, but Dr. Shami will look deeper earlier when age, history or a previous finding makes it sensible. Ask after the second failure rather than waiting.
Are immune tests useful?
Sometimes, in specific situations. Many immune tests and treatments are still unproven, and Dr. Shami is careful to distinguish what is evidence-based from what is fashionable. She will explain the reasoning behind anything she recommends.
Will this review mean starting over?
Not necessarily. Many couples already have frozen embryos. The review often changes how and when the next transfer is done rather than requiring a new stimulation cycle.
Medically reviewed by Dr. Ghina Shami, Consultant Reproductive Endocrinology & Infertility · September 2026
Tell Dr. Shami where you are in your journey
A message on WhatsApp is enough to start. She replies personally, in English or Arabic.