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. 2021 Jun 28;11(1):13420.
doi: 10.1038/s41598-021-92955-w.

The precise determination of the window of implantation significantly improves ART outcomes

M Enciso  1 , J Aizpurua  2 , B Rodríguez-Estrada  3 , I Jurado  3 , M Ferrández-Rives  3 , E Rodríguez  4 , E Pérez-Larrea  4 , A B Climent  2 , K Marron  5 , J Sarasa  3
Affiliations

The precise determination of the window of implantation significantly improves ART outcomes

M Enciso et al. Sci Rep. .

Abstract

The human endometrium is receptive to the embryo for a specific period of time known as the window of implantation (WOI). During this period, the endometrium shows a specific gene expression profile suitable for endometrial function evaluation. ER Map is a molecular tool able to accurately predict endometrial receptivity status by transcriptomic analysis. In this retrospective study, including 2256 subfertile patients undergoing ART treatment, the clinical value of precise WOI determination is studied in detail. Results obtained when single embryo transfers (sET) were scheduled either within the WOI timeframe as established by ER Map, or deviating from this WOI, are assessed and compared. Data obtained showed that 34.18% (771/2256) of patients had a displaced WOI. Analysis of ART outcomes showed significantly higher pregnancy rates in transfers scheduled within the WOI predicted compared to transfers that deviated more than 12h from this WOI (44.35% vs 23.08%, p < 0.001). The deviation from the WOI had also an impact on the progression of pregnancy, with a significant increase in pregnancy loss (~ twofold) observed in transfers that deviated more than 12h from the WOI predicted. These results indicate that the precise determination of the WOI and personalised embryo transfer can significantly improve clinical outcomes.

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Conflict of interest statement

M.E. is co-inventor of the patent for endometrial receptivity analysis (ER Map) issued to iGLS and an employee of iGLS. J.S. is co-inventor of the patent for endometrial receptivity analysis (ER Map) issued to iGLS and an employee of iGLS. J.A. is co-inventor of the patent for endometrial receptivity analysis (ER Map) issued to iGLS and owner of iGLS. B.R-E., I.J., M.F-R. are employees of iGLS. The rest of the authors have no potential conflict of interest to declare.

Figures

Figure 1
Figure 1
Endometrial receptivity status frequencies along different days of progesterone administration as assessed by ER Map. Frequencies of receptive, pre-receptive and post-receptive samples after a variable number of days of progesterone administration. N = 2828 biopsies.
Figure 2
Figure 2
Reproductive outcomes of patients after the first single embryo transfer following ER Map test. Positive B-hCG rates (green bars) and clinical pregnancy rates (grey bars) comparison between the group of patients that followed ER Map progesterone pretreatment and those that deviated more than 12h from this recommendation. X2 test, *p = 0.02, #p < 0.001 n = 746 sET (ER Map WOI N = 681, > 12h deviation n = 65).
Figure 3
Figure 3
ER Map clinical procedure diagram. Modified from “[pking4th, alexutemov, greyjj] 123RF.com”.
See this image and copyright information in PMC

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