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. 2024 May 15:11:1369317.
doi: 10.3389/fmed.2024.1369317. eCollection 2024.

Personalized embryo transfer guided by rsERT improves pregnancy outcomes in patients with repeated implantation failure

Ning Li #  1 , Yisheng Zhang #  2 , Rufei Li  1 , Yulin Chen  3 , Lin Huang  1 , Zhuojie Tan  1 , Xiaoying Ban  1 , Ling Zhou  1 , Changlong Xu  1 , Ying Qiu  1 , Rong Li  1
Affiliations

Personalized embryo transfer guided by rsERT improves pregnancy outcomes in patients with repeated implantation failure

Ning Li et al. Front Med (Lausanne). .

Abstract

Introduction: Embryo implantation requires synchronous communication between the embryo and maternal endometrium. Inadequate maternal endometrial receptivity is one of the principal causes for embryo implantation failure [especially repeated implantation failure (RIF)] when biopsied good-quality euploid embryos are transferred. An RNA-seq-based endometrial receptivity test (rsERT) was previously established to precisely guide successful embryo implantation. In this study, we aimed to evaluate the effect of personalized embryo transfer (pET) via rsERT on the clinical outcomes in patients with RIF.

Methods: A total of 155 patients with RIF were included in the present retrospective study and were divided into two groups: 60 patients who underwent rsERT and pET (Group rsERT) and 95 patients who underwent standard frozen embryo transfer (FET) without rsERT (Group FET). Reproductive outcomes were compared for patients who underwent rsERT-guided pET and standard FET.

Results: Forty percent (24/60) of the patients who underwent rsERT were receptive, and the remaining 60% (36/60) were non-receptive. The positive human chorionic gonadotropin (β-hCG) rate (56.3% vs. 30.5%, P = 0.003) and clinical pregnancy rate (43.8% vs. 24.2%, P = 0.017) were significantly higher in Group rsERT patients than in FET group patients. Additionally, Group rsERT patients also showed a higher implantation rate (32.1% vs. 22.1%, P = 0.104) and live birth rate (35.4% vs. 21.1%, P = 0.064) when compared with FET patients, although without significance. For subpopulation analysis, the positive β-hCG rate, clinical pregnancy rate, implantation rate, and live birth rate of receptive patients were not statistically significant different from those of non-receptive patients.

Conclusions: The rsERT can significantly improve the pregnancy outcomes of RIF patients, indicating the clinical potential of rsERT-guided pET.

Keywords: RNA-seq-based endometrial receptivity test; clinical outcomes; endometrial receptivity; personalized embryo transfer; repeated implantation failure.

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Conflict of interest statement

YC was employed by Yikon Genomics (Suzhou) Company Limited. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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