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个性化胚胎移植有助于改善反复种植失败患者的受精/卵胞浆内单精子注射结局。

Personalized Embryo Transfer Helps in Improving Fertilization/ICSI Outcomes in Patients with Recurrent Implantation Failure.

作者信息

Patel Jayesh A, Patel Azadeh J, Banker Jwal M, Shah Sandeep I, Banker Manish R

机构信息

Consultant, Nova IVI Fertility, Kankaria, Ahmedabad, Gujarat, India.

Third Year Resident Obs & Gynec, Shrimati Bhikhi ben Kanjibhai Shah (SBKS), Medical Institute and Research Center, Vadodara, Gujarat, India.

出版信息

J Hum Reprod Sci. 2019 Jan-Mar;12(1):59-66. doi: 10.4103/jhrs.JHRS_74_18.

DOI:10.4103/jhrs.JHRS_74_18
PMID:31007469
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6472200/
Abstract

AIMS

This study aims to compare clinical outcomes in patients of recurrent implantation failure (RIF), who had embryo transfer (ET) following a receptive (R) endometrial receptivity array (ERA) and a personalized embryo transfer (pET) after a nonreceptive (NR) ERA.

SETTINGS AND DESIGN

This was a retrospective observational study.

STUDY PERIOD

July 2013-September 2017.

SUBJECTS AND METHODS

Two hundred and forty-eight patients having unexplained RIF who underwent ERA test were included in the study. Clinical outcomes were compared between patients having a receptive (R) ERA and those having a NR ERA who underwent a pET-based on ERA.

STATISTICAL ANALYSIS USED

Chi-square and -test.

RESULTS

ERA predicted receptive (R) endometrium at + 5 in 82.3% (204/248) patients and NR in 17.7% (44/248) patients. Average failed previous fertilization cycles were 3.67 ± 1.67 among receptive ERA patients and 4.09 ± 1.68 among NR ERA patients. Pregnancy rate (PR), clinical PR, implantation rate (IR), abortion rate (AR), ongoing pregnancy rate (OPR), and cumulative PR were comparable between patients having receptive ERA who had a routine Embryo Transfer (ET) and those with an NR ERA who underwent a pET.

CONCLUSIONS

ERA is helpful in identifying the window of implantation (WOI) through genetic expressions of the endometrium to pinpoint embryo transfer timing. pET guided by ERA in patients of RIF with displaced WOI improves IRs and OPRs.

摘要

目的

本研究旨在比较复发性植入失败(RIF)患者在接受性(R)子宫内膜容受性阵列(ERA)检测后进行胚胎移植(ET),以及在非接受性(NR)ERA检测后进行个性化胚胎移植(pET)后的临床结局。

设置与设计

这是一项回顾性观察研究。

研究期间

2013年7月至2017年9月。

研究对象与方法

纳入248例不明原因复发性植入失败且接受ERA检测的患者。比较接受性(R)ERA患者与基于ERA接受pET的非接受性(NR)ERA患者的临床结局。

所用统计分析方法

卡方检验和t检验。

结果

ERA预测82.3%(204/248)的患者在+5时子宫内膜呈接受性(R),17.7%(44/248)的患者呈非接受性(NR)。接受性ERA患者之前平均失败的受精周期数为3.67±1.67,非接受性ERA患者为4.09±1.68。接受性ERA且进行常规胚胎移植(ET)的患者与非接受性ERA且接受pET的患者之间的妊娠率(PR)、临床PR、植入率(IR)、流产率(AR)、持续妊娠率(OPR)和累积PR相当。

结论

ERA有助于通过子宫内膜的基因表达确定植入窗(WOI),以精准胚胎移植时间。在WOI移位的RIF患者中,由ERA指导的pET可提高IR和OPR。

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Reprod Med Biol. 2017 Jun 27;16(3):290-296. doi: 10.1002/rmb2.12041. eCollection 2017 Jul.
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J Hum Reprod Sci. 2015 Jul-Sep;8(3):121-9. doi: 10.4103/0974-1208.165153.
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Validation of next-generation sequencing for comprehensive chromosome screening of embryos.用于胚胎染色体全面筛查的新一代测序技术的验证
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Fertil Steril. 2013 Sep;100(3):818-24. doi: 10.1016/j.fertnstert.2013.05.004. Epub 2013 Jun 4.
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Fertil Steril. 2013 Sep;100(3):697-703. doi: 10.1016/j.fertnstert.2013.04.035. Epub 2013 Jun 1.
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Profiling the gene signature of endometrial receptivity: clinical results.子宫内膜容受性基因特征分析:临床结果。
Fertil Steril. 2013 Mar 15;99(4):1078-85. doi: 10.1016/j.fertnstert.2012.12.005. Epub 2013 Jan 8.
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Preimplantation genetic screening using fluorescence in situ hybridization in patients with repetitive implantation failure and advanced maternal age: two randomized trials.反复着床失败且高龄患者应用荧光原位杂交进行胚胎植入前遗传学筛查:两项随机试验。
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