既往移植失败患者中子宫内膜容受性分析的临床应用。
Clinical utility of the endometrial receptivity analysis in women with prior failed transfers.
机构信息
Cedars-Sinai Medical Center, 8635 West 3rd Street, 160 West Tower, Los Angeles, CA, 90048, USA.
Southern California Reproductive Center, 450 North Roxbury Drive, #500, Beverly Hills, CA, 90210, USA.
出版信息
J Assist Reprod Genet. 2021 Mar;38(3):645-650. doi: 10.1007/s10815-020-02041-9. Epub 2021 Jan 17.
PURPOSE
To determine the utility of the endometrial receptivity analysis (ERA) in women with prior failed embryo transfers (ET).
METHODS
This was a retrospective study of patients who underwent an ERA test with a subsequent frozen ET. Women were classified based on their indication for an ERA test: (1) ≥ 1 prior failed ET (cases), or (2) as a prophylactic measure (controls). A subset analysis of women with ≥ 3 prior failed transfers was performed. Pregnancy outcomes of the subsequent cycle were examined, including conception, clinical pregnancy, and ongoing pregnancy/live birth.
RESULTS
A total of 222 women were included, 131 (59%) women with ≥ 1 prior failed ET and 91 (41%) controls. Among the 131 women with ≥ 1 prior failed ET, 20 women (9%) had ≥ 3 prior failed ETs. The proportion of non-receptive ERA tests in the three groups were the following: 45% (≥ 1 prior failed ET), 40% (≥ 3 prior failed ETs), and 52% (controls). The results did not differ between cases and controls. The pregnancy outcomes did not differ between women with ≥ 1 prior failed ET and controls. In women with ≥ 3 prior failed ETs, there was a lower ongoing pregnancy/live birth rate (28% vs 54%, P = 0.046).
CONCLUSION
Women with ≥ 1 prior failed ET and ≥ 3 prior failed ETs had a similar prevalence of non-receptive endometrium compared to controls. Women with ≥ 3 prior failed ETs had a lower ongoing pregnancy/live birth rate despite a personalized FET, suggesting that there are additional factors in implantation failure beyond an adjustment in progesterone exposure.
目的
确定子宫内膜容受性分析（ERA）在既往胚胎移植失败（ET）女性中的应用价值。
方法
这是一项回顾性研究，纳入了接受 ERA 检测并随后进行冷冻 ET 的患者。根据 ERA 检测的适应证将患者分为两组：（1）≥1 次既往 ET 失败（病例组），或（2）作为预防措施（对照组）。对≥3 次既往 ET 失败的患者进行亚组分析。检查随后周期的妊娠结局，包括受孕、临床妊娠和持续妊娠/活产。
结果
共纳入 222 例患者，其中≥1 次既往 ET 失败的患者 131 例（59%），对照组 91 例（41%）。在≥1 次既往 ET 失败的 131 例患者中，有 20 例（9%）患者有≥3 次既往 ET 失败。三组中无反应性 ERA 检测的比例如下：45%（≥1 次既往 ET 失败）、40%（≥3 次既往 ET 失败）和 52%（对照组）。病例组和对照组之间的结果无差异。既往 ET 失败≥1 次的患者与对照组的妊娠结局无差异。在有≥3 次既往 ET 失败的患者中，持续妊娠/活产率较低（28% vs. 54%，P=0.046）。
结论
既往 ET 失败≥1 次和≥3 次的患者与对照组相比，无反应性子宫内膜的发生率相似。尽管进行了个体化 FET，但有≥3 次既往 ET 失败的患者持续妊娠/活产率较低，这表明除了孕酮暴露调整外，还有其他因素导致着床失败。
Zotero 插件