IVIRMA Roma, Italy; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Universidad Rey Juan Carlos, Madrid, Spain.
IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.
Fertil Steril. 2022 Oct;118(4):724-736. doi: 10.1016/j.fertnstert.2022.07.007. Epub 2022 Sep 6.
To determine whether personalized embryo transfer (pET) guided by endometrial receptivity array (ERA) test improves reproductive outcomes for fresh embryo transfers (fsETs) or frozen embryo transfers (FETs) during autologous and donor cycles.
A retrospective, observational, multicenter cohort study.
University-affiliated in vitro fertilization center.
PATIENT(S): The study included patients with a single previous failed transfer and yielded 3,239 autologous transfers and 2,133 donor transfers. Among autologous transfers, 255 were pET guided by ERA; among unguided autologous transfers, 1,122 and 1,862 transfers involved fresh or previously frozen embryos, respectively. Among donor transfers, 319 were ERA-guided; among unguided donor transfers, 1,175 and 639 involved fsETs or FETs, respectively.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Primary outcomes were live birth rate per embryo transfer and cumulative live birth rate on consecutive transfers until live birth or cessation of pregnancy. Secondary outcomes were implantation, pregnancy rate, clinical pregnancy rates per embryo transfer, and miscarriage rate per pregnancy.
RESULT(S): During both autologous or donor transfers, live birth rate and cumulative live birth rate were higher in FET and fsET than in pET groups, even with euploid transfers. Logistic regression analysis, considering possible confounders, indicated patients receiving pET had poorer outcomes than those undergoing FET and fsET in autologous and donor cycles. Implantation, pregnancy, and clinical pregnancy rates were lower in patients undergoing pET.
CONCLUSION(S): Using ERA to guide pET during either autologous or donor cycles after a failed transfer attempt did not improve reproductive outcomes. Conversely, worse outcomes were detected when ERA was used.
确定子宫内膜容受性分析（ERA）指导下的个体化胚胎移植（pET）是否能提高自体和供体周期新鲜胚胎移植（fsET）或冷冻胚胎移植（FET）的妊娠结局。
回顾性、观察性、多中心队列研究。
大学附属体外受精中心。
该研究纳入了单次移植失败的患者，共纳入 3239 例自体移植和 2133 例供体移植。在自体移植中，255 例接受 ERA 指导的 pET；在未接受 ERA 指导的自体移植中，分别有 1122 例和 1862 例新鲜胚胎和之前冷冻的胚胎进行移植。在供体移植中，319 例接受 ERA 指导；在未接受 ERA 指导的供体移植中，分别有 1175 例和 639 例进行 fsET 或 FET。
无。
主要结局为胚胎移植的活产率和连续移植直至活产或妊娠停止的累积活产率。次要结局为胚胎种植率、妊娠率、胚胎移植的临床妊娠率和每例妊娠的流产率。
在自体或供体移植中，FET 和 fsET 的活产率和累积活产率均高于 pET 组，即使是整倍体移植也是如此。考虑到可能的混杂因素，逻辑回归分析表明，在自体和供体周期中，接受 pET 的患者的结局比接受 FET 和 fsET 的患者差。pET 组的胚胎种植率、妊娠率和临床妊娠率较低。
在失败的移植尝试后，ERA 指导自体或供体周期中的 pET 并不能改善妊娠结局。相反，使用 ERA 会导致更差的结果。
