Shu Mingming, Yao Shun, Zhong Wei, Song Chunlan, Chen Fu, Shang Wei
Department of Obstetrics and Gynecology, The Sixth Medical Center of PLA General Hospital, Beijing, China.
Department of Obstetrics and Gynecology, The Seventh Medical Center of PLA General Hospital, Beijing, China.
Gynecol Endocrinol. 2023 Dec;39(1):2181639. doi: 10.1080/09513590.2023.2181639. Epub 2023 Feb 23.
Embryo implantation provides an efficient way for patients with repeated implantation failure (RIF) to achieve pregnancy. The aim of this study is to compare the implantation outcomes of RIF patients in artificial cycle to those in natural cycle, both were treated with RNA sequencing endometrial receptivity test (rsERT) based personalized embryo implantation.
The endometrial receptivity (ER) analysis was performed using rsERT followed by personalized embryo transfer at optimal window of implantation (WOI). The implantation rate (IR), clinical pregnancy rate (CPR) and live birth rate (LBR) were calculated. The expression levels of biomarkers involved in pregnancy process in the patients detected as in receptivity status were also analyzed.
The rsERT shown that 44.8% (natural cycle) and 47.8% (artificial cycle) patients were in non-receptive status, which indicated a WOI displacement. After personalized embryo transfer, the IR of patients in artificial cycle was higher than those in natural cycle (52.2% vs 27.6%). The expressions of FKBP52, MUC1 and LPAR3 were significantly lower in artificial cycle than in natural cycle.
Using artificial cycle for personalized embryo transfer based on rsERT may yield better pregnancy outcomes for RIF patients. A gene expression analysis of FKBP52, MUC1 and LPAR3 provided a potential way to increase implantation outcomes for RIF patients.
胚胎植入为反复植入失败(RIF)患者实现妊娠提供了一种有效方法。本研究旨在比较人工周期与自然周期中RIF患者的植入结局,两者均采用基于RNA测序子宫内膜容受性检测(rsERT)的个性化胚胎植入治疗。
使用rsERT进行子宫内膜容受性(ER)分析,然后在最佳植入窗(WOI)进行个性化胚胎移植。计算植入率(IR)、临床妊娠率(CPR)和活产率(LBR)。还分析了检测为处于容受状态的患者中参与妊娠过程的生物标志物的表达水平。
rsERT显示,44.8%(自然周期)和47.8%(人工周期)的患者处于非容受状态,这表明存在植入窗移位。经过个性化胚胎移植后,人工周期患者的植入率高于自然周期患者(52.2%对27.6%)。FKBP52、MUC1和LPAR3在人工周期中的表达明显低于自然周期。
基于rsERT使用人工周期进行个性化胚胎移植可能为RIF患者带来更好的妊娠结局。对FKBP52、MUC1和LPAR3的基因表达分析为提高RIF患者的植入结局提供了一种潜在方法。