Lee Hyun Kyoung, Moon Kyoung Yong, Paik Haerin, Jee Byung Chul
iORA Fertility Clinic, Suwon, Republic of Korea.
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Clin Exp Reprod Med. 2023 Dec;50(4):277-284. doi: 10.5653/cerm.2023.06184. Epub 2023 Oct 19.
In this retrospective study, we analyzed factors influencing the ongoing pregnancy rate (PR) in women with repeated implantation failure (RIF) undergoing embryo transfer with endometrial receptivity array (ERA).
Eighty-three consecutive personalized embryo transfers (pETs) with ERA, from 54 women with RIF, were selected from June 2020 to April 2022. Vitrified blastocyst transfer was timed based on ERA results.
The ongoing PR per pET was 33.7%. Using ERA, the endometrium was identified as pre-receptive in 26 cycles, early receptive in 25 cycles, receptive in 31 cycles, and late receptive in one cycle. With cycles categorized into three receptivity phases (pre-receptive, early receptive, or receptive), no significant differences were found in the clinical PR (27.3%, 55.6%, and 40%, respectively) or ongoing PR (9.1%, 55.6%, and 40%, respectively) after a single blastocyst transfer. Similarly, no significant differences were observed in the clinical PR or ongoing PR after the transfer of two or more blastocysts. Among women with ongoing pregnancy relative to those without, age at first pET was significantly lower (35 years vs. 39 years, p=0.001), while blastocyst score (23 vs. 18, p=0.012) and the proportion of blastocyst scores >18 (71.4% vs. 38.9%, p=0.005) were significantly higher. In multiple logistic regression analysis, the woman's age (odds ratio [OR], 0.814; 95% confidence interval [CI], 0.706 to 0.940; p=0.005) and blastocyst score >18 (OR, 3.052; 95% CI, 1.075 to 8.665; p=0.036) were identified as significant factors influencing ongoing pregnancy.
In pET with ERA, ongoing pregnancy was closely associated with woman's age and blastocyst quality.
在这项回顾性研究中，我们分析了影响反复种植失败（RIF）女性接受子宫内膜容受性阵列（ERA）胚胎移植后的持续妊娠率（PR）的因素。
从2020年6月至2022年4月，选取54例RIF女性进行的83次连续个性化胚胎移植（pET），并根据ERA结果安排玻璃化囊胚移植时间。
每次pET的持续PR为33.7%。使用ERA，26个周期的子宫内膜被确定为容受前期，25个周期为容受早期，31个周期为容受期，1个周期为容受晚期。将周期分为三个容受阶段（容受前期、容受早期或容受期），单次囊胚移植后的临床PR（分别为27.3%、55.6%和40%）或持续PR（分别为9.1%、55.6%和40%）无显著差异。同样，移植两个或更多囊胚后的临床PR或持续PR也无显著差异。与未妊娠的女性相比，妊娠女性的首次pET年龄显著更低（35岁对39岁，p=0.001），而囊胚评分（23对18，p=0.012）以及囊胚评分>18的比例（71.4%对38.9%，p=0.005）显著更高。在多因素逻辑回归分析中，女性年龄（优势比[OR]，0.814；95%置信区间[CI]，0.706至0.940；p=0.005）和囊胚评分>18（OR，3.052；95%CI，1.075至8.665；p=0.036）被确定为影响持续妊娠的显著因素。
在采用ERA的pET中，持续妊娠与女性年龄和囊胚质量密切相关。
