Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, PR China; Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China.
Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China.
J Reprod Immunol. 2024 Jun;163:104218. doi: 10.1016/j.jri.2024.104218. Epub 2024 Feb 17.
This study aimed to evaluate the effectiveness of the endometrial receptivity array (ERA), endometrial immune profiling, and a combination of both in improving the pregnancy outcomes for multiple implantation failure patients. According to patients' willingness, 1429 women who incurred at least two or more consecutive implantation failures in IVF/ICSI treatment opted for frozen embryo transfer and were divided into four groups: 'No test', 'Immune Profiling', 'ERA' and 'ERA+ Immune Profiling'. Women in three test groups underwent timed endometrial biopsy for ERA, immune profiling, a combination of both. We observed the overall incidence rates of the displaced window of implantation (WOI) and endometrial immune dysregulation were 75.14% and 79.29%, respectively. After 1:1 propensity score matching (PSM), our data revealed that the 'ERA' and 'ERA + Immune Profiling' groups demonstrated significantly higher rates of biochemical, clinical, ongoing pregnancy, and implantation compared to the 'No test' group (p < 0.01). The 'Immune Profiling' group showed a higher implantation rate compared to 'No test' group (p < 0.05). Furthermore, when comparing three test groups, the 'ERA + Immune Profiling' group exhibited notably higher rates of clinical and ongoing pregnancy compared to the 'Immune Profiling' group (p < 0.017). However, there was no association between endometrial immune profiling and ERA phases, and their results did not differ between embryo implantation and non-implantation in these patients. Our findings underline the increased implantation rates by use of ERA and endometrial immune profiling in patients with multiple implantation failure, either individually or corporately. Moreover, a combination of both could improve their pregnancy outcomes significantly.
本研究旨在评估子宫内膜容受性分析（ERA）、子宫内膜免疫组化分析以及两者联合应用对提高多次着床失败患者妊娠结局的效果。根据患者的意愿，1429 名在体外受精/卵胞浆内单精子注射（IVF/ICSI）治疗中至少连续发生两次或两次以上着床失败的患者选择进行冻融胚胎移植，并分为四组：“无检测”、“免疫组化分析”、“ERA”和“ERA+免疫组化分析”。三组检测组的女性均进行定时子宫内膜活检，以进行 ERA、免疫组化分析和两者联合检测。我们观察到总体着床窗口期（WOI）位移和子宫内膜免疫失调的发生率分别为 75.14%和 79.29%。经过 1:1 倾向评分匹配（PSM）后，我们的数据显示，“ERA”和“ERA+免疫组化分析”组的生化妊娠、临床妊娠、持续妊娠和着床率均显著高于“无检测”组（p<0.01）。“免疫组化分析”组与“无检测”组相比，着床率更高（p<0.05）。此外，在比较三组检测组时，“ERA+免疫组化分析”组的临床妊娠和持续妊娠率显著高于“免疫组化分析”组（p<0.017）。然而，子宫内膜免疫组化分析和 ERA 期之间没有关联，而且在这些患者中，胚胎着床和非着床的结果没有差异。我们的研究结果表明，在多次着床失败的患者中，单独或联合使用 ERA 和子宫内膜免疫组化分析可以提高着床率。此外，两者联合使用可以显著提高妊娠结局。
