Li Ning, Zhang Yisheng, Li Rufei, Chen Yulin, Huang Lin, Tan Zhuojie, Ban Xiaoying, Zhou Ling, Xu Changlong, Qiu Ying, Li Rong
Reproductive Medical Center of the Second Nanning People's Hospital, Nanning, China.
Reproductive Medical Center of the Guangxi Zhuang Autonomous Region People's Hospital, Nanning, China.
Front Med (Lausanne). 2024 May 15;11:1369317. doi: 10.3389/fmed.2024.1369317. eCollection 2024.
Embryo implantation requires synchronous communication between the embryo and maternal endometrium. Inadequate maternal endometrial receptivity is one of the principal causes for embryo implantation failure [especially repeated implantation failure (RIF)] when biopsied good-quality euploid embryos are transferred. An RNA-seq-based endometrial receptivity test (rsERT) was previously established to precisely guide successful embryo implantation. In this study, we aimed to evaluate the effect of personalized embryo transfer (pET) via rsERT on the clinical outcomes in patients with RIF.
A total of 155 patients with RIF were included in the present retrospective study and were divided into two groups: 60 patients who underwent rsERT and pET (Group rsERT) and 95 patients who underwent standard frozen embryo transfer (FET) without rsERT (Group FET). Reproductive outcomes were compared for patients who underwent rsERT-guided pET and standard FET.
Forty percent (24/60) of the patients who underwent rsERT were receptive, and the remaining 60% (36/60) were non-receptive. The positive human chorionic gonadotropin (β-hCG) rate (56.3% vs. 30.5%, = 0.003) and clinical pregnancy rate (43.8% vs. 24.2%, = 0.017) were significantly higher in Group rsERT patients than in FET group patients. Additionally, Group rsERT patients also showed a higher implantation rate (32.1% vs. 22.1%, = 0.104) and live birth rate (35.4% vs. 21.1%, = 0.064) when compared with FET patients, although without significance. For subpopulation analysis, the positive β-hCG rate, clinical pregnancy rate, implantation rate, and live birth rate of receptive patients were not statistically significant different from those of non-receptive patients.
The rsERT can significantly improve the pregnancy outcomes of RIF patients, indicating the clinical potential of rsERT-guided pET.
胚胎着床需要胚胎与母体子宫内膜之间的同步通讯。当移植活检质量良好的整倍体胚胎时，母体子宫内膜容受性不足是胚胎着床失败（尤其是反复着床失败，RIF）的主要原因之一。先前已建立了基于RNA测序的子宫内膜容受性检测（rsERT），以精确指导成功的胚胎着床。在本研究中，我们旨在评估通过rsERT进行个性化胚胎移植（pET）对RIF患者临床结局的影响。
本回顾性研究共纳入155例RIF患者，分为两组：60例行rsERT和pET的患者（rsERT组）和95例行无rsERT的标准冻融胚胎移植（FET）的患者（FET组）。比较接受rsERT引导的pET和标准FET患者的生殖结局。
接受rsERT的患者中有40%（24/60）具有容受性，其余60%（36/60）不具有容受性。rsERT组患者的人绒毛膜促性腺激素（β-hCG）阳性率（56.3%对30.5%，P = 0.003）和临床妊娠率（43.8%对24.2%，P = 0.017）显著高于FET组患者。此外，与FET患者相比，rsERT组患者的着床率（32.1%对22.1%，P = 0.104）和活产率（35.4%对21.1%，P = 0.064）也更高，尽管无统计学意义。对于亚组分析，具有容受性患者与不具有容受性患者的β-hCG阳性率、临床妊娠率、着床率和活产率在统计学上无显著差异。
rsERT可显著改善RIF患者的妊娠结局，表明rsERT引导的pET具有临床应用潜力。
