Reproductive Medicine Centre, Boai Hospital of Zhongshan Affiliated with Southern Medical University, Zhongshan, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
Front Endocrinol (Lausanne). 2024 Jul 15;15:1408398. doi: 10.3389/fendo.2024.1408398. eCollection 2024.
This study investigated whether RNA-Seq-based endometrial receptivity test (rsERT)-which provides precision for the optimal hour of the window of implantation (WOI)-can improve clinical outcomes of frozen embryo transfer (FET) cycles in patients with a history of repeated implantation failure (RIF).
Patients with a history of RIF who received at least one autologous high-quality blastocyst during the subsequent FET cycle were retrospectively enrolled and divided into two groups: rsERT and FET, comprising patients who underwent rsERT-guided pET (n=115) and standard FET without rsERT (n=272), respectively.
In the rsERT group, 39.1% (45/115) of patients were receptive. rsERT patients showed a higher probability of achieving both positive human chorionic gonadotropin (63.5% vs. 51.5%, P=0.03) and clinical pregnancy (54.8% vs. 38.6%, P=0.003) rates. In subgroup analysis, rsERT patients with non-receptive results had higher clinical pregnancy rates than patients undergoing FET (58.6% vs. 38.6%, P=0.003). rsERT patients with receptive results guided by rsERT with a precise WOI time had higher, although non-significant, clinical pregnancy rates (48.9% vs. 38.6%, P=0.192) than patients who underwent standard-time FET.
Hourly precise rsERT can significantly improve the probability of achieving clinical pregnancy in patients with RIF, especially in those with non-receptive rsERT results.
本研究旨在探讨基于 RNA-Seq 的子宫内膜容受性检测（rsERT）——它为着床窗口期（WOI）的最佳时间提供了精准性——是否可以改善反复着床失败（RIF）患者的冷冻胚胎移植（FET）周期的临床结局。
回顾性纳入了在随后的 FET 周期中接受至少一个自体优质囊胚的 RIF 病史患者，并将其分为两组：rsERT 和 FET，分别包括接受 rsERT 指导的 pET（n=115）和无 rsERT 的标准 FET（n=272）的患者。
在 rsERT 组中，39.1%（45/115）的患者具有容受性。rsERT 患者的人绒毛膜促性腺激素阳性（63.5% vs. 51.5%，P=0.03）和临床妊娠（54.8% vs. 38.6%，P=0.003）的概率更高。亚组分析显示，rsERT 结果为非容受性的患者的临床妊娠率高于行 FET 的患者（58.6% vs. 38.6%，P=0.003）。rsERT 结果为容受性的患者，根据 rsERT 指导的精确 WOI 时间，尽管无统计学意义，但临床妊娠率更高（48.9% vs. 38.6%，P=0.192），高于行标准时间 FET 的患者。
精确的每小时 rsERT 可以显著提高 RIF 患者获得临床妊娠的概率，尤其是 rsERT 结果为非容受性的患者。
