Reproductive Medicine Center, Xiangya Hospital of Central South University, No.87 Xiangya Road, Changsha, 410008, Hunan, P. R. China.
Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha, 410008, Hunan, P. R. China.
J Assist Reprod Genet. 2024 Oct;41(10):2657-2665. doi: 10.1007/s10815-024-03246-y. Epub 2024 Sep 10.
To investigate whether personalized embryo transfer (pET) predicted by a modified RNA-sequencing-based endometrial receptivity test (rsERT) model can improve intrauterine pregnancy rate (IPR) in patients with a receptive window of implantation (WOI).
A retrospective pilot study was conducted in the Center for Reproductive Medicine, Central South University, from January 2018 to December 2023. A total of 524 patients with receptive WOI results from rsERT were assigned into two groups based on whether they underwent conventional embryo transfer (conventional ET) or pET. Patients in the conventional ET were matched with those in the pET group at a 1:1 ratio using propensity score matching (PSM).
Before PSM, the IPR (55.73% vs. 46.19%, P = 0.032) and implantation rate (IR) (47.51% vs. 34.03%, P = 0.000) in the pET group were significantly higher than that in the conventional ET group. However, the number and types of transferred embryos differed significantly between the two groups. After adjusting for confounding factors, IPR (57.38% vs. 44.81, P = 0.016) and IR (46.81% vs. 33.10%, P = 0.001) remained significantly higher in the pET group compared to the conventional ET group. The implantation failure rate was significantly lower in the pET group compared to controls (42.62% vs. 55.19%, P = 0.016). Additionally, the multiple-pregnancy rate was significantly higher in the pET group compared to the conventional ET group (10.29% vs. 1.68%, P = 0.001).
Women with receptive WOI results could benefit from the receptivity-timed pET predicted by the newly refined rsERT. These findings provide a basis for future research in precision medicine for embryo transfer.
探究基于改良 RNA 测序的子宫内膜容受性检测（rsERT）模型预测的个体化胚胎移植（pET）是否能提高具有种植窗（WOI）的患者的宫内妊娠率（IPR）。
本回顾性前瞻性研究于 2018 年 1 月至 2023 年 12 月在中南大学生殖医学中心进行。共有 524 名 rsERT 检测结果具有 WOI 的患者被分为两组，一组行常规胚胎移植（conventional ET），另一组行 pET。采用倾向性评分匹配（PSM）以 1:1 的比例将行 conventional ET 的患者与行 pET 的患者进行匹配。
PSM 前，pET 组的 IPR（55.73% vs. 46.19%，P=0.032）和种植率（IR）（47.51% vs. 34.03%，P=0.000）均显著高于 conventional ET 组，但两组移植胚胎的数量和类型差异有统计学意义。调整混杂因素后，pET 组的 IPR（57.38% vs. 44.81，P=0.016）和 IR（46.81% vs. 33.10%，P=0.001）仍显著高于 conventional ET 组。pET 组的种植失败率显著低于 conventional ET 组（42.62% vs. 55.19%，P=0.016），多胎妊娠率显著高于 conventional ET 组（10.29% vs. 1.68%，P=0.001）。
具有 WOI 结果的女性可能受益于新改良的 rsERT 预测的时机化 pET。这些发现为胚胎移植的精准医学研究提供了依据。
