Dahiphale Swati M, Dewani Deepika, Dahiphale Jayashree M, Agrawal Manjusha, Dave Apoorva, Pajai Sandhya, Jyotsna Garapati
Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Neurology, Fortis Hospital, Mumbai, IND.
Cureus. 2024 Aug 26;16(8):e67866. doi: 10.7759/cureus.67866. eCollection 2024 Aug.
Embryo transfer is a pivotal procedure in assisted reproductive technologies (ART). Yet, the success of this process hinges on multiple factors, with endometrial receptivity playing a critical role in determining the likelihood of successful implantation. The endometrial receptivity array (ERA) is an advanced diagnostic tool designed to personalize embryo transfer timing by assessing the endometrium's receptivity. This review comprehensively examines the ERA, exploring its biological foundation, technological development, and clinical applications. The ERA's ability to analyze the expression of genes associated with endometrial receptivity offers a tailored approach to identifying the optimal window of implantation (WOI), particularly benefiting patients with recurrent implantation failure (RIF) or repeated unsuccessful in vitro fertilization (IVF) cycles. Clinical outcomes from ERA-guided embryo transfers indicate improvements in implantation rates and overall pregnancy success, although challenges such as result variability and cost-effectiveness persist. This review also discusses the latest advancements in ERA technology, including integrating genomic and transcriptomic analyses, non-invasive techniques, and using artificial intelligence (AI). Controversies regarding the widespread application of ERA and its necessity in all IVF cases are critically examined. By summarizing the current state of ERA in embryo transfer, this review aims to inform clinicians, researchers, and patients about its potential to enhance ART outcomes and to highlight areas for future research and innovation.
胚胎移植是辅助生殖技术（ART）中的关键步骤。然而，这一过程的成功取决于多个因素，其中子宫内膜容受性在决定成功着床的可能性方面起着关键作用。子宫内膜容受性阵列（ERA）是一种先进的诊断工具，旨在通过评估子宫内膜的容受性来个性化胚胎移植时间。本综述全面审视了ERA，探讨了其生物学基础、技术发展和临床应用。ERA分析与子宫内膜容受性相关基因表达的能力提供了一种定制方法，以确定最佳着床窗（WOI），尤其使反复着床失败（RIF）或多次体外受精（IVF）周期不成功的患者受益。ERA引导的胚胎移植的临床结果表明着床率和总体妊娠成功率有所提高，尽管结果变异性和成本效益等挑战仍然存在。本综述还讨论了ERA技术的最新进展，包括整合基因组和转录组分析、非侵入性技术以及使用人工智能（AI）。对ERA在所有IVF病例中的广泛应用及其必要性的争议进行了批判性审视。通过总结ERA在胚胎移植中的现状，本综述旨在让临床医生、研究人员和患者了解其增强ART结果的潜力，并突出未来研究和创新的领域。
