Yu Shuang, Zhang Yongjie, Li Na, Su Zhuolun, Li Wenjing, Lou Hua, Guan Yichun
Reproductive Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Reproductive Center, The Second Hospital of Lanzhou University, Lanzhou, China.
Front Endocrinol (Lausanne). 2025 Jan 13;15:1402575. doi: 10.3389/fendo.2024.1402575. eCollection 2024.
One potential cause of implantation failure is abnormal endometrial receptivity, and how to objectively evaluate endometrial receptivity has been a matter of great concern. Endometrial receptivity analysis (ERA), a next-generation sequencing-based test that assesses endometrial gene expression, may be valuable in predicting endometrial receptivity, but whether ERA improves pregnancy outcomes in patients with recurrent implantation failure (RIF) is currently controversial. The purpose of this study was to investigate the effect of ERA on pregnancy outcomes in patients with RIF.
We performed a retrospective cohort study analysis for a population of patients with RIF undergoing frozen embryo transfer (FET) cycles in the reproductive center of the Third Affiliated Hospital of Zhengzhou University from January 2019 to December 2022(n=1598). FET cycles with personalized embryo transfer (PET) under ERA guidance were included in the ERA group (n=43); after using propensity score matching (PSM), a total of 120 FET cycles were included as a control group. Pregnancy outcomes were compared between the two groups. Further, the relationship between the number of previous implant failures and the rate of implant window displacement was discussed. The factors affecting the window of implantation (WOI) displacement were also assessed.
There was no statistically significant difference in embryo implantation rate, clinical pregnancy rate, spontaneous abortion rate, and live birth rate between the ERA group and the matched control patients ( > 0.05). There was no significant difference in the rate of WOI displacement between patients in the moderate or severe groups ( > 0.05) and no significant difference in pregnancy outcome ( >0.05). Finally, analysis of the clinical data of patients in the receptive and non-receptive groups did not uncover any factors influencing WOI displacement.
The results of the study showed no significant difference in pregnancy outcomes in patients who received ERA compared to those who did not.
着床失败的一个潜在原因是子宫内膜容受性异常，如何客观评估子宫内膜容受性一直是备受关注的问题。子宫内膜容受性分析（ERA）是一种基于下一代测序的评估子宫内膜基因表达的检测方法，可能在预测子宫内膜容受性方面具有价值，但ERA是否能改善反复着床失败（RIF）患者的妊娠结局目前存在争议。本研究的目的是探讨ERA对RIF患者妊娠结局的影响。
我们对2019年1月至2022年12月在郑州大学第三附属医院生殖中心接受冻融胚胎移植（FET）周期的RIF患者群体进行了回顾性队列研究分析（n = 1598）。ERA组纳入了在ERA指导下进行个性化胚胎移植（PET）的FET周期（n = 43）；使用倾向评分匹配（PSM）后，共纳入120个FET周期作为对照组。比较两组的妊娠结局。此外，还讨论了既往着床失败次数与着床窗移位率之间的关系。还评估了影响着床窗（WOI）移位的因素。
ERA组与匹配的对照组患者在胚胎着床率、临床妊娠率、自然流产率和活产率方面无统计学显著差异（> 0.05）。中度或重度组患者的WOI移位率无显著差异（> 0.05），妊娠结局也无显著差异（>0.05）。最后，对比接受ERA与未接受ERA患者的临床数据，未发现影响WOI移位的因素。
研究结果表明，接受ERA的患者与未接受ERA的患者在妊娠结局方面无显著差异。
