The endometrial receptivity array for diagnosis and personalized embryo transfer as a treatment for patients with repeated implantation failure

Capsule:
The endometrial receptivity array identifies the personalized window of implantation in patients with repeated implantation failure of endometrial origin and guides personalized embryo transfer as a treatment.

Authors:
Maria Ruiz-Alonso, Ph.D. Student, David Blesa, Ph.D., Patricia Díaz-Gimeno, Ph.D., Eva Gómez, Ph.D. student, Manuel Fernández-Sánchez, M.D., Francisco Carranza, M.D., Joan Carrera, M.D., Felip Vilella, Ph.D., Antonio Pellicer, M.D., Carlos Simón, M.D.

Volume 100, Issue 3, Pages 818-824, September 2013

Abstract:

Objective:
To demonstrate the clinical value of the endometrial receptivity array (ERA) in patients with repeated implantation failure (RIF), for guiding their personalized embryo transfer (pET) as a novel therapeutic strategy.

Design:
Prospective interventional multicenter clinical trial.

Setting:
University-affiliated infertility and private clinics.

Patient(s):
Eighty-five RIF patients and 25 comparison patients.

Intervention(s):
Endometrial sampling and pET guided by ERA.

Main Outcome Measure(s):
A receptive (R) or nonreceptive (NR) endometrial status according to ERA. Pregnancy (PR) and implantation (IR) rates after pET.

Result(s):
The ERA test gave an R result of 74.1% in RIF patients versus 88% in control subjects. Clinical follow-up was possible in 29 RIF patients, in whom pET was performed, resulting in 51.7% PR and 33.9% IR. The IRs and PRs in the 6 months after the biopsy showed that pregnancy was not related to the local injury. Twenty-two RIF patients (25.9%) were NR, and in 15 of them a second ERA validated a displacement of the window of implantation (WOI). In eight of them, pET was performed on the day designated by the ERA, resulting in 50.0% PR and 38.5% IR. These results should be considered as preliminary.

Conclusion(s):
There is an increased percentage of WOI displacement in RIF patients compared with comparison group patients, leading to the concept of pET as a therapeutic strategy. Rescue of NR patients by pET in a displaced WOI results in similar PR and IR.

  • Tom Esparon

    Found out about this in the guardian post today, it may be worth making it easier to find the original research as I did spend a while searching for it. Very interesting stuff and hope the trial yields good results

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