Purpose

To determine the utility of the endometrial receptivity analysis (ERA) in women with prior failed embryo transfers (ET).

Methods

This was a retrospective study of patients who underwent an ERA test with a subsequent frozen ET. Women were classified based on their indication for an ERA test: (1) ≥ 1 prior failed ET (cases), or (2) as a prophylactic measure (controls). A subset analysis of women with ≥ 3 prior failed transfers was performed. Pregnancy outcomes of the subsequent cycle were examined, including conception, clinical pregnancy, and ongoing pregnancy/live birth.

Results

A total of 222 women were included, 131 (59%) women with ≥ 1 prior failed ET and 91 (41%) controls. Among the 131 women with ≥ 1 prior failed ET, 20 women (9%) had ≥ 3 prior failed ETs. The proportion of non-receptive ERA tests in the three groups were the following: 45% (≥ 1 prior failed ET), 40% (≥ 3 prior failed ETs), and 52% (controls). The results did not differ between cases and controls. The pregnancy outcomes did not differ between women with ≥ 1 prior failed ET and controls. In women with ≥ 3 prior failed ETs, there was a lower ongoing pregnancy/live birth rate (28% vs 54%, P = 0.046).

Conclusion

Women with ≥ 1 prior failed ET and ≥ 3 prior failed ETs had a similar prevalence of non-receptive endometrium compared to controls. Women with ≥ 3 prior failed ETs had a lower ongoing pregnancy/live birth rate despite a personalized FET, suggesting that there are additional factors in implantation failure beyond an adjustment in progesterone exposure.

中文翻译：

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子宫内膜容受性分析在先前移植失败的女性中的临床应用

目的

确定子宫内膜容受性分析 (ERA) 在先前胚胎移植 (ET) 失败的女性中的效用。

方法

这是一项对接受 ERA 测试并随后进行冷冻 ET 的患者的回顾性研究。女性根据其进行 ERA 测试的指征进行分类：(1) ≥ 1 名先前失败的 ET（病例），或 (2) 作为预防措施（对照）。对先前有 ≥ 3 次转移失败的女性进行了子集分析。检查后续周期的妊娠结局，包括受孕、临床妊娠和持续妊娠/活产。

结果

共纳入 222 名女性，131 名 (59%) 女性有 ≥ 1 次先前失败的 ET 和 91 名 (41%) 对照。在 131 名有 ≥ 1 次 ET 失败的女性中，20 名女性（9%）有 ≥ 3 次 ET 失败。三组中不接受 ERA 测试的比例如下：45%（≥1 次之前失败的 ET）、40%（≥3 次之前失败的 ET）和 52%（对照组）。结果在病例和对照之间没有差异。先前有≥1次ET失败的女性和对照组的妊娠结局没有差异。在 ≥ 3 次 ET 失败的女性中，持续妊娠/活产率较低（28% 对 54%，P = 0.046）。

结论

与对照组相比，有 ≥ 1 次 ET 失败和 ≥ 3 次 ET 失败的女性具有相似的非接受性子宫内膜患病率。尽管有个性化的 FET，但之前有 ≥ 3 次 ET 失败的女性的持续妊娠/活产率较低，这表明除了调整黄体酮暴露外，还有其他因素导致植入失败。