Publication:

Personalized embryo transfer after endometrial receptivity array test in patients with recurrent unexplained implantation failure

Background Unexplained recurrent implantation failure is a devastating situation for both patients and the doctor treating them, with transfer of high grade euploid embryos this situation became more related to the endometrial receptivity and the interaction between the embryo and the endometrium. Till now the best way of detecting endometrial receptivity was through endometrial receptivity array of gene in endometrial tissue.

Methods A retrospective study was carried out in large IVF center in Abu Dhabi in period from 2017-2021. Patients included in the study were infertile patients with age limit of 43 years old with history of repeated IVF failure after multiple transfer trials of high grade embryos. All patients had ERA test then frozen embryo transfer of Euploid high grade embryos obtained through stimulated cycle of each patient according to Era test results.

Results 45 patients included in our study. Patients divided into 2 major groups according to Era test result. First group included patients with receptive endometrium. The second group was the patients with displaced window of implantation. Patients with receptive endometrium were 12 (26.7%) and the displaced window of implantation was found in 33 patients (73.3%). Higher pregnancy and cumulative pregnancy rate in the patients with displaced window of implantation more than the receptive group 19 (57.7%) versus 5 (41.6%) and 27 (81,8%) versus 6 (50%), but lower implantation rate in the displaced window of implantation group 6/12 (50%) versus 25/53 (47.2%) with higher miscarriage rate in the receptive group 2/6 (33.3%) versus 4/26 (14.8%), live birth and take home baby rate in the patients with displaced window of implantation 3 babies delivered to the receptive group 3/12 (25%), 24 babies to the group of displaced window of implantation 24/53 (45.3%).

Conclusions Patients with recurrent unexplained implantation failure may benefit from personalized embryo transfer after determining their window of implantations with endometrial receptivity array testing.