Clinical utility of the endometrial receptivity analysis in women with prior failed transfers

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:...

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Bibliographic Details
Published in:Journal of assisted reproduction and genetics 2021-03, Vol.38 (3), p.645-650
Main Authors: Eisman, Laura E., Pisarska, Margareta D., Wertheimer, Sahar, Chan, Jessica L., Akopians, Alin Lina, Surrey, Mark W., Danzer, Hal C., Ghadir, Shahin, Chang, Wendy Y., Alexander, Carolyn J., Wang, Erica T.
Format: Article
Language:English
Subjects:
Adult
Assisted Reproduction Technologies
Birth rate
Embryo Implantation
Embryo Transfer
Endometrium
Endometrium - physiopathology
Female
Fertilization in Vitro - methods
Gynecology
Human Genetics
Humans
Implantation
Infertility, Female - physiopathology
Infertility, Female - therapy
Live Birth - epidemiology
Medicine
Medicine & Public Health
Pregnancy
Pregnancy Outcome
Pregnancy Rate
Progesterone
Reproductive Medicine
Retrospective Studies
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Summary: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.
ISSN:1058-0468
1573-7330
DOI:10.1007/s10815-020-02041-9