#238 : rsERT Guided Personalized Embryo Transfer Improves Clinical Outcomes in RIF Patients

Abstract

Background and Aims: Narrowed or shifted window of implantation (WOI) is acknowledged to be one of the endometrial origins of embryo implantation failure, especially in patients with repeated implantation failure (RIF). RNA-Seq-based endometrial receptivity test (rsERT) was developed to assess the endometrial receptivity (ER) and guide the personalized embryo transfer (pET). Clinical studies were conducted to evaluate the clinical utility of rsERT in RIF patients. Method: 566 RIF patients with rsERT and pET in multi-centers from 2019-2022 were included in this retrospective study, which was defined as rsERT-pET group. RIF patients without rsERT and pET in the same period was used as control for comparison. rsERT-pET group was further divided into normal WOI (nWOI) and shifted WOI (sWOI) groups. Clinical pregnancy rate and ongoing pregnancy rate were therefore compared among these groups by nonparametric statistical approaches. Results: The intrauterine pregnancy and ongoing pregnancy rates of rsERT-pET group were receptively 55.0% and 46.2%, which were significantly higher than those of the control group (55.0% vs 35.1%, OR = 2.26, p-value = 2.33×10[Formula: see text]; 46.2% vs 19.8%, OR = 3.45, p-value = 4.08×10[Formula: see text] ). We further evaluated the intrauterine pregnancy rates of sWOI and nWOI and found remarkably better pregnancy outcomes in patients from nWOI group compared to those in sWOI group patients (62.4% vs 50.4%, OR = 1.64, p-value = 0.005). Conclusion: The pET guided by the result of rsERT significantly improved the clinical outcomes in patients with RIF based on the intrauterine pregnancy rate and the ongoing pregnancy rate, indicating the clinical potential of rsERT method.