Displacement of Window of Implantation in Cases of Unexplained Recurrent Implantation Failure as Detected by Endometrial Receptivity Array Testing

Abstract

Patients with recurrent implantation failure had to be extensively studied to find way to achieve clinical pregnancy, it is well known that defects in the embryo or the endometrium or the alteration between both could be the reason. Exclusion of the possibilities of embryo abnormalities could help us to concentrate on the endometrial factors of failure. In this study we concentrated on endometrial receptivity displacement as a factor of implantation failure in patients with recurrent unexplained IVF failure. This is done through studying gene expression of endometrium in those cases to determine the receptivity timing and the window of implantation. Through retrospective study of 93 patients with recurrent implantation failure who underwent endometrial receptivity array testing, we found that the incidence of non-receptive endometrium in such cases was 45% 38 patients of 83 which is higher than other studies in the same field. Prevalence of pre receptive endometrium in those cases more than post receptive, Indicates the need to more exposure to Progesterone to achieve receptivity. Polycystic ovarian syndrome patients included in this study showed also high incidence of non-receptive endometrium10 out of 11patients (90.9%). In conclusion personalized embryo transfer according to ERA test could be useful to this category of patients. However larger studies are needed in the same group of patient