O-116 New options for a personalised approach to improve implantation

Abstract

Abstract Embryo implantation is a highly coordinated complex process whereby a blastocyst-stage embryo attaches and invades the maternal endometrium before placentation and pregnancy. Implantation can only occur during a brief restricted period when the endometrium becomes receptive, described as the window of implantation. Embryo development and endometrium status must therefore be synchronized, and an important two-way fetal-maternal dialogue is required for successful implantation and the maternal recognition of the semi-allogenic conceptus. Despite significant progress in ART, implantation failure still affects numerous infertile couples worldwide and fewer that 10% of embryos successfully implant. Improved selection of both the viable embryos and the optimal endometrial phenotype for transfer remains crucial to enhancing implantation changes. Classical morphological embryo selection was the first strategy to improve successful implantation. Recently, new strategies were incorporated into clinical practice such as, embryonic genetic analysis, morphokinetics or ultrasound endometrial dating. However, these strategies remain insufficient to predict successful implantation. Recent years have seen a trend towards ‘omics’ methods, which enables the assessment of complete endometrial and embryonic molecular profiles during implantation. Omics approaches have advanced our knowledge of the implantation process, identifying potential biomarkers of successful and personalized implantation. Omics assays of the embryo and endometrium are being proposed or already being used as diagnostic tools for personalized embryo transfer in the most favorable endometrial environment. However, despite the large amount of biomarker information provided by omics, strong evidence to link data from all omics with a successful implantation outcome is still missing.