子宮內膜接受性分析endometrial receptivity analysis (ERA)於 (1) ≥ 1 prior failed ET (cases), or (2) as a prophylactic measure (controls). 3組並無明顯差異

ERA於提高胚胎植入ET之成功懷孕率仍具局限性

著床失敗主體原因只要仍是胚胎染色體基因異常

. 2021 Mar;38(3):645-650.

 doi: 10.1007/s10815-020-02041-9. Epub 2021 Jan 17.

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: (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.