The role of transcriptomic biomarkers of endometrial receptivity in personalized embryo transfer for patients with repeated implantation failure

作者：Aihua He, Yangyun Zou, Cheng Wan, Jing Zhao, Qiong Zhang, Zhongyuan Yao, Fen Tian, Hong Wu, Xi Huang, Jing Fu, Chunxu Hu, Yue Sun, Lan Xiao, Tianli Yang, Zhaojuan Hou, Xin Dong, Sijia Lü, Yanping Li · 发表于：Journal of Translational Medicine · 年份：2021 · DOI：10.1186/s12967-021-02837-y · 被引用次数：80 · 研究领域：Reproductive System and Pregnancy、Reproductive Biology and Fertility、Ovarian function and disorders

BACKGROUND: Window of implantation (WOI) displacement is one of the endometrial origins of embryo implantation failure, especially repeated implantation failure (RIF). An accurate prediction tool for endometrial receptivity (ER) is extraordinarily needed to precisely guide successful embryo implantation. We aimed to establish an RNA-Seq-based endometrial receptivity test (rsERT) tool using transcriptomic biomarkers and to evaluate the benefit of personalized embryo transfer (pET) guided by this tool in patients with RIF. METHODS: This was a two-phase strategy comprising tool establishment with retrospective data and benefit evaluation with a prospective, nonrandomized controlled trial. In the first phase, rsERT was established by sequencing and analyzing the RNA of endometrial tissues from 50 IVF patients with normal WOI timing. In the second phase, 142 patients with RIF were recruited and grouped by patient self-selection (experimental group, n = 56; control group, n = 86). pET guided by rsERT was performed in the experimental group and conventional ET in the control group. RESULTS: The rsERT, comprising 175 biomarker genes, showed an average accuracy of 98.4% by using tenfold cross-validation. The intrauterine pregnancy rate (IPR) of the experimental group (50.0%) was significantly improved compared to that (23.7%) of the control group (RR, 2.107; 95% CI 1.159 to 3.830; P = 0.017) when transferring day-3 embryos. Although not significantly different, the IPR of the experime...