The endometrial receptivity array for diagnosis and personalized embryo transfer as a treatment for patients with repeated implantation failure
Por:
M. RUIZ-ALONSO, D. BLESA, P. DIAZ-GIMENO, E. GOMEZ, M. FERNANDEZ-SANCHEZ, F. CARRANZA, J. CARRERA, F. VILELLA, A. PELLICER and C. SIMON
Publicada:
1 sep 2013
Resumen:
Objective: To demonstrate the clinical value of the endometrial receptivity array (ERA) in patients with repeated implantation failure (RIF), for guiding their personalized embryo transfer (pET) as a novel therapeutic strategy.
Design: Prospective interventional multicenter clinical trial.
Setting: University-affiliated infertility and private clinics.
Patient(s): Eighty-five RIF patients and 25 comparison patients.
Intervention(s): Endometrial sampling and pET guided by ERA.
Main Outcome Measure(s): A receptive (R) or nonreceptive (NR) endometrial status according to ERA. Pregnancy (PR) and implantation (IR) rates after pET.
Result(s): The ERA test gave an R result of 74.1% in RIF patients versus 88% in control subjects. Clinical follow-up was possible in 29 RIF patients, in whom pET was performed, resulting in 51.7% PR and 33.9% IR. The IRs and PRs in the 6 months after the biopsy showed that pregnancy was not related to the local injury. Twenty-two RIF patients (25.9%) were NR, and in 15 of them a second ERA validated a displacement of the window of implantation (WOI). In eight of them, pET was performed on the day designated by the ERA, resulting in 50.0% PR and 38.5% IR. These results should be considered as preliminary.
Conclusion(s): There is an increased percentage of WOI displacement in RIF patients compared with comparison group patients, leading to the concept of pET as a therapeutic strategy. Rescue of NR patients by pET in a displaced WOI results in similar PR and IR. ((C) 2013 by American Society for Reproductive Medicine.)
Filiaciones:
M. RUIZ-ALONSO:
Iviomics, Paterna, Spain
D. BLESA:
Univ Valencia, Fdn Inst Valenciano Infertilidad, Valencia, Spain
Univ Valencia, Inst Univ IVI Incliva, Valencia, Spain
Iviomics, Paterna, Spain
P. DIAZ-GIMENO:
Univ Valencia, Fdn Inst Valenciano Infertilidad, Valencia, Spain
Univ Valencia, Inst Univ IVI Incliva, Valencia, Spain
Ctr Invest Principe Felipe, Computat Med Inst, Valencia, Spain
E. GOMEZ:
Univ Valencia, Fdn Inst Valenciano Infertilidad, Valencia, Spain
Univ Valencia, Inst Univ IVI Incliva, Valencia, Spain
M. FERNANDEZ-SANCHEZ:
Inst Valenciano Infertilidad Sevilla, Seville, Spain
F. CARRANZA:
Inst Valenciano Infertilidad Sevilla, Seville, Spain
J. CARRERA:
Clin Girona Unidad Reprod Humana, Girona, Spain
:
Univ Valencia, Fdn Inst Valenciano Infertilidad, Valencia, Spain
Univ Valencia, Inst Univ IVI Incliva, Valencia, Spain
A. PELLICER:
Univ Valencia, Fdn Inst Valenciano Infertilidad, Valencia, Spain
Univ Valencia, Inst Univ IVI Incliva, Valencia, Spain
Iviomics, Paterna, Spain
:
Univ Valencia, Fdn Inst Valenciano Infertilidad, Valencia, Spain
Univ Valencia, Inst Univ IVI Incliva, Valencia, Spain
Iviomics, Paterna, Spain
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