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Journal of Assisted Reproduction and Genetics

, Volume 35, Issue 4, pp 683–692 | Cite as

The role of the endometrial receptivity array (ERA) in patients who have failed euploid embryo transfers

  • J Tan
  • A Kan
  • J Hitkari
  • B Taylor
  • N Tallon
  • G Warraich
  • A Yuzpe
  • G Nakhuda
Assisted Reproduction Technologies

Abstract

Purpose

Endometrial receptivity issues represent a potential source of implantation failure. The aim of this study was to document our experience with the endometrial receptivity array (ERA) among patients with a history of euploid blastocyst implantation failure. We investigated whether the contribution of the endometrial factor could be identified with the ERA test and if actionable results can lead to improved outcomes.

Methods

A retrospective review was performed for 88 patients who underwent ERA testing between 2014 and 2017. Reproductive outcomes were compared for patients undergoing frozen embryo transfer (FET) using a standard progesterone protocol versus those with non-receptive results by ERA and subsequent FET according to a personalized embryo transfer (pET) protocol.

Results

Of patients with at least one previously failed euploid FET, 22.5% had a displaced WOI diagnosed by ERA and qualified for pET. After pET, we found that implantation and ongoing pregnancy rates were higher (73.7 vs. 54.2% and 63.2 vs. 41.7%, respectively) compared to patients without pET, although differences were not statistically significant.

Conclusions

Our experience demonstrates that a significant proportion of patients with a history of implantation failure of a euploid embryo have a displaced WOI as detected by the ERA. For these patients, pET using a modified progesterone protocol may improve the outcomes of subsequent euploid FET. Larger randomized studies are required to validate these results.

Keywords

Endometrial receptivity ERA In vitro fertilization Recurrent implantation failure CCS 

Notes

Acknowledgements

We would like to thank colleagues at the University of British Columbia and Olive Fertility Centre.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Brosens JJ, Salker MS, Teklenburg G, Nautiyal J, Salter S, Lucas ES, et al. Uterine selection of human embryos at implantation. Sci Rep. 2014;4:3894.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Dahdouh EM, Balayla J, Garcia-Velasco JA. Impact of blastocyst biopsy and comprehensive chromosome screening technology on preimplantation genetic screening: a systematic review of randomized controlled trials. Reprod BioMed Online. 2015;30(3):281–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Yang Z, Liu J, Collins GS, Salem SA, Liu X, Lyle SS, et al. Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study. Mol Cytogenet. 2012;5(1):24.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Forman EJ, Hong KH, Ferry KM, Tao X, Taylor D, Levy B, et al. In vitro fertilization with single euploid blastocyst transfer: a randomized controlled trial. Fertil Steril. 2013;100(1):100–7. e1CrossRefPubMedGoogle Scholar
  5. 5.
    Cha J, Sun X, Dey SK. Mechanisms of implantation: strategies for successful pregnancy. Nat Med. 2012;18(12):1754–67.CrossRefPubMedGoogle Scholar
  6. 6.
    Remohi J, Ardiles G, Garcia-Velasco JA, Gaitan P, Simon C, Pellicer A. Endometrial thickness and serum oestradiol concentrations as predictors of outcome in oocyte donation. Hum Reprod. 1997;12(10):2271–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Koot YE, van Hooff SR, Boomsma CM, van Leenen D, Groot Koerkamp MJ, Goddijn M, et al. An endometrial gene expression signature accurately predicts recurrent implantation failure after IVF. Sci Rep. 2016;6:19411.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Altmae S, Esteban FJ, Stavreus-Evers A, Simon C, Giudice L, Lessey BA, et al. Guidelines for the design, analysis and interpretation of 'omics' data: focus on human endometrium. Hum Reprod Update. 2014;20(1):12–28.CrossRefPubMedGoogle Scholar
  9. 9.
    Ruiz-Alonso M, Blesa D, Diaz-Gimeno P, Gomez E, Fernandez-Sanchez M, Carranza F, et al. The endometrial receptivity array for diagnosis and personalized embryo transfer as a treatment for patients with repeated implantation failure. Fertil Steril. 2013;100(3):818–24.CrossRefPubMedGoogle Scholar
  10. 10.
    Dominguez F, Garrido-Gomez T, Lopez JA, Camafeita E, Quinonero A, Pellicer A, et al. Proteomic analysis of the human receptive versus non-receptive endometrium using differential in-gel electrophoresis and MALDI-MS unveils stathmin 1 and annexin A2 as differentially regulated. Hum Reprod. 2009;24(10):2607–17.CrossRefPubMedGoogle Scholar
  11. 11.
    Ruiz-Alonso M, Galindo N, Pellicer A, Simon C. What a difference two days make: “personalized” embryo transfer (pET) paradigm: a case report and pilot study. Hum Reprod. 2014;29(6):1244–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Diaz-Gimeno P, Ruiz-Alonso M, Blesa D, Bosch N, Martinez-Conejero JA, Alama P, et al. The accuracy and reproducibility of the endometrial receptivity array is superior to histology as a diagnostic method for endometrial receptivity. Fertil Steril. 2013;99(2):508–17.CrossRefPubMedGoogle Scholar
  13. 13.
    Website E. Endometrial receptivity test for implantation failure: Igenomix; 2017 [Available from: https://www.igenomix.com/tests/endometrial-receptivity-test-era/.
  14. 14.
    Fox C, Morin S, Jeong JW, Scott RT Jr, Lessey BA. Local and systemic factors and implantation: what is the evidence? Fertil Steril. 2016;105(4):873–84.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Hashimoto T, Koizumi M, Doshida M, Toya M, Sagara E, Oka N, et al. Efficacy of the endometrial receptivity array for repeated implantation failure in Japan: a retrospective, two-centers study. Reprod Med Biol. 2017;16(3):290–6.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Mahajan N. Endometrial receptivity array: clinical application. J Hum Reprod Sci. 2015;8(3):121–9.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Jones EE, Prapas Y, Olive DL, Prapas N, Vlassis G, Duleba AJ, et al. The window for embryo transfer in oocyte donation cycles depends on the duration of progesterone therapy. Hum Reprod. 1998;13(3):720–3.CrossRefPubMedGoogle Scholar
  18. 18.
    Schreiner-Engel P, Garrlsi GJ, Fox J, Williams M, Hofmann GE, Navot D, et al. An insight into early reproductive processes through the in VivoModel of ovum donation. J Clin Endocrinol Metab. 1991;72(2):408–14.CrossRefPubMedGoogle Scholar
  19. 19.
    Sharma S, Majumdar A. Determining the optimal duration of progesterone supplementation prior to transfer of cryopreserved embryos and its impact on implantation and pregnancy rates: a pilot study. Int J Reprod Med. 2016;2016(6):1–7.CrossRefGoogle Scholar
  20. 20.
    Mitri F, Casper RF, Bentov Y, Nayot D. Current tools for the optimization of embryo transfer technique for recurrent implantation failure. Minerva Ginecol. 2016;68(4):431–49.PubMedGoogle Scholar
  21. 21.
    Das M, Holzer HEG. Recurrent implantation failure: gamete and embryo factors. Fertil Steril. 2012;97(5):1021–7.CrossRefPubMedGoogle Scholar
  22. 22.
    El-Toukhy T, Sunkara S, Khalaf Y. Local endometrial injury and IVF outcome: a systematic review and meta-analysis. Reprod BioMed Online. 2012;25(4):345–54.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUniversity of British Columbia and the Children’s and Women’s Hospital and Health Centre of British ColumbiaVancouverCanada
  2. 2.Olive Fertility CentreVancouverCanada

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