Routine endometrial receptivity array in first embryo transfer cycles does not improve live birth rate

Area of Science:

• Reproductive endocrinology and infertility research.
• Genomic and molecular diagnostics in assisted reproductive technology.

Background:

• Personalized embryo transfer (pET) using the Endometrial Receptivity Array (ERA) aims to optimize implantation timing.
• Standard frozen embryo transfer (FET) relies on timed protocols, with potential for window of implantation (WOI) displacement.

Purpose of the Study:

• To compare live birth rates between ERA-guided personalized embryo transfer (pET) and standard-timed frozen embryo transfer (FET) in first single euploid FET cycles.
• To determine the incidence of window of implantation (WOI) displacement in infertile patients without prior implantation failure.

Main Methods:

• A prospective cohort study included 228 patients undergoing their first single euploid programmed FET.
• Interventions included ERA testing followed by pET or standard-timed FET.
• Live birth rate and ERA receptivity status were the primary outcome measures.

Main Results:

• No significant difference in live birth rates was observed between the ERA/pET group (56.5%) and the standard FET group (56.6%).
• The Endometrial Receptivity Array identified receptive endometria in 40.8% of patients, with 59.2% showing non-receptivity, primarily prereceptive.
• The study included 147 ERA/pET cycles and 81 standard FET cycles.

Conclusions:

• Current data do not support the routine utilization of ERA in unselected patients undergoing their first autologous single euploid programmed embryo transfer.
• The study suggests that standard-timed FET is as effective as ERA-guided pET for this patient population.
• Further research may explore ERA's utility in specific subgroups with a history of implantation failure.