Pinopode versus endometrial receptivity analysis for personalized embryo transfer in recurrent implantation failure

Does pinopode detection or endometrial receptivity analysis (ERA) improve personalized embryo transfer (PET) outcomes in patients with recurrent implantation failure (RIF) more effectively?

This retrospective study analysed 488 patients with RIF: 222 underwent pinopode detection, 81 underwent ERA and 185 served as controls without any testing. Propensity score matching was used to mitigate confounding factors, resulting in matched pairs: 108 pinopode controls, 66 ERA controls and 66 pinopode ERA.

In matched pairs, the pinopode group showed significantly higher rates of embryo implantation (41.55% versus 27.01%, P = 0.002), biochemical pregnancy (69.44% versus 53.70%, P = 0.017), clinical pregnancy (60.19% versus 43.52%, P = 0.014) and live birth (53.70% versus 33.33%, P = 0.003) compared with controls. The ERA showed marginal non-significant improvements. In comparison, the pinopode group had a higher clinical pregnancy rate than the ERA group (63.64% versus 45.45%, P = 0.036). Among patients with the window of implantation (WOI) displacement, the pinopode group had a significantly higher clinical pregnancy rate (66.67% versus 43.59%, P = 0.045).

Pinopode detection significantly improves clinical pregnancy outcomes in patients who have had RIF compared with controls and ERA, particularly in cases of window of implantation displacement. Prospective studies with larger cohorts are needed to validate these findings and to assess the potential for standardizing pinopode detection in clinical practice.