Personalized Embryo Transfer Improves Live Birth Rates in Recurrent Implantation Failure: A Propensity Score-Matched...

Area of Science:

• Reproductive Medicine
• Embryology
• Infertility Research

Background:

• Recurrent implantation failure (RIF) poses a significant challenge in assisted reproductive technologies.
• Optimizing embryo transfer timing is crucial for successful pregnancy outcomes.
• The window of implantation (WOI) can vary between individuals and over time.

Purpose of the Study:

• To assess the clinical effectiveness of ERPeak-guided personalized embryo transfer (pET) for patients with and without RIF.
• To evaluate the stability of the window of implantation (WOI) over time.
• To compare pET with non-personalized embryo transfer (npET) in frozen embryo transfer (FET) cycles.

Main Methods:

• A prospective cohort study involving patients undergoing FET with good-quality embryos.
• Comparison of pET versus npET in hormone replacement therapy (HRT) cycles for RIF and non-RIF patients.
• Analysis of modified natural cycle (mNC) FET using inverse probability of treatment weighting (IPTW) and propensity score matching (PSM).

Main Results:

• In RIF patients, pET significantly increased live birth rates (LBR) (41.0% vs. 23.6%) and reduced miscarriage rates (17.4% vs. 36.2%) post-PSM.
• pET did not significantly improve LBR in non-RIF patients (35.8% vs. 25.4%).
• IPTW analysis showed higher LBR with pET in mNC-FET cycles (46.3% vs. 19.2%).
• WOI stability decreased significantly faster in patients aged 38 years and older.

Conclusions:

• ERPeak-guided pET enhances LBR in RIF patients undergoing HRT and mNC-FET.
• pET does not confer benefits for non-RIF patients.
• The WOI is dynamic, and its stability diminishes with age, necessitating reevaluation in older individuals.