Personalized embryo transfer in women with repeated implantation failures: A retrospective group study
DOI:
https://doi.org/10.37800/RM.3.2023.7-11Keywords:
Personalized embryo transfer, a window of implantation, leukemia inhibitory factor (LIF), repeated implantation failureAbstract
Relevance: Achieving a positive result in the programs of assisted reproductive technologies is possible when the endometrium and the embryo are synchronized at the time of embryo transfer, which will lead to implantation. One of the reasons for the desynchronization of the endometrium and the embryo is the shift of the window of implantation, which can be an individual feature of a woman and not just a result of chronic endometritis. Determination of the morphological “substrate” of the endometrium - pinopode - and the expression of the leukemia inhibitory factor (LIF) on the day of the intended embryo transfer with appropriate preparation of the endometrium, allows carrying out personalized embryo transfer (RET).
The study aimed to study the pregnancy rate in women with repeated implantation failures during the “implantation window” depending on the duration of progesterone intake and the level of implantation markers expression of LIF, pinopodium.
Materials and Methods: A retrospective cohort study was conducted from January 2021 to September 2022 at the private fertility unit PERSONA International Clinical Center for Reproductive Health in Almaty, Kazakhstan, performing in vitro fertilization. 51 patients with RIF underwent hysteroscopy with biopsy of the endometrium in the proliferative phase of the menstrual cycle on days 6 and 8 of taking progesterone. IGH study of LIF and pinopodes was also conducted.
Results: The frequency of clinical pregnancy after personalized transfer in group 1 was 60% (9 patients); in group 2 - 52.9% (27 patients), p=0.63. In group 2, patients who previously had a positive result received a positive result during personalized transfer, comparable to the general population.
Conclusion: A shift of the “implantation window” can lead to unsuccessful attempts to apply assisted reproductive technologies. A change in the time frames of the development of pinopode and abnormal expression of LIF in the endometrium leads to implantation failures since there is no synchronous readiness of the endometrium and embryo for implantation. Therefore, the standard transfer of embryos leads to failure. Personalized embryo transfer (RET) increases the chance of pregnancy in women with a sliding window implantation.
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