Clinical Evaluation of genetic screenings in overcoming Recurrent
Implantation Failure patients
Abstract
Objective: We evaluated the clinical usefulness of the endometrial
receptivity array (ERA) and the preimplantation genetic test for
aneuploidy (PGT-A) Genetic screenings in patients with severe or
moderate recurrent implantation failure. Design: Retrospective
multicenter cohort. Setting: University affiliate IVF centers.
Population: Patients who failed to achieve implantation following
transfer of ≥3 or ≥5 embryos at least in three single embryo transfers
were evaluated as moderate or severe recurrent implantation failure,
respectively. Methods: Patients with previous RIF were compared in
PGT-A, ERA and PGT-A+ERA and control group. Multiple logistic regression
analysis was performed and adjusted ORs were calculated with the aim to
control possible bias. Main Outcomes Measures: Mean implantation rate
and ongoing pregnancy rates per embryo transfer were considered as
primary outcomes. Results: Of the 2,110 patients belonging to the
moderate group, those who underwent transfer of euploid embryos after
the preimplantation genetic test for aneuploidy had a higher
implantation rate than those who did not. Additionally, the
preimplantation genetic test for aneuploidy group had a significantly
higher rate of ongoing pregnancy. The same outcomes measured for the 488
patients in the severe group did not reveal any statistically
significant improvements. The use of the endometrial receptivity array
did not significantly improve outcomes in either group. Conclusions: The
preimplantation genetic test for aneuploidy may be beneficial for
patients with moderate recurrent implantation failure. At its current
level of development, the endometrial receptivity analysis by ERA does
not appear to be clinically useful for patients with recurrent
implantation failure.