Objective Pilot study to identify relationships between body temperature and levels of peripheral P4 blood progesterone, and examine if these differ according to body temperature cycle pattern. Design Prospective, observational study. Setting IVIRMA IVF clinics in Madrid, Mallorca and Malaga, Spain. Population 62 data points from 18 patients undergoing hormone assisted embryo-implantation cycles that volunteered to use OvuSense, an intra-vaginal body temperature monitor. Main Outcome Measures OvuSense Raw and Smooth Temperature (°C), P4 (ng/ml). Results A graphical analysis showed an apparent relationship between P4 levels and Temperature taken on P4 blood draw day. A multilevel regression analysis using MLwiN 3.10 1 software investigated this relationship, allowing between-patient variation to be accounted for and estimated. This established a strong linear relationship between LnP4 and ST, and cross correlation was carried out which identified the optimum predictor of levels of LnP4 was ST measured on the day prior to blood sampling. Further graphical analyses showed an apparent lower luteal level of P4 for cycles flagged as atypical by OvuSense, and for negative outcomes, except on embryo transfer day. Conclusions The results provide extremely strong evidence (Z = 15.6, p < 0.0001, 2 sided) of a linear relationship between LnP4 and Smooth Temperature (ST) measured the day before blood sampling. This suggests that ST could provide a less invasive, continuous, and more practical method of assessing P4 response. Further investigation is required to establish the value for improving outcomes.

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.