P-468 Personalized embryo transfer guided by transcriptomic endometrial receptivity analysis (ERA) in infertile patients: a systematic review and meta-analysis

Abstract Study question What is the effectiveness of a personalized embryo transfer (pET) guided by an endometrial receptivity test in assisted reproduction? Summary answer We have not found evidence supporting routine use any case yet. known already Currently, outcomes good quality transfers are far from ideal. Clinical focus shifting towards other actors that could play key role good-quality embryos implantation failure, such as preparation and achievement embryo-endometrium synchrony, so has better chance to implant during window (WOI). Today, there wide range different tests sets genes identify patients with displacements their WOI order adjust individual length progesterone exposure (pET). design, size, duration This systematic review meta-analysis were conducted following Cochrane methods GRADE approach rate certainty (CoE). The protocol been sent for registration PROSPERO (CRD42022299827). included studies compared women tested transcriptomic versus those tested. only comparative studies, including randomized controlled trials (RCTs), retrospective prospective cohorts. Participants/materials, setting, Participants undergoing infertility treatment (both own or donor gametes), without repeated failure (RIF), preimplantation genetic testing aneuploidies (PGT-A). Each above-mentioned populations was analyzed separately subgroups. Electronic searches CENTRAL via Register Studies Online (CRSO), PubMed, Embase performed inception October 2022. Screening, study inclusion data extraction pairs independent reviewers. Main results 35 studies. Two them RCTs 25 cohort pET sET non-tested endometrium. Besides, we 16 receptive endometrium non-receptive And three specific population (RIF adenomyosis) control population. two no history RIF. In non-RIF women, important differences (moderate-CoE) live birth (LBR) clinical pregnancy (CPR). population, cumulative CPR may be higher (RR 1.15, 95%CI 1.00-1.34; low-CoE) but LBR. Seven adjusted confounding meta-analyzed. RIF, improve (OR 2.50, 95% CI 1.42-4.40; but, agreement RCTs, benefits non-RIF. summary, supported current published women. However, low-CoE suggests it useful Limitations, reasons caution Most come non-RCTs which increases risk bias. large heterogeneity interventions comparisons led imprecision due few per strata. It avoid extrapolation setting. Wider implications findings Routine Better designed needed find out if these work Trial number applicable