The role of transcriptomic biomarkers of endometrial receptivity in personalized embryo transfer for patients with repeated implantation failure

Abstract Background Window of implantation (WOI) displacement is one the endometrial origins embryo failure, especially repeated failure (RIF). An accurate prediction tool for receptivity (ER) extraordinarily needed to precisely guide successful implantation. We aimed establish an RNA-Seq-based test (rsERT) using transcriptomic biomarkers and evaluate benefit personalized transfer (pET) guided by this in patients with RIF. Methods This was a two-phase strategy comprising establishment retrospective data evaluation prospective, nonrandomized controlled trial. In first phase, rsERT established sequencing analyzing RNA tissues from 50 IVF normal WOI timing. second 142 RIF were recruited grouped patient self-selection (experimental group, n = 56; control 86). pET performed experimental group conventional ET group. Results The rsERT, 175 biomarker genes, showed average accuracy 98.4% tenfold cross-validation. intrauterine pregnancy rate (IPR) (50.0%) significantly improved compared that (23.7%) (RR, 2.107; 95% CI 1.159 3.830; P 0.017) when transferring day-3 embryos. Although not different, IPR (63.6%) still 20 percentage points higher than (40.7%) 1.562; 0.898 2.718; 0.111) blastocysts. Conclusions developed accurately predict period improve outcomes RIF, indicating clinical potential rsERT-guided pET. Trial registration Chinese Clinical Registry: ChiCTR-DDD-17013375. Registered 14 November 2017, http://www.chictr.org.cn/index.aspx