AUTHOR=Liu Zhenteng , Liu Xuemei , Wang Meimei , Zhao Huishan , He Shunzhi , Lai Shoucui , Qu Qinglan , Wang Xinrong , Zhao Dongmei , Bao Hongchu 

TITLE=The Clinical Efficacy of Personalized Embryo Transfer Guided by the Endometrial Receptivity Array/Analysis on IVF/ICSI Outcomes: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Physiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2022.841437

DOI=10.3389/fphys.2022.841437

ISSN=1664-042X

ABSTRACT=<p><bold>Objective:</bold> To assess the prevalence of displaced window of implantation (WOI) in infertile women, and the clinical utility of personalized embryo transfer (pET) guided by the endometrial receptivity array/analysis (ERA) on IVF/ICSI outcomes.</p><p><bold>Methods:</bold> The protocol was registered at Prospero: CRD42020204237. We systematically searched all published English literature related to the prevalence of WOI displacement and ongoing pregnancy rate/live birth rate in the overall good-prognosis infertile patients (GPP) and/or repeated implantation failure (RIF) patients undergoing IVF/ICSI-ET cycles after ERA test until August 2021.</p><p><bold>Result(s):</bold> 11 published studies were enrolled in the final analysis. The estimate of the incidence of WOI displacement based on ERA was 38% (95%CI 19–57%) in GPP and 34% (95%CI 24–43%) in RIF, respectively. There was no difference in OPR/LBR between patients undergoing routine ET without ERA test and those who following pET with ERA (39.5 vs. 53.7%, OR 1.28, <italic>p</italic> = 0.49, 95%CI 0.92–1.77, <italic>I</italic><sup><italic>2</italic></sup> = 0%) in relative GPP. Notably, the meta-analysis revealed that OPR/LBR of patients with RIF undergoing pET who had non-receptive ERA increased to the level of to those undergoing sET with receptive ERA (40.7 vs.49.6%, OR 0.94, <italic>p</italic> = 0.85, 95%CI 0.70–1.26, <italic>I</italic><sup><italic>2</italic></sup> = 0%).</p><p><bold>Conclusion:</bold> Considering the approximately one third of infertile women could suffered from displaced WOI, the ERA test emerged as a promising tool. Although the present meta-analysis demonstrates that patients with general good-prognosis may not benefit from ERA, pET guided by ERA significantly increases the chances of pregnancy for non-receptive patients with RIF of endometrial origin.</p>