Effectiveness evaluation of endometrial receptivity analysis for recurrent implantation failure and analysis of clinical factors affecting implantation window.

BACKGROUND

Recurrent implantation failure (RIF) is a major challenge in in vitro fertilization (IVF). The window of implantation (WOI) is the endometrium’s receptive period for embryos, and endometrial receptivity analysis (ERA) is a potential intervention for transfer failure, requiring further validation. This study aimed to evaluate the efficacy of ERA in improving clinical outcomes for patients with RIF and to identify clinical factors that influence WOI displacement in this patient population.

METHODS

A total of 284 RIF patients undergoing assisted reproductive technology (ART) were divided into ERA (n = 131) and non-ERA (n = 153) groups; the ERA group was subclassified into WOI displacement (n = 87) and normal (n = 44) subgroups. Collected clinical data were compared across these groups to analyze differences in baseline characteristics and outcomes.

RESULTS

Results showed ERA-guided personalized transfer significantly improved clinical pregnancy rate (88.55% vs. 32.03%) and embryo implantation rate (63.72% vs. 27.42%) versus non-ERA. WOI displacement was identified in 66.41% of ERA patients, with induced abortion history emerging as a potential correlative factor.

CONCLUSIONS

ERA effectively assesses endometrial WOI in patients with RIF and contributes to improved success rates of embryo transfer, supporting its clinical value as a personalized intervention for this patient cohort.