open access
Personalized embryo transfer (pET) guided by endometrial receptivity (ER) assessment — a possibility to increase effectiveness of IVF procedures. Review of available methods
- III Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
- OVIklinika Infertility Center, Warsaw, Poland
- Poludniowy Hospital, Warsaw, Poland, Poland
- Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Poland
- Women's Health Research Institute, Calisia University, Kalisz, Poland
- Faculty of Medicine, Lazarski Uniwersity, Warsaw, Poland, Poland
open access
Abstract
The continuous development of assisted reproductive techniques (ART) implies the search for solutions that could increase the effectiveness of available methods. In the context of in vitro fertilization (IVF), a significant proportion of failures are due to unsuccessful embryo transfers. At this stage the most important issue is proper dialogue between implanting embryo and the maternal endometrium. Therefore, it seems justified to assess endometrial receptivity (ER), defined as the tissue's ability to accept an embryo to attach and invade into the mucosa. Window of implantation (WOI), is a certain period in which implantation of the properly developed embryo is possible. The cause of endometrial receptivity disorders is believed to be the disturbed expression of cytokines and endometrial surface proteins, the presence of which has been proven in commonly diagnosed diseases such as endometriosis or chronic endometritis. Despite many years of research on endometrial receptivity, the area of diagnostic methods enabling clinical monitoring of ER still remains undeveloped. The aim of this study is to review the utility of selected markers and the available methods of ER assessment, ranging from noninvasive ultrasound, through endometrial fluid analysis, to genomic studies based on endometrial biopsy, in order to increase the effectiveness of IVF. Such an approach could potentially be a significant step towards personalizing medical procedures especially in patients diagnosed with repeated implantation failure (RIF).
Abstract
The continuous development of assisted reproductive techniques (ART) implies the search for solutions that could increase the effectiveness of available methods. In the context of in vitro fertilization (IVF), a significant proportion of failures are due to unsuccessful embryo transfers. At this stage the most important issue is proper dialogue between implanting embryo and the maternal endometrium. Therefore, it seems justified to assess endometrial receptivity (ER), defined as the tissue's ability to accept an embryo to attach and invade into the mucosa. Window of implantation (WOI), is a certain period in which implantation of the properly developed embryo is possible. The cause of endometrial receptivity disorders is believed to be the disturbed expression of cytokines and endometrial surface proteins, the presence of which has been proven in commonly diagnosed diseases such as endometriosis or chronic endometritis. Despite many years of research on endometrial receptivity, the area of diagnostic methods enabling clinical monitoring of ER still remains undeveloped. The aim of this study is to review the utility of selected markers and the available methods of ER assessment, ranging from noninvasive ultrasound, through endometrial fluid analysis, to genomic studies based on endometrial biopsy, in order to increase the effectiveness of IVF. Such an approach could potentially be a significant step towards personalizing medical procedures especially in patients diagnosed with repeated implantation failure (RIF).
Keywords
in vitro fertilization; embryo transfer; personalized medicine; endometrium; endometrial receptivity
Title
Personalized embryo transfer (pET) guided by endometrial receptivity (ER) assessment — a possibility to increase effectiveness of IVF procedures. Review of available methods
Journal
Issue
Article type
Review paper
Pages
1004-1010
Published online
2023-05-04
Page views
766
Article views/downloads
553
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(12):1004-1010.
Keywords
in vitro fertilization
embryo transfer
personalized medicine
endometrium
endometrial receptivity
Authors
Aleksandra Urban
Damian Warzecha
Piotr Laudanski
Bronislawa Pietrzak
Miroslaw Wielgos
- Kiani Z, Simbar M, Hajian S, et al. The prevalence of depression symptoms among infertile women: a systematic review and meta-analysis. Fertil Res Pract. 2021; 7(1): 6.
- Diedrich K, Fauser BC, Devroey P, et al. Evian Annual Reproduction (EVAR) Workshop Group. The role of the endometrium and embryo in human implantation. Hum Reprod Update. 2007; 13(4): 365–377.
- Lessey BA, Young SL. What exactly is endometrial receptivity? Fertil Steril. 2019; 111(4): 611–617.
- Sharma A, Kumar P. Understanding implantation window, a crucial phenomenon. J Hum Reprod Sci. 2012; 5(1): 2–6.
- Makker A, Singh MM. Endometrial receptivity: clinical assessment in relation to fertility, infertility, and antifertility. Med Res Rev. 2006; 26(6): 699–746.
- Wilcox AJ, Baird DD, Weinberg CR. Time of implantation of the conceptus and loss of pregnancy. N Engl J Med. 1999; 340(23): 1796–1799.
- Garrido-Gómez T, Castillo-Marco N, Cordero T, et al. Decidualization resistance in the origin of preeclampsia. Am J Obstet Gynecol. 2022; 226(2S): S886–S894.
- Beier HM, Beier-Hellwig K. Molecular and cellular aspects of endometrial receptivity. Hum Reprod Update. 1998; 4(5): 448–458.
- ROCK J. BIOPSY STUDIES OF HUMAN ENDOMETRIUM. Journal of the American Medical Association. 1937; 108(24): 2022.
- Noyes RW, Hertig AT, Rock J. Dating the endometrial biopsy. Am J Obstet Gynecol. 1975; 122(2): 262–263.
- Murray MJ, Meyer WR, Zaino RJ, et al. A critical analysis of the accuracy, reproducibility, and clinical utility of histologic endometrial dating in fertile women. Fertil Steril. 2004; 81(5): 1333–1343.
- Zhao D, Qu Q, Dai H, et al. Effects of hypoxia‑inducible factor‑1α on endometrial receptivity of women with polycystic ovary syndrome. Mol Med Rep. 2018; 17(1): 414–421.
- Evans-Hoeker E, Lessey BA, Jeong JW, et al. Endometrial BCL6 Overexpression in Eutopic Endometrium of Women With Endometriosis. Reprod Sci. 2016; 23(9): 1234–1241.
- Yoo JY, Kim TH, Fazleabas AT, et al. KRAS Activation and over-expression of SIRT1/BCL6 Contributes to the Pathogenesis of Endometriosis and Progesterone Resistance. Sci Rep. 2017; 7(1): 6765.
- Almquist LD, Likes CE, Stone B, et al. Endometrial BCL6 testing for the prediction of in vitro fertilization outcomes: a cohort study. Fertil Steril. 2017; 108(6): 1063–1069.
- Kim TH, Yoo JY, Choi KC, et al. Loss of HDAC3 results in nonreceptive endometrium and female infertility. Sci Transl Med. 2019; 11(474).
- Guo SW. Genesis, genes and epigenetics of endometriosis-associated infertility. Nat Rev Endocrinol. 2019; 15(5): 259–260.
- Osiński M, Wirstlein P, Wender-Ożegowska E, et al. HSD3B2, HSD17B1, HSD17B2, ESR1, ESR2 and AR expression in infertile women with endometriosis. Ginekol Pol. 2018; 89(3): 125–134.
- Liu Y, Chen X, Huang J, et al. Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure. Fertil Steril. 2018; 109(5): 832–839.
- Wang WJ, Zhang H, Chen ZQ, et al. Endometrial TGF-β, IL-10, IL-17 and autophagy are dysregulated in women with recurrent implantation failure with chronic endometritis. Reprod Biol Endocrinol. 2019; 17(1): 2.
- Mercé LT, Barco MJ, Bau S, et al. Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome? Fertil Steril. 2008; 89(1): 111–117.
- Rashidi BH, Sadeghi M, Jafarabadi M, et al. Relationships between pregnancy rates following in vitro fertilization or intracytoplasmic sperm injection and endometrial thickness and pattern. Eur J Obstet Gynecol Reprod Biol. 2005; 120(2): 179–184.
- van der Gaast MH, Beier-Hellwig K, Fauser BC, et al. Endometrial secretion aspiration prior to embryo transfer does not reduce implantation rates. Reprod Biomed Online. 2003; 7(1): 105–109.
- Casado-Vela J, Rodriguez-Suarez E, Iloro I, et al. Comprehensive proteomic analysis of human endometrial fluid aspirate. J Proteome Res. 2009; 8(10): 4622–4632.
- Rahiminejad ME, Moaddab A, Ebrahimi M, et al. The relationship between some endometrial secretion cytokines and in vitro fertilization. Iran J Reprod Med. 2015; 13(9): 557–562.
- Wang Li, Lv S, Mao W, et al. Assessment of endometrial receptivity during implantation window in women with unexplained infertility. Gynecol Endocrinol. 2020; 36(10): 917–921.
- Franasiak JM, Holoch KJ, Yuan L, et al. Prospective assessment of midsecretory endometrial leukemia inhibitor factor expression versus ανβ3 testing in women with unexplained infertility. Fertil Steril. 2014; 101(6): 1724–1731.
- Díaz-Gimeno P, Horcajadas JA, Martínez-Conejero JA, et al. A genomic diagnostic tool for human endometrial receptivity based on the transcriptomic signature. Fertil Steril. 2011; 95(1): 50–60, 60.e1.
- Garrido-Gómez T, Ruiz-Alonso M, Blesa D, et al. Profiling the gene signature of endometrial receptivity: clinical results. Fertil Steril. 2013; 99(4): 1078–1085.
- Simón C, Gómez C, Cabanillas S, et al. ERA-RCT Study Consortium Group. A 5-year multicentre randomized controlled trial comparing personalized, frozen and fresh blastocyst transfer in IVF. Reprod Biomed Online. 2020; 41(3): 402–415.
- Teder H, Koel M, Paluoja P, et al. TAC-seq: targeted DNA and RNA sequencing for precise biomarker molecule counting. NPJ Genom Med. 2018; 3: 34.
- Altmäe S, Koel M, Võsa U, et al. Meta-signature of human endometrial receptivity: a meta-analysis and validation study of transcriptomic biomarkers. Sci Rep. 2017; 7(1): 10077.
- Saare M, Laisk T, Teder H, et al. A molecular tool for menstrual cycle phase dating of endometrial samples in endometriosis transcriptome studies†. Biol Reprod. 2019; 101(1): 1–3.
- Nezhat C, Rambhatla A, Miranda-Silva C, et al. BCL-6 Overexpression as a Predictor for Endometriosis in Patients Undergoing In Vitro Fertilization. JSLS. 2020; 24(4).
- Likes CE, Cooper LJ, Efird J, et al. Medical or surgical treatment before embryo transfer improves outcomes in women with abnormal endometrial BCL6 expression. J Assist Reprod Genet. 2019; 36(3): 483–490.