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Endometrial receptivity array: Clinical application

Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium. Diagnosis of endometrial receptivity (ER) has posed a challenge and so far most available tests have been subjective and lack accuracy and a predictive value. M...

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Autor principal: Mahajan, Nalini
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4601169/
https://www.ncbi.nlm.nih.gov/pubmed/26538853
http://dx.doi.org/10.4103/0974-1208.165153
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author Mahajan, Nalini
author_facet Mahajan, Nalini
author_sort Mahajan, Nalini
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description Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium. Diagnosis of endometrial receptivity (ER) has posed a challenge and so far most available tests have been subjective and lack accuracy and a predictive value. Microarray technology has allowed identification of the transcriptomic signature of the window of receptivity window of implantation (WOI). This technology has led to the development of a molecular diagnostic tool, the ER array (ERA) for diagnosis of ER. Use of this test in patients with recurrent implantation failure (RIF) has shown that the WOI is displaced in a quarter of these patients and use of a personalized embryo transfer (pET) on the day designated by ERA improves reproductive performance. Our results in the Indian population revealed an endometrial factor in 27.5% RIF patients, which was significantly greater than the non-RIF group 15% (P = 0.04). After pET, the overall ongoing pregnancy rate was 42.4% and implantation rate was 33%, which was at par with our in-vitro fertilization results over 1-year. We also performed ERA in patients with persistently thin endometrium, and it was reassuring to find that the endometrium in 75% of these patients was receptive despite being 6 mm or less. A pregnancy rate of 66.7% was achieved in this group. Though larger studies are required to validate these results ERA has become a useful tool in our diagnostic armamentarium for ER.
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spelling pubmed-46011692015-11-04 Endometrial receptivity array: Clinical application Mahajan, Nalini J Hum Reprod Sci Review Article Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium. Diagnosis of endometrial receptivity (ER) has posed a challenge and so far most available tests have been subjective and lack accuracy and a predictive value. Microarray technology has allowed identification of the transcriptomic signature of the window of receptivity window of implantation (WOI). This technology has led to the development of a molecular diagnostic tool, the ER array (ERA) for diagnosis of ER. Use of this test in patients with recurrent implantation failure (RIF) has shown that the WOI is displaced in a quarter of these patients and use of a personalized embryo transfer (pET) on the day designated by ERA improves reproductive performance. Our results in the Indian population revealed an endometrial factor in 27.5% RIF patients, which was significantly greater than the non-RIF group 15% (P = 0.04). After pET, the overall ongoing pregnancy rate was 42.4% and implantation rate was 33%, which was at par with our in-vitro fertilization results over 1-year. We also performed ERA in patients with persistently thin endometrium, and it was reassuring to find that the endometrium in 75% of these patients was receptive despite being 6 mm or less. A pregnancy rate of 66.7% was achieved in this group. Though larger studies are required to validate these results ERA has become a useful tool in our diagnostic armamentarium for ER. Medknow Publications & Pvt Ltd 2015 /pmc/articles/PMC4601169/ /pubmed/26538853 http://dx.doi.org/10.4103/0974-1208.165153 Text en Copyright: © Journal of Human Reproductive Sciences http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms
spellingShingle Review Article
Mahajan, Nalini
Endometrial receptivity array: Clinical application
title Endometrial receptivity array: Clinical application
title_full Endometrial receptivity array: Clinical application
title_fullStr Endometrial receptivity array: Clinical application
title_full_unstemmed Endometrial receptivity array: Clinical application
title_short Endometrial receptivity array: Clinical application
title_sort endometrial receptivity array: clinical application
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4601169/
https://www.ncbi.nlm.nih.gov/pubmed/26538853
http://dx.doi.org/10.4103/0974-1208.165153
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