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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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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Pvt Ltd
2015
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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 |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-4601169 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Pvt Ltd |
record_format | MEDLINE/PubMed |
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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