JBRA Assist. Reprod. 2025;29(Suppl 1):33-33
POSTER PRESENTATION
doi: 10.5935/1518-0557.20250087
1Yikon Genomics, S.L. Unipersonal., Barcelona, Spain
2Yikon Genomics Company, Ltd., Suzhou, China
Objective: To investigate whether RNA-Seq-based endometrial receptivity test (rsERT) can improve clinical outcomes in patients with recurrent implantation failure (RIF) and the impact of endometrial cell composition on clinical outcomes.
Methods: A retrospective cohort of 464 RIF patients underwent rsERT and receptivity-timed personalized embryo transfer (Group rt-pET) or receptivity-status pET (Group pET) and 288 RIF patients without rsERT received conventional embryo transfer (Group ET) were recruited. The implantation rate (IR), intrauterine pregnancy rate (IPR), ongoing pregnancy rate (OPR), and miscarriage rate (MR) were compared between groups using non-parametric statistical methods. Leveraging RNA sequencing data, the proportions of immune and tissue cells were analyzed utilizing deconvolution algorithms to excavate their correlations with clinical outcomes.
Results: The IR of Group pET was significantly higher than that of Group ET (43.2% vs. 30.9%, p=0.032). Whereas, Group rtpET achieved a significantly higher IR (48.4% vs. 30.9%, p<0.001), IPR (52.5% vs. 36.3%, p<0.001), OPR (48.0% vs. 29.1%, p<0.001) and a significantly lower MR (8.6% vs. 20.0%, p=0.024) compared to Group ET. The proportions of unciliated epithelial cells from all RIF patients were stratified as different groups, and IPR of each group was 27.3%, 30.0%, 37.5%, 35.3%, 44.7%, 56.1%, 58.8%, and displayed a tendency that higher IPR connected with higher proportion of unciliated epithelial cells (p=0.039). The proportions of uterine natural killer (uNK) cells were categorized as low, medium, and high-level, and patients with the medium-level uNK cells showed higher IPR (57.1% vs. 44% or 47%). Besides, patients with high-level proportions of plasma cells exhibited lower IPR than that of patients with low-level proportions of plasma cells (56.4% vs. 35.0%, p>0.05).
Conclusion: The receptivity-timed pET predicted by rsERT could be advantageous for RIF patients. Abnormal immune and tissue cell compositions in the endometrium were found to impact clinical outcomes, potentially providing future personalized guidance.