Impact of Endometrial Receptivity Analysis on Pregnancy Outcomes In Patients Undergoing Embryo Transfer: A Systematic Review and Meta-Analysis

J Assist Reprod Genet. 2023 May;40(5):985-994. doi: 10.1007/s10815-023-02791-2. Epub 2023 Apr 12.

Abstract

To analyze the influence of endometrial receptivity analysis (ERA) on embryo transfer (ET) results in patients undergoing in vitro fertilization (IVF) treatment. PubMed, Embase, Cochrane Central Register of Controlled Trials, and BioMed Central databases were searched from inception up to December 2022 for studies comparing pregnancy outcomes in patients undergoing personalized embryo transfer (pET) by ERA versus standard ET. Data were pooled by meta-analysis using a random effects model. We identified twelve studies, including 14,224 patients. No differences were observed between patients undergoing ERA test and those not undergoing ERA test prior to ET in terms of live birth (OR 1.00, 95% CI 0.63-1.58, I2 = 92.7%), clinical pregnancy (OR 1.20, 95% CI 0.90-1.61, I2 = 86.5%), biochemical pregnancy (OR 0.83, 95% CI 0.46-1.49, I2 = 87%), positive pregnancy test (OR 0.99, 95% CI 0.80-1.22, I2 = 0%), miscarriage (OR 0.91, 95% CI 0.62-1.34, I2 = 67.1%), and implantation rate (OR 1.18, 95% CI 0.44-3.14, I2 = 93.2%). pET with ERA is not associated with any significant differences in pregnancy outcomes as compared to standard ET protocols. Therefore, the utility of ERA in patients undergoing IVF should be revisited.

Keywords: Assisted reproductive technology; Embryo transfer; Endometrial receptivity; Endometrial receptivity analysis; In vitro fertility.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Abortion, Spontaneous* / epidemiology
  • Embryo Transfer / methods
  • Female
  • Fertilization in Vitro
  • Humans
  • Live Birth
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Rate
  • Pregnancy, Multiple