Establishment and application of an RNA-seq-based predictive model for the hourly precision window of implantation (WOI) in patients with recurrent implantation failure.

IF 3.2 3区 医学 Q2 GENETICS & HEREDITY
Aihua He, Tianli Yang, Sijia Lu, Yangyun Zou, Cheng Wan, Yulin Chen, Jing Zhao, Nenghui Liu, Donge Liu, Yumei Li, Yonggang Wang, Bin Xu, Jie Hao, Jing Fu, Qiong Zhang, Baisheng Wang, Yanping Li
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引用次数: 0

Abstract

Purpose: This study aims to establish a single-time point RNA-sequencing-based endometrial receptivity test (rsERT) to provide hourly precision of endometrial WOI for patients with recurrent implantation failure (RIF).

Methods: A two-phase study was conducted. In the first phase, a total of 70 patients with successful intrauterine pregnancy after personalized embryo transfer (pET) guided by three-time points rsERT were recruited for modified rsERT. Another 21 patients who underwent the prototype of single-time point rsERT were further included for optimization. In the second phase, another cohort of 574 patients with RIF that was recruited and assigned to the experimental group underwent pET guided by the modified rsERT (n = 261) or the control group underwent conventional ET (n = 313). The positive β-human chorionic gonadotropin (β-hCG), intrauterine pregnancy rate (IPR), implantation rate (IR), ongoing pregnancy rate, and live birth rate of the two groups were analyzed.

Result: The modified rsERT provided an hour-based predictive result of endometrial WOI with an average accuracy of 94.51% and sensitivity and specificity of 92.73% and 96.29%, respectively. The positive β-hCG, IPR, IR, ongoing pregnancy rate, and live birth rate of the experimental group were significantly different from those in the control group. After propensity score matching (PSM) control for the confounders, positive β-hCG, IR, and early spontaneous abortion rate showed significant differences.

Conclusion: The modified rsERT provided hourly precision WOI prediction using a single-time point endometrial biopsy and pregnancy outcomes were significantly improved, providing an enhanced endometrial receptivity test as an alternative requiring only a single-time point sampling for patients with RIF.

基于rna序列的反复植入失败患者每小时植入精确窗口(WOI)预测模型的建立与应用
目的:本研究旨在建立基于单时间点rna测序的子宫内膜容受性试验(rsERT),为复发性着床失败(RIF)患者提供子宫内膜WOI的小时精度。方法:采用两期研究。在第一阶段,共招募70例经3时间点rsERT指导的个体化胚胎移植(pET)后宫内妊娠成功的患者进行改良rsERT。另外21例接受单时间点rsERT原型的患者进一步纳入以进行优化。在第二阶段,另一组574名RIF患者被招募并分配到实验组(n = 261)接受改良rsERT引导的pET,对照组接受常规ET (n = 313)。分析两组患者β-人绒毛膜促性腺激素(β-hCG)阳性、宫内妊娠率(IPR)、着床率(IR)、持续妊娠率、活产率。结果:改进后的rsERT可提供基于小时的子宫内膜WOI预测结果,平均准确率为94.51%,敏感性和特异性分别为92.73%和96.29%。试验组β-hCG阳性、IPR、IR、持续妊娠率、活产率与对照组比较差异均有统计学意义。对混杂因素进行倾向评分匹配(PSM)控制后,β-hCG阳性、IR和早期自然流产率差异有统计学意义。结论:改进后的rsERT使用单时间点子宫内膜活检提供了每小时精确的WOI预测,妊娠结局显著改善,为RIF患者提供了一种增强的子宫内膜容受性试验,作为一种只需要单时间点采样的替代方法。
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来源期刊
CiteScore
5.70
自引率
9.70%
发文量
286
审稿时长
1 months
期刊介绍: The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.
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