Diaz–Gimeno P, et al. – The goal of this study was to refine the endometrial window of implantation (WOI) transcriptomic signature by characterizing new subsignatures associated to live birth and biochemical pregnancy. The significant differences between the WOI transcriptomic stratification were in the ongoing pregnancy rate (OPR) and biochemical pregnancy rate. The OPR ranged from 76.9% and 80% in the late prereceptive (LPR) and RR signatures, respectively, versus 33.3% in the LR. The biochemical pregnancy rate was 7.7% and 6.6% in LPR and RR, respectively, but 50% in LR, which features the relevance of endometrial status in the progression of embryonic implantation.

Methods

• For this research, they designed a retrospective cohort study.
• This study was conducted at University–affiliated in vitro fertilization clinic and reproductive genetics laboratory.
• In this study, they included healthy fertile oocyte donors (n = 79) and patients with infertility diagnosed by Endometrial Receptivity Analysis (n = 771).

Results

• This study perform a prediction model based on transcriptomic clusters for endometrial classification (training set, n = 529).
• The clinical follow–up set in the expected WOI (n = 321) was tested with the transcriptomic predictor to detect WOI variability and the pregnancy outcomes related to these subsignatures (n = 228).
• The endometrial receptivity signature was redefined into four WOI transcriptomic profiles.
• This stratification identified an optimal endometrial receptivity (RR) signature resulting in an ongoing pregnancy rate (OPR) of 80% in terms of live birth, as well as a late receptive–stage (LR) signature with a potential high risk of 50% biochemical pregnancy.
• Abnormal down–regulation of the cell cycle was the main dysregulated function among the 22 genes related to biochemical pregnancy.