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CASE REPORT
Year : 2019  |  Volume : 2  |  Issue : 1  |  Page : 46-49

Why results of endometrial receptivity assay testing should not be discounted in recurrent implantation failure?


1 Department of Reproductive Medicine, Apollo Cradle, New Delhi, India
2 Department of Reproductive Medicine, Mother and Child Hospital, New Delhi, India

Correspondence Address:
Dr. Simrandeep Kaur
Department of Reproductive Medicine, Apollo Cradle, Moti Nagar, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tofj.tofj_9_19

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Recurrent implantation failure (RIF) is often encountered in patients undergoing ART leading to severe emotional, financial and physical distress. Thorough investigations should be carried out to ascertain whether there is any underlying cause of the condition. Endometrial receptivity (ER) remains a major stumbling block in IVF success as most available tests for diagnosis lack accuracy and predictive value. Microarray technology allows identification of the transcriptomic signature of the window of implantation, hence the development of an ER assay (ERA) for the diagnosis of an altered ER. ERA evaluates 238 genes expressed during WOI using RNA sequencing. Use of ERA test in patients with RIF has shown that window of implantation (WOI) is displaced in a quarter of these patients and use of a personalized embryo transfer (pET) significantly improves reproductive performance. We report three cases of RIF all of whom had failed IVF cycles despite good quality blastocysts transfer with apparently, no identifiable cause of implantation failure (uterine factores, embryonic, immunological factors ruled out). Two patients though had ERA testing done outside which showed displaced WOI, but however pET was not carried out leading to RIF. Subsequently pET carried out at our centre led to successful implantation and clinical pregnancy in both the patients.


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