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dc.contributor.author
Glujovsky, D.
dc.contributor.author
Lattes, K.
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Miguens, M.
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Pesce, R.
dc.contributor.author
Ciapponi, Agustín
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dc.date.available
2024-02-28T11:58:01Z
dc.date.issued
2023-07
dc.identifier.citation
Glujovsky, D.; Lattes, K.; Miguens, M.; Pesce, R.; Ciapponi, Agustín; Personalized embryo transfer guided by endometrial receptivity analysis: a systematic review with meta-analysis; Oxford University Press; Human Reproduction; 38; 7; 7-2023; 1305-1317
dc.identifier.issn
0268-1161
dc.identifier.uri
http://hdl.handle.net/11336/228714
dc.description.abstract
STUDY QUESTION: Does a personalized embryo transfer (pET) guided by tests for endometrial receptivity (TER) increase the effectiveness of ART procedures? SUMMARY ANSWER: The use of TER-guided pET is not supported by current published evidence in women without repeated implantation failure (RIF), while in women with RIF more research is needed to assess a potential benefit. WHAT IS KNOWN ALREADY: Implantation rates are still far from ideal, especially in some patients that have RIF with good-quality embryos. As a potential solution, a wide range of diverse TER use different sets of genes to identify displacements of the window of implantation to adjust the individual length of progesterone exposure in a pET. STUDY DESIGN, SIZE, DURATION: A systematic review with meta-analysis was performed. Search terms included endometrial receptivity analysis, ERA, personalized embryo transfer. CENTRAL, PubMed, Embase, reference lists, clinical trials registers, and conference proceedings (search date October 2022) were searched, with no language restrictions. PARTICIPANTS/MATERIALS, SETTING, METHODS: Randomized controlled trials (RCTs) and cohort studies comparing a pET guided by TER vs standard embryo transfer (sET) in different subgroups that undergo ART were identified. We also investigated pET in non-receptive-TER vs sET in receptive-TER, and pET in a specific population vs sET in a general population. Risk of bias (RoB) was assessed with the Cochrane tool and ROBINS-I. Only those with low/moderate RoB underwent meta-analysis. The GRADE approach was used to evaluate the certainty of evidence (CoE). MAIN RESULTS AND THE ROLE OF CHANCE: We screened 2136 studies and included 35 (85% used ERA and 15% used other TER). Two studies were RCTs comparing endometrial receptivity analysis (ERA)-guided pET vs sET in women with no history of RIF. In women without RIF, no important differences (moderate-CoE) were found in live birth rates and clinical pregnancy rates (CPR). We also performed a meta-analysis of four cohort studies that were adjusted for confounding. In agreement with the RCTs, no benefits were found in women without RIF. However, in women with RIF, low CoE suggests that pET might improve the CPR (OR 2.50, 95% CI 1.42-4.40). LIMITATIONS, REASONS FOR CAUTION: We found few studies with low RoB. Only two RCTs in women without RIF were published, and none in women with RIF. Furthermore, the heterogeneity observed in populations, interventions, co-interventions, outcomes, comparisons, and procedures limited the pooling of many of the included studies. WIDER IMPLICATIONS OF THE FINDINGS: In the population of women without RIF, in agreement with previously published reviews, pET did not prove to be more effective than sET and, therefore, it precludes the routine use of this strategy in this population until more evidence is available. However, more research is advisable in women with RIF as low-certainty evidence from observational studies adjusted for confounders suggests that the CPR might be higher with pET guided by TER in this population. Although this review presents the best available evidence, it is still insufficient to change current policies. STUDY FUNDING/COMPETING INTEREST(S): No specific funding was obtained for this study. There are no conflicts of interest to declare.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Oxford University Press
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dc.rights
info:eu-repo/semantics/restrictedAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
ENDOMETRIAL BIOPSY
dc.subject
ENDOMETRIAL RECEPTIVITY ANALYSIS
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ERA
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META-ANALYSIS
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PERSONALIZED EMBRYO TRANSFER
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PROGESTERONE EXPOSURE
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REPEATED IMPLANTATION FAILURE
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SYSTEMATIC REVIEW
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TESTS FOR ENDOMETRIAL RECEPTIVITY
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WINDOW OF IMPLANTATION
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Otras Ciencias de la Salud
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dc.subject.classification
Ciencias de la Salud
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dc.subject.classification
CIENCIAS MÉDICAS Y DE LA SALUD
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dc.title
Personalized embryo transfer guided by endometrial receptivity analysis: a systematic review with meta-analysis
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2024-02-28T10:18:27Z
dc.journal.volume
38
dc.journal.number
7
dc.journal.pagination
1305-1317
dc.journal.pais
Reino Unido
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dc.description.fil
Fil: Glujovsky, D.. Instituto de Efectividad Clínica y Sanitaria; Argentina
dc.description.fil
Fil: Lattes, K.. No especifíca;
dc.description.fil
Fil: Miguens, M.. Instituto de Efectividad Clínica y Sanitaria; Argentina
dc.description.fil
Fil: Pesce, R.. Hospital Italiano; Argentina
dc.description.fil
Fil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
dc.journal.title
Human Reproduction
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dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/humrep/article/38/7/1305/7172833
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1093/humrep/dead098
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