Prediction of pregnancy outcome of IVF-ET cycles following endometrial injury in women with previously failed implantation based on endometrial transcriptomics: A preliminary report

Abstract

Background/aims

Timed administration of endometrial scratching in natural cycles followed by IVF-ET reportedly yields improved clinical pregnancy in women. In the present study, we have examined the issue of endometrial transcriptomic response in natural cycles preceding to the intervention cycles of IVF-ET to explore the differences, if any, in transcript expression profiles between those who conceived and those who did not following endometrial scratching in IVF-ET.

Methods

Patients (n = 25) undergoing autologous IVF-ET cycles with history of failed IVF-ET/ICSI cycles underwent endometrial scratching and sampling during 12–18 day of untreated cycles preceding to intervention. Each patient was monitored for pregnancy outcome using the routine protocol. Each sample was subjected to whole genome expression array experiment (n = 20) followed by exploratory and differential display analysis.

Results

Endometrial whole genome transcriptomics of two groups (pregnancy positive, n = 10; pregnancy negative, n = 10) revealed that samples mutually clustered primarily based on pregnancy outcome. The secretory maturation of endometrium was seen to involve pathways related to oxidative phosphorylation, ubiquinone metabolism, cellular adhesion, skeletal and motor activities, and transcription and translation regulation. Additionally, genes related to neurogenesis and synaptogenesis, chemokines associated with cell adhesion, and developmental signalling were up-regulated in samples obtained from pregnancy-positive women. Further, patients with affected endometrial expression of genes involved in gynaecological neoplasm and transcriptional dysregulation in natural cycles did not conceive in IVF-ET.

Conclusion

Transcriptomic expressions in endometrium yielded information with predictive value of pregnancy outcome following endometrial scratching in women with history of repeated implantation failure upon IVF-ET.