Adjustment of progesterone administration after endometrial transcriptomic analysis does not improve reproductive outcomes in women with adenomyosis
Abstract
Research question Do patients with adenomyosis present a dysregulated endometrial receptivity that can be reversed with personalized embryo transfer (PET) by transcriptomic-based progesterone adjustment, improving IVF outcomes?Design A multicentre, retrospective, cohort study that transcriptomically analysed the endometrial receptivity of the endometrium in patients with adenomyosis (n = 81) and healthy women (n = 231). Subsequently, implantation, biochemical and clinical miscarriage, and live birth rates between adenomyosis patients with one previous implantation failure using donor oocytes who received (n = 59) or did not receive (n = 66) PET based on endometrial receptivity, were observed to evaluate if adjusted progesterone improves reproductive outcomes of adenomyosis patients.Results Patients with adenomyosis significantly presented an altered endometrial receptivity (non-receptive) compared with healthy patients (53.1% versus 37.2%, P = 0.0179), elevating the risk of adenomyosis patients having a non-receptive endometrium 42.59% higher (95% CI 41.50 to 44.45). No significant differences were found in implantation (62.7% versus 78.8%, P = 0.0514), biochemical (13.5% versus 3.9%, P = 0.1223) and clinical (10.8% versus 15.4%, P = 0.7543) miscarriage, or live birth rates (75.7% versus 80.8%, P = 0.6066), in patients with PET compared with those without PET.Conclusions Women with adenomyosis presented an altered expression of genes involved in decidualization, and a higher rate of non-receptive endometrial statuses than controls. Although progesterone is indispensable for implantation, adjusting progesterone before PET, using endometrial transcriptomic signatures, does not improve IVF outcomes in patients with adenomyosis. Other molecular mechanisms beyond progesterone regulation may be involved in implantation failure.
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Molecular mechanisms other than progesterone resistance may be involved in implantation failure.
“Other molecular mechanisms beyond progesterone resistance may be involved in implantation failure (53).”
From Endometrial receptivity in adenomyosis and/or endometriosis (2023) · cites this paper as [53]
Women with adenomyosis have altered expression of genes involved in decidualization.
“For example, Ju arez-Barber et al. (53) reported that women with adenomyosis have an altered expression of genes involved in decidualization.”
From Endometrial receptivity in adenomyosis and/or endometriosis (2023) · cites this paper as [53]
Adjusting progesterone doses before frozen embryo transfers did not improve ART outcome in patients with adenomyosis.
“Their results indicate that adjusting progesterone doses before FETs did not improve the ART outcome in patients with adenomyosis.”
From Endometrial receptivity in adenomyosis and/or endometriosis (2023) · cites this paper as [53]
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- Authors
- Juárez-Barber, E., Cozzolino, M., Corachán, A., Alecsandru, D., Pellicer, N., Pellicer, A., & Ferrero, H.
- Affiliations
- Universidad Rey Juan Carlos (ES)
- Universitat de València (ES)
- IVIRMA Global (ES)
- Instituto de Investigación Sanitaria La Fe (ES)
- Corresponding author
- Cozzolino, Mauro
- Venue
- Reproductive BioMedicine Online
- Publisher
- Elsevier BV
- Published
- 2023-01
- Volume
- 46
- Issue
- 1
- Pages
- 99-106
- ISSN
- 1472-6483 (ISSN-L)
- OpenAlex
- W4295941957
- Cited by
- 16
- References
- 52
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 4 · 2023: 5 · 2022: 1
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Reproductive BioMedicine Online (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Generalitat Valenciana (APOSTD/2020/123)
- Instituto de Salud Carlos III (FI19/00110, PI21/00184)
- European Social Fund (CP20/00120)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Keywords
- adenomyosis, endometrial receptivity, personalized embryo transfer, progesterone supplementation, IVF outcomes, implantation failure, decidualization, donor oocytes, live birth rate, miscarriage
- MeSH terms
- Abortion, Spontaneous, Endometrium, Female, Humans, Embryo Implantation, Pregnancy, Progesterone, Retrospective Studies, Cohort Studies, Transcriptome, Adenomyosis
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