The endometrial gene expression signature of recurrent implantation failure after IVF

Transcriptomic studies have identified gene expression profiles characteristic of the window of implantation and preliminary studies have indicated that these may be disrupted in some women with recurrent implantation failure (RIF). The aims of this study were to elucidate how the endometrial gene expression profile differs between women with RIF and controls, and to investigate whether a predictor set of genes could be identified able to distinguish between these women. Between 2006 and 2013, mid-luteal phase endometrial biopsies were taken in the natural cycle from two serial cohorts, each consisting of women with RIF, defined as ≥3 failed IVF/ICSI treatments or replacement ≥10 embryos without the occurrence of a pregnancy (n=22 and n=21), and controls (n=23 and n=49). All subjects had undergone IVF/ICSI treatment in two tertiary hospitals. The control group had all conceived within the first two cycles of ICSI (n=49) or first three cycles of IVF treatment (n=23), and were therefore considered unlikely to have an endometrial factor. Microarray profiling and subsequent analysis sought to identify a gene expression signature predictive of RIF.