A new investigation, led by IVI, presents a new way of differentiating between endometria with a good and poor prognosis, with an accuracy of 95%. It is possible thanks to the combination of Artificial Intelligence and transcriptomics. This study has been presented these days at the 39th edition of the Congress of the European Society of Human Reproduction and Embryology (ESHRE).
The importance of the endometrium in reproductive success
In Spain we have one of the highest percentages of infertility and the average age at which women become mothers for the first time. It is well known that from the age of 35 there is a lower oocyte quality and, therefore, the embryos that are generated from these oocytes will, in most cases, have greater difficulties to implant and carry a gestation to completion. term.
Also in our country we have more than 40 years of experience in In Vitro Fertilization (IVF). In this sense, all research efforts have been focused on the analysis and improvement of embryo quality. However, we must not forget the fundamental role that the endometrium also plays in the success of the treatment, since it is here where the implantation of the embryo and the early development of that future being take place. This scenario is the starting point of the work entitled “A gene expression risk signature of endometrial failure for prognosis in In Vitro Fertilization (IVF) patients”, presented at the aforementioned congress that was held in Copenhagen these days.
“The research that we present in this scientific framework, for the first time, and thanks to transcriptomics in conjunction with Artificial Intelligence algorithms, offers a new method with 95% accuracy when it comes to identifying genetic signatures that will help us distinguish between endometrium with good and bad prognosis before starting a reproductive treatment”explains the doctor Patricia Diaz-Gimenoresearcher of the IVI Foundation and study supervisor.
Diagnosis of endometrium with good and bad prognosis
The results of this research will allow, in a pioneering way, the identification of these two types of endometrial profiles: good and bad prognosis. In addition, it also makes it possible to find, between these two profiles, a difference of a relative risk 3 times greater for endometrial failure (implantation failure, biochemical abortion, or clinical abortion) in patients with a poor prognosis.
Until now, the tools available to us to evaluate the endometrium are based on the identification of endometria displaced from the implantation window, without substantial improvements in pregnancy rates.
“Although new lines of study are necessary for patients with poor prognosis endometria, being able to distinguish them preventively using the method that we present at the ESHRE is the starting point in the investigation of new procedures that improve their diagnosis and treatment, avoiding the suffering of women and couples due to a possible loss of embryos, and in turn improving the chances of success in their reproductive processes. These promising results are one more example of our firm commitment to personalized or precision medicine”adds Dr. Díaz-Gimeno.
The last 40 years of research have been focused on the embryo, to the point that today we can select the highest quality ones, reaching a pregnancy success rate of 95% on the third attempt.
“The objective of this research is to improve the endometrial factor to achieve that 95% success rate, not on the third attempt, but on the first. Currently, without controlling this factor, the probability of pregnancy in a first attempt is approximately 65%, or 68% in the specific case of IVI”concludes Dr. Díaz-Gimeno.
Dialogue between embryo and endometrium
Regarding the failures of an assisted reproduction treatment, the origin can be in the embryo, the endometrium or both. In this sense, both the compatibility and the communication between the embryo and the endometrium become important for the success of embryo implantation. This is the context from which the study “Extracellular vesicles secreted by the maternal endometrium functionally regulate processes related to embryo development and implantation in human blastocyst”, supervised by Dr. Hortensia Ferrero, researcher at the IVI Foundation. This research focuses on describing the molecules secreted by the endometrium and which, when captured by the embryo, are involved in this dialogue and which can explain implantation failures.
“The maternal endometrium secretes vesicles that are taken up by human embryos and when the content of these vesicles enters the embryo, it regulates molecular mechanisms involved in improving embryonic quality and, consequently, its competence to implant. These findings demonstrate the importance of the communication system between the maternal endometrium and the embryo through these small sacs for successful implantation.”explains Dr. Ferrero, supervisor of this study.
