Fertility experts have identified a specific genetic pattern in the womb that could predict whether or not in vitro fertilization is likely to be successful.
Dealing with IVF can be a harrowing emotional and physical process. But this discovery can help doctors understand why in vitro fails repeatedly in some women, and could lead to the development of a new test to help patients understand how likely they are to achieve a pregnancy before they start the treatment process.
"Many women undergo a number of IVF cycles without success despite having good quality embryos and, up to now, it has been unclear whether or not the lining of the womb may be the cause of that," said study co-author Nick Macklon, chair in obstetrics and gynaecology at the University of Southampton. "We have now shown that an abnormal gene expression in the lining can be identified in many of these women and that a specific gene 'fingerprint,' when present, is always associated with failure, which is very significant in aiding our understanding."
For the study, researchers obtained biopsies of the lining of the womb from 43 women with recurrent implantation failure—which occurs when three or more transfers of high-quality embryos or the placement of 10 or more embryos in multiple transfers fail to result in pregnancy—as well as 72 women who gave birth after in vitro or intra-cytoplasmic sperm injection (ICSI).
During analysis of the biopsies, they found an abnormal gene profile in the lining of the womb in 80 percent of women with recurrent implantation failure that was not present among women who had given birth after IVF treatment.
"What this tells us is that a large proportion of women who suffer recurrent implantation failure may be infertile due to a problem with the receptivity of their uterus," said Professor Frank Holstege, head of the genomics laboratory at University Medical Center Utrecht. "Their chances of achieving successful pregnancy are likely to be very small, and this information gives clinicians much more clarity in counselling patients as to the wisdom of investing further time, effort, and money in ongoing treatment. At the same time, those patients who have undergone a number of unsuccessful cycles of IVF but do not have the genetic pattern could be advised to persist as they have a much better chance of achieving a pregnancy."