Influencing Factors of Repeated Implantation Failure in In-Vitro Fertilization-embryo Transfer and its Correlation with Endometrial Endothelial Nitric Oxide Synthase
LI Na, Hu Meng-di, WANG Ying
Department of Gynecology, Shaanxi Provincial Hospital of Chinese Medicine, Xi'an Shaanxi 710003
Abstract 【Objective】To explore the influencing factors of repeated implantation failure in in-vitro fertilization-embryo transfer (IVF-ET) and its correlation with endometrial endothelial nitric oxide synthase (eNOS). 【Methods】To retrospectively analyze the clinical data of 88 patients who underwent in-vitro fertilization-embryo transfer assisted conception at the Reproductive Medicine Center of our hospital from January 2018 to January 2021. According to the results of fertility, the first cycle of in-vitro fertilization-embryo transfer assisted pregnancy was set as the successful pregnancy group (n=56 cases), those who were still infertile after≥ 2 fresh cycles of assisted fertilization were set as the pregnancy failure group (n=32 cases). Logistic regression was used to analyze the related factors affecting pregnancy failure in patients with in vitro fertilization-embryo transfer implantation failures, the endometrium of all patients was sampled during the implantation window period of 1 cycle before embryo transfer, Reverse transcription-polymerase chain reaction was used to detect eNOS mRNA expression, the receiver operating curve (ROC) was used to analyze the value of eNOS mRNA expression level in predicting the pregnancy success of patients with in vitro fertilization-embryo transfer implantation failures. 【Results】Compared with patients in the pregnancy failure group, there were statistically significant differences in the composition ratio of miscarriage history, the length of infertility, estradiol level on HCG day, eNOS mRNA expression in the successful pregnancy group (P<0.05). Logistic multivariate regression analysis showed that the expression level of eNOS mRNA, the length of infertility, and the estradiol level on HCG day were all effect factors affecting pregnancy failure in patients with in vitro fertilization-embryo transfer implantation failures (P<0.05). ROC analysis showed that eNOS mRNA expression level predicts the best cut-off point for pregnancy success in patients with in vitro fertilization-embryo transfer implantation failure was 0.47, the sensitivity was 91.07%, the specificity was 87.50%, and the area under the curve (AUC) was 0.892. 【Conclusion】In vitro fertilization-embryo transfer implantation failures are related to eNOS mRNA expression levels, and eNOS mRNA expression levels, infertility years, and miscarriage history are all effect factors that affect pregnancy failure in patients with in vitro fertilization-embryo transfer implantation failures. Clinical detection of eNOS mRNA expression level can be used as a sensitive indicator for predicting pregnancy success in patients with in vitro fertilization-embryo transfer implantation failures.
LI Na,Hu Meng-di,WANG Ying. Influencing Factors of Repeated Implantation Failure in In-Vitro Fertilization-embryo Transfer and its Correlation with Endometrial Endothelial Nitric Oxide Synthase[J]. JOURNAL OF CLINICAL RESEARCH, 2022, 39(2): 191-193.
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2022, Vol. 39 
