The following is a summary of the “Adjustment of progesterone administration after endometrial transcriptomic analysis does not improve reproductive outcomes in women with adenomyosis,” published in the January 2023 issue of Reproductive Biomedicine Online by Barber, et al.

Transcriptomic analysis of endometrial receptivity in patients with adenomyosis (n = 81) and healthy women (n = 231) in a retrospective, multicenter cohort study. To determine if adjusted progesterone enhances the reproductive outcomes of adenomyosis patients, we compared implantation, biochemical and clinical miscarriage, and live birth rates between adenomyosis patients who had experienced one prior implantation failure using donor oocytes and those who did not (n = 59 and n = 66, respectively).

The risk of an adenomyosis patient having a non-receptive endometrium was 42.59% higher (95% CI 41.50 to 44.45), as adenomyosis patients significantly presented an altered endometrial receptivity (non-receptive) compared with healthy patients (53.1% versus 37.2%, P = 0.0179). However, when comparing patients with and without PET, no statistically significant differences were found in implantation (62.7 vs. 78.8%, P = 0.0514), biochemical (13.5% vs. 3.9%, P = 0.1223), or clinical miscarriage (10.8 vs. 15.5%, P = 0.7543) rates, or live birth rates (75.7 vs. 80.8%, P = 0.6066).

Adenomyosis affected the expression of genes involved in decidualization, leading to a higher rate of non-receptive endometrial status in affected women compared to controls. However, adjusting progesterone before PET in patients with adenomyosis using endometrial transcriptomic signatures does not improve IVF outcomes despite the importance of progesterone for implantation. Implantation failure may be caused by molecular mechanisms other than progesterone regulation.

Source: sciencedirect.com/science/article/abs/pii/S1472648322007003