Attachment of trophoblastic spheroid onto endometrial epithelial cells predicts cumulative livebirth of women aged 35 or over

Abstract

<h3>Objective</h3><p>To evaluate the attachment rate of a human embryonic stem cell–derived trophoblastic spheroid onto endometrial epithelial cells in predicting the cumulative live birth rate of an in vitro fertilization (IVF) cycle.</p><h3>Design</h3><p>A prospective observational study.</p><h3>Setting</h3><p>University hospital and research laboratory.</p><h3>Patient(s)</h3><p>A total of 240 infertile women from 2017–2021.</p><h3>Intervention(s)</h3><p>Infertile women with regular cycles attending for IVF were recruited. An endometrial aspirate was collected from a natural cycle 1 month before IVF to determine the BAP-EB attachment rate.</p><h3>Main Outcome Measure(s)</h3><p>Cumulative live birth rates from a stimulated cycle and its derived frozen embryo transfer cycles within 6 months of ovarian stimulation were obtained.</p><h3>Result(s)</h3><p>The BAP-EB attachment rate in women who attained a cumulative live birth was similar to that in those who did not. When women were stratified by age into <35 years and ≥35 years, the BAP-EB attachment rate was significantly higher only in women aged ≥35 years having a live birth when compared with those in the same age group without a live birth. Receiver operating characteristic curve analysis of BAP-EB attachment rate in predicting cumulative live birth showed the areas under the curve of 0.559 (95% confidence interval [CI], 0.479–0.639), 0.448 (95% CI, 0.310–0.585), and 0.613 (95% CI, 0.517–0.710) for all ages, an age of <35 years, and an age of ≥35 years, respectively.</p><h3>Conclusion(s)</h3><p>The BAP-EB attachment rate offers only a very modest prediction of the cumulative live birth rate in women aged ≥35 years undergoing IVF.</p>