Evaluating the efficacy of a novel endometrial receptivity test in improving pregnancy outcomes for Chinese in vitro fertilization patients: a single-center retrospective study

Background Current evidence on whether endometrial receptivity tests improve pregnancy outcomes among in vitro fertilization (IVF) patients remains conflicting and limited. This study aimed to evaluate the efficacy of HerRecepta, a novel transcriptomic endometrial receptivity test, in guiding personalized embryo transfer (pET) for Chinese IVF patients, with a focus on recurrent implantation failure (RIF) and clinical factors influencing the window of implantation (WOI). Methods This retrospective study included 220 IVF patients who had undergone endometrial receptivity testing. Based on the receptivity test results, patients were stratified into the standard embryo transfer (ET) group or pET group. Pregnancy outcomes following frozen embryo transfer were then compared between groups. Results Of the 220 patients, 124 (56.36%) had a receptive endometrium and underwent standard ET, while 96 (43.64%) had a non-receptive endometrium and underwent pET. Among the latter group, 69 (71.87%) were classified as pre-receptive. Advanced age (> 35 years, P = 0.036) and high anti-Müllerian hormone (AMH) levels (> 5 ng/mL, P < 0.001) were associated with a higher rate of non-receptivity. The overall clinical pregnancy rate (CPR) and live birth rate (LBR) were 46.50% and 32.11%, respectively. The pET group showed comparable outcomes to the standard ET group in CPR (46.36% vs. 46.67%, P = 0.966), and LBR (32.38% vs. 31.76%, P = 0.930). Similar results were observed in the RIF subgroup (124 patients: 79 in the standard ET group and 45 in the pET group). Conclusion HerRecepta-guided pET yielded pregnancy and live birth rates comparable to those achieved with standard ET. Given the retrospective design and lack of a control group, these findings support the feasibility of this test rather than demonstrating its effectiveness or superiority, and further randomized trials are warranted.