Patients often undergo multiple failures before additional - PowerPoint PPT Presentation

Patients often undergo multiple failures before additional investigations occur. 3 in 10 women have a displaced Window of Implantation (WOI)

PROGESTERONE ESTROGEN HRT cycle WOI WOI WOI ERA

Publications 13 Igenomix 8 External

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Day 5/6 FET pET ET Frozen Embryo transfer Personalized Embryo transfer Fresh Embryo transfer ERA Transfer Cryopreserved Cryopreserved embryos embryos HRT HRT

Cumulative LBR at one year follow up Implantation rate Pregnancy rate Biochemical and clinical miscarriages Live birth rate Ectopic pregnancy Obstetrical, neonatal outcomes Cost-effectiveness

Up to 37 years IVF first appointment Body mass index: 18.5-30 Normal ovarian reserve (AFC ≥ 8; FSH <8)

The stimulation protocol Blastocyst transfer was decided by the doctor (day 5 or 6) Exclusion criteria Post-Randomization Exclusion Criteria   Recurrent miscarriage. P4 level ≥ 1.5ng/ml at the day of hCG  Severe male factor (<2 million/ml). administration in all groups.   Implantation failure (>3 failed cycles). Absence of blastocysts for embryo  Any pathology affecting the endometrial transfer.  cavity and hydrosalpinx must be Risk of OHSS in the fresh ET group. previously operated. Patients using PGT-A were not excluded

Per Protocol Analysis LIVE BIRTH RATE +13.8 pp +10.5 pp 56.2% 42.4% 45.7% ET FET pET (pp) Percentage points

Per Protocol Analysis Cumulative Live Birth rate in pET Implantation rate in pET increased increased 14.1 pp * vs FET 15.8 pp * vs FET 18.7 pp * vs ET 22.3 pp * versus ET Pregnancy rate in pET increased Live Birth rate in pET increased 18.2 pp * vs FET 13.8 pp vs FET 14.3 pp vs ET 10.5 pp vs ET Cumulative Pregnancy rate in pET increased 24.4 pp* vs FET 32.2 pp* vs ET * Statistically significant

Per Protocol Analysis Obstetrical, delivery and neonatal outcomes were not different among pET, FET and ET USA $42,658 $36,780 $50,482 ET pET FET Cost-effectiveness Estimated cost of a delivery with at least 1 LB at first attempt Europe 19,555€ 15,674€ 23,448€ ET pET FET

Intention to Treat Analysis Cumulative pregnancy rate significantly increased in the pET group versus FET and ET pET 93.6% FET 79.7% 80.7% ET

Live birth rate ERA maximizes the chances of FIRST EMBRYO TRAN S FER CUMULATIVE RATE pregnancy Our study confirms that a personalized embryo transfer is superior to the conventional frozen embryo +15.8 pp transfer. 71.2% +13.8 pp 71 % 56.2% 55.4% Of women gave birth after 1 year 42.4% pET FET pET FET

Pregnancy rate +14 pp +18.2 pp 72.5% 72.5% 58.5% 54.3% pET FET pET ET

65 60 LIVE BIRTH RATES % 14% Endometrial 55 Factor 50 50 45 Chromosomal 15% 40 Embryo Factor 35 30 30 NCT03530254 (May 21, 2018) 25 NCT3558399 (June 15, 2018) 20 15 IVF 1.0 IVF 2.0 10 5 1978 2010

This study shows that performing ERA in a patient’s first IVF cycle significantly improves their chance of having a baby.