Impact of Anti-Endometrial Antibodies on IVF Implantation and Pregnancy Outcomes: A Retrospective Study

PROBLEMS: To investigate the impact of anti-endometrial antibodies (EMAb) on pregnancy outcomes in infertile patients undergoing in vitro fertilization (IVF) and to assess the potential value of personalized treatment strategies.

METHOD OF STUDY: A total of 47 EMAb-positive and 166 EMAb-negative oocyte retrieval cycles were retrospectively included following propensity score matching (PSM) to control for basic clinical characteristics influencing pregnancy outcomes. The two groups were compared in terms of various aspects closely associated with IVF outcomes. Pregnancy outcomes were assessed based on implantation, clinical pregnancy, miscarriage, and ongoing pregnancy rates.

No significant differences were found between the two groups regarding infertility-related clinical characteristics, oocyte- and embryo-related indicators, endometriosis incidence, and so forth. Compared with the EMAb-negative group, the implantation rate in the EMAb-positive group was lower by 10.3 percentage points (p = 0.047), whereas the 8.2-point lower clinical pregnancy rate did not reach statistical significance (p = 0.234). There were no significant differences in ongoing pregnancy and miscarriage rates between the two groups.

Our study observed that the presence of EMAb was associated with less favorable IVF outcomes, primarily reflected in lower implantation and clinical pregnancy rates. However, once the implantation was successful, the risk of miscarriage did not increase. These findings suggest a potential role for EMAb screening in guiding personalized treatment strategies, such as increasing the number of embryos transferred or using immunosuppressive agents, to improve IVF outcomes. Future research should involve more extensive and diverse populations to explore the mechanisms of action of EMAb and their impact on IVF treatment outcomes.