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All Journal Kertha Negara : Journal Ilmu Hukum Medicina Jurnal BETA (Biosistem dan Teknik Pertanian) E-Journal Obstetric & Gynecology Udayana The Indonesian Biomedical Journal JUTIK : Jurnal Teknologi Informasi dan Komputer Indonesian Journal of Obstetrics & Gynecology Science Jurnal Kesehatan Reproduksi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) ISM (Intisari Sains Medis) : Jurnal Kedokteran Andalas obstetrics and gynecology journal PAEDAGOGY : Jurnal Ilmu Pendidikan dan Psikologi International Journal of Social Service and Research Indonesian Journal of Perinatology HEALTHY: Jurnal Inovasi Riset Ilmu Kesehatan Majalah Ilmiah Widyacakra Jurnal Pendidikan DEIKSIS Indonesian Research Journal on Education Seminar Ilmiah Nasional Teknologi, Sains, dan Sosial Humaniora (SINTESA) Seminar Nasional Aplikasi Iptek (SINAPTEK) JAKADARA: JURNAL EKONOMIKA, BISNIS, DAN HUMANIORA Finger : Jurnal Ilmiah Teknologi Pendidikan Paradharma: Jurnal Aplikasi IPTEK The International Journal of Medical Science and Health Research MEDIA EDUKASI: JURNAL ILMU PENDIDIKAN
I Made Darmayasa
Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
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Evaluating The Role of Endometrial Receptivity in IVF Success : A Comprehensive Systematic Review Made Krisna Wibawa Pramartha; I Made Sudarmayasa
The International Journal of Medical Science and Health Research Vol. 36 No. 1 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/9tmdjh80

Abstract

Introduction: Endometrial receptivity is a critical determinant of successful embryo implantation in in vitro fertilization (IVF). Despite advances in assisted reproductive technology, implantation failure remains a significant barrier to successful pregnancy. This systematic review evaluates the role of various endometrial receptivity assessment methods in predicting and improving IVF outcomes. Methods: A comprehensive systematic review was conducted including 80 studies published to 2025. Studies were included if they assessed endometrial receptivity using validated methods (transcriptomic, ultrasound-based, histological, or molecular approaches) and reported IVF outcomes including implantation, clinical pregnancy, or live birth rates. Data were extracted on receptivity measures, IVF success outcomes, cycle types, patient populations, and statistical associations. Results: Endometrial receptivity was assessed using diverse methodologies including transcriptomic testing (ERA, rsERT), ultrasound parameters (thickness, pattern, vascularity, compaction), histological evaluation (pinopodes, chronic endometritis), and molecular biomarkers. Endometrial thickness demonstrated consistent threshold effects: thickness <7-8 mm was associated with significantly lower clinical pregnancy rates (OR 0.42, 95% CI 0.27-0.67) and live birth rates (OR 0.47, 95% CI 0.37-0.61). ERA-guided personalized transfer showed population-dependent efficacy, with significant benefits in recurrent implantation failure (RIF) patients (OR 2.50, 95% CI 1.42-4.40 for clinical pregnancy) but no benefit in good-prognosis populations (RR 0.95, 95% CI 0.79-1.13 for live birth). Chronic endometritis treatment restored normal IVF outcomes, with cured patients achieving comparable pregnancy rates to those without the condition. Endometrial scratching demonstrated variable results, with benefit primarily in RIF patients when performed in the luteal phase (clinical pregnancy RR 2.32, 95% CI 1.72-3.13). Discussion: The clinical utility of endometrial receptivity assessment depends critically on patient selection. In good-prognosis patients with euploid embryos, endometrial factors contribute minimally to success beyond achieving adequate thickness. Conversely, in RIF patients, advanced maternal age, or those with documented endometrial pathology, receptivity assessment and intervention provide meaningful improvements. The interaction between embryo quality and endometrial factors explains substantial heterogeneity in study findings. Conclusion: Endometrial receptivity assessment should be stratified based on patient characteristics. Routine ERA testing in unselected populations is not supported by evidence. Clinical recommendations include: ensuring endometrial thickness ≥8 mm before transfer, screening for chronic endometritis in RIF patients, and considering ERA or endometrial scratching specifically in RIF populations after excluding other causes. Future research should focus on developing integrated assessment approaches combining multiple receptivity parameters.
Co-Authors AA Sri Wahyuni Amelia Dwi Nurulita Sugiharta Anak Agung Gede Putra Wiradnyana Anak Agung Ngurah Anantasika Anak Agung Ngurah Jaya Kusuma Anom Suardika Antika, Sindi Ariani, Ni Ketut Putri Ariani, Ni Komang Arista, Luh Febi Aryana, Made Bagus Dwi ARYANI , LUH NYOMAN ALIT Astuti, Ni Made Erpia Ordani Aulia Iefan Datya Bay, Godefridus Paulo Budiana, Nyoman Gede Chrismayoga, I Made Donny Dr. Christimulia Eka Yadnya, Ni Putu Florencia Desiree I Gde Sastra Winata I Gede Agus Mertayasa I Gede Ngurah Harry Wijaya Surya I Gusti Ayu Puspawati I Gusti Putu Mayun Mayura I Kadek Dedi Susila Yasa I Ketut Suwiyoga I Made Bagus Widiastra I Made W Jembawan I Nyoman Gede Budiana I Nyoman Sucipta I PUTU PRANATHA SENTOSA I Wayan Artana Putra I Wayan Jian Ambara Raja I Wayan Megadhana I Wayan Susrama I Wayan Tika I Wayan Toni Astika Putra I Wayan Yuda Tama Wiguna Ida Bagus Arjuna Ida Bagus Gde Fajar Manuaba IWK Teja Sukmana Janawati, Desak Putu Anom KADE YUDI SASPRIYANA Krismawintari, N.P.D. Kunto Ajibroto, Kunto Kusuma, A.A.N Jaya Kusuma, Anak Agung Ngurah Jaya Luh Putu Mahatya Valdini Putri Made Bagus Dwi Aryana Made Krisna Wibawa Pramartha Marta, Kadek Fajar Mayasari, Ni Nyoman Wistya Tri Muhammad Freddy Candra Sitepu Mustaqmah, Sri Asyrafil Natanael, Raymond Josafat Major Ng Teng Fung Vincent Ni Kadek Mulyantari Ni Ketut Sri Diniari, Ni Ketut Sri Ni Komang Ayunda Paramita Ni L.P. Suarmi Sri Patni Ni Luh Putu Suarmi Sri Patni Ni Luh Sri Purnama Pradnyani Ni Made Erni Damayanti Ni Made Erpia Ordani Astuti Ni Made Nena Sucilestari Ni Nyoman Eva Listyani Ni Nyoman Sulastri Ni Putu Candra Vania Pebrianti Ni Putu Devi PradnyaWulantari Nicholas Renata Lazarosony Nicholas Renata Lazarosony Nugraha, Cokorda Gde Angga Ary Nyoman Bayu Mahendra Ongko, Eric Gradiyanto Ordani Astuti, Ni Made Erpia Pradnyana, Putu Beny Prayudi, Pande Kadek Aditya PUTRA, SURYA PRADNYANA Putu Adi Sujana Putra Putu Doster Mahayasa Putu Suarmi Sri Patni R. Tri Priyono Budi Santoso Rela Hamdanillah Ryan Saktika Mulyana Santini, Ni Nyoman Santini Santoso, R. Tri Priyono Budi Sarah Endang S Siahaan Sari, Ni Kadek Dwita Sidhi Bayu Turker SILAEN, REBECCA MUTIA AGUSTINA Sitanggang, Amita Rouli Purnama Surya, I Gede Ngurah Harry Wijaya Susrama, I Wayan Sutandi, Chatrine Tri Oktin Windha Daniaty TULUS, ANGELINA Wardani, Ida Aju Kusuma Wasita, Putu Aristya Adi Wasita Wati, Ni Putu Eka Yadnya Winarso, Ervinna Agatha