Pinopode versus endometrial receptivity analysis for personalized embryo transfer in recurrent implantation failure

Lijuan Zhao; Fei Yin; Xiaoxiao Hu; Jing Li; Cheng Wei; Feng Zhou; Xiaoying Jin; Xiaomei Tong; Song-Ying Zhang

doi:10.1016/j.rbmo.2025.104875

Pinopode versus endometrial receptivity analysis for personalized embryo transfer in recurrent implantation failure

Reprod Biomed Online. 2025 Feb 25;51(2):104875. doi: 10.1016/j.rbmo.2025.104875. Online ahead of print.

Authors

Lijuan Zhao¹, Fei Yin², Xiaoxiao Hu¹, Jing Li¹, Cheng Wei¹, Feng Zhou¹, Xiaoying Jin¹, Xiaomei Tong¹, Song-Ying Zhang³

Affiliations

¹ Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology; Zhejiang Key Laboratory of Precise Protection and Promotion of Fertility, Hangzhou, Zhejiang, 310016, China.
² Department of Neurosurgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
³ Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology; Zhejiang Key Laboratory of Precise Protection and Promotion of Fertility, Hangzhou, Zhejiang, 310016, China.. Electronic address: zhangsongying@zju.edu.cn.

PMID: 40614408
DOI: 10.1016/j.rbmo.2025.104875

Abstract

Research question: Does pinopode detection or endometrial receptivity analysis (ERA) improve personalized embryo transfer (PET) outcomes in patients with recurrent implantation failure (RIF) more effectively?

Design: This retrospective study analysed 488 patients with RIF: 222 underwent pinopode detection, 81 underwent ERA and 185 served as controls without any testing. Propensity score matching was used to mitigate confounding factors, resulting in matched pairs: 108 pinopode controls, 66 ERA controls and 66 pinopode ERA.

Results: In matched pairs, the pinopode group showed significantly higher rates of embryo implantation (41.55% versus 27.01%, P = 0.002), biochemical pregnancy (69.44% versus 53.70%, P = 0.017), clinical pregnancy (60.19% versus 43.52%, P = 0.014) and live birth (53.70% versus 33.33%, P = 0.003) compared with controls. The ERA showed marginal non-significant improvements. In comparison, the pinopode group had a higher clinical pregnancy rate than the ERA group (63.64% versus 45.45%, P = 0.036). Among patients with the window of implantation (WOI) displacement, the pinopode group had a significantly higher clinical pregnancy rate (66.67% versus 43.59%, P = 0.045).

Conclusions: Pinopode detection significantly improves clinical pregnancy outcomes in patients who have had RIF compared with controls and ERA, particularly in cases of window of implantation displacement. Prospective studies with larger cohorts are needed to validate these findings and to assess the potential for standardizing pinopode detection in clinical practice.

Keywords: Endometrial receptivity analysis; Personalized embryo transfer; Pinopode; Recurrent implantation failure; Window of implantation.