Precise hourly personalized embryo transfer significantly improves clinical outcomes in patients with repeated implantation failure

This was a retrospective study enrolling patients with a history of RIF who received at least one autologous high-quality blastocyst during the subsequent FET cycle. Patients were divided into two groups: Group rsERT, comprising patients who underwent rsERT-guided pET (n=115), and Group FET, comprising patients who underwent standard FET without rsERT (n=272). Of the patients who underwent rsERT, 39.1% (45/115) were receptive, and 60.9% (70/115) were non-receptive. Group rsERT patients showed a significantly higher probability of achieving both a positive human chorionic gonadotropin rate (63.5% vs. 51.5%, P=0.03) and clinical pregnancy rate (54.8% vs. 38.6%, P=0.003). In the subgroup analysis, Group rsERT patients with non-receptive results showed a significantly higher clinical pregnancy rate than patients in Group FET (58.6% vs. 38.6%, P=0.003). Furthermore, Group rsERT patients with receptive results guided by rsERT with a precise window-of-implantation time showed a higher clinical pregnancy rate (48.9% vs. 38.6%, P=0.192) compared with patients who underwent standard-time FET, although the difference was not significant. Hourly precise rsERT can significantly improve the probability of achieving clinical pregnancy in patients with RIF, especially in those with non-receptive rsERT results.