Conclusions
The main discovery of this study is to distinguish into two types of
implantation failure patients, the ones that could be benefited by PGT-A
and the ones that are not benefited due to the implantation failure
origin. There is no clinical evidence that ERA test benefits any
patient, pET cannot be based on the morphological characteristics of the
embryo and chromosomal screening should be considered for M-RIF
patients. Additionally, ERA cannot identify the most appropriate time
for embryo transfer and cannot detect uterine diseases making the
endometrium unsuitable for implantation. New technologies may be
necessary to assess the endometrial aspect of implantation. A more
thorough investigation of the effect of pET on reproductive outcomes
could also shed light on the role of the endometrium. Prospective
studies with enough power are needed to evaluate whether ERA has a
clinical benefit. Although S-RIF was uncommon in our population of IVF
patients, it warrants further study because designing treatments for
this condition will likely prove challenging.