Clinical and anamnestic predictors of implantation failures in women with diminished ovarian reserve: retrospective study
Dubinskaya E.D., Gasparov A.S., Mglinets A.P., Lukyanova Ya.S., Matskevich E.N.
Objective. To identify clinical and anamnestic predictors of implantation failures in women with diminished ovarian reserve, who underwent assisted reproductive technology (ART) cycles with good-quality embryo transfer.
Materials and methods. A retrospective analysis of medical records of 150 women of reproductive age
(20–35 years) with diminished ovarian reserve was performed. The women were divided into groups based on successful clinical pregnancies (n=58) or pregnancy failures (n=92) after two attempts of morphological good-quality embryo transfer. The data of reproductive and gynecological history, biomarkers of ovarian reserve, ovarian stimulation parameters, embryological characteristics, and endometrial sonographic parameters were analyzed. Statistical analysis included group comparisons, univariate logistic regression, calculation of odds ratios (OR) and 95% confidence intervals (95% CI).
Results. Significant predictors of implantation failure included primary infertility (OR=4.5), endometrial polyps (OR=4.6), previous surgery for ovarian endometriomas (OR=3.0), hypomenorrhea (OR=2.9), dysmenorrhea (OR=2.9), and adenomysosis (OR=2.3). Endometrial thickness <7.8 mm in the later stage of follicular phase was associated with a twofold increased risk of implantation failure (OR=2.7). There was no significant difference between the groups in ovarian response parameters and embryo quality.
Conclusion. In women of early and middle reproductive age with diminished ovarian reserve, implantation outcome after good-quality embryo transfer in ART programs can be determined by clinical and anamnestic factors. Decreased endometrial thickness in the later stage of the follicular phase of the menstrual cycle is a significant marker of implantation failure, indicating defective endometrial receptivity and displaced implantation window.
Authors' contributions. Dubinskaya E.D., Gasparov A.S. – the study concept and design, manuscript editing; Mglinets A.P., Lukyanova Ya.S., Matskevich E.N. – material collection and processing; Mglinets A.P., Dubinskaya E.D. – manuscript writing.
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. The study was carried out without any sponsorship.
Ethical Approval. The study was approved by the local Ethics Committee of Peoples' Friendship University of Russia named after Patrice Lumumba of the Ministry of Science and Higher Education of the Russian Federation.
Patient Consent for Publication. The patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Dubinskaya E.D., Gasparov A.S., Mglinets A.P., Lukyanova Ya.S., Matskevich E.N. Clinical and anamnestic predictors of implantation failures in women with diminished ovarian reserve: retrospective study.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (5): 140-147 (in Russian)
https://dx.doi.org/10.18565/aig.2026.58
Keywords
diminished ovarian reserve
implantation
endometrium
assisted reproductive technologies
infertility
References
- Ma J., Gao W., Li D. Recurrent implantation failure: a comprehensive summary from etiology to treatment. Front. Endocrinol. (Lausanne). 2023; 13: 1061766. https://dx.doi.org/10.3389/fendo.2022.1061766
- Karimi S., Baharaghdam S., Danaii S., Yousefi M. Embryo-maternal cross-talk: key players in successful implantation and live birth rates. Reprod. Biol. Endocrinol. 2025; 23(1): 136. https://dx.doi.org/10.1186/s12958-025-01477-x
- Bulletti F.M., Sciorio R., Conforti A., De Luca R., Bulletti C., Palagiano A. et al. Causes of embryo implantation failure: a systematic review and metaanalysis of procedures to increase embryo implantation potential. Front. Endocrinol. (Lausanne). 2025; 15: 1429193. https://dx.doi.org/10.3389/fendo.2024.1429193
- Erdoğan K., Şanlıer N., Utlu E., Güvey H., Kahyaoğlu İ., Neşelioğlu S. et al. Serum and follicular fluid thiol / disulfide homeostasis in diminished ovarian reserve patients undergoing in vitro fertilization / intracytoplasmic sperm injection treatment. Cureus. 2023; 15(2): e35476. https://dx.doi.org/10.7759/cureus.35476
- Choi R., Park W., Chun G., Lee S.G., Lee E.H. Investigation of the prevalence of diminished ovarian reserve in Korean women of reproductive age. J. Clin. Med. 2023; 12(15): 5099. https://dx.doi.org/10.3390/jcm12155099
- Zhu S., Jiang W., Liao X., Sun Y., Chen X., Zheng B. Effect of diminished ovarian reserve on the outcome of fresh embryo transfer in IVF / ICSI cycles among young women: a retrospective cohort study. BMC Womens Health. 2024; 24(1): 230. https://dx.doi.org/10.1186/s12905-024-03039-6
- Hu S., Xu B., Jin L. Perinatal outcome in young patients with diminished ovarian reserve undergoing assisted reproductive technology. Fertil. Steril. 2020; 114(1): 118-24.e1. https://dx.doi.org/10.1016/j.fertnstert.2020.02.112
- Mei Y., Wang Y., Ke X., Liang X., Lin Y., Wang F. Does endometrial receptivity array improve reproductive outcomes in euploid embryo transfer cycles? A systematic review. Front. Endocrinol. (Lausanne). 2023; 14: 1251699. https://dx.doi.org/10.3389/fendo.2023.1251699
- Liu F.X., Ming H.X., Huang K.L., Yi S.J., Liang X.F., Luo W.W. et al. Clinical pregnancy outcomes in young women with diminished ovarian reserve undergoing frozen embryo transfer: a comprehensive analysis with exploratory insights into endometrial aging. Front. Endocrinol. (Lausanne). 2025; 16: 1608200. https://dx.doi.org/10.3389/fendo.2025.1608200
- Ferraretti A.P., La Marca A., Fauser B.C.J.M., Tarlatzis B., Nargund G., Gianaroli L. ESHRE consensus on the definition of “poor response” to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum. Reprod. 2011; 26(7): 1616-24. https://dx.doi.org/10.1093/humrep/der092
- Maziotis E., Kalampokas T., Giannelou P., Grigoriadis S., Rapani A., Anifantakis M. Commercially available molecular approaches to evaluate endometrial receptivity: a systematic review and critical analysis of the literature. Diagnostics (Basel). 2022; 12(11): 2611. https://dx.doi.org/10.3390/diagnostics12112611
- Hiraoka T., Hirota Y., Osuga Y. How does adenomyosis impact endometrial receptivity? An updated systematic review of clinical and molecular insights. F&S Reviews. 2023; 4(1): 15-25. https://dx.doi.org/10.1016/j.xfnr.2022.11.004
- Lacconi V., Massimiani M., Carriero I., Bianco C., Ticconi C., Pavone V. et al. When the embryo meets the endometrium: identifying the features required for successful embryo implantation. Int. J. Mol. Sci. 2024; 25(5): 2834. https://dx.doi.org/10.3390/ijms25052834
- Wu J.X., Lin S., Kong S.B. Psychological stress and functional endometrial disorders: update of mechanism insights. Front. Endocrinol. (Lausanne). 2021; 12: 690255. https://dx.doi.org/10.3389/fendo.2021.690255
- Opuchlik K., Pankiewicz K., Pierzyński P., Sierdziński J., Aleksejeva E., Salumets A. et al. Factors influencing endometrial receptivity in women with recurrent implantation failure. BMC Women's Health. 2025; 25(1): 15. https://dx.doi.org/10.1186/s12905-024-03531-z
- Simon A., Laufer N. Repeated implantation failure: clinical approach. Fertil. Steril. 2012; 97(5): 1039-43. https://dx.doi.org/10.1016/j.fertnstert.2012.03.010
- Alson S., Stenqvist A., Sladkevicius P. Cumulative live birth rates under three consecutive IVF / ICSI treatment cycles are reduced in women with endometriosis and/or adenomyosis diagnosed by ultrasonography. Hum. Reprod. 2025; 40(12): 2332-41. https://dx.doi.org/10.1093/humrep/deaf184
- Базина М.И., Сыромятникова С.А., Емельянова Е.Ю., Савалова Н.С. Эффективность программ вспомогательных репродуктивных технологий у пациенток с трубным бесплодием в Красноярском крае. Доктор.Ру. Гинекология. 2015; 11(112): 8-12. [Bazina M.I., Syromyatnikova S.A., Emelianova E.Yu., Savalova N.S. Tubal infertility: effectiveness of assisted-reproductive technologies in women living in Krasnoyarsk region. Doctor.Ru. Gynecology. 2015; 11(12): 8-12 (in Russian)].
- Pérez-Milán F., Caballero-Campo M., Carrera-Roig M., Domínguez-Arroyo J.A., Moratalla-Bartolomé E., Alcázar-Zambrano J.L. et al. Impact of endometrial thickness on reproductive outcome in fresh and frozen-thawed embryo transfer: systematic review and meta-analysis. Ultrasound Obstet. Gynecol. 2025; 66(3): 271-81. https://dx.doi.org/10.1002/uog.29270
- Исакова Э.В., Савина В.А. Тонкий эндометрий в циклах вспомогательных репродуктивных технологий. Влияние на исходы беременности и лечение (обзор литературы, часть 2). Проблемы репродукции. 2021; 27(2): 65-75. [Isakova E.V., Savina V.A. Thin endometrium in ART treatment and outcome (literature review, part 2). Russian Journal of Human Reproduction. 2021; 27(2): 65-75 (in Russian)]. https://dx.doi.org/10.17116/repro20212702165
- Mathyk B., Schwartz A., DeCherney A., Ata B. A critical appraisal of studies on endometrial thickness and embryo transfer outcome. Reprod. Biomed. Online. 2023; 47(4): 103259. https://dx.doi.org/10.1016/j.rbmo.2023.103259
- Homer H.A. Effects of endometriosis on in vitro fertilisation - Myth or reality? Aust. N. Z. J. Obstet. Gynaecol. 2023; 63(1): 3-5. https://dx.doi.org/10.1111/ajo.13643
- Huang Y., Wang Z., Li B., Ke L., Xiong Y., Zhang Y. Loss of KLF15 impairs endometrial receptivity by inhibiting EMT in endometriosis. J. Endocrinol. 2024; 261(2): e230319. https://dx.doi.org/10.1530/JOE-23-0319
- Shan J., Li D.J., Wang X.Q. Towards a better understanding of endometriosis-related infertility: a review on how endometriosis affects endometrial receptivity. Biomolecules. 2023; 13(3): 430. https://dx.doi.org/10.3390/biom13030430
- Pîrlog L.M., Pătrășcanu A.A., Ona M.D., Cătană A., Rotar I.C. HOXA10 and HOXA11 in human endometrial benign disorders: unraveling molecular pathways and their impact on reproduction. Biomolecules. 2025; 15(4): 563. https://dx.doi.org/10.3390/biom15040563
- Gao Y., Hong X., Wang Z., Zhu Y. Endometrial receptivity and conception outcome among women with light menstrual bleeding of unidentified etiology. Int. J. Gynaecol. Obstet. 2018; 140(1): 37-41. https://dx.doi.org/10.1002/ijgo.12335
- Maldonado Rosas I., Mottola F., Palmieri I., Ibello L., Kalita J.C., Roychoudhury S. Molecular biomarkers of endometrial function and receptivity in natural and stimulated assisted reproductive technology (ART) cycles. Reprod. Med. 2026; 7(1): 2. https://dx.doi.org/10.3390/reprodmed7010002
- Жылкыбаева И.М., Клюев Д.А., Огизбаева А.В., Омертаева Д.Е., Камышанский Е.К. Маркеры рецептивности эндометрия: современные представления и клиническое значение. Репродуктивная медицина (Центральная Азия). 2025; 4: 31-44. [Zhylkybayeva I., Klyuyev D., Ogizbayeva A., Omertayeva D., Kamyshansky Y. Markers of endometrial receptivity: modern concepts and clinical significance (a literature review). Reproductive Medicine (Central Asia). 2025; 4: 31-44 (in Russian)]. https://dx.doi.org/10.37800/RM.4.2025.637
- Rackow B.W., Jorgensen E., Taylor H.S. Endometrial polyps affect uterine receptivity. Fertil. Steril. 2011; 95(8): 2690-2. https://dx.doi.org/10.1016/j.fertnstert.2010.12.034
- Obayashi S., Ideno Y., Kubota T., Takamatsu K., Hayashi K. Associations between lifestyle factors and primary dysmenorrhea in the Japan nurses’ health study. Women’s Health Rep. 2025; 6(1): 702-10. https://dx.doi.org/10.1177/26884844251362183
Received 16.02.2026
Accepted 17.03.2026
About the Authors
Ekaterina D. Dubinskaya, Dr. Med. Sci., Professor at the Department of Obstetrics, Gynecology and Perinatology, Medical Institute, Peoples’ Friendship University of Russia named after Patrice Lumumba, 8 Miklukho-Maklaya str., Moscow, 117198, Russia, +7(903)117-55-58, eka-dubinskaya@yandex.ru, https://orcid.org/0000-0002-8311-0381Alexander S. Gasparov, Dr. Med. Sci., Professor at the Department of Obstetrics, Gynecology and Perinatology, Medical Institute, Peoples’ Friendship University of Russia named after Patrice Lumumba, 8 Miklukho-Maklaya str., Moscow, 117198, Russia, +7(985)776-77-78, 13513520@mail.ru, https://orcid.org/0000-0001-6301-1880
Anna P. Mglinets, PhD Student, Department of Obstetrics, Gynecology and Perinatology, Medical Institute, Peoples’ Friendship University of Russia named
after Patrice Lumumba, 8 Miklukho-Maklaya str., Moscow, 117198, Russia, +7(906)056-49-98, mg.anna@mail.ru, https://orcid.org/0009-0001-3985-3954
Yana S. Lukyanova, Teaching Assistant at the Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Postgraduate Education, Peoples’ Friendship University of Russia named after Patrice Lumumba, 8 Miklukho-Maklaya str., Moscow, 117198, Russia, +7(916)013-98-88, yana.lykuanova@gmail.com,
https://orcid.org/0000-0002-0083-9231
Elizaveta N. Matskevich, Teaching Assistant at the Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Postgraduate Education, Peoples’ Friendship University of Russia named after Patrice Lumumba, 8 Miklukho-Maklaya str., Moscow, 117198, Russia, +7(911)176-66-94, liza151196chik@mail.ru,
https://orcid.org/0009-0000-3315-7408
Similar Articles
