Evaluation of Single-Cell RNA Sequencing for the Identification of Endometrial Receptivity Biomarkers in Patients with Recurrent Implantation Failure

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 181–192

DOI: 10.46882/2026/IJOG/000492

Original Research Article

Title: Evaluation of Single-Cell RNA Sequencing for the Identification of Endometrial Receptivity Biomarkers in Patients with Recurrent Implantation Failure

Names of Authors: Anita P. Nwosu¹, Samuel T. Kudoyin²

Authors’ Affiliations:
¹ Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, Lagos State University Teaching Hospital, Ikeja, Nigeria
² Department of Radiology, College of Medicine, University of Lagos, Lagos, Nigeria

Abstract:
Recurrent Implantation Failure (RIF) remains a substantial barrier to successful in vitro fertilization cycles. This prospective case-control study utilized single-cell RNA sequencing (scRNA-seq) to profile the transcriptomic landscape of endometrial biopsies during the mid-luteal implantation window to discover novel cell-specific biomarkers of endometrial receptivity. Endometrial tissue samples were collected on day LH+7 from 30 women diagnosed with RIF and 30 fertile controls. High-throughput scRNA-seq mapped the gene expression profiles of epithelial, stromal, endothelial, and immune cell populations. Computational analysis revealed a distinct transcriptomic dysregulation in the luminal and glandular epithelial cells of RIF patients. Specifically, a total of 45 genes associated with cell adhesion and ciliogenesis, including PAX8, GPX3, and HOXA10, were significantly downregulated in the RIF cohort compared to controls (p < 0.001). Conversely, pro-inflammatory chemokine genes (CXCL14 and CCL4) were overexpressed in the stromal compartments of RIF biopsies. A predictive model constructed using an 8-gene epithelial transcriptomic panel achieved a diagnostic sensitivity of 90.0% and a specificity of 86.7% (Area Under the Curve [AUC] = 0.92) for identifying impaired endometrial receptivity. In conclusion, single-cell RNA sequencing highlights distinct cell-type-specific molecular abnormalities in women experiencing recurrent implantation failure, offering a highly accurate diagnostic panel to optimize personalized embryo transfer timing.

Keywords: Recurrent Implantation Failure; Endometrial Receptivity; Single-Cell RNA Sequencing; Implantation Window; Transcriptomics; Biomarkers.

Manuscript Timeline: Received: April 28, 2026; Revised: June 22, 2026; Accepted: July 15, 2026; Published: August 02, 2026.

Citation: Nwosu AP, Kudoyin ST. Evaluation of Single-Cell RNA Sequencing for the Identification of Endometrial Receptivity Biomarkers in Patients with Recurrent Implantation Failure. International Journal of Obstetrics and Gynecology. 2026; 14(8): 181–192

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