Evidence mapPaperPMID 42369067Full record

SynthesisFrontiers in endocrinology2026

Clinical potential of fluid-based biomarkers for recurrent implantation failure: a systematic review.

Mojtaba Moradi, Leilani L Santos, Wei Zhou, Ellen Menkhorst, Evdokia Dimitriadis

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mojtaba MoradiDepartment of Obstetrics, Gynecology and Newborn Health, University of Melbourne, Parkville, VIC, Australia.
Leilani L SantosDepartment of Obstetrics, Gynecology and Newborn Health, University of Melbourne, Parkville, VIC, Australia.
Wei ZhouDepartment of Obstetrics, Gynecology and Newborn Health, University of Melbourne, Parkville, VIC, Australia.
Ellen MenkhorstDepartment of Obstetrics, Gynecology and Newborn Health, University of Melbourne, Parkville, VIC, Australia.
Evdokia DimitriadisDepartment of Obstetrics, Gynecology and Newborn Health, University of Melbourne, Parkville, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Recurrent implantation failure (RIF) remains a significant challenge in reproductive medicine, with diagnostic approaches that are limited and widely debated. This systematic review evaluates whether fluid-based biomarkers from blood, uterine fluid, and menstrual fluid can provide more accessible and clinically informative alternatives. Methods: A systematic search of MEDLINE, Embase, Scopus, and Web of Science was conducted (2015-2025). Study quality was assessed using QUADAS-2 for diagnostic studies and PROBAST for prognostic studies. Due to substantial methodological heterogeneity, meta-analysis was not performed. Findings were synthesized narratively, and diagnostic performance was summarized using forest plots of reported AUC values without statistical pooling. Results: From 3,105 records, 18 studies met the inclusion criteria. The evidence base was dominated by blood-based biomarkers (n = 17). Multi-marker models consistently demonstrated higher diagnostic performance than single analytes, with immune-cell profiling panels and cytokine-clinical parameter models achieving AUC values up to 0.94. In contrast, individual biomarkers generally showed lower performance (e.g., lymphocyte count, AUC = 0.577). Prognostic evidence for blood biomarkers was limited, although plasma D-dimer (AUC ≈ 0.81) and immune-cell profiling models (AUC ≈ 0.72) showed potential for predicting pregnancy outcomes. Only one study evaluated uterine fluid biomarkers, identifying a four-protein panel with promising diagnostic performance, while no eligible studies assessed menstrual fluid. Conclusion: Fluid-based biomarkers, particularly multi-marker models, may have diagnostic potential in RIF; however, current evidence remains insufficient to support routine clinical implementation. Future research should prioritize prospective validation of blood-based multi-marker models in standardized, euploidy-controlled cohorts, alongside greater investigation of biologically proximal uterine and menstrual biofluids. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251068643.

Indexed as

BiomarkersBody FluidsEmbryo ImplantationFemaleHumansPregnancyPrognosisBiomarkersbiomarkerbloodendometrial receptivitymenstrual fluidrepeated implantation failureuterine fluid

Identifiers

PMID42369067
PMCPMC13303133

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.