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Embryonic factors have often been ignored in previous studies about the role of endometrium in implantation. In this study, we sought to identify the endometrial genes associated with negative pregnancy outcomes following the transfer of a single euploid blastocyst.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Computational analyses of the transcriptomes of mid\u2010secretory endometria from nine pregnant and seven non\u2010pregnant patients in a cycle preceding the transfer of a single euploid blastocyst in a vitrified\u2010warmed cycle were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Principal component analysis of two reported endometrial receptivity gene sets showed close clustering of the pregnant and non\u2010pregnant samples. Differential gene expression analysis and co\u2010expression module analysis identified 131 genes associated with the pregnancy status. The endometrial signatures identified highlight the importance of immune and metabolic regulation in pregnancy outcome. Network analysis identified 20 hub genes that could predict pregnancy outcomes with\u00a088.9% sensitivity and 85.7% specificity. Single\u2010cell gene expression analysis highlighted the regulation of endometrial natural killer (NK) cells, T cells, and macrophages during embryo implantation. Immune cell abundance analysis supported the dysregulation of cytotoxic immune cells in the endometria of non\u2010pregnant women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We reported the first endometrial gene signature associated with pregnancy after elimination of embryo aneuploidy and highlighted the importance of the endometrial immune microenvironment and metabolic status in pregnancy outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13672","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T16:50:25Z","timestamp":1671641425000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Transcriptomic analysis of mid\u2010secretory endometrium reveals essential immune factors associated with pregnancy after single euploid blastocyst transfer"],"prefix":"10.1111","volume":"89","author":[{"given":"Yanfei","family":"Cheng","sequence":"first","affiliation":[{"name":"Shenzhen Key Laboratory of Fertility Regulation, Reproductive Medicine Center The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"},{"name":"Center for Energy Metabolism and Reproduction Shenzhen Institute of Advanced Technology Chinese Academy of Sciences  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology the First Medical Center of PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Shang","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jue","family":"Wang","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory of Fertility Regulation, Reproductive Medicine Center The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingwen","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Third Hospital Peking University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinning","family":"Zhang","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinmeng","family":"Guo","sequence":"additional","affiliation":[{"name":"College of Medicine Nankai University  Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidong","family":"Wang","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5350-892X","authenticated-orcid":false,"given":"Yong\u2010Gang","family":"Duan","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory of Fertility Regulation, Reproductive Medicine Center The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheuk\u2010Lun","family":"Lee","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory of Fertility Regulation, Reproductive Medicine Center The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"},{"name":"Department of Obstetrics and Gynaecology The University of Hong Kong  Hong Kong S.A.R., China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip C. 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