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Zhang WB, Li J, Li Q, Lu X, Chen JL, Li L, Chen H, Fu W, Chen JC, Lu BJ, Wu H, Sun XX. Endometrial transcriptome profiling of patients with recurrent implantation failure during hormone replacement therapy cycles. Front Endocrinol (Lausanne) 2024; 14:1292723. [PMID: 38352249 PMCID: PMC10863671 DOI: 10.3389/fendo.2023.1292723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024] Open
Abstract
Background The molecular mechanisms underlying window of implantation (WOI) displacement in patients with recurrent implantation failure (RIF) remain unclear. This study aims to explore the transcriptomic signatures of endometrium with normal and displaced WOIs and to identify the causes of endometrial receptivity (ER) abnormalities and WOI displacement in RIF patients. Methods In this study, 40 RIF patients were recruited and underwent personalized embryo transfer (pET) guided by the predicted results of endometrial receptivity diagnosis (ERD) model. Transcriptome analysis of endometrium from patients with clinical pregnancies after pET was performed to identify differentially expressed genes (DEGs) associated with WOI displacement. Gene expression data from HRT and natural cycle endometrium were compared to identify specific gene expression patterns of ER-related genes during WOI. Results The ERD results indicated that 67.5% of RIF patients (27/40) were non-receptive in the conventional WOI (P+5) of the HRT cycle. The clinical pregnancy rate in RIF patients improved to 65% (26/40) after ERD-guided pET, indicating the effectiveness of transcriptome-based WOI prediction. Among the 26 patients with clinical pregnancy, the gene expression profiles of P+5 endometrium from advanced (n=6), normal (n=10) and delayed (n=10) WOI groups were significantly different from each other. Furthermore, 10 DEGs identified among P+5 endometrium of 3 groups were involved in immunomodulation, transmembrane transport and tissue regeneration, which could accurately classify the endometrium with different WOIs. Additionally, a large number of ER-related genes showed significant correlation and similar gene expression patterns in P+3, P+5, and P+7 endometrium from HRT cycles and LH+5, LH+7, and LH+9 endometrium from natural cycles. Conclusion Our study shows that ER-related genes share similar gene expression patterns during WOI in both natural and HRT cycles, and their aberrant expression is associated with WOI displacements. The improvement of pregnancy outcomes in RIF patients by adjusting ET timing according to ERD results demonstrates the importance of transcriptome-based endometrial receptivity assessment and the clinical efficiency of ERD model.
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Affiliation(s)
- Wen-bi Zhang
- Shanghai Ji Ai Genetics and In vitro Fertilization and Embryo Transfer (IVF-ET) Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Jue Li
- Unimed Biotech (Shanghai) Co., Ltd., Shanghai, China
| | - Qing Li
- Unimed Biotech (Shanghai) Co., Ltd., Shanghai, China
| | - Xiang Lu
- Shanghai Ji Ai Genetics and In vitro Fertilization and Embryo Transfer (IVF-ET) Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Jun-ling Chen
- Shanghai Ji Ai Genetics and In vitro Fertilization and Embryo Transfer (IVF-ET) Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Lu Li
- Shanghai Ji Ai Genetics and In vitro Fertilization and Embryo Transfer (IVF-ET) Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Hua Chen
- Shanghai Ji Ai Genetics and In vitro Fertilization and Embryo Transfer (IVF-ET) Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Wei Fu
- Shanghai Ji Ai Genetics and In vitro Fertilization and Embryo Transfer (IVF-ET) Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | | | - Bing-jie Lu
- Unimed Biotech (Shanghai) Co., Ltd., Shanghai, China
| | - Han Wu
- Unimed Biotech (Shanghai) Co., Ltd., Shanghai, China
| | - Xiao-xi Sun
- Shanghai Ji Ai Genetics and In vitro Fertilization and Embryo Transfer (IVF-ET) Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Key Laboratory of Female Reproductive Endocrine-Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
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Yang J, Wang L, Ma J, Diao L, Chen J, Cheng Y, Yang J, Li L. Endometrial proteomic profile of patients with repeated implantation failure. Front Endocrinol (Lausanne) 2023; 14:1144393. [PMID: 37583433 PMCID: PMC10424929 DOI: 10.3389/fendo.2023.1144393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 07/13/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction Successful embryo implantation, is the initiating step of pregnancy, relies on not only the high quality of the embryo but also the synergistic development of a healthy endometrium. Characterization and identification of biomarkers for the receptive endometrium is an effective method for increasing the probability of successful embryo implantation. Methods Endometrial tissues from 22 women with a history of recurrent implantation failure (RIF) and 19 fertile controls were collected using biopsy catheters on 7-9 days after the peak of luteinizing hormone. Differentially expressed proteins (DEPs) were identified in six patients with RIF and six fertile controls using isobaric tag for relative and absolute quantitation (iTRAQ)-based proteomics analysis. Results Two hundred and sixty-three DEPs, including proteins with multiple bioactivities, such as protein translation, mitochondrial function, oxidoreductase activity, fatty acid and amino acid metabolism, were identified from iTRAQ. Four potential biomarkers for receptive endometrium named tubulin polymerization-promoting protein family member 3 TPPP3, S100 Calcium Binding Protein A13 (S100A13), 17b-hydroxysteroid dehydrogenase 2 (HSD17B2), and alpha-2-glycoprotein 1, zinc binding (AZGP1) were further verified using ProteinSimple Wes and immunohistochemical staining in all included samples (n=22 for RIF and n=19 for controls). Of the four proteins, the protein levels of TPPP3 and HSD17B2 were significantly downregulated in the endometrium of patients with RIF. Discussion Poor endometrial receptivity is considered the main reason for the decrease in pregnancy success rates in patients suffering from RIF. iTRAQ techniques based on isotope markers can identify and quantify low abundance proteomics, and may be suitable for identifying differentially expressed proteins in RIF. This study provides novel evidence that TPPP3 and HSD17B2 may be effective targets for the diagnosis and treatment of non-receptive endometrium and RIF.
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Affiliation(s)
- Jing Yang
- Reproductive Medical Center, Renmin Hospital of Wuhan University & Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, China
| | - Linlin Wang
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
- Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Jingwen Ma
- Department of Reproductive Medicine, Chengdu XiNan Gynecological Hospital, Chengdu, China
| | - Lianghui Diao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
- Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Jiao Chen
- Reproductive Medical Center, Renmin Hospital of Wuhan University & Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, China
| | - Yanxiang Cheng
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jing Yang
- Reproductive Medical Center, Renmin Hospital of Wuhan University & Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, China
| | - Longfei Li
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
- Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
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Sun K, Xiu Y, Wang Y, Yu T, Lu X, Wang X, Yu Y. Predictive value of 3D ultrasound assessment of endometrial receptivity for PGD/PGS for transfer pregnancy outcome. BMC Pregnancy Childbirth 2023; 23:213. [PMID: 36991412 DOI: 10.1186/s12884-023-05534-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE To investigate the predictive value of three-dimensional ultrasound assessment of endometrial receptivity in PGD/PGS transplantation patients on pregnancy outcome. METHODS 280 patients undergoing PGD/PGS transplantation were enrolled and divided into group A and group B according to the patients' pregnancy outcomes. The general conditions, endometrial receptivity indexes of the two groups were compared. Multifactorial logistic regression analysis was used to determine the factors influencing pregnancy outcome in PGD/PGS transplant patients. ROC curves were plotted to analyze the predictive value of 3D ultrasound parameters on pregnancy outcome. The results of the study were validated with patients who underwent FET transplantation, and the patients in the validation group were treated with the same 3D ultrasound examination method and treatment plan as the observation group. RESULTS The differences in basic situations between two groups were not statistically significant (P > 0.05). The percentage of endometrial thickness, endometrial blood flow, and endometrial blood flow classification type II + II were higher in group A than in group B (P < 0.05). Multifactorial logistic regression analysis showed that endometrial thickness, endometrial blood flow and endometrial blood flow classification were influencing factors of pregnancy outcome in PGD/PGS patients. The sensitivity of predicting pregnancy outcome based on the results of transcatheter 3D ultrasound was 91.18%, the specificity was 82.35%, and the accuracy was 90.00%, which has a high predictive value. CONCLUSION 3D ultrasound can predict pregnancy outcome by assessing the endometrial receptivity of PGD/PGS transplantation, in which endometrial thickness and endometrial blood flow have a good predictive value.
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Affiliation(s)
- Kaixuan Sun
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, No. 5 Guangrong Road, Heping Area, Shenyang, Liaoning, 110016, People's Republic of China
| | - Yinling Xiu
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, No. 5 Guangrong Road, Heping Area, Shenyang, Liaoning, 110016, People's Republic of China
| | - Yinghua Wang
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, No. 5 Guangrong Road, Heping Area, Shenyang, Liaoning, 110016, People's Republic of China
| | - Tingting Yu
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, No. 5 Guangrong Road, Heping Area, Shenyang, Liaoning, 110016, People's Republic of China
| | - Xiaoli Lu
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, No. 5 Guangrong Road, Heping Area, Shenyang, Liaoning, 110016, People's Republic of China
| | - Xiliang Wang
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, No. 5 Guangrong Road, Heping Area, Shenyang, Liaoning, 110016, People's Republic of China
| | - Yuexin Yu
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, No. 5 Guangrong Road, Heping Area, Shenyang, Liaoning, 110016, People's Republic of China.
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Lee YX, Su PH, Do AQ, Tzeng CR, Hu YM, Chen CH, Chen CW, Liao CC, Chen LY, Weng YC, Wang HC, Lai HC. Cervical Secretion Methylation Is Associated with the Pregnancy Outcome of Frozen-Thawed Embryo Transfer. Int J Mol Sci 2023; 24:ijms24021726. [PMID: 36675243 PMCID: PMC9863254 DOI: 10.3390/ijms24021726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
The causes of implantation failure remain a black box in reproductive medicine. The exact mechanism behind the regulation of endometrial receptivity is still unknown. Epigenetic modifications influence gene expression patterns and may alter the receptivity of human endometrium. Cervical secretions contain endometrial genetic material, which can be used as an indicator of the endometrial condition. This study evaluates the association between the cervical secretion gene methylation profile and pregnancy outcome in a frozen-thawed embryonic transfer (FET) cycle. Cervical secretions were collected from women who entered the FET cycle with a blastocyst transfer (36 pregnant and 36 non-pregnant women). The DNA methylation profiles of six candidate genes selected from the literature review were measured by quantitative methylation-specific PCR (qMSP). Bioinformatic analysis of six selected candidate genes showed significant differences in DNA methylation between receptive and pre-receptive endometrium. All candidate genes showed different degrees of correlation with the pregnancy outcomes in the logistic regression model. A machine learning approach showed that the combination of candidate genes' DNA methylation profiles could differentiate pregnant from non-pregnant samples with an accuracy as high as 86.67% and an AUC of 0.81. This study demonstrated the association between cervical secretion methylation profiles and pregnancy outcomes in an FET cycle and provides a basis for potential clinical application as a non-invasive method for implantation prediction.
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Affiliation(s)
- Yi-Xuan Lee
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11030, Taiwan
- Taipei Fertility Center, Taipei 11030, Taiwan
- Translational Epigenetics Center, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
| | - Po-Hsuan Su
- Translational Epigenetics Center, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
| | - Anh Q. Do
- International Ph.D. Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Department of Obstetrics and Gynecology, Hai Phong University of Medicine and Pharmacy, Hai Phong 04254, Vietnam
| | - Chii-Ruei Tzeng
- Taipei Fertility Center, Taipei 11030, Taiwan
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11303, Taiwan
| | - Yu-Ming Hu
- Taipei Fertility Center, Taipei 11030, Taiwan
| | - Chi-Huang Chen
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11303, Taiwan
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei 11030, Taiwan
| | - Chien-Wen Chen
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
| | - Chi-Chun Liao
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
| | - Lin-Yu Chen
- Translational Epigenetics Center, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11303, Taiwan
| | - Yu-Chun Weng
- Translational Epigenetics Center, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
| | - Hui-Chen Wang
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Hung-Cheng Lai
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11030, Taiwan
- Translational Epigenetics Center, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23504, Taiwan
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11303, Taiwan
- Correspondence: or ; Tel.: +886-2-2249-0088 (ext. 8868)
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Koel M, Krjutškov K, Saare M, Samuel K, Lubenets D, Katayama S, Einarsdottir E, Vargas E, Sola-Leyva A, Lalitkumar PG, Gemzell-Danielsson K, Blesa D, Simon C, Lanner F, Kere J, Salumets A, Altmäe S. Human endometrial cell-type-specific RNA sequencing provides new insights into the embryo-endometrium interplay. Hum Reprod Open 2022; 2022:hoac043. [PMID: 36339249 PMCID: PMC9632455 DOI: 10.1093/hropen/hoac043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 09/21/2022] [Indexed: 08/17/2023] Open
Abstract
STUDY QUESTION Which genes regulate receptivity in the epithelial and stromal cellular compartments of the human endometrium, and which molecules are interacting in the implantation process between the blastocyst and the endometrial cells? SUMMARY ANSWER A set of receptivity-specific genes in the endometrial epithelial and stromal cells was identified, and the role of galectins (LGALS1 and LGALS3), integrin β1 (ITGB1), basigin (BSG) and osteopontin (SPP1) in embryo-endometrium dialogue among many other protein-protein interactions were highlighted. WHAT IS KNOWN ALREADY The molecular dialogue taking place between the human embryo and the endometrium is poorly understood due to ethical and technical reasons, leaving human embryo implantation mostly uncharted. STUDY DESIGN SIZE DURATION Paired pre-receptive and receptive phase endometrial tissue samples from 16 healthy women were used for RNA sequencing. Trophectoderm RNA sequences were from blastocysts. PARTICIPANTS/MATERIALS SETTING METHODS Cell-type-specific RNA-seq analysis of freshly isolated endometrial epithelial and stromal cells using fluorescence-activated cell sorting (FACS) from 16 paired pre-receptive and receptive tissue samples was performed. Endometrial transcriptome data were further combined in silico with trophectodermal gene expression data from 466 single cells originating from 17 blastocysts to characterize the first steps of embryo implantation. We constructed a protein-protein interaction network between endometrial epithelial and embryonal trophectodermal cells, and between endometrial stromal and trophectodermal cells, thereby focusing on the very first phases of embryo implantation, and highlighting the molecules likely to be involved in the embryo apposition, attachment and invasion. MAIN RESULTS AND THE ROLE OF CHANCE In total, 499 epithelial and 581 stromal genes were up-regulated in the receptive phase endometria when compared to pre-receptive samples. The constructed protein-protein interactions identified a complex network of 558 prioritized protein-protein interactions between trophectodermal, epithelial and stromal cells, which were grouped into clusters based on the function of the involved molecules. The role of galectins (LGALS1 and LGALS3), integrin β1 (ITGB1), basigin (BSG) and osteopontin (SPP1) in the embryo implantation process were highlighted. LARGE SCALE DATA RNA-seq data are available at www.ncbi.nlm.nih.gov/geo under accession number GSE97929. LIMITATIONS REASONS FOR CAUTION Providing a static snap-shot of a dynamic process and the nature of prediction analysis is limited to the known interactions available in databases. Furthermore, the cell sorting technique used separated enriched epithelial cells and stromal cells but did not separate luminal from glandular epithelium. Also, the use of biopsies taken from non-pregnant women and using spare IVF embryos (due to ethical considerations) might miss some of the critical interactions characteristic of natural conception only. WIDER IMPLICATIONS OF THE FINDINGS The findings of our study provide new insights into the molecular embryo-endometrium interplay in the first steps of implantation process in humans. Knowledge about the endometrial cell-type-specific molecules that coordinate successful implantation is vital for understanding human reproduction and the underlying causes of implantation failure and infertility. Our study results provide a useful resource for future reproductive research, allowing the exploration of unknown mechanisms of implantation. We envision that those studies will help to improve the understanding of the complex embryo implantation process, and hopefully generate new prognostic and diagnostic biomarkers and therapeutic approaches to target both infertility and fertility, in the form of new contraceptives. STUDY FUNDING/COMPETING INTERESTS This research was funded by the Estonian Research Council (grant PRG1076); Horizon 2020 innovation grant (ERIN, grant no. EU952516); Enterprise Estonia (grant EU48695); the EU-FP7 Marie Curie Industry-Academia Partnerships and Pathways (IAPP, grant SARM, EU324509); Spanish Ministry of Economy, Industry and Competitiveness (MINECO) and European Regional Development Fund (FEDER) (grants RYC-2016-21199, ENDORE SAF2017-87526-R, and Endo-Map PID2021-127280OB-100); Programa Operativo FEDER Andalucía (B-CTS-500-UGR18; A-CTS-614-UGR20), Junta de Andalucía (PAIDI P20_00158); Margarita Salas program for the Requalification of the Spanish University system (UJAR01MS); the Knut and Alice Wallenberg Foundation (KAW 2015.0096); Swedish Research Council (2012-2844); and Sigrid Jusélius Foundation; Academy of Finland. A.S.-L. is funded by the Spanish Ministry of Science, Innovation and Universities (PRE2018-085440). K.G.-D. has received consulting fees and/or honoraria from RemovAid AS, Norway Bayer, MSD, Gedeon Richter, Mithra, Exeltis, MedinCell, Natural cycles, Exelgyn, Vifor, Organon, Campus Pharma and HRA-Pharma and NIH support to the institution; D.B. is an employee of IGENOMIX. The rest of the authors declare no conflict of interest.
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Affiliation(s)
- Mariann Koel
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Cell Biology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Kaarel Krjutškov
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Merli Saare
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Külli Samuel
- Competence Centre on Health Technologies, Tartu, Estonia
| | - Dmitri Lubenets
- Department of Cell Biology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Shintaro Katayama
- Stem Cells and Metabolism Research Program, Research Programs Unit, University of Helsinki, and Folkhälsan Research Center, Helsinki, Finland
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Elisabet Einarsdottir
- Stem Cells and Metabolism Research Program, Research Programs Unit, University of Helsinki, and Folkhälsan Research Center, Helsinki, Finland
- Science for Life Laboratory, Department of Gene Technology, KTH-Royal Institute of Technology, Solna, Sweden
| | - Eva Vargas
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Systems Biology Unit, Department of Experimental Biology, Faculty of Experimental Sciences, University of Jaén, Jaén, Spain
| | - Alberto Sola-Leyva
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Parameswaran Grace Lalitkumar
- Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institutet, and Karolinska Univeristy Hospital, Stockholm,Sweden
| | - Kristina Gemzell-Danielsson
- Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institutet, and Karolinska Univeristy Hospital, Stockholm,Sweden
| | - David Blesa
- Department of Product Development, IGENOMIX, Valencia, Spain
| | - Carlos Simon
- Department of Obstetrics and Gynecology, Valencia University and INCLIVA in Valencia, Valencia, Spain
- Department of Obstetrics and Gynecology, BIDMC, Harvard University, Boston, MA, USA
| | - Fredrik Lanner
- Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm,Sweden
- Ming Wai Lau Center for Reparative Medicine, Stockholm node, Karolinska Institutet, Stockholm, Sweden
| | - Juha Kere
- Stem Cells and Metabolism Research Program, Research Programs Unit, University of Helsinki, and Folkhälsan Research Center, Helsinki, Finland
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Andres Salumets
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm,Sweden
| | - Signe Altmäe
- Competence Centre on Health Technologies, Tartu, Estonia
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm,Sweden
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Erten O, Taskomur AT, Albayrak M. Current Biomarkers for Endometrial Receptivity. Biomark Med 2022. [DOI: 10.2174/9789815040463122010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Implantation and the continuation of pregnancy occur through a complicated
and sophisticated dialogue, called “cross-talk,” which starts between the embryo and
the endometrium in the early stages of oocyte maturation. This dialogue provides
synchronization of the journey of the embryo to be implanted with the receptive
endometrium. Understanding the activity and function of the hormones and factors
involved in this dialogue will provide an understanding of endometrial receptivity,
which plays a key role in implantation, and the determination of biomarkers specific
for this period. As a result of the development of omics technology, it has become
possible to identify biomarkers specific to endometrial receptivity by performing
genomic, proteomic, and lipidomic analyses of these hormones and factors. The
determination of these biomarkers, their optimization, and making them usable in the
clinic will allow increased success in ART.
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Affiliation(s)
- Ozlem Erten
- Department of Obstetrics and Gynecology, School of Medicine, Kutahya Health Sciences
University, Kutahya, Turkey
| | - Aysun Tekeli Taskomur
- Department of Obstetrics and Gynecology, Faculty of Medicine, Amasya University, Amasya,
Turkey
| | - Mustafa Albayrak
- Department of Obstetrics and Gynecology, Sisli Florence Nightingale Hospital, Istanbul, Turkey
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7
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Zhang WB, Li H, Lu X, Chen JL, Li L, Chen JC, Wu H, Sun XX. The clinical efficiency of transcriptome-based endometrial receptivity assessment (Tb-ERA) in Chinese patients with recurrent implantation failure (RIF): A study protocol for a prospective randomized controlled trial. Contemp Clin Trials Commun 2022; 28:100928. [PMID: 35669489 PMCID: PMC9163422 DOI: 10.1016/j.conctc.2022.100928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/11/2022] [Accepted: 05/24/2022] [Indexed: 11/28/2022] Open
Abstract
Background Today, approximately 10% of participants in assisted reproductive technology (ART) are defined as having recurrent implantation failure (RIF). Recent studies show that endometrial receptivity array can improve pregnancy and implantation rates by nearly 20% in women with RIF. However, these studies are limited, with little published data in the Chinese population. Recently, we have established a transcriptome-based endometrial receptivity assessment (Tb-ERA) method of predicting the endometrial window of implantation (WOI) using transcriptome-profiling data of different phases of the menstrual cycle from healthy fertile Chinese women by RNA-Seq. It is meaningful to conduct a randomized controlled trial (RCT) to assess the clinical efficiency of Tb-ERA in Chinese patients with RIF. Methods In this RCT, a total of 200 RIF patients will be recruited and randomized into 2 groups. Patients in the Tb-ERA group will undergo a Tb-ERA test, after which embryo transfer time will be adjusted according to Tb-ERA results and embryo transfer will be performed again in the next cycle. Patients in the control group will not receive any interventions until the next transfer cycle. We will perform statistical analysis on both groups at the primary endpoint (clinical-pregnancy rate) and at secondary endpoints (rate of WOI displacement, embryo implantation, biochemical pregnancy, early abortion, and ectopic pregnancy). Implications: This study aims to evaluate the effectiveness of our Tb-ERA test in Chinese RIF patients and to determine that whether Tb-ERA could improve the clinical-pregnancy rate in these RIF patients. Trial registration NCT04497558, registered August 4, 2020.
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Affiliation(s)
- Wen-bi Zhang
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - He Li
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Xiang Lu
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Jun-ling Chen
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Lu Li
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | | | - Han Wu
- Unimed Biotech (Shanghai) Co., Ltd., Shanghai, China
| | - Xiao-xi Sun
- Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
- Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
- Corresponding author. Shanghai Ji Ai Genetics & IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, NO. 352 Da lin Road, Shanghai, 200011, China.
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8
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Emerging in vitro platforms and omics technologies for studying the endometrium and early embryo-maternal interface in humans. Placenta 2022; 125:36-46. [DOI: 10.1016/j.placenta.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/09/2021] [Accepted: 01/09/2022] [Indexed: 12/11/2022]
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9
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Recurrent Implantation Failure-Is It the Egg or the Chicken? LIFE (BASEL, SWITZERLAND) 2021; 12:life12010039. [PMID: 35054432 PMCID: PMC8777926 DOI: 10.3390/life12010039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 12/31/2022]
Abstract
Recurrent implantation failure (RIF) is an undefined, quite often, clinical phenomenon that can result from the repeated failure of embryo transfers to obtain a viable pregnancy. Careful clinical evaluation prior to assisted reproduction can uncover various treatable causes, including endocrine dysfunction, fibroid(s), polyp(s), adhesions, uterine malformations. Despite the fact that it is often encountered and has a critical role in Assisted Reproductive Technique (ART) and human reproduction, RIF’s do not yet have an agreed-on definition, and its etiologic factors have not been entirely determined. ART is a complex treatment with a variable percentage of success among patients and care providers. ART depends on several factors that are not always known and probably not always the same. When confronted with repeated ART failure, medical care providers should try to determine whether the cause is an embryo or endometrium related. One of the most common causes of pregnancy failure is aneuploidy. Therefore, it is likely that this represents a common cause of RIF. Other RIF potential causes include immune and endometrial factors; however, with a very poorly defined role. Recent data indicate that the possible endometrial causes of RIF are very rare, thereby throwing into doubt all endometrial receptivity assays. All recent reports indicate that the true origin of RIF is probably due to the “egg”.
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10
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Haouzi D, Entezami F, Tuaillon E, Gala A, Ferrières-Hoa A, Brouillet S, Thierry AR, Hamamah S. SARS-CoV-2 and Implantation Window: Gene Expression Mapping of Human Endometrium and Preimplantation Embryo. Life (Basel) 2021; 11:life11121378. [PMID: 34947909 PMCID: PMC8706202 DOI: 10.3390/life11121378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Understanding whether SARS-CoV-2 could infect cells and tissues handled during ART is crucial for risk mitigation, especially during the implantation window when either endometrial biopsies are often practiced for endometrial receptivity assessment or embryo transfer is performed. To address this question, this review analyzed current knowledge of the field and retrospectively examined the gene expression profiles of SARS-CoV-2-associated receptors and proteases in a cohort of ART candidates using our previous Affymetrix microarray data. Human endometrial tissue under natural and controlled ovarian stimulation cycles and preimplantation embryos were analyzed. A focus was particularly drawn on the renin-angiotensin system, which plays a prominent role in the virus infection, and we compared the gene expression levels of receptors and proteases related to SARS-CoV-2 infection in the samples. High prevalence of genes related to the ACE2 pathway during both cycle phases and mainly during the mid-secretory phase for ACE2 were reported. The impact of COS protocols on endometrial gene expression profile of SARS-CoV-2-associated receptors and proteases is minimal, suggesting no additional potential risks during stimulated ART procedure. In blastocysts, ACE2, BSG, CTSL, CTSA and FURIN were detectable in the entire cohort at high expression level. Specimens from female genital tract should be considered as potential targets for SARS-CoV-2, especially during the implantation window.
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Affiliation(s)
- Delphine Haouzi
- Univ Montpellier, INSERM U1203, DEFE, 34295 Montpellier, France; (D.H.); (F.E.); (A.G.); (A.F.-H.); (S.B.)
- IRMB (Institute for Regenerative Medicine & Biotherapy), Univ Montpellier, INSERM, 34295 Montpellier, France
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, 34295 Montpellier, France
- Global ART Innovation Network, IRMB, CHU Montpellier, 34295 Montpellier, France
| | - Frida Entezami
- Univ Montpellier, INSERM U1203, DEFE, 34295 Montpellier, France; (D.H.); (F.E.); (A.G.); (A.F.-H.); (S.B.)
- ART Department, American Hospital of Paris, 92200 Neuilly-Sur-Seine, France
| | - Edward Tuaillon
- CHU Montpellier, Bacteriology-Virology Department, 34295 Montpellier, France;
| | - Anna Gala
- Univ Montpellier, INSERM U1203, DEFE, 34295 Montpellier, France; (D.H.); (F.E.); (A.G.); (A.F.-H.); (S.B.)
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, 34295 Montpellier, France
| | - Alice Ferrières-Hoa
- Univ Montpellier, INSERM U1203, DEFE, 34295 Montpellier, France; (D.H.); (F.E.); (A.G.); (A.F.-H.); (S.B.)
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, 34295 Montpellier, France
| | - Sophie Brouillet
- Univ Montpellier, INSERM U1203, DEFE, 34295 Montpellier, France; (D.H.); (F.E.); (A.G.); (A.F.-H.); (S.B.)
- IRMB (Institute for Regenerative Medicine & Biotherapy), Univ Montpellier, INSERM, 34295 Montpellier, France
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, 34295 Montpellier, France
| | - Alain R. Thierry
- Regional Institute of Cancer of Montpellier, 34090 Montpellier, France;
| | - Samir Hamamah
- Univ Montpellier, INSERM U1203, DEFE, 34295 Montpellier, France; (D.H.); (F.E.); (A.G.); (A.F.-H.); (S.B.)
- IRMB (Institute for Regenerative Medicine & Biotherapy), Univ Montpellier, INSERM, 34295 Montpellier, France
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, 34295 Montpellier, France
- Global ART Innovation Network, IRMB, CHU Montpellier, 34295 Montpellier, France
- Correspondence: ; Tel.: +33-04-67-33-64-04; Fax: +33-04-67-33-62-90
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11
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Bisphenol A Analogues Suppress Spheroid Attachment on Human Endometrial Epithelial Cells through Modulation of Steroid Hormone Receptors Signaling Pathway. Cells 2021; 10:cells10112882. [PMID: 34831106 PMCID: PMC8616109 DOI: 10.3390/cells10112882] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 11/17/2022] Open
Abstract
Bisphenol A (BPA) is a well-known endocrine disruptor, widely used in various consumer products and ubiquitously found in air, water, food, dust, and sewage leachates. Recently, several countries have restricted the use of BPA and replaced them with bisphenol S (BPS) and bisphenol F (BPF), which have a similar chemical structure to BPA. Compared to BPA, both BPS and BPF have weaker estrogenic effects, but their effects on human reproductive function including endometrial receptivity and embryo implantation still remain largely unknown. We used an in vitro spheroid (blastocyst surrogate) co-culture assay to investigate the effects of BPA, BPS, and BPF on spheroid attachment on human endometrial epithelial cells, and further delineated their role on steroid hormone receptor expression. We also used transcriptomics to investigate the effects of BPA, BPS, and BPF on the transcriptome of human endometrial cells. We found that bisphenol treatment in human endometrial Ishikawa cells altered estrogen receptor alpha (ERα) signaling and upregulated progesterone receptors (PR). Bisphenols suppressed spheroid attachment onto Ishikawa cells, which was reversed by the downregulation of PR through PR siRNA. Overall, we found that bisphenol compounds can affect human endometrial epithelial cell receptivity through the modulation of steroid hormone receptor function leading to impaired embryo implantation.
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12
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Polanski LT, Baumgarten M. Endometrial Receptivity Testing and Therapy in Assisted Reproductive Treatment. Semin Reprod Med 2021; 39:27-33. [PMID: 34391208 DOI: 10.1055/s-0041-1730421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Assisted reproductive treatment (ART) gave numerous couples the chance to have their biological child. Improvement in laboratory and culture conditions allows for selection of embryos with the best developmental potential, although replacement of these top-quality embryos does not, however, guarantee reproductive success. Endometrial receptivity is essential for pregnancy establishment and may be the limiting factor for the observed pregnancy rates with ART. Multiple modalities have been in use to assess endometrial receptivity, with ultrasound assessment of the endometrial morphology most commonly used due to its noninvasive nature and availability. Utilization of various "omics" increases our understanding of endometrial receptivity and selectivity; however, significantly more work is required to develop clinically relevant and validated tests of endometrial receptivity and treatments which could improve a suboptimal endometrial milieu. Current evidence for and against use of various tests of endometrial receptivity in women undergoing ART is presented in this article.
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Affiliation(s)
- Lukasz Tadeusz Polanski
- Division of Obstetrics and Gynaecology, Department of Reproductive Medicine, Peterborough City Hospital, Peterborough, United Kingdom
| | - Miriam Baumgarten
- Department of Obstetrics and Gynaecology, Addenbrooke's Hospital, Cambridge, United Kingdom
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13
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Barrenetxea G, Romero I, Celis R, Abio A, Bilbao M, Barrenetxea J. Correlation between plasmatic progesterone, endometrial receptivity genetic assay and implantation rates in frozen-thawed transferred euploid embryos. A multivariate analysis. Eur J Obstet Gynecol Reprod Biol 2021; 263:192-197. [PMID: 34229182 DOI: 10.1016/j.ejogrb.2021.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 02/21/2021] [Accepted: 05/29/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To ascertain the predictive value of different parameters to determine endometrial receptivity among assisted reproduction treatments in which single embryo transfer of frozen-thawed euploid blastocysts are performed. STUDY DESIGN Observational study involving 104 patients recruited between September.2018 and June.2019 at a University associated assisted reproduction center. The relationship of different parameters (age, body mass index (BMI), duration of hormonal preparation, plasmatic progesterone levels, endometrial parameters at ultrasound assessment and endometrial receptivity determined by endometrial receptivity assay (ERA) was evaluated by a multivariable logistic (binomial) analysis after hormonal preparation. According to the ERA test results a personalized endometrial transfer (pET) was scheduled and live birth rate was assessed. Only single transfers of frozen euploid blastocysts were performed. RESULTS ERA test report predicted receptive endometrium (RE) in 54,64% patients and non-receptive (NR) in 45,31% patients. Among NR endometrial samples, 20,62% were classified as pre-receptive or early receptive, whereas 24,74% as post-receptive or late-receptive. The univariate analysis showed a relationship between BMI, doses of progesterone administered before biopsy and the receptivity of endometrium. There was no relationship between age of women, duration of hormonal supplementation, and the results of ERA test. In our series, endometrial receptivity was not related neither to endometrial thickness nor plasmatic progesterone levels. The multivariate analysis showed that both, BMI and cumulative progesterone administered prior to the test are independent predictive factors of endometrial receptivity (p = 0,047 and p = 0,034 respectively). The overall live birth rate after FET of euploid embryos was 62,35%. The odd of pregnancy was higher when ERA test was performed prior to the first embryo transfer (93,10% vs. 46,43%; OR = 15,58;95%CI 3,38-71,89). Overall, ongoing pregnancy rates showed a favorable trend after "non-receptive" endometria had been diagnosed and, thus, a modified (pET) preparation was performed (70,00% vs. 55,56%; OR = 1,87; 95% CI 0,76-4,57). CONCLUSION Regarding implantation potential of genetically screened blastocysts, the traditional tools used for assessing endometrial receptivity such as transvaginal evaluation of endometrial thickness and pattern or progesterone levels determination were not useful among our patients for predicting a receptive endometrium.
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Affiliation(s)
- G Barrenetxea
- Reproducción Bilbao, Spain; Universidad del País Vasco/Euskal Herriko Univertsitatea/University of the Basque Country (UPV/EHU), Spain.
| | | | | | - A Abio
- Reproducción Bilbao, Spain
| | | | - J Barrenetxea
- Reproducción Bilbao, Spain; Osakidetza, Servicio Vasco de Salud, Basque Health Service, Spain
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14
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Pirtea P, Scott RT, de Ziegler D, Ayoubi JM. Recurrent implantation failure: how common is it? Curr Opin Obstet Gynecol 2021; 33:207-212. [PMID: 33896917 DOI: 10.1097/gco.0000000000000698] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To clarify a lingering issue, the true incidence of repeated implantation failures (RIF) in women undergoing successive frozen euploid single embryo transfers (FE-SET). RECENT FINDINGS As not all Assisted reproductive techinique (ART) attempts are crowned by success, it has been questioned since incept of ART whether failures resulted from an embryonic or endometrial cause. RIF has received no precise definition but a trend has existed toward setting a more stringent definition, as reproductive biology has become more effective and ART success rates improved. No scientific society has yet convened on a universally accepted definition. The advent of effective and well tolerated pregestational testing of embryos for aneuploidy (PGT-A) has allowed to not transfer aneuploid embryos, which are bound not to succeed. This, therefore, justify revisiting the concept of RIF when only euploid embryos are transferred. SUMMARY Contrary to lingering beliefs, the results of our study indicate that RIF following three successive euploid embryo transfers in a morphologically normal endometrium is a rare occurrence (<5%). This supports the concept that ART failures mainly result from embryonic causes. Our data also propose a new - functional - definition of RIF being an ART failure following 3 successive FE-SET attempts. Our findings, therefore seriously question the soundness of prescribing the often complex and expensive endometrial testing procedures that largely publicized for treating RIF.
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Affiliation(s)
- Paul Pirtea
- Department of Obstetrics and Gynecology and Reproductive Medicine, Hopital Foch - Faculté de Médecine Paris Ouest (UVSQ), Suresnes, France
- IVI-RMA New Jersey, Basking Ridge, New Jersey, USA
| | | | - Dominique de Ziegler
- Department of Obstetrics and Gynecology and Reproductive Medicine, Hopital Foch - Faculté de Médecine Paris Ouest (UVSQ), Suresnes, France
| | - Jean Marc Ayoubi
- Department of Obstetrics and Gynecology and Reproductive Medicine, Hopital Foch - Faculté de Médecine Paris Ouest (UVSQ), Suresnes, France
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15
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Paule SG, Heng S, Samarajeewa N, Li Y, Mansilla M, Webb AI, Nebl T, Young SL, Lessey BA, Hull ML, Scelwyn M, Lim R, Vollenhoven B, Rombauts LJ, Nie G. Podocalyxin is a key negative regulator of human endometrial epithelial receptivity for embryo implantation. Hum Reprod 2021; 36:1353-1366. [PMID: 33822049 DOI: 10.1093/humrep/deab032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/09/2020] [Indexed: 02/02/2023] Open
Abstract
STUDY QUESTION How is endometrial epithelial receptivity, particularly adhesiveness, regulated at the luminal epithelial surface for embryo implantation in the human? SUMMARY ANSWER Podocalyxin (PCX), a transmembrane protein, was identified as a key negative regulator of endometrial epithelial receptivity; specific downregulation of PCX in the luminal epithelium in the mid-secretory phase, likely mediated by progesterone, may act as a critical step in converting endometrial surface from a non-receptive to an implantation-permitting state. WHAT IS KNOWN ALREADY The human endometrium must undergo major molecular and cellular changes to transform from a non-receptive to a receptive state to accommodate embryo implantation. However, the fundamental mechanisms governing receptivity, particularly at the luminal surface where the embryo first interacts with, are not well understood. A widely held view is that upregulation of adhesion-promoting molecules is important, but the details are not well characterized. STUDY DESIGN, SIZE, DURATION This study first aimed to identify novel adhesion-related membrane proteins with potential roles in receptivity in primary human endometrial epithelial cells (HEECs). Further experiments were then conducted to determine candidates' in vivo expression pattern in the human endometrium across the menstrual cycle, regulation by progesterone using cell culture, and functional importance in receptivity using in vitro human embryo attachment and invasion models. PARTICIPANTS/MATERIALS, SETTING, METHODS Primary HEECs (n = 9) were isolated from the proliferative phase endometrial tissue, combined into three pools, subjected to plasma membrane protein enrichment by ultracentrifugation followed by proteomics analysis, which led to the discovery of PCX as a novel candidate of interest. Immunohistochemical analysis determined the in vivo expression pattern and cellular localization of PCX in the human endometrium across the menstrual cycle (n = 23). To investigate whether PCX is regulated by progesterone, the master driver of endometrial differentiation, primary HEECs were treated in culture with estradiol and progesterone and analyzed by RT-PCR (n = 5) and western blot (n = 4). To demonstrate that PCX acts as a negative regulator of receptivity, PCX was overexpressed in Ishikawa cells (a receptive line) and the impact on receptivity was determined using in vitro attachment (n = 3-5) and invasion models (n = 4-6), in which an Ishikawa monolayer mimicked the endometrial surface and primary human trophoblast spheroids mimicked embryos. Mann-Whitney U-test and ANOVA analyses established statistical significance at *P ≤ 0.05 and **P ≤ 0.01. MAIN RESULTS AND THE ROLE OF CHANCE PCX was expressed on the apical surface of all epithelial and endothelial cells in the non-receptive endometrium, but selectively downregulated in the luminal epithelium from the mid-secretory phase coinciding with the establishment of receptivity. Progesterone was confirmed to be able to suppress PCX in primary HEECs, suggesting this hormone likely mediates the downregulation of luminal PCX in vivo for receptivity. Overexpression of PCX in Ishikawa monolayer inhibited not only the attachment but also the penetration of human embryo surrogates, demonstrating that PCX acts as an important negative regulator of epithelial receptivity for implantation. LIMITATIONS, REASONS FOR CAUTION Primary HEECs isolated from the human endometrial tissue contained a mixture of luminal and glandular epithelial cells, as further purification into subtypes was not possible due to the lack of specific markers. Future study would need to investigate how progesterone differentially regulates PCX in endometrial epithelial subtypes. In addition, this study used primary human trophoblast spheroids as human embryo mimics and Ishikawa as endometrial epithelial cells in functional models, future studies with human blastocysts and primary epithelial cells would further validate the findings. WIDER IMPLICATIONS OF THE FINDINGS The findings of this study add important new knowledge to the understanding of human endometrial remodeling for receptivity. The identification of PCX as a negative regulator of epithelial receptivity and the knowledge that its specific downregulation in the luminal epithelium coincides with receptivity development may provide new avenues to assess endometrial receptivity and individualize endometrial preparation protocols in assisted reproductive technology (ART). The study also discovered PCX as progesterone target in HEECs, identifying a potentially useful functional biomarker to monitor progesterone action, such as in the optimization of progesterone type/dose/route of administration for luteal support. STUDY FUNDING/COMPETING INTEREST(S) Study funding was obtained from ESHRE, Monash IVF and NHMRC. LR reports potential conflict of interests (received grants from Ferring Australia; personal fees from Monash IVF Group and Ferring Australia; and non-financial support from Merck Serono, MSD, and Guerbet outside the submitted work. LR is also a minority shareholder and the Group Medical Director for Monash IVF Group, a provider of fertility preservation services). The remaining authors have no potential conflict of interest to declare. TRIAL REGISTRATION NUMBER NA.
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Affiliation(s)
- Sarah G Paule
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Sophea Heng
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, VIC, Australia
| | - Nirukshi Samarajeewa
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, VIC, Australia
| | - Ying Li
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, VIC, Australia
| | - Mary Mansilla
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, VIC, Australia
| | - Andrew I Webb
- Advance Technology and Biology Division, The Walter and Eliza Hall Institute, Parkville, VIC, Australia
| | - Thomas Nebl
- Advance Technology and Biology Division, The Walter and Eliza Hall Institute, Parkville, VIC, Australia
| | - Steven L Young
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA
| | - Bruce A Lessey
- Department of Obstetrics and Gynecology, Greenville Health System, Greenville, SC, USA
| | - M Louise Hull
- The Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | | | - Rebecca Lim
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Beverley Vollenhoven
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.,Womens and Newborn Programme, Monash Health, Clayton, VIC, Australia
| | - Luk J Rombauts
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.,Womens and Newborn Programme, Monash Health, Clayton, VIC, Australia
| | - Guiying Nie
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Implantation and Pregnancy Research Laboratory, School of Health and Biomedical Sciences, RMIT University, VIC, Australia
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16
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Merviel P, Bouée S, Jacamon AS, Chabaud JJ, Le Martelot MT, Roche S, Rince C, Drapier H, Perrin A, Beauvillard D. Progesterone levels on the human chorionic gonadotropin trigger day affect the pregnancy rates for embryos transferred at different stages of development in both general and selected IVF/ICSI populations. BMC Pregnancy Childbirth 2021; 21:363. [PMID: 33957886 PMCID: PMC8101180 DOI: 10.1186/s12884-021-03832-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background Two meta-analyses have shown that pregnancy and birth rates are significantly higher after blastocyst transfer than after cleaved embryo transfer. Other studies have revealed that a serum progesterone level > 1.5 ng/ml on the trigger day is responsible for premature luteinization and is associated with a low pregnancy rate. The objectives of this retrospective study were to determine whether blastocyst transfer gave higher pregnancy rates than cleaved embryo transfer at day 3 in both the general and selected IVF/ICSI populations, and whether the serum progesterone level influenced the pregnancy rate. Method We studied IVF/ICSI cycles with GnRH antagonist - FSH/hMG protocols in a general population (n = 1210) and a selected “top cycle” population (n = 677), after blastocyst transfer on day 5 or cleaved embryo transfer on day 3. The selected couples had to meet the following criteria: female age < 35, first or second cycle, and one or two embryos transferred. We recorded predictive factors for pregnancy and calculated the progesterone to oocyte index (POI), the progesterone:estradiol ratio (P:E2 ratio), and the progesterone to follicle (> 14 mm) index (PFI). Results In the general population, the clinical pregnancy rate was significantly higher after blastocyst transfer (33.3%) than after cleaved embryo transfer (25.3%; p < 0.01); the same was true for the birth rate (32.1 and 22.8%, respectively, p < 0.01). The differences between blastocyst and embryo transfer groups were not significant in the selected population (respectively 35.7% vs. 35.8% for the clinical pregnancy rate, and 33.9 and 34.9% for the birth rate). The serum progesterone levels on the eve of the trigger day and on the day itself were significantly lower in the pregnant women (p < 0.01). We found a serum progesterone threshold of 0.9 ng/ml, as also reported by other researchers. The POI and the PFI appear to have predictive value for cleaved embryos transfers. Conclusions Blastocyst transfers were associated with higher clinical pregnancy and birth rates than cleaved embryo transfers in a general population but not in a selected population. The serum progesterone levels on the eve of the trigger day and on the day itself predicted the likelihood of pregnancy.
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Affiliation(s)
- P Merviel
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France.
| | - S Bouée
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France
| | - A S Jacamon
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France
| | - J J Chabaud
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France
| | - M T Le Martelot
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France
| | - S Roche
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France
| | - C Rince
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France
| | - H Drapier
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France
| | - A Perrin
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France
| | - D Beauvillard
- Department of Gynecology, Obstetrics and Reproductive Medicine, Brest University Hospital, 2 avenue Foch, F-29200, Brest, France
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17
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Siristatidis C, Stavros S, Drakeley A, Bettocchi S, Pouliakis A, Drakakis P, Papapanou M, Vlahos N. Omics and Artificial Intelligence to Improve In Vitro Fertilization (IVF) Success: A Proposed Protocol. Diagnostics (Basel) 2021; 11:diagnostics11050743. [PMID: 33919350 PMCID: PMC8143333 DOI: 10.3390/diagnostics11050743] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 02/06/2023] Open
Abstract
The prediction of in vitro fertilization (IVF) outcome is an imperative achievement in assisted reproduction, substantially aiding infertile couples, health systems and communities. To date, the assessment of infertile couples depends on medical/reproductive history, biochemical indications and investigations of the reproductive tract, along with data obtained from previous IVF cycles, if any. Our project aims to develop a novel tool, integrating omics and artificial intelligence, to propose optimal treatment options and enhance treatment success rates. For this purpose, we will proceed with the following: (1) recording subfertile couples’ lifestyle and demographic parameters and previous IVF cycle characteristics; (2) measurement and evaluation of metabolomics, transcriptomics and biomarkers, and deep machine learning assessment of the oocyte, sperm and embryo; (3) creation of artificial neural network models to increase objectivity and accuracy in comparison to traditional techniques for the improvement of the success rates of IVF cycles following an IVF failure. Therefore, “omics” data are a valuable parameter for embryo selection optimization and promoting personalized IVF treatment. “Omics” combined with predictive models will substantially promote health management individualization; contribute to the successful treatment of infertile couples, particularly those with unexplained infertility or repeated implantation failures; and reduce multiple gestation rates.
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Affiliation(s)
- Charalampos Siristatidis
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (N.V.)
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece
- Correspondence: ; Tel.: +30-69-3229-4994
| | - Sofoklis Stavros
- Assisted Reproduction Unit, First Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Alexandra Hospital, 80 Vas. Sofias Av. and Lourou str., 11528 Athens, Greece; (S.S.); (P.D.)
| | - Andrew Drakeley
- Hewitt Fertility Centre, Liverpool Women’s NHS Foundation Trust, Crown Street, Liverpool L8 7SS, UK;
| | - Stefano Bettocchi
- Second Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, Policlinico University of Bari, 70124 Bari, Italy;
| | - Abraham Pouliakis
- Second Department of Pathology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Rimini 1, Chaidari, 12642 Athens, Greece;
| | - Peter Drakakis
- Assisted Reproduction Unit, First Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Alexandra Hospital, 80 Vas. Sofias Av. and Lourou str., 11528 Athens, Greece; (S.S.); (P.D.)
| | - Michail Papapanou
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (N.V.)
| | - Nikolaos Vlahos
- Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (M.P.); (N.V.)
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece
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Matorras R, Pijoan JI, Perez‐Ruiz I, Lainz L, Malaina I, Borjaba S. Meta-analysis of the embryo freezing transfer interval. Reprod Med Biol 2021; 20:144-158. [PMID: 33850447 PMCID: PMC8022104 DOI: 10.1002/rmb2.12363] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/18/2020] [Accepted: 12/12/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The decision of whether frozen embryo transfer (FET) should be performed in the cycle immediately after OPU or at least one cycle later is controversial. FET could improve pregnancy rates in IVF; however, how much time is needed for the endometrium to return to optimal receptivity after ovarian stimulation is not known. METHODS Electronic search in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials to identify studies providing data on the influence of the interval between embryo freezing (or OPU) and FET in FET cycles published between January 1, 2007, and February 1, 2020. MAIN FINDINGS Data analyzed indicated that in the immediate FET cycles, there was a trend to an increased biochemical pregnancy rate (RR = 1.08; CI = 1.00-1.18), whereas the clinical pregnancy rate was somewhat higher, but without reaching statistical significance (RR = 1.07; CI = 0.99-1.15). The live birth rate was similar in the two groups (RR = 1.05; CI = 0.95-1.15), as was the implantation rate (RR = 0.98; CI = 0.83-1.16). Stratifying by embryo stage or FET type (freeze-all or FET after failed fresh transfer) showed no differences. CONCLUSION Systematically delaying FET does not offer benefits to IVF outcomes. In addition, immediate transfer is associated with a nonsignificant trend to better clinical pregnancy rate and it also avoids the psychological effects of prolonging the stress on prospective parents.
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Affiliation(s)
- Roberto Matorras
- Reproduction UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
- Department of Gynecology and ObstetricsFaculty of Medicine and NursingUniversity of the Basque CountryVizcayaSpain
- IVI BilbaoVizcayaSpain
| | - Jose Ignacio Pijoan
- Clinical Epidemiological UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
| | - Irantzu Perez‐Ruiz
- Reproduction UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
| | - Lucía Lainz
- Reproduction UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
| | - Iker Malaina
- Clinical Epidemiological UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
- Department of MathematicsFaculty of Science and TechnologyUniversity of the Basque CountryVizcayaSpain
| | - Sonia Borjaba
- Reproduction UnitCruces HospitalBiocruces Health Research InstituteBIOEFVizcayaSpain
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Fernando SR, Kottawatta KSA, Jiang L, Chen X, Cheng KW, Wong BPC, Ng EHY, Yeung WSB, Lee KF. Differential expression of protein disulfide isomerase (PDI) in regulating endometrial receptivity in humans. Reprod Biol 2021; 21:100498. [PMID: 33677360 DOI: 10.1016/j.repbio.2021.100498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 12/17/2022]
Abstract
Estrogen and progesterone regulate the expression of endometrial proteins that determine endometrial receptivity for embryo implantation. The protein disulfide isomerase (PDI) family of proteins play a diverse role in regulating protein modification and redox function. Although the role of PDIs in cancer progression has been widely studied, their role in endometrial receptivity is largely unknown. We have focused on the expressions of PDIA1, PDIA2, PDIA3, PDIA4, PDIA5, and PDIA6 isoforms in endometrial epithelium under the influence of estrogen and progesterone and investigated their functional role in regulating endometrial receptivity. We found PDIA1-6 transcripts were expressed in endometrial epithelial Ishikawa, RL95-2, AN3CA, and HEC1-B cell lines. The expression of PDIA1 was low and PDIA5 was high in HEC1-B cells, whereas PDIA2 was high in both AN3CA and HEC1-B cells. In Ishikawa cells, estrogen (10 and 100 nM) upregulated PDIA1 and PDIA6, whereas estrogen (100 nM) downregulated PDIA4 and PDIA5; and progesterone (0.1 and 1 μM) downregulated transcript expressions of PDIA1-6. In human endometrial samples, significantly lowered transcript expressions of PDIA2 and PDIA5 were observed in the secretory phase compared with the proliferative phase, whereas no change was observed in the other studied transcripts throughout the cycle. Inhibition of PDI by PDI antibody (5 and 10 μg/mL) and PDI inhibitor bacitracin (1 and 5 mM) significantly increased the attachment of Jeg-3 spheroids onto AN3CA cells. Taken together, our study suggests a role of PDI in regulating endometrial receptivity and the possibility of using PDI inhibitors to enhance endometrial receptivity.
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Affiliation(s)
- Sudini Ranshaya Fernando
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region; Department of Animal Science, Faculty of Animal Science and Export Agriculture, Uva Wellassa University, Badulla, Sri Lanka
| | - Kottawattage Sanda Arunika Kottawatta
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region; Department of Veterinary Public Health and Pharmacology, Faculty of Veterinary Medicine and Animal Science, The University of Peradeniya, Peradeniya, Sri Lanka
| | - Luhan Jiang
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region
| | - Xian Chen
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region
| | - Kiu-Wai Cheng
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region
| | - Benancy Po-Chau Wong
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region
| | - Ernest Hung-Yu Ng
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region; Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong-Shenzhen Hospital, Futian District, Shenzhen, China
| | - William Shu-Biu Yeung
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region; Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong-Shenzhen Hospital, Futian District, Shenzhen, China
| | - Kai-Fai Lee
- Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region; Shenzhen Key Laboratory of Fertility Regulation, The University of Hong Kong-Shenzhen Hospital, Futian District, Shenzhen, China.
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20
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Transcriptomic analysis of endometrial receptivity for a genomic diagnostics model of Chinese women. Fertil Steril 2021; 116:157-164. [PMID: 33589135 DOI: 10.1016/j.fertnstert.2020.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/24/2020] [Accepted: 11/04/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To define the transcriptomic signature with respect to human endometrial receptivity in Chinese women by next-generation sequencing and to develop a more refined and customized bioinformatic predictive method for endometrial dating in Chinese women. DESIGN Randomized. SETTING A tertiary hospital-based reproductive medicine center. PATIENT(S) Ninety healthy, fertile Chinese women. INTERVENTION(S) Human endometrial biopsies. MAIN OUTCOME MEASURE(S) Gene expression of endometrial biopsies. RESULT(S) Ninety endometrial samples from healthy Chinese women during their menstrual cycles-including prereceptive (luteinizing hormone [LH] + 3 days/LH + 5 days), receptive (LH + 7 days), and post-receptive (LH + 9 days) phases-were subjected to transcriptomic analysis using messenger RNA (mRNA)-enriched RNA-Seq. Feature genes were obtained and used to train the predictor for endometrial dating, with 63 samples for the training set and 27 samples for the validation set. Differentially expressed genes (DEGs) were identified by comparing samples from different phases of the menstrual cycle. Based on the transcriptomic feature genes, we constructed a bioinformatic predictor for endometrial dating. The accuracy on assessment of the endometrium on days LH + 3, LH + 5, LH + 7, and LH + 9 was 100% in the training set and 85.19% in the validation set. CONCLUSION(S) Our transcriptomic profiling method can be used to monitor the window of implantation with regard to the endometrium in the Chinese population. This method potentially provides an evaluation of endometrial status, and can be used to predict a personal window of implantation by reproductive medicine clinicians.
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21
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Ojosnegros S, Seriola A, Godeau AL, Veiga A. Embryo implantation in the laboratory: an update on current techniques. Hum Reprod Update 2021; 27:501-530. [PMID: 33410481 DOI: 10.1093/humupd/dmaa054] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 07/18/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The embryo implantation process is crucial for the correct establishment and progress of pregnancy. During implantation, the blastocyst trophectoderm cells attach to the epithelium of the endometrium, triggering intense cell-to-cell crosstalk that leads to trophoblast outgrowth, invasion of the endometrial tissue, and formation of the placenta. However, this process, which is vital for embryo and foetal development in utero, is still elusive to experimentation because of its inaccessibility. Experimental implantation is cumbersome and impractical in adult animal models and is inconceivable in humans. OBJECTIVE AND RATIONALE A number of custom experimental solutions have been proposed to recreate different stages of the implantation process in vitro, by combining a human embryo (or a human embryo surrogate) and endometrial cells (or a surrogate for the endometrial tissue). In vitro models allow rapid high-throughput interrogation of embryos and cells, and efficient screening of molecules, such as cytokines, drugs, or transcription factors, that control embryo implantation and the receptivity of the endometrium. However, the broad selection of available in vitro systems makes it complicated to decide which system best fits the needs of a specific experiment or scientific question. To orient the reader, this review will explore the experimental options proposed in the literature, and classify them into amenable categories based on the embryo/cell pairs employed.The goal is to give an overview of the tools available to study the complex process of human embryo implantation, and explain the differences between them, including the advantages and disadvantages of each system. SEARCH METHODS We performed a comprehensive review of the literature to come up with different categories that mimic the different stages of embryo implantation in vitro, ranging from initial blastocyst apposition to later stages of trophoblast invasion or gastrulation. We will also review recent breakthrough advances on stem cells and organoids, assembling embryo-like structures and endometrial tissues. OUTCOMES We highlight the most relevant systems and describe the most significant experiments. We focus on in vitro systems that have contributed to the study of human reproduction by discovering molecules that control implantation, including hormones, signalling molecules, transcription factors and cytokines. WIDER IMPLICATIONS The momentum of this field is growing thanks to the use of stem cells to build embryo-like structures and endometrial tissues, and the use of bioengineering to extend the life of embryos in culture. We propose to merge bioengineering methods derived from the fields of stem cells and reproduction to develop new systems covering a wider window of the implantation process.
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Affiliation(s)
- Samuel Ojosnegros
- Bioengineering in Reproductive Health, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Anna Seriola
- Bioengineering in Reproductive Health, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Amélie L Godeau
- Bioengineering in Reproductive Health, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Anna Veiga
- B arcelona Stem Cell Bank, Regenerative Medicine Programme, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Duran i Reynals, Barcelona, Spain.,Reproductive Medicine Service, Dexeus Mujer, Hospital Universitari Dexeus, Barcelona, Spain
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22
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Pirtea P, De Ziegler D, Tao X, Sun L, Zhan Y, Ayoubi JM, Seli E, Franasiak JM, Scott RT. Rate of true recurrent implantation failure is low: results of three successive frozen euploid single embryo transfers. Fertil Steril 2021; 115:45-53. [DOI: 10.1016/j.fertnstert.2020.07.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/13/2020] [Accepted: 07/02/2020] [Indexed: 12/30/2022]
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Haouzi D, Entezami F, Torre A, Innocenti C, Antoine Y, Mauries C, Vincens C, Bringer-Deutsch S, Gala A, Ferrieres-Hoa A, Ohl J, Gonzalez Marti B, Brouillet S, Hamamah S. Customized Frozen Embryo Transfer after Identification of the Receptivity Window with a Transcriptomic Approach Improves the Implantation and Live Birth Rates in Patients with Repeated Implantation Failure. Reprod Sci 2021; 28:69-78. [PMID: 32725589 PMCID: PMC7782404 DOI: 10.1007/s43032-020-00252-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/04/2020] [Accepted: 06/30/2020] [Indexed: 01/10/2023]
Abstract
The aim of this prospective study was to evaluate outcome benefits expected in repeated implantation failure (RIF) patients (n = 217) after customized embryo transfer based upon identification of the receptivity window by transcriptomic approach using the Win-Test. In this test, the expression of 11 endometrial genes known to be predictive of endometrial receptivity is assessed by RT-PCR in biopsies collected during the implantation window (6-9 days after the spontaneous luteinizing hormone surge during natural cycles, 5-9 days after progesterone administration during hormone replacement therapy cycles). Then, patients underwent either customized embryo transfer (cET, n = 157 patients) according to the Win-Test results or embryo transfer according to the classical procedure (control group, n = 60). Pregnancy and live birth rates were compared in the two groups. The Win-Test showed that in 78.5% of women, the receptivity window lasted less than 48 h, although it could be shorter (< 24 h, 9.5%) or longer (> 48 h, 12%). This highlighted that only in 20% of patients with RIF the endometrium would have been receptive if the classical embryo transfer protocol was followed. In the other 80% of patients, the receptivity window was delayed by 1-3 days relative to the classical timing. This suggests that implantation failure could be linked to inadequate timing of embryo transfer. In agreement, both implantation (22.7% vs. 7.2%) and live birth rates per patient (31.8% vs. 8.3%) were significantly higher in the cET group than in the control group. cET on the basis of the Win-Test results could be proposed to improve pregnancy and live birth rates.ClinicalTrials.gov ID: NCT04192396; December 5, 2019, retrospectively registered.
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Affiliation(s)
- Delphine Haouzi
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France.
- IRMB, Univ Montpellier, INSERM, Montpellier, France.
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, Montpellier, France.
| | - Frida Entezami
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- ART Department, American Hospital of Paris, Neuilly-Sur-Seine, France
- Laboratoire Eylau-UNILABS-La Muette, Clinique de La Muette-Ramsay-Générale de Santé, Paris, France
| | - Antoine Torre
- Division of Child Health, Obstetrics & Gynaecology Department, University of Nottingham, Nottingham, UK
| | - Charlène Innocenti
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- IRMB, Univ Montpellier, INSERM, Montpellier, France
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Yannick Antoine
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- IRMB, Univ Montpellier, INSERM, Montpellier, France
| | - Charlotte Mauries
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Claire Vincens
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, Montpellier, France
| | | | - Anna Gala
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Alice Ferrieres-Hoa
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Jeanine Ohl
- Department of reproductive medicine, CMCO, Schiltigheim, France
| | - Beatriz Gonzalez Marti
- ART Department, American Hospital of Paris, Neuilly-Sur-Seine, France
- Laboratoire Eylau-UNILABS-La Muette, Clinique de La Muette-Ramsay-Générale de Santé, Paris, France
| | - Sophie Brouillet
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- IRMB, Univ Montpellier, INSERM, Montpellier, France
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, Montpellier, France
- Univ Grenoble-Alpes, INSERM U1036, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Institut de Biosciences et Biotechnologies de Grenoble (BIG), Laboratoire Biologie du Cancer et de l'Infection (BCI), 38000, Grenoble, France
| | - Samir Hamamah
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- IRMB, Univ Montpellier, INSERM, Montpellier, France
- CHU Montpellier, ART/PGD Department, Arnaud de Villeneuve Hospital, Montpellier, France
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Li T, Greenblatt EM, Shin ME, Brown TJ, Chan C. Cargo small non-coding RNAs of extracellular vesicles isolated from uterine fluid associate with endometrial receptivity and implantation success. Fertil Steril 2020; 115:1327-1336. [PMID: 33272614 DOI: 10.1016/j.fertnstert.2020.10.046] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/04/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To optimize a method of isolating extracellular vesicles (EVs) from uterine fluid and to characterize small non-coding RNAs (sncRNAs) from the EVs, with the goal of identifying novel receptivity-associated biomarkers. DESIGN Longitudinal study comparing sncRNA expression profiles from endometrial EVs. SETTING University-affiliated, hospital-based fertility clinic. PATIENT(S) Healthy volunteers with no history of infertility (Group A) and women receiving controlled ovarian stimulation (COS)-in vitro fertilization treatment (Group B). INTERVENTIONS(S) In Group A, EVs were isolated from uterine fluid obtained on luteinizing hormone (LH)+2 and LH+7 in one natural menstrual cycle. In Group B, EVs were isolated from uterine fluid obtained on human chorionic gonadotropin (hCG)+2 and hCG+7 in one COS cycle. RNAs extracted from EVs were profiled using next-generation sequencing. MAIN OUTCOME MEASURE(S) Differential EV-sncRNAs between LH+2 and LH+7 (Group A), between hCG+2 and hCG+7 (Group B), and between pregnant and nonpregnant in vitro fertilization cycles (Group B). RESULT(S) Ultracentrifugation was validated as the most efficient method to isolate EVs from uterine fluid. We identified 12 endometrial EV-sncRNAs (11 microRNAs and 1 piwi-interacting RNA) as receptivity-associated transcripts conserved in both natural and COS cycles. These sncRNAs were associated strongly with biological functions related to immune response, extracellular matrix, and cell junction. Within COS cycles, we also identified a group of EV-sncRNAs that exhibited differential expression in patients who conceived versus those who did not, with hsa-miR-362-3p most robustly overexpressed in the nonpregnant patients. CONCLUSION(S) This study is the first to profile comprehensively sncRNAs in endometrial EVs from uterine fluid and identify sncRNA biomarkers of endometrial receptivity and implantation success.
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Affiliation(s)
- Tiantian Li
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Ellen M Greenblatt
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada; Mount Sinai Fertility, Sinai Health System, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
| | | | - Theodore J Brown
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
| | - Crystal Chan
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada; Mount Sinai Fertility, Sinai Health System, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada.
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25
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Hernández-Vargas P, Muñoz M, Domínguez F. Identifying biomarkers for predicting successful embryo implantation: applying single to multi-OMICs to improve reproductive outcomes. Hum Reprod Update 2020; 26:264-301. [PMID: 32096829 DOI: 10.1093/humupd/dmz042] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 10/08/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Successful embryo implantation is a complex process that requires the coordination of a series of events, involving both the embryo and the maternal endometrium. Key to this process is the intricate cascade of molecular mechanisms regulated by endocrine, paracrine and autocrine modulators of embryonic and maternal origin. Despite significant progress in ART, implantation failure still affects numerous infertile couples worldwide and fewer than 10% of embryos successfully implant. Improved selection of both the viable embryos and the optimal endometrial phenotype for transfer remains crucial to enhancing implantation chances. However, both classical morphological embryo selection and new strategies incorporated into clinical practice, such as embryonic genetic analysis, morphokinetics or ultrasound endometrial dating, remain insufficient to predict successful implantation. Additionally, no techniques are widely applied to analyse molecular signals involved in the embryo-uterine interaction. More reliable biological markers to predict embryo and uterine reproductive competence are needed to improve pregnancy outcomes. Recent years have seen a trend towards 'omics' methods, which enable the assessment of complete endometrial and embryonic molecular profiles during implantation. Omics have advanced our knowledge of the implantation process, identifying potential but rarely implemented biomarkers of successful implantation. OBJECTIVE AND RATIONALE Differences between the findings of published omics studies, and perhaps because embryonic and endometrial molecular signatures were often not investigated jointly, have prevented firm conclusions being reached. A timely review summarizing omics studies on the molecular determinants of human implantation in both the embryo and the endometrium will help facilitate integrative and reliable omics approaches to enhance ART outcomes. SEARCH METHODS In order to provide a comprehensive review of the literature published up to September 2019, Medline databases were searched using keywords pertaining to omics, including 'transcriptome', 'proteome', 'secretome', 'metabolome' and 'expression profiles', combined with terms related to implantation, such as 'endometrial receptivity', 'embryo viability' and 'embryo implantation'. No language restrictions were imposed. References from articles were also used for additional literature. OUTCOMES Here we provide a complete summary of the major achievements in human implantation research supplied by omics approaches, highlighting their potential to improve reproductive outcomes while fully elucidating the implantation mechanism. The review highlights the existence of discrepancies among the postulated biomarkers from studies on embryo viability or endometrial receptivity, even using the same omic analysis. WIDER IMPLICATIONS Despite the huge amount of biomarker information provided by omics, we still do not have enough evidence to link data from all omics with an implantation outcome. However, in the foreseeable future, application of minimally or non-invasive omics tools, together with a more integrative interpretation of uniformly collected data, will help to overcome the difficulties for clinical implementation of omics tools. Omics assays of the embryo and endometrium are being proposed or already being used as diagnostic tools for personalised single-embryo transfer in the most favourable endometrial environment, avoiding the risk of multiple pregnancies and ensuring better pregnancy rates.
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Affiliation(s)
- Purificación Hernández-Vargas
- IVI-RMA Alicante, Innovation. Avda. de Denia 111, 03015 Alicante, Spain.,Fundación IVI, Innovation-IIS La Fe, Avda. Fernando Abril Martorell 106, Torre A, 1° 1.23, 46026 Valencia, Spain
| | - Manuel Muñoz
- IVI-RMA Alicante, Innovation. Avda. de Denia 111, 03015 Alicante, Spain.,Fundación IVI, Innovation-IIS La Fe, Avda. Fernando Abril Martorell 106, Torre A, 1° 1.23, 46026 Valencia, Spain
| | - Francisco Domínguez
- Fundación IVI, Innovation-IIS La Fe, Avda. Fernando Abril Martorell 106, Torre A, 1° 1.23, 46026 Valencia, Spain
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Suthaporn S, Jayaprakasan K, Thornton J, Walker K, Medrano JH, Castellanos M, May S, Polanski L, Raine-Fenning N, Maalouf WE. Suboptimal mid-luteal progesterone concentrations are associated with aberrant endometrial gene expression, potentially resulting in implantation failure. Reprod Biomed Online 2020; 42:595-608. [PMID: 33608186 DOI: 10.1016/j.rbmo.2020.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/13/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022]
Abstract
RESEARCH QUESTION What is the difference in endometrial transcriptomics between women with normal and with low mid-luteal progesterone during the implantation window? DESIGN An endometrial biopsy and serum progesterone concentration were taken from participants during the mid-luteal phase (LH+7 to LH+9). A total of 12 participants were recruited and categorized into two groups based on their progesterone concentrations: normal progesterone (>15 ng/ml, n = 6) and low progesterone (<15 ng/ml, n = 6). Global endometrial gene expression between the two groups was compared by microarray techniques. Principal component analysis was used to display the gene's expression pattern. Pathway and gene ontology enrichment analysis were performed to determine the biological mechanism of progesterone on the endometrium. RESULTS Several key genes related to endometrial receptivity were found to be regulated by progesterone. With regard to gene ontology and pathway analysis, progesterone was shown to be mainly involved in structure morphogenesis predominantly during a process of decidualization, extracellular matrix-receptor interaction and cell adhesion. Distinct differences were observed in the transcriptomic profiles between the two groups, indicating potential impairment of endometrial receptivity in women with suboptimal progesterone concentrations. There was a relatively similar pattern of gene expression between endometrial samples with progesterone concentrations approximately 10 ng/ml and >15 ng/ml. Thus, a progesterone concentration of between 10 and 15 ng/ml appears to be sufficient to induce endometrial receptivity. CONCLUSIONS Abnormally low progesterone below the threshold of 10-15 ng/ml during the implantation window results in aberrant endometrial gene expression that may affect implantation potential.
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Affiliation(s)
- Sutham Suthaporn
- Division of Obstetrics and Gynaecology, School of Clinical Sciences, University of Nottingham, Nottingham, UK
| | | | - Jim Thornton
- Division of Obstetrics and Gynaecology, School of Clinical Sciences, University of Nottingham, Nottingham, UK
| | - Kate Walker
- Division of Obstetrics and Gynaecology, School of Clinical Sciences, University of Nottingham, Nottingham, UK
| | - Juan Hernandez Medrano
- Division of Obstetrics and Gynaecology, School of Clinical Sciences, University of Nottingham, Nottingham, UK
| | - Marcos Castellanos
- Nottingham Arabidopsis Stock Centre, School of Biosciences, University of Nottingham, Nottingham, UK
| | - Sean May
- Nottingham Arabidopsis Stock Centre, School of Biosciences, University of Nottingham, Nottingham, UK
| | - Lukasz Polanski
- Division of Obstetrics and Gynaecology, School of Clinical Sciences, University of Nottingham, Nottingham, UK
| | - Nick Raine-Fenning
- Nurture Fertility, The East Midlands Fertility Centre, Bostocks Lane, Nottingham, UK
| | - Walid E Maalouf
- Division of Obstetrics and Gynaecology, School of Clinical Sciences, University of Nottingham, Nottingham, UK.
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Martins RS, Oliani AH, Oliani DV, de Oliveira JM. Continuous endometrial volumetric analysis for endometrial receptivity assessment on assisted reproductive technology cycles. BMC Pregnancy Childbirth 2020; 20:663. [PMID: 33143675 PMCID: PMC7640386 DOI: 10.1186/s12884-020-03372-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/28/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium. In order to assess endometrial receptivity in Assisted Reproductive Technology (ART) cycles serial evaluation of endometrial volumetric analysis may have a predictive value on a positive outcome. METHODS Serial 3D transvaginal ultrasound performed in women on ART cycle to evaluate embryo implantation predictors. Prospective case control study of 169 subjects were assessed. Endometrial pattern, thickness, volume and adjusted endometrial volume (ratio between endometrial volume and uterine volume) was performed to all subjects on a continuous process from baseline, during controlled ovarian stimulation, trigger day with human chorionic gonadotropin hormone (hCG) and at embryo transfer day. RESULTS Demographics and ART procedures and scores, was similar between the two groups. Endometrial morphology also showed no difference between the two groups. Endometrial volume and adjusted endometrial volume was significantly higher in the positive group as soon as day 6 of ovarian controlled stimulation. CONCLUSIONS Serial 3D endometrial volume and adjusted endometrial volumes provides a predicting clinical tool enhancing elective embryo transfers in fresh ART cycle. Thus providing a non-invasive continuous technique for endometrial receptivity assessment that reflects endometrial changes during ART procedures.
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Affiliation(s)
- Renato Silva Martins
- Centro Hospitalar Universitário Cova da Beira EPE, Quinta do Alvito, 6200 503, Covilha, Portugal. .,Centro Investigação Ciências da Saúde - Faculdade Ciências da Saúde, Universidade da Beira Interior, Alameda Infante D, Henrique, 6200 506, Covilha, Portugal.
| | - António Helio Oliani
- Centro Hospitalar Universitário Cova da Beira EPE, Quinta do Alvito, 6200 503, Covilha, Portugal
| | - Denise Vaz Oliani
- Centro Hospitalar Universitário Cova da Beira EPE, Quinta do Alvito, 6200 503, Covilha, Portugal
| | - José Martinez de Oliveira
- Centro Hospitalar Universitário Cova da Beira EPE, Quinta do Alvito, 6200 503, Covilha, Portugal.,Centro Investigação Ciências da Saúde - Faculdade Ciências da Saúde, Universidade da Beira Interior, Alameda Infante D, Henrique, 6200 506, Covilha, Portugal
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28
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Lédée N, Petitbarat M, Prat-Ellenberg L, Dray G, Cassuto GN, Chevrier L, Kazhalawi A, Vezmar K, Chaouat G. The uterine immune profile: A method for individualizing the management of women who have failed to implant an embryo after IVF/ICSI. J Reprod Immunol 2020; 142:103207. [DOI: 10.1016/j.jri.2020.103207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/06/2020] [Accepted: 09/08/2020] [Indexed: 11/28/2022]
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29
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Drissennek L, Baron C, Brouillet S, Entezami F, Hamamah S, Haouzi D. Endometrial miRNome profile according to the receptivity status and implantation failure. HUM FERTIL 2020; 25:356-368. [DOI: 10.1080/14647273.2020.1807065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Loubna Drissennek
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- IRMB, Univ Montpellier, INSERM, Montpellier, France
| | - Chloé Baron
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- IRMB, Univ Montpellier, INSERM, Montpellier, France
| | - Sophie Brouillet
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- IRMB, Univ Montpellier, INSERM, Montpellier, France
- CHU Montpellier, ART/PDG department, Arnaud de Villeneuve Hospital, Montpellier, Montpellier, France
- Univ Grenoble-Alpes, INSERM 1036, Institut de Biosciences et Biotechnologies de Grenoble (BIG), Laboratoire Biologie du Cancer et de l’Infection (BCI), Grenoble, France
| | - Frida Entezami
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- American Hospital of Paris, IVF department, Neuilly-Sur-Seine, France
| | - Samir Hamamah
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- IRMB, Univ Montpellier, INSERM, Montpellier, France
- CHU Montpellier, ART/PDG department, Arnaud de Villeneuve Hospital, Montpellier, Montpellier, France
| | - Delphine Haouzi
- Univ Montpellier, INSERM U1203, EmbryoPluripotency, Montpellier, France
- IRMB, Univ Montpellier, INSERM, Montpellier, France
- CHU Montpellier, ART/PDG department, Arnaud de Villeneuve Hospital, Montpellier, Montpellier, France
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30
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Neykova K, Tosto V, Giardina I, Tsibizova V, Vakrilov G. Endometrial receptivity and pregnancy outcome. J Matern Fetal Neonatal Med 2020; 35:2591-2605. [PMID: 32744104 DOI: 10.1080/14767058.2020.1787977] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Human implantation is a highly complex and multifactorial process. Successful implantation requires the presence of a healthy embryo, a receptive endometrium, and a synchronized molecular dialogue between the two, as well as immune tolerance/protection from the host. The endometrial receptivity refers to a hormonally limited period in which the endometrial tissue acquires a transient functional status allowing blastocyst implantation and pregnancy initiation. Global knowledge of endometrial receptivity grew up in recent years. Improvements in genetics, new biomarkers, noninvasive methods, new advanced techniques (Endometrial receptivity assay - the ERA system, proteomic analysis) offer the possibility to evaluate the endometrial status and to manage patients with infertility problems, especially women undergoing assisted reproductive treatment. This overview reports the most relevant knowledge and recent advances in the study of implantation processes from the perspective of the endometrium, often considered as being the main barrier for a successful pregnancy initiation. Endometrial receptivity is a topic of great interest and further studies are needed for the early identification of endometrial abnormalities and the discovery of new strategies for increasing the chance for the establishment of pregnancy.
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Affiliation(s)
- Konstantsa Neykova
- Department of Reproductive Medicine, "Maichin Dom" State University Hospital, Sofia, Bulgaria
| | - Valentina Tosto
- Department of Obstetrics and Gynecology, Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Irene Giardina
- Department of Obstetrics and Gynecology, Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
| | - Valentina Tsibizova
- Almazov National Medical Research Centre, St Petetrsburg, Russian Federation
| | - Georgi Vakrilov
- Department of Reproductive Medicine, "Maichin Dom" State University Hospital, Sofia, Bulgaria
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31
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Two of a kind? Immunological and clinical risk factors differ between recurrent implantation failure and recurrent miscarriage. J Reprod Immunol 2020; 141:103166. [PMID: 32623188 DOI: 10.1016/j.jri.2020.103166] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/18/2020] [Accepted: 06/10/2020] [Indexed: 11/23/2022]
Abstract
Recurrent miscarriage (RM) and recurrent implantation failure (RIF) are unsolved challenges in reproductive medicine. Whether RIF patients share the same risk factors as RM patients is a matter of debate. Besides clinical factors, immune alterations are discussed in both conditions. The scope of this study was to compare the prevalence of clinical and immunological risk factors in a large cohort of RM and RIF patients. Between 11/2011 and 02/2019, 613 RM and 185 RIF patients were included. A screening for anatomical malformations, endocrine, autoimmune, prothrombotic and parental chromosomal disorders was performed. The immune status was assessed using flow cytometry analysis of peripheral lymphocyte subpopulations and uterine natural killer cells (uNK cells) using immunohistochemistry. RM patients showed a higher rate of intrauterine adhesions and elevated antinuclear antibodies ≥ 1:160 (p < 0.05). A higher prevalence of submucous fibroids and increased factor VIII levels were observed in RIF patients (p < 0.05). The prevalence of an antiphospholipid syndrome (APLS) was low and did not differ between the two groups. RIF patients had higher numbers of peripheral regulatory T-cells (p < 0.05). Significant more RIF patients were diagnosed with elevated uNK cells (p < 0.05). Differences in clinical and immunological risk factors of RM and RIF patients reflect different entities. Lower Tregs in RM and higher uNK cells in RIF patients might be related to the previous exposure of the immune system to fetal cells. The low prevalence of an APLS indicates a potential overestimation of this factor in the pathophysiology of RM and RIF.
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32
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Hayashi N, Enatsu N, Iwasaki T, Otsuki J, Matsumoto Y, Kokeguchi S, Shiotani M. Predictive factors influencing pregnancy rate in frozen embryo transfer. Reprod Med Biol 2020; 19:182-188. [PMID: 32273825 PMCID: PMC7138944 DOI: 10.1002/rmb2.12322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/18/2019] [Accepted: 02/15/2020] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To evaluate the outcomes of embryo transfer (ET) and to identify the parameters influencing pregnancy outcomes. METHODS This study included 938 ET cycles involving single frozen and thawed good-quality blastocyst (Gardner grade ≥3BB) between August 2017 and January 2018. The significance of several parameters including endometrial thickness, position of the transferred air bubble, self-evaluation score by physicians, and uterus direction at ET as predictors of clinical pregnancy was evaluated using univariate and multivariate analyses. RESULTS Among 938 ET cycles, 462 (49.3%) resulted in a clinical pregnancy. Endometrial thickness was positively associated with clinical pregnancy in a linear trend. Between the variable position of the transferred air bubble and clinical pregnancy rate showed a curvilinear relationship. Clinical pregnancy rate was higher in cases with good self-evaluation score, whereas there was no difference between groups with different uterus directions. Univariate analysis of predictive parameters identified endometrial thickness, self-evaluation score by physicians, and position of air bubbles as significant predictors of clinical pregnancy, of which endometrial thickness and position of air bubbles appeared to be independently related to clinical pregnancy. CONCLUSION Endometrial thickness and the position of transferred air bubbles influenced clinical pregnancy in ET cycles.
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Affiliation(s)
| | | | | | - Junko Otsuki
- Hanabusa Women's ClinicKobe CityJapan
- Okayama University Assisted Reproduction Technology CenterOkayama CityJapan
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33
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Matorras R, Martinez-Arranz I, Arretxe E, Iruarrizaga-Lejarreta M, Corral B, Ibañez-Perez J, Exposito A, Prieto B, Elortza F, Alonso C. The lipidome of endometrial fluid differs between implantative and non-implantative IVF cycles. J Assist Reprod Genet 2019; 37:385-394. [PMID: 31865491 DOI: 10.1007/s10815-019-01670-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/13/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To characterize the most relevant changes in the lipidome of endometrial fluid aspirate (EFA) in non-implantative cycles. DESIGN Lipidomics in a prospective cohort study. SETTINGS Reproductive unit of a university hospital. PATIENTS Twenty-nine women undergoing an IVF cycle. Fifteen achieved pregnancy and 14 did not. INTERVENTION Endometrial fluid aspiration immediately before performing embryo transfer. MAIN OUTCOME MEASURES Clinical pregnancy rate and lipidomic profiles obtained on an ultra-high performance liquid chromatography coupled to time-of-flight mass spectrometry (UHPLC-ToF-MS)-based analytical platform. RESULTS The comparative analysis of the lipidomic patterns of endometrial fluid in implantative and non-implantative IVF cycles revealed eight altered metabolites: seven glycerophospholipids and an omega-6 polyunsaturated fatty acid. Then, women with a non-implantative cycle were accurately classified with a support vector machine algorithm including these eight lipid metabolites. The diagnostic performances of the algorithm showed an area under the receiver operating characteristic curve, sensitivity, specificity, and accuracy of 0.893 ± 0.07, 85.7%, 80.0%, and 82.8%, respectively. CONCLUSION A predictive lipidomic signature linked to the implantative status of the endometrial fluid has been found.
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Affiliation(s)
- Roberto Matorras
- Human Reproduction Unit, Cruces University Hospital, BioCruces, University of the Basque Country, Bilbao, Spain. .,Instituto Valenciano de Infertilidad, IVI, Bilbao, Spain.
| | | | - Enara Arretxe
- OWL Metabolomics, Parque Tecnológico de Bizkaia, Derio, Spain
| | | | - Blanca Corral
- Human Reproduction Unit, Cruces University Hospital, BioCruces, University of the Basque Country, Bilbao, Spain
| | - Jone Ibañez-Perez
- Human Reproduction Unit, Cruces University Hospital, BioCruces, University of the Basque Country, Bilbao, Spain
| | - Antonia Exposito
- Human Reproduction Unit, Cruces University Hospital, BioCruces, University of the Basque Country, Bilbao, Spain
| | - Begoña Prieto
- Human Reproduction Unit, Cruces University Hospital, BioCruces, University of the Basque Country, Bilbao, Spain.,Instituto Valenciano de Infertilidad, IVI, Bilbao, Spain
| | - Felix Elortza
- Proteomics Platform, CIC bioGUNE, CIBERehd, ProteoRed-ISCIII, Parque Tecnológico de Bizkaia, Derio, Spain
| | - Cristina Alonso
- OWL Metabolomics, Parque Tecnológico de Bizkaia, Derio, Spain
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Chen Q, Xin A, Qu R, Zhang W, Li L, Chen J, Lu X, Gu Y, Li J, Sun X. Expression of ENPP3 in human cyclic endometrium: a novel molecule involved in embryo implantation. Reprod Fertil Dev 2019; 30:1277-1285. [PMID: 29614240 DOI: 10.1071/rd17257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 03/04/2018] [Indexed: 01/13/2023] Open
Abstract
Ectonucleotide pyrophosphatase-phosphodiesterase 3 (ENPP3), a protein detected in the human uterus, has been found to play an important role in the development and invasion of tumours. It was recently discovered that ENPP3 was upregulated during the window of implantation in the human endometrium but its functional relevance remains elusive. The objective was to determine ENPP3 expression in human endometrium and its roles in endometrial receptivity and embryo implantation. ENPP3 expression was analysed using immunohistochemistry and western blot assay. The effects of ENPP3 on embryo implantation were evaluated using a BeWo cell (a human choriocarcinoma cell line) spheroid attachment assay and BeWo cells were dual cultured with Ishikawa cells transfected with lentiviral vectors (LV5-NC or LV5-ENPP3) to mimic embryo implantation in a Transwell model. The effects of endometrial ENPP3 on factors related to endometrial receptivity were also determined. The results showed that ENPP3 was expressed in human endometrial epithelial cells and its expression levels changed during the menstrual cycle, peaking in the mid-secretory phase, corresponding to the time of embryo implantation. The overexpression of endometrial ENPP3 not only increased the embryo implantation rate but also had positive effects on the expression of factors related to endometrial receptivity in human endometrial cells. The results indicate that ENPP3 levels undergo cyclic changes in the endometrium and affect embryo adhesion and invasion via altering the expression of implantation factors in the human endometrium. Therefore, ENPP3 may play an important role in embryo implantation and may be a unique biomarker of endometrial receptivity.
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Affiliation(s)
- Qianqian Chen
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Aijie Xin
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Ronggui Qu
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Wenbi Zhang
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Lu Li
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Junling Chen
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Xiang Lu
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Yongwei Gu
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Jing Li
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Xiaoxi Sun
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
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35
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Messaoudi S, El Kasmi I, Bourdiec A, Crespo K, Bissonnette L, Le Saint C, Bissonnette F, Kadoch IJ. 15 years of transcriptomic analysis on endometrial receptivity: what have we learnt? FERTILITY RESEARCH AND PRACTICE 2019; 5:9. [PMID: 31396393 PMCID: PMC6681490 DOI: 10.1186/s40738-019-0059-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 07/05/2019] [Indexed: 01/25/2023]
Affiliation(s)
| | | | | | | | | | | | - François Bissonnette
- Ovo r&d, Montreal, Quebec Canada.,2Department of Obstetrics and Gynecology, University of Montreal Hospital Centre, Montreal, Quebec Canada
| | - Isaac-Jacques Kadoch
- Ovo r&d, Montreal, Quebec Canada.,2Department of Obstetrics and Gynecology, University of Montreal Hospital Centre, Montreal, Quebec Canada
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36
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Silva Martins R, Helio Oliani A, Vaz Oliani D, Martinez de Oliveira J. Subendometrial resistence and pulsatility index assessment of endometrial receptivity in assisted reproductive technology cycles. Reprod Biol Endocrinol 2019; 17:62. [PMID: 31375113 PMCID: PMC6676512 DOI: 10.1186/s12958-019-0507-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 07/25/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To evaluate Subendometrial and Uterine artery resistance and pulsatility index continuous analysis as a predictor of Endometrial receptivity in Assisted Reproductive Technology (ART) Cycles. DESIGN Serial 2D transvaginal coloured power doppler ultrasound performed in women on ART cycle to evaluate a pattern that better predicts implantation rates. One hundred sixty-nine subjects on a prospective case control study were assessed. Uterine artery and Subendometrial resistance and pulsatility index was performed to all subjects at baseline (prior to ovarian controlled stimulation), at day 6, 8 and 10 of controlled ovarian stimulation, at trigger day and at embryo transfer day. Also the ratio of fluxometric parameters between Subendometrial blood flow and uterine artery was measured. RESULTS No statistical difference was noted between two groups in terms of demographics and ART procedures and scores. Uterine artery resistance and pulsatility index showed statistical difference between the two groups (implantation versus non-implantation group). Also statistical significance was obtained between two groups in terms of Subendometrial vascularization. Ratio between Subendometrial and Uterine artery showed lower values of fluxometric parameters in all range for the Subendometrial territory. CONCLUSIONS Serial Subendometrial and Uterine artery fluxometry may be a useful tool for clinicians in predicting endometrial receptivity enhancing elective embryo transfers in the same ART cycle.
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Affiliation(s)
- R. Silva Martins
- Centro Hospitalar Universitário Cova da Beira EPE, Quinta do Alvito, 6200 503 Covilha, Portugal
- 0000 0001 2220 7094grid.7427.6Centro Investigação Ciências da Saúde – Faculdade Ciências da Saúde, Universidade da Beira Interior, Alameda Infante D, Henrique, 6200 506 Covilha, Portugal
| | - A. Helio Oliani
- Centro Hospitalar Universitário Cova da Beira EPE, Quinta do Alvito, 6200 503 Covilha, Portugal
| | - D. Vaz Oliani
- Centro Hospitalar Universitário Cova da Beira EPE, Quinta do Alvito, 6200 503 Covilha, Portugal
| | - J. Martinez de Oliveira
- Centro Hospitalar Universitário Cova da Beira EPE, Quinta do Alvito, 6200 503 Covilha, Portugal
- 0000 0001 2220 7094grid.7427.6Centro Investigação Ciências da Saúde – Faculdade Ciências da Saúde, Universidade da Beira Interior, Alameda Infante D, Henrique, 6200 506 Covilha, Portugal
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37
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Neradugomma NK, Drafton K, Mor GG, Mao Q. Marijuana-derived cannabinoids inhibit uterine endometrial stromal cell decidualization and compromise trophoblast-endometrium cross-talk. Reprod Toxicol 2019; 87:100-107. [PMID: 31154070 PMCID: PMC6613995 DOI: 10.1016/j.reprotox.2019.05.064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 12/31/2022]
Abstract
Marijuana (cannabis) use by pregnant women in the United States is increasing and there is a dire need to understand the beneficial or harmful effects of cannabis during pregnancy. Uterine endometrial stromal cells are fibroblast-like cells that differentiate into secretory cells, a process called decidualization, to create a microenvironment conducive for placenta formation and early embryonic growth. In this study, using model human cell lines, we for the first time demonstrate that Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD) and cannabinol (CBN) inhibit endometrial stromal cell decidualization and have adverse effects on trophoblast-endometrium cross-talk.
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Affiliation(s)
- Naveen K Neradugomma
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, USA.
| | - Kaitlyn Drafton
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, USA
| | - Gil G Mor
- Division of Reproductive Sciences, School of Medicine, Yale University, New Haven, CT 06520, USA
| | - Qingcheng Mao
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA 98195, USA.
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38
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iTRAQ comparison of proteomic profiles of endometrial receptivity. J Proteomics 2019; 203:103381. [PMID: 31102758 DOI: 10.1016/j.jprot.2019.103381] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 04/17/2019] [Accepted: 05/06/2019] [Indexed: 01/01/2023]
Abstract
Endometrial receptivity is a limiting step in human reproduction. A disruption in the development of endometrial receptivity is responsible for recurrent implantation failures (RIF) of endometrial origin. To understand the molecular mechanisms behind the endometrial receptivity process, we used the isobaric tag for relative and absolute quantitation (iTRAQ) method to compare three different endometrial statuses: fertile women, intrauterine device (IUD) carriers, and RIF patients. Overall, iTRAQ allowed identified 1889 non-redundant proteins. Of these, 188 were differentially expressed proteins (DEP) (p-value < .05). Pairwise comparisons revealed 133 significant DEP in fertile vs. IUD carriers and 158 DEP in RIF vs. IUD carriers. However, no DEP were identified between fertile and RIF patients. Western blot validation of three DEP involved in endometrial receptivity (plastin 2, lactotransferrin, and lysozyme) confirmed our iTRAQ results. Moreover, functional KEGG enrichment revealed that complement and coagulation cascades and peroxisome were the two most significant pathways for the RIF vs. IUD comparison and ribosome and spliceosome for the fertile vs. IUD comparison, as possible important pathways involved in the endometrial receptivity acquisition. The lack of DEP between fertile and RIF patient endometria suggest that idiopathic RIF may not have an endometrial origin, with other as-yet-unknown factors involved. SIGNIFICANCE: A pilot study where a comparison of the endometrial protein profile from women with different endometrial receptive grade (fertile women, IUD carriers and RIF patients) during the same period of time (overlapping with the window of implantation) of a hormone replacement therapy was performed using a high-throughput proteomic technique. This approach lead us to better understand the molecular mechanisms undergoing endometrial receptivity, a time-limiting step to achieve pregnancy in humans. Moreover, the number of samples per group (10 Fertile women, 10 IUD carriers and 8 RIF patients) according to the methodology here employed (8plex iTRAQ), give more robustness to our results. Our findings confirm that an IUD introduces numerous changes in the endometrial protein profile when compared to fertile and RIF endometria, revealing some key proteins involved in endometrial receptivity. Finding no significant differences between Fertile and RIF patient endometria could suggest that other as-yet-unknown factors could be involved in the etiology of idiopathic RIF.
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Lira-Albarrán S, Vega CC, Durand M, Rangel C, Larrea F. Functional genomic analysis of the human receptive endometrium transcriptome upon administration of mifepristone at the time of follicle rupture. Mol Cell Endocrinol 2019; 485:88-96. [PMID: 30796948 DOI: 10.1016/j.mce.2019.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/06/2019] [Accepted: 02/15/2019] [Indexed: 01/10/2023]
Abstract
The aim of this study was to analyze the effects of progesterone withdrawal on gene transcription in receptive endometrium by the administration of a single dose of 50 mg of the anti-progesterone receptor mifepristone (MFP) at the time of follicle rupture (FR). Six volunteer ovulatory women were studied, taking endometrial biopsies of three control and three MFP-treated women on days LH+2 (C-LH+2) and LH+7 (T-MFP), respectively. The biopsies were prepared for RNA isolation or histological and immunohistochemistry studies. The genomic data from 14 women (C-LH+7) were included as a historical control. The functional genomic analysis of the differentially expressed genes showed that MFP interfered negatively with the bio-functions decidualization of uterus and implantation of blastocyst and embryo. The results of this study confirm but also give new information on how MFP affects endometrial gene expression when administered at the time of FR and the dose used in emergency contraception.
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Affiliation(s)
- Saúl Lira-Albarrán
- Departmento de Biología de La Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México, 14080, México
| | - Claudia C Vega
- Departmento de Biología de La Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México, 14080, México
| | - Marta Durand
- Departmento de Biología de La Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México, 14080, México
| | - Claudia Rangel
- Departamento de Genómica Computacional, Instituto Nacional de Medicina Genómica, Periférico Sur No. 4809, Ciudad de México, 14610, México
| | - Fernando Larrea
- Departmento de Biología de La Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México, 14080, México.
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Sebastian-Leon P, Garrido N, Remohí J, Pellicer A, Diaz-Gimeno P. Asynchronous and pathological windows of implantation: two causes of recurrent implantation failure. Hum Reprod 2019; 33:626-635. [PMID: 29452422 DOI: 10.1093/humrep/dey023] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 01/24/2018] [Indexed: 02/06/2023] Open
Abstract
STUDY QUESTION Is endometrial recurrent implantation failure (RIF) only a matter of an asynchronous (displaced) window of implantation (WOI), or could it also be a pathological (disrupted) WOI? SUMMARY ANSWER Our predictive results demonstrate that both displaced and disrupted WOIs exist and can present independently or together in the same RIF patient. WHAT IS KNOWN ALREADY Since 2002, many gene expression signatures associated with endometrial receptivity and RIF have been described. Endometrial transcriptomics prediction has been applied to the human WOI in two previous studies. One study describes endometrial RIF to be the result of a temporal displacement of the WOI. The other indicates that endometrial RIF can also result from a molecularly disrupted WOI without temporal displacement. STUDY DESIGN, SIZE, DURATION Retrospective analysis was undertaken to compare WOI endometrial transcriptomics predictions in controls (n = 72) and RIF patients (n = 43). RIF was clinically designated by the absence of implantation after four or more transfers of high quality embryos or after the placement of 10 or more embryos in multiple transfers. Endometrial tissue samples were collected from LH + 5 to LH + 8. We compared the two molecular causes of RIF to signatures currently described in the literature. We propose a new transcriptomic RIF taxonomy to fill the gap between the two hypotheses and to guide the development of clinical detection and determination of both types of RIF. PARTICIPANTS/MATERIALS, SETTING, METHODS Utilizing 115 gene expression profiles, two different predictive designs were developed: one considering RIF versus controls removing menstrual cycle timing, called the disrupted or pathological model, and another stratifying the WOI in transcriptomic profiles related to timing for predicting displacements. The predictive value of each model was compared between all signatures selected. We propose a new genomic approach that distinguishes between both types of RIF in the same sample cohort. MAIN RESULTS AND THE ROLE OF CHANCE From the 16 signatures analysed, we clearly predicted two causes of RIF-both a displaced WOI and an on-time but pathologically disrupted WOI. A high predictive value related to WOI profiles associated with menstrual cycle timing was found in most of the signatures. Specifically, 69% of the signatures analysed presented an accuracy higher than expected by chance in a range from 0.87 to 0.97. Displacements and disruptions were not molecularly independent, as some signatures were moderately associated with both causes. The gene and functional comparison between signatures revealed that they were not similar, although we did find functions in common and a cluster of moderate functional concordance between some of the signatures that predicted displacements (the highest Cohen's Kappa index were between 0.55 and 0.62 depending on the functional database). We propose a new transcriptomic RIF taxonomy to fill the gap between these prior studies and to establish methodology for detecting and distinguishing both types of RIF in clinical practice. Our findings indicate these two phenotypes could present independently or together in the same RIF patient. RIF patients designated by clinical criteria have been stratified transcriptomically as 18.6% with only a displaced WOI, 53.5% with a displaced and pathological WOI, 23.3% with only a disrupted WOI, and 4.7% could be a clinical RIF with non-endometrial origin. The new RIF transcriptomic taxonomy avoids menstrual cycle timing as a confounding variable that should be controlled for, distinguishing clearly between a disrupted and a displaced WOI for precision medicine in RIF. LIMITATIONS REASONS FOR CAUTION The main objective of this study was to use transcriptomics to detect both RIF causes and to understand the role of transcriptomic signatures in these phenotypes. The predictive value in absolute terms for each signature was not indicative in these prediction designs; instead, the comparison between signatures was most important for prediction capability in the same sample cohort for both RIF causes. Clinical follow up of the RIF taxonomies proposed has not been analysed in this study, so further prospective clinical studies are necessary to determine the prevalence and penetrance of these phenotypes. WIDER IMPLICATIONS OF THE FINDINGS The main insight from this study is a new understanding of RIF taxonomy. Understanding how to classify RIF patients to distinguish clinically between a patient who could benefit from a personalized embryo transfer day and a patient with a disrupted WOI will enable identification and stratification for the research and development of new treatments. In addition, we demonstrate that basic research designs in endometrial transcriptomics cause masking of the study variable by the menstrual cycle timing. STUDY FUNDING/COMPETING INTEREST(S) This research has been funded by IVI-RMA; the authors do not have any competing interests.
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Affiliation(s)
- P Sebastian-Leon
- IVI-RMA Fundación IVI, Avda Fernando Abril Martorell 106, CP 46026, Valencia, Spain
- Instituto de Investigación Sanitaria INCLIVA, Universidad de Valencia, Avda de Menéndez y Pelayo, 4, CP 46010, Valencia, Spain
| | - N Garrido
- IVI-RMA Fundación IVI, Avda Fernando Abril Martorell 106, CP 46026, Valencia, Spain
- Instituto de Investigación Sanitaria INCLIVA, Universidad de Valencia, Avda de Menéndez y Pelayo, 4, CP 46010, Valencia, Spain
| | - J Remohí
- IVI-RMA Fundación IVI, Avda Fernando Abril Martorell 106, CP 46026, Valencia, Spain
- Instituto de Investigación Sanitaria INCLIVA, Universidad de Valencia, Avda de Menéndez y Pelayo, 4, CP 46010, Valencia, Spain
- Department of Pediatrics, Obstetrics, and Gynecology, Universidad de Valencia, Instituto Universitario IVI, Av. Blásco Ibáñez, 15, CP 46010, Valencia, Spain
| | - A Pellicer
- IVI-RMA Fundación IVI, Avda Fernando Abril Martorell 106, CP 46026, Valencia, Spain
- Department of Pediatrics, Obstetrics, and Gynecology, Universidad de Valencia, Instituto Universitario IVI, Av. Blásco Ibáñez, 15, CP 46010, Valencia, Spain
- Instituto de Investigación Sanitaria Hospital Universitario y Politécnico La Fe, Avda Fernando Abril Martorell 106, CP 46026, Valencia, Spain
| | - P Diaz-Gimeno
- IVI-RMA Fundación IVI, Avda Fernando Abril Martorell 106, CP 46026, Valencia, Spain
- Instituto de Investigación Sanitaria INCLIVA, Universidad de Valencia, Avda de Menéndez y Pelayo, 4, CP 46010, Valencia, Spain
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Braga DPDAF, Borges E, Godoy AT, Montani DA, Setti AS, Zanetti BF, Figueira RDCS, Eberlin MN, Lo Turco EG. Lipidomic profile as a noninvasive tool to predict endometrial receptivity. Mol Reprod Dev 2018; 86:145-155. [PMID: 30418697 DOI: 10.1002/mrd.23088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 11/05/2018] [Indexed: 12/28/2022]
Abstract
For the present study we asked whether the endometrial fluid lipidomic may be a useful approach to predict endometrial receptivity in freeze-all cycles. For this case-control study, endometrial fluid samples were collected from 41 patients undergoing freeze-all cycles. Samples were split depending on the pregnancy outcome: positive group (n = 24) and negative group (n = 17). Data were acquired by the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were applied. A list of potential biomarker ion ratios was obtained and the values were used to build a receiver operating characteristic (ROC) curve to predict pregnancy success. The lipid categories were attributed by LIPID MAPS database. Ion ratios were established according to their correlations and used for the analysis. The PCA showed a tendency of separation between the studied groups, whereas the PLS-DA was able to clearly distinguish them. Fifteen ratios (13 hyper-represented in the negative and two hyper-represented in the positive group) were selected according to their importance for model prediction. These ratios were used to build the ROC curve, which presented an area under curve of 84.0% (95%CI: 69.2-97.4%; p = 0.009). These findings suggest that lipidomic profiling of endometrial fluid may be a valuable tool for identifying the time interval comprising the window of implantation.
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Affiliation(s)
- Daniela Paes de Almeida Ferreira Braga
- Departamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo -UNIFESP, São Paulo, Brazil.,Fertility Medical Group, Av. Brigadeiro Luiz Antônio, 4545 São Paulo, Brazil
| | - Edson Borges
- Fertility Medical Group, Av. Brigadeiro Luiz Antônio, 4545 São Paulo, Brazil
| | - Adriana Teixeira Godoy
- Laboratorio ThoMSon de Espectrometria de Massas, Universidade de Campinas-UNICAMP, Rua Sérgio Buarque de Holanda, S/N - Cidade Universitária, Campinas, Brazil
| | - Daniela Antunes Montani
- Departamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo -UNIFESP, São Paulo, Brazil
| | - Amanda Souza Setti
- Fertility Medical Group, Av. Brigadeiro Luiz Antônio, 4545 São Paulo, Brazil
| | | | | | - Marcos Nogueira Eberlin
- Laboratorio ThoMSon de Espectrometria de Massas, Universidade de Campinas-UNICAMP, Rua Sérgio Buarque de Holanda, S/N - Cidade Universitária, Campinas, Brazil
| | - Edson Guimarães Lo Turco
- Departamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo -UNIFESP, São Paulo, Brazil
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Manta-Vogli PD, Schulpis KH, Dotsikas Y, Loukas YL. The significant role of amino acids during pregnancy: nutritional support. J Matern Fetal Neonatal Med 2018; 33:334-340. [PMID: 29909700 DOI: 10.1080/14767058.2018.1489795] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Background: Pregnancy is characterized by a complexity of metabolic processes that may impact fetal development and infant health outcome. Normal fetal growth and development depend on a continuous supply of nutrients via the placenta. The placenta transports, utilizes, produces, and interconverts amino acids (AAs).Findings: Concentrations of both nonessential and essential AAs in maternal plasma decrease in early pregnancy and persist at low concentrations throughout. The decline is greatest for the glucogenic AAs and AAs of the urea cycle. Additionally, there is a large placental utilization of the branched-chain AAs, some of which are transaminated to alpha ketoacids and contribute to placental ammonia production. Both nonessential and essential AAs regulate key metabolic pathways to improve health, survival, growth, development, lactation, and reproduction of organisms. Some of the nonessential AAs (e.g. glutamine, glutamate, and arginine) play also important roles in regulating gene expression, cell signaling, antioxidant responses, immunity, and neurological function.Conclusions: Nutritional support during pregnancy is of great interest focusing not only to common pregnancies but also to those with low socioeconomic status, vegan-vegetarian groups, and pregnant women with metabolic disorders, the most known maternal phenylketonuria. The latter is of great interest because phenylalanine must be within the recommended range throughout pregnancy in addition to other nutrients such as vitamin B12, folate, etc. Loss of the adherence to this specific diet results in congenital malformations of the fetus. In addition to the routine laboratory test, quantitation of plasma AAs may be necessary throughout pregnancy.
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Affiliation(s)
- Penelope D Manta-Vogli
- Department of Clinical Nutrition and Dietetics, Agia Sofia Children's Hospital, Athens, Greece
| | | | - Yannis Dotsikas
- Laboratory of Pharm. Analysis, Department of Pharmacy, National and Kapodestrian University of Athens, Athens, Greece
| | - Yannis L Loukas
- Laboratory of Pharm. Analysis, Department of Pharmacy, National and Kapodestrian University of Athens, Athens, Greece
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Matorras R, Quevedo S, Corral B, Prieto B, Exposito A, Mendoza R, Rabanal A, Diaz-Nuñez M, Ferrando M, Elortza F, Ametzazurra A, Nagore D. Proteomic pattern of implantative human endometrial fluid in in vitro fertilization cycles. Arch Gynecol Obstet 2018; 297:1577-1586. [DOI: 10.1007/s00404-018-4753-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 03/14/2018] [Indexed: 01/11/2023]
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Lira-Albarrán S, Durand M, Larrea-Schiavon MF, González L, Barrera D, Vega C, Gamboa-Domínguez A, Rangel C, Larrea F. Ulipristal acetate administration at mid-cycle changes gene expression profiling of endometrial biopsies taken during the receptive period of the human menstrual cycle. Mol Cell Endocrinol 2017; 447:1-11. [PMID: 28219738 DOI: 10.1016/j.mce.2017.02.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 10/20/2022]
Abstract
The aim of this study was to analyze the effects of mid-cycle administration of Ulipristal acetate (UPA) on gene expression in endometrial biopsies taken during the receptive phase of the cycle. Fourteen healthy menstruating women were studied during 14 control non-treated and 12 treated cycles with a single dose of 30 mg UPA when follicle diameter reached 20 mm. Ovulation in both treated and control cycles was confirmed by serial determinations of serum LH, progesterone and vaginal ultrasound. An endometrial biopsy at day LH+7, in each cycle, was taken for RNA microarray and qPCR analysis or prepared for histological and immunohistochemistry studies. Functional analysis of differentially expressed genes showed the presence of changes compatible with a non-receptive endometrial phenotype, further confirmed by qPCR and immunohistochemistry. This study suggests the effects of UPA on endometrial receptivity, offering a plausible explanation for the higher contraceptive efficacy of this method compared to that of levonorgestrel.
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Affiliation(s)
- Saúl Lira-Albarrán
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México 14080, México
| | - Marta Durand
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México 14080, México
| | - Marco F Larrea-Schiavon
- Departamento de Genómica Computacional, Instituto Nacional de Medicina Genómica, Periférico Sur No. 4809, Ciudad de México 14610, México
| | - Leticia González
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México 14080, México
| | - David Barrera
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México 14080, México
| | - Claudia Vega
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México 14080, México
| | - Armando Gamboa-Domínguez
- Departamento de Patología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México 14080, México
| | - Claudia Rangel
- Departamento de Genómica Computacional, Instituto Nacional de Medicina Genómica, Periférico Sur No. 4809, Ciudad de México 14610, México
| | - Fernando Larrea
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Ciudad de México 14080, México.
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Abstract
Epidemiological evidence links an individual's susceptibility to chronic disease in adult life to events during their intrauterine phase of development. Biologically this should not be unexpected, for organ systems are at their most plastic when progenitor cells are proliferating and differentiating. Influences operating at this time can permanently affect their structure and functional capacity, and the activity of enzyme systems and endocrine axes. It is now appreciated that such effects lay the foundations for a diverse array of diseases that become manifest many years later, often in response to secondary environmental stressors. Fetal development is underpinned by the placenta, the organ that forms the interface between the fetus and its mother. All nutrients and oxygen reaching the fetus must pass through this organ. The placenta also has major endocrine functions, orchestrating maternal adaptations to pregnancy and mobilizing resources for fetal use. In addition, it acts as a selective barrier, creating a protective milieu by minimizing exposure of the fetus to maternal hormones, such as glucocorticoids, xenobiotics, pathogens, and parasites. The placenta shows a remarkable capacity to adapt to adverse environmental cues and lessen their impact on the fetus. However, if placental function is impaired, or its capacity to adapt is exceeded, then fetal development may be compromised. Here, we explore the complex relationships between the placental phenotype and developmental programming of chronic disease in the offspring. Ensuring optimal placentation offers a new approach to the prevention of disorders such as cardiovascular disease, diabetes, and obesity, which are reaching epidemic proportions.
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Affiliation(s)
- Graham J Burton
- Centre for Trophoblast Research and Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom; and Department of Medicine, Knight Cardiovascular Institute, and Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, Oregon
| | - Abigail L Fowden
- Centre for Trophoblast Research and Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom; and Department of Medicine, Knight Cardiovascular Institute, and Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, Oregon
| | - Kent L Thornburg
- Centre for Trophoblast Research and Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom; and Department of Medicine, Knight Cardiovascular Institute, and Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, Oregon
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Kosteria I, Anagnostopoulos AK, Kanaka-Gantenbein C, Chrousos GP, Tsangaris GT. The Use of Proteomics in Assisted Reproduction. In Vivo 2017; 31:267-283. [PMID: 28438852 PMCID: PMC5461434 DOI: 10.21873/invivo.11056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 02/06/2023]
Abstract
Despite the explosive increase in the use of Assisted Reproductive Technologies (ART) over the last 30 years, their success rates remain suboptimal. Proteomics is a rapidly-evolving technology-driven science that has already been widely applied in the exploration of human reproduction and fertility, providing useful insights into its physiology and leading to the identification of numerous proteins that may be potential biomarkers and/or treatment targets of a successful ART pregnancy. Here we present a brief overview of the techniques used in proteomic analyses and attempt a comprehensive presentation of recent data from mass spectrometry-based proteomic studies in humans, regarding all components of ARTs, including the male and female gamete, the derived zygote and embryo, the endometrium and, finally, the ART offspring both pre- and postnatally.
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Affiliation(s)
- Ioanna Kosteria
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | | | - Christina Kanaka-Gantenbein
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - George P Chrousos
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
- Proteomics Research Unit, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George T Tsangaris
- Proteomics Research Unit, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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Pathare ADS, Zaveri K, Hinduja I. Downregulation of genes related to immune and inflammatory response in IVF implantation failure cases under controlled ovarian stimulation. Am J Reprod Immunol 2017; 78. [PMID: 28370781 DOI: 10.1111/aji.12679] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 02/28/2017] [Indexed: 12/28/2022] Open
Abstract
PROBLEM Implantation failure (IF) even after the good-quality embryo transfer (ET) is main obstacle in in vitro fertilization (IVF). We aim to study the genomics of endometrial receptivity in IF patients under controlled ovarian stimulation (COS) during which ET is generally practised in IVF. METHOD OF STUDY Endometrial gene expression profiling in IF patients (n=10) and oocyte donors (n=8) were compared during window of implantation under COS by microarray. Enrichment analysis of microarray data was performed to determine dysregulated pathways. Microarray results were validated by real-time PCR. Localization of genes related to immune response (progestagen-associated endometrial protein (PAEP), leukaemia inhibitory factor (LIF), interleukin-6 signal transducer (IL6ST) was detected by immunohistochemistry. RESULTS The gene ontology, pathway analysis and enrichment mapping revealed significant downregulation in activation and regulation of immune and inflammation response in IF patients under COS. The lower expression of PAEP, LIF and IL6ST in cases compared to controls by real time and immunohistochemistry suggests the functional importance of these genes. CONCLUSION Importance of immune and inflammatory response in endometrial receptivity adds on to the current knowledge of gene expression profile in IF under COS. The panel of genes involved in these pathways would be useful in determining further line of treatment for IF during IVF.
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Gómez E, Martin D, Carrocera S, Sánchez-Calabuig MJ, Gutierrez-Adán A, Alonso-Guervos M, Peynot N, Giraud-Delville C, Sandra O, Duranthon V, Muñoz M. Expression and localization of ARTEMIN in the bovine uterus and embryos. Theriogenology 2016; 90:153-162. [PMID: 28166962 DOI: 10.1016/j.theriogenology.2016.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/29/2016] [Accepted: 12/03/2016] [Indexed: 12/28/2022]
Abstract
Artemin a member of the glial cell line-derived neurotrophic factor (GDNF) family is present in mice and human preimplantation embryos, and reproductive tract, during early pregnancy promoting embryo development in vitro. The presence of artemin in cattle embryos and reproductive tract, however, is unknown. In the present work we identified for first time artemin in bovine uterine fluid (UF) (Western blot), endometrium (RT-PCR, Western blot and immunohistochemistry) and embryos (RT-PCR and immunohistochemistry) during early preimplantation development. In addition, GFRalpha3, a component of the artemin receptor was localized in blastocysts produced in vitro. Individually developing embryos released ARTEMIN in culture medium and triggered ARTEMIN mRNA down-regulation in epithelial cells from endometrial cell cultures. Our results suggest that ARTEMIN derived from early embryos and maternal reproductive tract may exert important roles during early development in cattle.
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Affiliation(s)
- E Gómez
- Centro de Biotecnología Animal, SERIDA, Camino de Rioseco 1225, 33394, Gijón, Spain
| | - D Martin
- Centro de Biotecnología Animal, SERIDA, Camino de Rioseco 1225, 33394, Gijón, Spain
| | - S Carrocera
- Centro de Biotecnología Animal, SERIDA, Camino de Rioseco 1225, 33394, Gijón, Spain
| | - M J Sánchez-Calabuig
- INIA Departamento de Reproducción Animal y Conservación de Recursos Zoogenéticos, Cra de La Coruña Km 5600, 28040, Madrid, Spain
| | - A Gutierrez-Adán
- INIA Departamento de Reproducción Animal y Conservación de Recursos Zoogenéticos, Cra de La Coruña Km 5600, 28040, Madrid, Spain
| | - M Alonso-Guervos
- Unidad de Microscopía Fotónica y Proceso de Imágenes, Servicios Científico Técnicos, Universidad de Oviedo, Instituto Universitario de Oncología de Asturias (IUOPA), 33006, Oviedo, Spain
| | - N Peynot
- INRA, UMR1198 Biologie du Développement et Reproduction, F-78350, Jouy-en-Josas, France
| | - C Giraud-Delville
- INRA, UMR1198 Biologie du Développement et Reproduction, F-78350, Jouy-en-Josas, France
| | - O Sandra
- INRA, UMR1198 Biologie du Développement et Reproduction, F-78350, Jouy-en-Josas, France
| | - V Duranthon
- INRA, UMR1198 Biologie du Développement et Reproduction, F-78350, Jouy-en-Josas, France
| | - M Muñoz
- Centro de Biotecnología Animal, SERIDA, Camino de Rioseco 1225, 33394, Gijón, Spain.
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Evans J, Salamonsen LA, Winship A, Menkhorst E, Nie G, Gargett CE, Dimitriadis E. Fertile ground: human endometrial programming and lessons in health and disease. Nat Rev Endocrinol 2016; 12:654-667. [PMID: 27448058 DOI: 10.1038/nrendo.2016.116] [Citation(s) in RCA: 181] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The human endometrium is a highly dynamic tissue that is cyclically shed, repaired, regenerated and remodelled, primarily under the orchestration of oestrogen and progesterone, in preparation for embryo implantation. Humans are among the very few species that menstruate and that, consequently, are equipped with unique cellular and molecular mechanisms controlling these cyclic processes. Many reproductive pathologies are specific to menstruating species, and studies in animal models rarely translate to humans. Abnormal remodelling and regeneration of the human endometrium leads to a range of reproductive complications. Furthermore, the processes regulating endometrial remodelling and implantation, including those controlling hormonal impact, breakdown and repair, stem/progenitor cell activation, inflammation and cell invasion have broad applications to other fields. This Review presents current knowledge regarding the normal and abnormal function of the human endometrium. The development of biomarkers for prediction of uterine diseases and pregnancy disorders and future avenues of investigation to improve fertility and enhance endometrial function are also discussed.
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Affiliation(s)
- Jemma Evans
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, 3168, Australia
- Department of Molecular and Translational Medicine, Monash University, Clayton, 3800, Australia
- Department of Physiology, Monash University, Clayton, 3800, Australia
| | - Lois A Salamonsen
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, 3168, Australia
- Department of Molecular and Translational Medicine, Monash University, Clayton, 3800, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, 3800, Australia
| | - Amy Winship
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, 3168, Australia
- Department of Molecular and Translational Medicine, Monash University, Clayton, 3800, Australia
| | - Ellen Menkhorst
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, 3168, Australia
- Department of Molecular and Translational Medicine, Monash University, Clayton, 3800, Australia
| | - Guiying Nie
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, 3168, Australia
- Department of Molecular and Translational Medicine, Monash University, Clayton, 3800, Australia
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, 3800, Australia
| | - Caroline E Gargett
- Department of Obstetrics and Gynaecology, Monash University, Clayton, 3800, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, 3168, Australia
| | - Eva Dimitriadis
- Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, 3168, Australia
- Department of Molecular and Translational Medicine, Monash University, Clayton, 3800, Australia
- Department of Anatomy and Developmental Biology, Monash University, Clayton, 3800, Australia
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50
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Braga DPAF, Setti AS, Lo Turco EG, Cordeiro FB, Cabral EC, Cortezzi SS, Ono E, Figueira RCS, Eberlin MN, Borges E. Protein expression in human cumulus cells as an indicator of blastocyst formation and pregnancy success. J Assist Reprod Genet 2016; 33:1571-1583. [PMID: 27614633 DOI: 10.1007/s10815-016-0800-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/17/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The goal for the present study was to implement a technique for protein extraction and identification in human cumulus cells (CCs). METHODS Forty samples of CCs were collected after ovum pick-up from patients undergoing intracytoplasmic sperm injection (ICSI). Samples were split into the blastocyst group (n = 10), including patients in which all embryos converted into blastocysts, and the non-blastocyst group (n = 10), including patients in which none of the embryos reached the blastocyst stage or the positive-pregnancy (n = 10) and negative-pregnancy group (n = 10). Proteins were extracted and injected into a liquid chromatography system coupled to a mass spectrometer. The spectra were processed and used to search a database. RESULTS There were 87 different proteins in samples from the blastocyst and non-blastocyst groups, in which 30 were exclusively expressed in the blastocyst group and 17 in the non-blastocyst group. Among the 72 proteins detected in the pregnancy groups, 19 were exclusively expressed in the positive, and 16 were exclusively expressed in the negative-pregnancy group. CONCLUSIONS CC proteomics may be useful for predicting pregnancy success and the identification of patients that should be included in extended embryo culture programs.
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Affiliation(s)
- Daniela Paes Almeida Ferreira Braga
- Fertility Medical Group, Av. Brigadeiro Luis Antônio, 4545, São Paulo, SP, 01401-002, Brazil.,Disciplina de Urologia, Área de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo-UNIFESP, Rua Embaú, 231, São Paulo, SP, 04039-060, Brazil.,Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo, SP, 04503-040, Brazil
| | - Amanda Souza Setti
- Fertility Medical Group, Av. Brigadeiro Luis Antônio, 4545, São Paulo, SP, 01401-002, Brazil.,Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo, SP, 04503-040, Brazil
| | - Edson Guimarães Lo Turco
- Disciplina de Urologia, Área de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo-UNIFESP, Rua Embaú, 231, São Paulo, SP, 04039-060, Brazil
| | - Fernanda Bertuccez Cordeiro
- Disciplina de Urologia, Área de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo-UNIFESP, Rua Embaú, 231, São Paulo, SP, 04039-060, Brazil
| | - Elaine Cristina Cabral
- Centro Pluridisciplinar de Pesquisas Químicas, Biológicas e Agronômicas (CPQBA)-Universidade de Campinas-UNICAMP, Campinas, SP, 13083-970, Brazil
| | - Sylvia Sanches Cortezzi
- Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo, SP, 04503-040, Brazil
| | - Erika Ono
- Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo, SP, 04503-040, Brazil
| | | | - Marcos Nogueira Eberlin
- Laboratório ThoMSon de Espectrometria de Massas-Instituto de Química, Universidade de Campinas-UNICAMP, Campinas, SP, 13083-970, Brazil
| | - Edson Borges
- Fertility Medical Group, Av. Brigadeiro Luis Antônio, 4545, São Paulo, SP, 01401-002, Brazil. .,Disciplina de Urologia, Área de Reprodução Humana, Departamento de Cirurgia, Universidade Federal de São Paulo-UNIFESP, Rua Embaú, 231, São Paulo, SP, 04039-060, Brazil.
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