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Kuroda K. Management strategies following implantation failure of euploid embryos. Reprod Med Biol 2024; 23:e12576. [PMID: 38590944 PMCID: PMC11000815 DOI: 10.1002/rmb2.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/29/2024] [Accepted: 03/25/2024] [Indexed: 04/10/2024] Open
Abstract
Background Euploid blastocyst implantation failure may result from embryonic factors undetectable by preimplantation genetic testing for aneuploidy (PGT-A); however, various nonembryonic factors can also intricately interfere with implantation. This review seeks to clarify evidence-based testing and treatments for implantation failure after euploid embryo transfer. Methods We conducted a review of the literature on implantation failure after euploid embryo transfer or multiple embryo transfer cycles, which mainly included systematic reviews and meta-analyses. Results The recommended tests for implantation failure include (1) hysteroscopy, (2) endometrial CD138 immunohistochemistry and bacterial culture, (3) serum 25-hydroxyvitamin D3, and (4) thrombophilia screening. Based on diagnostic findings, the following treatments have been recommended: (1) antibiotics for chronic endometritis, (2) vitamin D replacement, (3) lifestyle modification, and (4) low-dose aspirin starting from the postimplantation period for thrombophilia. Moreover, frozen-thawed single euploid blastocyst transfer using assisted hatching and hyaluronan-enriched transfer medium may support embryo implantation. Conclusion To ensure a successful pregnancy in subsequent embryo transfers, simple, inexpensive, and evidence-based tests and treatments should be selected.
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Affiliation(s)
- Keiji Kuroda
- Center for Reproductive Medicine and EndoscopySugiyama Clinic MarunouchiTokyoJapan
- Department of Obstetrics and GynaecologyJuntendo University Faculty of MedicineTokyoJapan
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Yao WX, Zheng DZ, Liu WF, Zhou MM, Liu L, Cai MJ. Prognostic value of hysterosalpingography after salpingostomy in patients with hydrosalpinx. J OBSTET GYNAECOL 2023; 43:2158322. [PMID: 36606700 DOI: 10.1080/01443615.2022.2158322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
To assess whether post-hysterosalpingography evaluation was associated with pregnancy rate and to identify independent risk factors for pregnancy success after salpingostomy in patients with hydrosalpinx. A retrospective analysis was conducted on the clinical data of 47 patients diagnosed with hydrosalpingography (HSG) in our hospital from 2015 to 2018. These patients received laparoscopic surgery and another salpingography within 2 months after surgery. According to the fallopian tube conditions evaluated by HSG before and after surgery, the patients could be divided into two groups. According to the pregnancy rate and postoperative HSG of patients with hydrosalpinx after laparoscopy, the total pregnancy rate of the tubal improved group was 65.62%, while that of the non-improved group was 20%, with statistical significance (p < 0.05). We found that hysterosalpingography after salpingostomy in patients with hydrosalpinx can provide reference for clinical treatment and improve the prognosis of patients.
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Affiliation(s)
- Wen-Xi Yao
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, PR China
| | - Du-Zhou Zheng
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, PR China
| | - Wei-Feng Liu
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, PR China
| | - Mi-Mi Zhou
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, PR China
| | - Li Liu
- Department of Gynaecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, PR China
| | - Ming-Jin Cai
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, PR China
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Canha-Gouveia A, Di Nisio V, Salumets A, Damdimopoulou P, Coy P, Altmäe S, Sola-Leyva A. The Upper Reproductive System Microbiome: Evidence beyond the Uterus. Semin Reprod Med 2023; 41:190-199. [PMID: 38320577 DOI: 10.1055/s-0043-1778056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
The microbiome of the female upper reproductive system has garnered increasing recognition and has become an area of interest in the study of women's health. This intricate ecosystem encompasses a diverse consortium of microorganisms (i.e., microbiota) and their genomes (i.e., microbiome) residing in the female upper reproductive system, including the uterus, the fallopian tubes, and ovaries. In recent years, remarkable advancements have been witnessed in sequencing technologies and microbiome research, indicating the potential importance of the microbial composition within these anatomical sites and its impact in women's reproductive health and overall well-being. Understanding the composition, dynamics, and functions of the microbiome of the female upper reproductive system opens up exciting avenues for improving fertility, treating gynecological conditions, and advancing our comprehension of the intricate interplay between the microbiome and the female reproductive system. The aim of this study is to compile currently available information on the microbial composition of the female upper reproductive system in humans, with a focus beyond the uterus, which has received more attention in recent microbiome studies compared with the fallopian tubes and ovaries. In conclusion, this review underscores the potential role of this microbiome in women's physiology, both in health and disease.
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Affiliation(s)
- Analuce Canha-Gouveia
- Department of Physiology, Faculty of Veterinary, University of Murcia, Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University Clinical Hospital "Virgen de la Arrixaca," Murcia, Spain
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Valentina Di Nisio
- Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Andres Salumets
- Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, Stockholm, Sweden
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Competence Centre on Health Technologies, Tartu, Estonia
| | - Pauliina Damdimopoulou
- Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Pilar Coy
- Department of Physiology, Faculty of Veterinary, University of Murcia, Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University Clinical Hospital "Virgen de la Arrixaca," Murcia, Spain
| | - Signe Altmäe
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Alberto Sola-Leyva
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, Stockholm, Sweden
- Competence Centre on Health Technologies, Tartu, Estonia
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Canha-Gouveia A, Pérez-Prieto I, Rodríguez CM, Escamez T, Leonés-Baños I, Salas-Espejo E, Prieto-Sánchez MT, Sánchez-Ferrer ML, Coy P, Altmäe S. The female upper reproductive tract harbors endogenous microbial profiles. Front Endocrinol (Lausanne) 2023; 14:1096050. [PMID: 37415669 PMCID: PMC10321600 DOI: 10.3389/fendo.2023.1096050] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 05/26/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction The female reproductive tract harbours unique microbial communities (known as microbiota) which have been associated with reproductive functions in health and disease. While endometrial microbiome studies have shown that the uterus possesses higher bacterial diversity and richness compared to the vagina, the knowledge regarding the composition of the Fallopian tubes (FT) is lacking, especially in fertile women without any underlying conditions. Methods To address this gap, our study included 19 patients who underwent abdominal hysterectomy for benign uterine pathology, and 5 women who underwent tubal ligation as a permanent contraceptive method at Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA). We analyzed the microbiome of samples collected from the FT and endometrium using 16S rRNA gene sequencing. Results Our findings revealed distinct microbiome profiles in the endometrial and FT samples, indicating that the upper reproductive tract harbors an endogenous microbiome. However, these two sites also shared some similarities, with 69% of the detected taxa Being common to both. Interestingly, we identified seventeen bacterial taxa exclusively present in the FT samples, including the genera Enhydrobacter, Granulicatella, Haemophilus, Rhizobium, Alistipes, and Paracoccus, among others. On the other hand, 10 bacterial taxa were only found in the endometrium, including the genera Klebsiella, Olsenella, Oscillibacter and Veillonella (FDR <0.05). Furthermore, our study highlighted the influence of the endometrial collection method on the findings. Samples obtained transcervically showed a dominance of the genus Lactobacillus, which may indicate potential vaginal contamination. In contrast, uterine samples obtained through hysterescopy revealed higher abundance of the genera Acinetobacter, Arthrobacter, Coprococcus, Methylobacterium, Prevotella, Roseburia, Staphylococcus, and Streptococcus. Discussion Although the upper reproductive tract appears to have a low microbial biomass, our results suggest that the endometrial and FT microbiome is unique to each individual. In fact, samples obtained from the same individual showed more microbial similarity between the endometrium and FT compared to samples from different women. Understanding the composition of the female upper reproductive microbiome provides valuable insights into the natural microenvironment where processes such as oocyte fertilization, embryo development and implantation occur. This knowledge can improve in vitro fertilization and embryo culture conditions for the treatment of infertility.
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Affiliation(s)
- Analuce Canha-Gouveia
- Department of Physiology, Faculty of Veterinary, University of Murcia, Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University Clinical Hospital "Virgen de la Arrixaca", Murcia, Spain
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
| | - Inmaculada Pérez-Prieto
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Carmen Martínez Rodríguez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University Clinical Hospital "Virgen de la Arrixaca", Murcia, Spain
- Genomics Unit, Biomedical Research Institute of Murcia (IMIB)-Arrixaca, Murcia, Spain
| | - Teresa Escamez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University Clinical Hospital "Virgen de la Arrixaca", Murcia, Spain
- BiobancMur-Nodo 1, Biomedical Research Institute of Murcia (IMIB)-Arrixaca, Murcia, Spain
- Spanish Biobank Platform, Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Irene Leonés-Baños
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
| | - Eduardo Salas-Espejo
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
| | - Maria Teresa Prieto-Sánchez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University Clinical Hospital "Virgen de la Arrixaca", Murcia, Spain
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, Murcia, Spain
| | - Maria Luisa Sánchez-Ferrer
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University Clinical Hospital "Virgen de la Arrixaca", Murcia, Spain
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, Murcia, Spain
| | - Pilar Coy
- Department of Physiology, Faculty of Veterinary, University of Murcia, Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University Clinical Hospital "Virgen de la Arrixaca", Murcia, Spain
| | - Signe Altmäe
- Department of Biochemistry and Molecular Biology I, Faculty of Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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El-Kharoubi AF. Tubal Pathologies and Fertility Outcomes: A Review. Cureus 2023; 15:e38881. [PMID: 37197301 PMCID: PMC10184952 DOI: 10.7759/cureus.38881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 05/19/2023] Open
Abstract
Anomalies of the fallopian tubes represent one of the most significant elements that might contribute to reproductive issues. They can be inherited or acquired; they are among the most important problems of the profession. Although there is much discussion regarding which therapies for each tubal disease are the most effective and result in the best long-term reproductive outcomes. During the evaluation of an infertile couple, certain anomalies of the fallopian tubes are frequently discovered. These abnormalities were thought, for a long time, to not have an influence on fertility; however, in recent years, researchers have discovered that they seem to play a crucial role in fertility problems. Couples in industrialized countries are postponing childbearing, which raises the risk of women developing tubal diseases before they are ready to become pregnant. These disorders may have a negative impact on a woman's ability to get pregnant. The goals of this study are to conduct research to gain a deeper understanding of the recent advancements that have been made in the field of tubal diseases and to carry out an evaluation of the medical conducts that have the best fertility outcomes. We searched both Medline and PubMed, paying special attention to the most relevant articles that have been added to either database over the course of the last six years.
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Effects of Hydrosalpinx on Endometrial Receptivity and Uterine Microbiome: An Interesting Case of Double Uterus with Unilateral Hydrosalpinx. ENDOCRINES 2022. [DOI: 10.3390/endocrines3040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Endometrial receptivity array (ERA)—an objective tool used in assisted reproductive technology—is used for personalized embryo transfer in in vitro fertilization. Hydrosalpinx affects implantation through various mechanisms. However, its effects on ERA are not well established. In this case report, we present the diagnosis and treatment of a 34-year-old nulligravida woman with infertility for two years, obesity, double uterus with unilateral hydrosalpinx and right kidney deficiency. Based on ERA results, endometrial microbiome metagenomic analysis (EMMA), analysis of infectious chronic endometritis (ALICE), and CD138 immunostaining, the patient was treated with hormonal replacement cycle and amoxicillin/clavulanic acid. After one week of amoxicillin/clavulanic acid administration, the vitirified-warmed 4AA blastocyst was transferred to the left uterus—which was absent of hydrosalpinx and easily accessible to transfer and pregnancy was achieved. To the best of our knowledge, this case study is the first one in which we found that there were no differences between the left and right uterus in ERA, EMMA, ALICE, and CD138 immunostainings. Hence, we suggest that hydrosalpinx does not necessarily cause endometrial changes in all cases. Further research to evaluate the effects of hydrosalpinx on implantation with ERA and EMMA/ALICE is warranted.
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7
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Guo H, Du T, Lyu Q, Wu L, Chai W, Zhu Q. Live birth rate and neonatal outcomes following interventional embolization of hydrosalpinx. Reprod Health 2022; 19:213. [PMID: 36457061 PMCID: PMC9713958 DOI: 10.1186/s12978-022-01522-7] [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: 12/02/2021] [Accepted: 11/04/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Hydrosalpinx has a negative effect on the pregnancy outcomes of in vitro fertilization and embryo transfer (IVF-ET), and the pretreatment for hydrosalpinx play an important role in improving the outcomes of IVF-ET. This study aimed to investigate the impacts of interventional embolization of hydrosalpinx on the live birth rate and neonatal outcome after in-vitro fertilization. METHOD In the present retrospective study, 3351 women receiving the first frozen embryo transfer (FET) after freeze-all policy were reviewed. Patients who received interventional embolization of hydrosalpinx (n = 1268) were included in the study group and those with hydrosalpinx-free bilateral fallopian tube obstruction (n = 2083) in the control group. The primary outcome was live birth (LB) rate; the secondary endpoints included rates of implantation, clinical pregnancy (CP), multiple pregnancy, and pregnancy loss. RESULTS The LB rate was similar between embolization group (39.91%) and control group (43.21%) (P > 0.05). The rate of implantation (35.81% vs. 32.24%), CP (50.84% vs. 47%) and multiple pregnancy rate (28.71% vs. 24.16%) in the control group were significantly higher than in the embolization group (P < 0.05). The miscarriage rate (39.91%, vs 43.21%, P > 0.05), ectopic gestation rate (2.35% vs 2.83%, P > 0.05), and ongoing pregnancy rate (41.56% vs 44.89%, P > 0.05) were comparable between two groups. After adjustment for confounding factors, interventional embolization of hydrosalpinx was found to have no influence on the LB rate. The thicker endometrium, more embryos transferred, and transfer of blastocyst stage embryos significantly increased the LB rate and CP rate. CONCLUSION The interventional embolization of hydrosalpinx can achieve the LB rate similar to that of hydrosalpinx-free obstruction patients with less risk, less pain and reduced medical cost. Thus, embolization of hydrosalpinx is one of the preferable clinical treatments for patients with hydrosalpinx.
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Affiliation(s)
- Haiyan Guo
- grid.16821.3c0000 0004 0368 8293Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Center for Specialty Strategy Research of Shanghai, Jiao Tong University China Hospital Development Institute, Shanghai, 200011 China
| | - Tong Du
- grid.16821.3c0000 0004 0368 8293Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Center for Specialty Strategy Research of Shanghai, Jiao Tong University China Hospital Development Institute, Shanghai, 200011 China
| | - Qifeng Lyu
- grid.16821.3c0000 0004 0368 8293Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Center for Specialty Strategy Research of Shanghai, Jiao Tong University China Hospital Development Institute, Shanghai, 200011 China
| | - Ling Wu
- grid.16821.3c0000 0004 0368 8293Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Center for Specialty Strategy Research of Shanghai, Jiao Tong University China Hospital Development Institute, Shanghai, 200011 China
| | - Weiran Chai
- grid.16821.3c0000 0004 0368 8293Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Center for Specialty Strategy Research of Shanghai, Jiao Tong University China Hospital Development Institute, Shanghai, 200011 China
| | - Qianqian Zhu
- grid.16821.3c0000 0004 0368 8293Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Center for Specialty Strategy Research of Shanghai, Jiao Tong University China Hospital Development Institute, Shanghai, 200011 China
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Muacevic A, Adler JR, Yoshida T, Taniguchi F. Unilateral Partial Absence of the Fallopian Tube in a Female Patient With Infertility: A Case Report and Literature Review. Cureus 2022; 14:e33057. [PMID: 36721610 PMCID: PMC9883063 DOI: 10.7759/cureus.33057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/29/2022] Open
Abstract
Unilateral partial absence of the fallopian tube is rare, and its clinical importance in fertility is unclear. A 35-year-old nulligravid female patient with infertility was suspected to have a left hydrosalpinx on hysterosalpingography and sonography. Therefore, the patient underwent diagnostic laparoscopy. The left fallopian tube lacked the ampullary portion, and its proximal end had a hydrosalpinx. A left salpingectomy was performed, and the pathological finding was a unilateral partial absence of the ampullary portion of the fallopian tube with hydrosalpinx. Postoperatively, she conceived via in vitro fertilization-embryo transfer-and delivered a healthy baby. Hydrosalpinx is a well-known cause of infertility and can develop due to the partial absence of a fallopian tube. Furthermore, salpingectomy may be effective in improving fertility in female patients with a unilateral partial absence of the fallopian tube.
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Kalam SN, Dowland S, Lindsay L, Murphy CR. Porosomes in uterine epithelial cells: Ultrastructural identification and characterization during early pregnancy. J Morphol 2022; 283:1381-1389. [PMID: 36059156 PMCID: PMC9828572 DOI: 10.1002/jmor.21504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 01/12/2023]
Abstract
Porosomes are plasma membrane structures in secretory cells that allow transient docking and/or partial fusion of vesicles during which they release their content then disengage. This is referred to as "kiss and run" exocytosis. During early pregnancy, at the time of receptivity, there is a high level of vesicle activity in uterine epithelial cells (UECs). One of the secretory pathways for these vesicles could be via porosomes, which have yet to be identified in UECs. This study identified porosomes in the apical plasma membrane of UECs for the first time. These structures were present on days 1, 5.5, and 6 of early pregnancy, where they likely facilitate partial secretion via "kiss and run" exocytosis. The porosomes were measured and quantified on days 1, 5.5, and 6, which showed there are significantly more porosomes on day 5.5 (receptive) compared to day 1 (nonreceptive) of pregnancy. This increase in porosome numbers may reflect major morphological and molecular changes in the apical plasma membrane at this time such as increased cholesterol and soluble NSF attachment protein receptor proteins, as these are structural and functional components of the porosome complex assembly. Porosomes were observed in both resting (inactive) and dilated (active) states on days 1, 5.5, and 6 of early pregnancy. Porosomes on day 5.5 are significantly more active than on day 1 as demonstrated by the dilation of their base diameter. Further two-way ANOVA analysis of base diameter in resting and dilated states found a significant increase in porosome activity in day 5.5 compared to day 1. This study therefore indicates an increase in the number and activity of porosomes at the time of uterine receptivity in the rat, revealing a mechanism by which the UECs modify the uterine luminal environment at this time.
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Affiliation(s)
- Sadaf N. Kalam
- School of Medical Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Samson Dowland
- School of Medical Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Laura Lindsay
- School of Medical Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Christopher R. Murphy
- School of Medical Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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Cao Z, Xu B, Wu Y, Luan K, Du X. A comprehensive analysis of miRNA/isomiRs profile of hydrosalpinx patients with interventional ultrasound sclerotherapy. PLoS One 2022; 17:e0268328. [PMID: 35969523 PMCID: PMC9377599 DOI: 10.1371/journal.pone.0268328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
Hydrosalpinx is a chronic inflammatory condition with high recurrence rate, and it is reported among female population having fallopian tubal factor infertility. Previously, we have reported that interventional ultrasound sclerotherapy improves endometrial receptivity and pregnancy rate with negligible adverse effects in patients suffering from hydrosalpinx. During present investigation, we have used next generation sequencing (NGS) to characterize the isomiR profiles from the endometrium of patients suffering from hydrosalpinx before and after interventional ultrasound sclerotherapy. Our results indicated that miRNA arm shift and switch remained unaffected when compared in patients before and after interventional ultrasound sclerotherapy. We observed that isomiRs with trimming at 3’ and isomiRs with canonical sequences were lower in post-treatment than in pre-treatment group. Gene ontology (GO) annotation and KEGG pathway analysis revealed that the expression of mature mir-30 was significantly lower in the pre-treatment as compared to post treatment group while the expression of mir-30 isomiR was 4.26-fold higher in pre-treatment when compared with the post-treatment group. These different expression patterns of mir-30 mature miRNA and mir-30 isomiRs in two groups are affecting the physiological function of the endometrium. Our results suggested that differential isomiR distribution in hydrosalpinx patients before and after treatment plays an important role in hydrosalpinx incidence and can help in designing novel strategy for the treatment of hydrosalpinx in female population.
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Affiliation(s)
- Zhengyi Cao
- Reproductive Medicine Center, Hefei, Anhui, P.R. China
| | - Bo Xu
- Division of Life Sciences and Medicine, Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Yan Wu
- Reproductive Medicine Center, Hefei, Anhui, P.R. China
| | - Kang Luan
- Reproductive Medicine Center, Hefei, Anhui, P.R. China
| | - Xin Du
- Reproductive Medicine Center, Hefei, Anhui, P.R. China
- * E-mail:
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Maignien C, Bourdon M, Scarano-Pereira JP, Martinino A, Cheloufi M, Marcellin L, Chapron C, Santulli P. ART Outcomes After Hysteroscopic Proximal Tubal Occlusion Versus Laparoscopic Salpingectomy for Hydrosalpinx Management in Endometriosis Patients. Reprod Sci 2021; 29:427-435. [PMID: 34642914 DOI: 10.1007/s43032-021-00737-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
The objective of this paper is to compare assisted reproductive technology (ART) cumulative live birth rates after hysteroscopic proximal tubal occlusion and laparoscopic salpingectomy in endometriosis patients, for management of hydrosalpinx. This is an observational cohort study at a university hospital, including all endometriosis patients with hydrosalpinges undergoing ART, between January 2013 and December 2018. The patients underwent either laparoscopic salpingectomy or hysteroscopic proximal tubal occlusion with Essure® when laparoscopy was not an option (extensive pelvic adhesions at exploratory laparoscopy or a history of multiple abdominal surgeries with frozen pelvis). The diagnosis of endometriosis was based on published imaging criteria using transvaginal sonography (TVUS) and magnetic resonance imaging (MRI). Endometriosis patients with hydrosalpinges diagnosed by hysterosalpingography and/or TVUS and/or MRI were included. The primary outcome was the cumulative live birth rate. A total of 104 patients were included in the study; 74 underwent laparoscopic salpingectomy and 30 underwent proximal tubal occlusion with Essure®. The Essure® group had longer infertility durations (58.9 ± 30.0 months vs. 39.5 ± 19.1 months, p = 0.002) and a higher incidence of associated adenomyosis (76.7% vs. 39.1%, p < 0.001) than the salpingectomy group. The cumulative live birth rate was 56.6% after 44 ART cycles in the Essure® group and 40.5% after 99 ART cycles in the salpingectomy group (p = 0.13). In a population of endometriosis patients undergoing ART, women treated by Essure® for management of hydrosalpinx have similar cumulative live birth rates as women treated by laparoscopic salpingectomy.
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Affiliation(s)
- Chloé Maignien
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Mathilde Bourdon
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Juan Pablo Scarano-Pereira
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Alessandro Martinino
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Meryam Cheloufi
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Louis Marcellin
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Charles Chapron
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Pietro Santulli
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France.
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France.
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
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12
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Sawada Y, Sato T, Nagaya M, Saito C, Yoshihara H, Banno C, Matsumoto Y, Matsuda Y, Yoshikai K, Sawada T, Ukita N, Sugiura-Ogasawara M. Evaluation of artificial intelligence using time-lapse images of IVF embryos to predict live birth. Reprod Biomed Online 2021; 43:843-852. [PMID: 34521598 DOI: 10.1016/j.rbmo.2021.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/18/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
RESEARCH QUESTION Can artificial intelligence (AI) improve the prediction of live births based on embryo images? DESIGN The AI system was created by using the Attention Branch Network associated with deep learning to predict the probability of live birth from 141,444 images recorded by time-lapse imaging of 470 transferred embryos, of which 91 resulted in live birth and 379 resulted in non-live birth that included implantation failure, biochemical pregnancy and clinical miscarriage. The possibility that the calculated confidence scores of each embryo and the focused areas visualized in each embryo image can help predict subsequent live birth was examined. RESULTS The AI system for the first time successfully visualized embryo features in focused areas that had potential to distinguish between live and non-live births. No visual feature of embryos were visualized that were associated with live or non-live births, although there were many images in which high-focused areas existed around the zona pellucida. When a cut-off level for the confidence score was set at 0.341, the live birth rate was significantly greater for embryos with a score higher than the cut-off level than for those with a score lower than the cut-off level (P < 0.001). In addition, the live birth rate of embryos with good morphological quality and confidence scores higher than 0.341 was 41.1%. CONCLUSIONS The authors have created an AI system with a confidence score that is useful for non-invasive selection of embryos that could result in live birth. Further study is necessary to improve selection accuracy.
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Affiliation(s)
- Yuki Sawada
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takeshi Sato
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| | - Masashi Nagaya
- Intelligent Information Media Lab, Graduate School of Engineering, Toyota Technological Institute, Nagoya, Japan
| | - Chieko Saito
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroyuki Yoshihara
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Chihiro Banno
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yosuke Matsumoto
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | | | | | - Norimichi Ukita
- Intelligent Information Media Lab, Graduate School of Engineering, Toyota Technological Institute, Nagoya, Japan
| | - Mayumi Sugiura-Ogasawara
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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13
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Pradervand PA, Antaki R, Phillips S, Guedon AC, Lapensée L, Preaubert L. Risk factors for the development of endometrial fluid in women undergoing IVF: A retrospective cohort study ✰. J Gynecol Obstet Hum Reprod 2021; 50:102143. [PMID: 33862265 DOI: 10.1016/j.jogoh.2021.102143] [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: 07/29/2020] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
RESEARCH QUESTION Presence of endometrial fluid (EF) is a poorly understood pathology and remains a challenge for clinicians, as very little data exists to explain its consequences and treatment. Our objective was to investigate risk factors for EF during IVF. DESIGN This retrospective cohort study included all women with a freeze all embryos cycle (FAE) for EF between 2010 and 2016 at a university-affiliated private IVF center. Controls (2:1) were randomly selected out of the database of our fresh autologous IVF cycles during the same period. Main outcome measures were possible risk factors for EF, comprising polycystic ovarian syndrome (PCOS), ovarian hyperstimulation syndrome (OHSS), previous pelvic or endometrial surgery (polypectomy or synechia removal), cesarean section, myomas and severe endometriosis. A logistic regression model was used to assess independent risk factors for EF. RESULTS Out of 9000 IVF cycles, 1204 were FAE cycles, among which we identified 86 EF cases. We then selected 171 controls. Independent risk factors for presence of EF were a history of previous myomectomy (adjusted odds ratio (aOR) 19.77, 95%CI [4.01-97.53]), severe endometriosis (aOR 5.97, 95%CI [2.09-17.05]), PCOS (aOR 5.72, 95%CI [2.66-12.33]) and previous cesarean section (aOR 5.17, 95%CI [1.84-14.49]). CONCLUSIONS Our results are not only confirming the association between PCOS, severe endometriosis, previous cesarean procedure and EF, but also reporting for the first time an association between previous myomectomy and EF.
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Affiliation(s)
- Pierre-Antoine Pradervand
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Roland Antaki
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Simon Phillips
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | | | - Louise Lapensée
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Lise Preaubert
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada.
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14
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Wu V, Mar W, Milad MP, Horowitz JM. Magnetic Resonance Imaging in the Evaluation of Female Infertility. Curr Probl Diagn Radiol 2021; 51:181-188. [PMID: 33487486 DOI: 10.1067/j.cpradiol.2020.11.011] [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: 08/26/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 11/22/2022]
Abstract
Pelvic MRI plays an important adjunctive role in the clinical workup of female infertility. Hysterosalpingography is the first line imaging modality in evaluation of female infertility, and hysterosalpingo-contrast sonography can also be used to evaluate both the uterine cavity and fallopian tubes. Pelvic MRI can be helpful in the workup of female infertility, particularly in cases of Mullerian duct anomalies, fibroids, adenomyosis, endometriosis, and tubal disease. These conditions and their appearance on imaging will be reviewed in this article.
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Affiliation(s)
- Victoria Wu
- University of Illinois Hospital and Health Systems, Chicago, IL.
| | - Winnie Mar
- University of Illinois Hospital and Health Systems, Chicago, IL
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Melo P, Georgiou EX, Johnson N, van Voorst SF, Strandell A, Mol BWJ, Becker C, Granne IE. Surgical treatment for tubal disease in women due to undergo in vitro fertilisation. Cochrane Database Syst Rev 2020; 10:CD002125. [PMID: 33091963 PMCID: PMC8094448 DOI: 10.1002/14651858.cd002125.pub4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Tubal disease accounts for 20% of infertility cases. Hydrosalpinx, caused by distal tubal occlusion leading to fluid accumulation in the tube(s), is a particularly severe form of tubal disease negatively affecting the outcomes of assisted reproductive technology (ART). It is thought that tubal surgery may improve the outcome of ART in women with hydrosalpinges. OBJECTIVES To assess the effectiveness and safety of tubal surgery in women with hydrosalpinges prior to undergoing conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). SEARCH METHODS We searched the Cochrane Gynaecology and Fertility (CGF) Group trials register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, DARE, and two trial registers on 8 January 2020, together with reference checking and contact with study authors and experts in the field to identify additional trials. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing surgical treatment versus no surgical treatment, or comparing surgical interventions head-to-head, in women with tubal disease prior to undergoing IVF. DATA COLLECTION AND ANALYSIS We used Cochrane's standard methodological procedures. The primary outcomes were live birth rate (LBR) and surgical complication rate per woman randomised. Secondary outcomes included clinical, multiple and ectopic pregnancy rates, miscarriage rates and mean numbers of oocytes retrieved and of embryos obtained. MAIN RESULTS We included 11 parallel-design RCTs, involving a total of 1386 participants. The included trials compared different types of tubal surgery (salpingectomy, tubal occlusion or transvaginal aspiration of hydrosalpingeal fluid) to no tubal surgery, or individual interventions to one another. We assessed no studies as being at low risk of bias across all domains, with the main limitations being lack of blinding, wide confidence intervals and low event and sample sizes. We used GRADE methodology to rate the quality of the evidence. Apart from one moderate-quality result in one review comparison, the evidence provided by these 11 trials ranged between very low- to low-quality. Salpingectomy versus no tubal surgery No included study reported on LBR for this comparison. We are uncertain of the effect of salpingectomy on surgical complications such as the rate of conversion to laparotomy (Peto odds ratio (OR) 5.80, 95% confidence interval (CI) 0.11 to 303.69; one RCT; n = 204; very low-quality evidence) and pelvic infection (Peto OR 5.80, 95% CI 0.11 to 303.69; one RCT; n = 204; very low-quality evidence). Salpingectomy probably increases clinical pregnancy rate (CPR) versus no surgery (risk ratio (RR) 2.02, 95% CI 1.44 to 2.82; four RCTs; n = 455; I2 = 42.5%; moderate-quality evidence). This suggests that in women with a CPR of approximately 19% without tubal surgery, the rate with salpingectomy lies between 27% and 52%. Proximal tubal occlusion versus no surgery No study reported on LBR and surgical complication rate for this comparison. Tubal occlusion may increase CPR compared to no tubal surgery (RR 3.21, 95% CI 1.72 to 5.99; two RCTs; n = 209; I2 = 0%; low-quality evidence). This suggests that with a CPR of approximately 12% without tubal surgery, the rate with tubal occlusion lies between 21% and 74%. Transvaginal aspiration of hydrosalpingeal fluid versus no surgery No study reported on LBR for this comparison, and there was insufficient evidence to identify a difference in surgical complication rate between groups (Peto OR not estimable; one RCT; n = 176). We are uncertain whether transvaginal aspiration of hydrosalpingeal fluid increases CPR compared to no tubal surgery (RR 1.67, 95% CI 1.10 to 2.55; three RCTs; n = 311; I2 = 0%; very low-quality evidence). Laparoscopic proximal tubal occlusion versus laparoscopic salpingectomy We are uncertain of the effect of laparoscopic proximal tubal occlusion versus laparoscopic salpingectomy on LBR (RR 1.21, 95% CI 0.76 to 1.95; one RCT; n = 165; very low-quality evidence) and CPR (RR 0.81, 95% CI 0.62 to 1.07; three RCTs; n = 347; I2 = 77%; very low-quality evidence). No study reported on surgical complication rate for this comparison. Transvaginal aspiration of hydrosalpingeal fluid versus laparoscopic salpingectomy No study reported on LBR for this comparison, and there was insufficient evidence to identify a difference in surgical complication rate between groups (Peto OR not estimable; one RCT; n = 160). We are uncertain of the effect of transvaginal aspiration of hydrosalpingeal fluid versus laparoscopic salpingectomy on CPR (RR 0.69, 95% CI 0.44 to 1.07; one RCT; n = 160; very low-quality evidence). AUTHORS' CONCLUSIONS We found moderate-quality evidence that salpingectomy prior to ART probably increases the CPR compared to no surgery in women with hydrosalpinges. When comparing tubal occlusion to no intervention, we found that tubal occlusion may increase CPR, although the evidence was of low quality. We found insufficient evidence of any effect on procedure- or pregnancy-related adverse events when comparing tubal surgery to no intervention. Importantly, none of the studies reported on long term fertility outcomes. Further high-quality trials are required to definitely determine the impact of tubal surgery on IVF and pregnancy outcomes of women with hydrosalpinges, particularly for LBR and surgical complications; and to investigate the relative efficacy and safety of the different surgical modalities in the treatment of hydrosalpinges prior to ART.
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Affiliation(s)
- Pedro Melo
- Buckinghamshire Hospitals NHS Trust, Aylesbury, UK
| | | | - Neil Johnson
- Discipline of Obstetrics and Gynaecology, School of Medicine, Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | | | - Annika Strandell
- Obstetrics and Gynecology, University of Gothenburg, Gothenburg, Sweden
| | - Ben Willem J Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | - Christian Becker
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Ingrid E Granne
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
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Preaubert L, Shaulov T, Phillips S, Pradervand PA, Kadoch IJ, Lapensee L. In freeze-all embryo cycles due to endometrial fluid (EF), live birth rates are comparable to those of controls, despite high rates of EF recurrence and cycle cancellation. J Gynecol Obstet Hum Reprod 2020; 50:101960. [PMID: 33099027 DOI: 10.1016/j.jogoh.2020.101960] [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: 07/19/2020] [Revised: 10/03/2020] [Accepted: 10/17/2020] [Indexed: 12/19/2022]
Abstract
RESEARCH QUESTION Do cumulative live birth rates (CLBRs) differ between women who have had a freeze-all embryo cycle (FAE) for endometrial fluid (EF) and controls? DESIGN This retrospective cohort study included 83 women who had a FAE cycle due to the presence of EF between 2010 and 2016 at a university-affiliated private IVF center. The controls were 219 women who had FAE for other indications during the same period and were randomly selected. The main outcome measures were CLBRs, EF recurrence, cancellation and pregnancy loss rates. RESULTS Population characteristics were comparable between the two groups. The CLBR was not significantly different between the EF and the control group: 39.8 % vs. 47.0 %, respectively, p=0.26. Cancellation rates in the two first FETs were higher in the EF group than the control group: 18.1 % vs. 4.1 % (p<0.001) and 22.9 % vs. 8.5 % (p=0.02). After FAE for EF, we observed a significant risk of EF recurrence (32/177 cycles, 18.1 %), allowing us to identify a poor prognosis subgroup. When EF was detected, the LBR per transfer was 7.1 % (1/14) when the transfer was finally performed (after EF aspiration or EF disappearance), compared to 25 % (32/128) in cycles without EF recurrence (p<0.05). Conversely, in the absence of EF recurrence (145/177, 81.9 %), the LBR was comparable to that of the control group. The type of endometrial preparation does not seem to be associated with EF recurrence. CONCLUSION Despite higher rates of EF recurrence and cycle cancellation, women with FAE for EF ultimately have comparable LBRs to those who have had a FAE for other indications. However, women presenting with at least one EF recurrence during FETs seem to have a lower LBR.
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Affiliation(s)
- Lise Preaubert
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada.
| | - Talya Shaulov
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Simon Phillips
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Pierre-Antoine Pradervand
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Isaac Jacques Kadoch
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
| | - Louise Lapensee
- OVO Clinic, Montreal, QC, Canada; Department of Obstetrics and Gynecology, University of Montreal, Canada
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Wu S, Zhang Q, Li Y. Effect comparison of salpingectomy versus proximal tubal occlusion on ovarian reserve: A meta-analysis. Medicine (Baltimore) 2020; 99:e20601. [PMID: 32791661 PMCID: PMC7387007 DOI: 10.1097/md.0000000000020601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The women with hydrosalpinx have lower pregnancy rates in assisted reproductive technology, and only laparoscopic salpingectomy and tubal occlusion has proven to be effective to improve the outcome of in vitro fertilization. The main objective of the present meta-analysis was to assess and compare the ovarian reserve after salpingectomy or proximal tubal occlusion (PTO) in the published literature. MATERIAL AND METHODS We considered all published cohort (retrospective and prospective) and cross-sectional studies as well as randomized controlled trials that investigated changes in serum anti-Müllerian hormone (AMH), follicle-stimulating hormone levels or antral follicle count (AFC) following salpingectomy or PTO. Two investigators (SW, QZ) independently screened the full text of all identified articles to assess relevance to our meta-analysis. RESULTS In total, 648 patients were included in 5 studies. In the analysis of comparative studies. In the analysis of comparative studies, the follicle-stimulating hormone of salpingectomy had no significant difference with that of PTO (WMD 0.46IU/L, 95% CI[-0.14,1.05]). The AMH and AFC of salpingectomy were significantly higher than that of PTO (AFC: WMD -0.80IU/L, 95% CI [-1.46, -0.14]; AMH: WMD -1.01IU/L, 95% CI [-1.28, -0.74]). CONCLUSIONS Salpingectomy did more harm to ovarian reserve than PTO in the short-term. However, the long-term effects on ovarian reserve remains uncertain.
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18
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ATILGAN R, PALA Ş, KULOĞLU T, ŞANLI C, YAVUZKIR Ş, ÖZKAN ZS. Comparison of the efficacy between bilateral proximal tubal occlusion and total salpingectomy on ovarian reserve and the cholinergic system: an experimental study. Turk J Med Sci 2020; 50:1097-1105. [PMID: 32394684 PMCID: PMC7379445 DOI: 10.3906/sag-2002-179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/10/2020] [Indexed: 01/11/2023] Open
Abstract
Background and aim To compare the effects of bilateral proximal tubal occlusion and bilateral total salpingectomy on ovarian reserve and the cholinergic system via rat experiment. Materials and methods Twenty-one adult female rats were randomly divided into the following three groups:G1 (n = 7), sham group;G2 (n = 7), bilateral total salpingectomy group; and G3 (n = 7), bilateral proximal tubal occlusion group. Four weeks later, the abdomen of the rats was opened. The right ovarian tissues were stored in 10% formaldehyde, whereas the left ovarian tissues were stored at –80 °C in aluminum foil. Serum samples were evaluated for antimullerian hormone. The right ovary was used for histological and immunoreactive examination, and the left ovary was used for tissue MDA analysis. Tissue samples were analyzed for MDA levels with spectrophotometric measurement, apoptosis with TUNEL staining, fibrosis score with Mason trichrome staining, ovarian reserve with HE staining, and cholinergic receptor muscarinic 1 (CHRM1) level with immunoreactivity method. Results Compared to G1 and G3, the number of corpus luteum with secondary follicles was significantly lower in G2, whereas the number of ovarian cysts and fibrosis and apoptosis scores increased significantly. The CHRM1 immunoreactivity was significantly lower in G2 than in G1 and G3. Conclusions Compared to the bilateral proximal tubal occlusion performed by using bipolar cautery, bilateral total salpingectomy in rats leads to a significant damage in ovarian histopathology and the cholinergic system.
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Affiliation(s)
- Remzi ATILGAN
- Department of Obstetrics and Gynecology, School of Medicine, Fırat University, ElazığTurkey
| | - Şehmus PALA
- Department of Obstetrics and Gynecology, School of Medicine, Fırat University, ElazığTurkey
| | - Tuncay KULOĞLU
- Department of Histology and Embryology, School of Medicine, Fırat University, ElazığTurkey
| | - Cengiz ŞANLI
- Department of Obstetrics and Gynecology, School of Medicine, Fırat University, ElazığTurkey
| | - Şeyda YAVUZKIR
- Department of Obstetrics and Gynecology, School of Medicine, Fırat University, ElazığTurkey
| | - Zehra Sema ÖZKAN
- Department of Obstetrics and Gynecology, School of Medicine, Kırıkkale University, KırıkkaleTurkey
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Gurbuz AS, Gode F, Ozcimen N. Non-Invasive Isthmocele Treatment: A New Therapeutic Option During Assisted Reproductive Technology Cycles? J Clin Med Res 2020; 12:307-314. [PMID: 32489506 PMCID: PMC7239582 DOI: 10.14740/jocmr4140] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/17/2020] [Indexed: 12/26/2022] Open
Abstract
Background The objective of the study was to evaluate a new medical treatment strategy for infertile patients with isthmocele. Methods This was a retrospective evaluation of the records of infertile patients with symptomatic isthmocele who received non-invasive isthmocele treatment (NIIT) before in vitro fertilization (IVF) treatment cycles. Isthmocele volumes were measured before and after NIIT. The IVF results and isthmocele-related complaints were also analyzed. The patients were treated with a depot gonadotropin-releasing hormone agonist for 3 months before frozen-thawed embryo transfer cycles. Results The mean isthmocele volume was 471.06 ± 182.81 mm3 (range: 289.43 - 765.4 mm3) in fresh cycles, but was reduced to 47.94 ± 29.48 mm3 (range: 18.70 - 105.6 mm3) in frozen-thawed cycles (P < 0.05). Intrauterine fluid was observed in two patients during fresh cycles, but was absent after NIIT during frozen-thawed cycles. There was no brown bloody discharge on the tip of the embryo transfer catheter in any case after NIIT. Two patients became pregnant and underwent term cesarean delivery (25%). Conclusions NIIT can serve as an alternative pretreatment option for patients with isthmocele during IVF cycles.
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Affiliation(s)
- Ali Sami Gurbuz
- Department of Obstetrics and Gynaecology, KTO Karatay University Medical Faculty, Konya, Turkey.,Novafertil IVF Center, Konya, Turkey
| | - Funda Gode
- Department of Obstetrics and Gynecology, Bahcesehir University Medical Faculty, Istanbul, Turkey
| | - Necati Ozcimen
- Department of Obstetrics and Gynaecology, KTO Karatay University Medical Faculty, Konya, Turkey
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20
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Impact on Fertility After Failure of Restorative Proctocolectomy in Men and Women With Ulcerative Colitis: A 17-Year Cohort Study. Dis Colon Rectum 2020; 63:816-822. [PMID: 32149783 DOI: 10.1097/dcr.0000000000001640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Impact of restorative proctocolectomy failure on fertility has not been studied and is greatly relevant. OBJECTIVE The purpose of this study was to evaluate the impact of restorative proctocolectomy failure on birth rate in women and men, along with in vitro fertilization incidence and success. DESIGN This was a retrospective registry-based cohort study over 17 years. SETTINGS Records for parenting a child were cross-linked with patient records. In women, in vitro fertilization records were cross-linked. All data were prospectively registered. PATIENTS Patients of fertile age with ulcerative colitis between 1994 and 2010 were identified in Danish national databases. Patients with restorative proctocolectomy and restorative proctocolectomy failure were identified as subgroups. MAIN OUTCOME MEASURES Birth rate ratios and in vitro fertilization incidence and success were measured. RESULTS We included 11,939 women and 13,569 men with ulcerative colitis. A total of 711 women and 730 men had restorative proctocolectomy; 114 women and 90 men had failure. Birth rate in women with failure was significantly reduced compared with women without (birth rate ratio = 0.50 (95% CI, 0.29-0.82)). In men with failure, birth rate tended to be lower compared with men without (birth rate ratio = 0.74 (95% CI, 0.51-1.05)). In vitro fertilization incidence was similar with and without failure (HRs adjusted for age at start of follow-up = 0.98 (95% CI, 0.58-1.67]). In vitro fertilization success was significantly lower with failure compared with ulcerative colitis (OR adjusted for age at start of follow-up = 0.36 (95% CI, 0.4-0.92)). LIMITATIONS Information on patients leading up to restorative proctocolectomy failure is lacking. Failure patients may have had children during a period with pouch function. Therefore, the impact of failure may be underestimated. CONCLUSIONS Restorative proctocolectomy failure impairs birth rate, primarily in women. Although in vitro fertilization incidence is similar in women with and without failure, the likelihood of giving birth after in vitro fertilization is reduced. See Video Abstract at http://links.lww.com/DCR/B202. IMPACTO SOBRE LA FERTILIDAD DESPUéS DEL FRACASO DE LA PROCTOCOLECTOMíA RESTAURADORA EN HOMBRES Y MUJERES CON COLITIS ULCEROSA: UN ESTUDIO DE COHORTE DE 17 AñOS: No se ha estudiado el impacto de la falla de la proctocolectomía restauradora en la fertilidad y es muy relevante.Evaluar el impacto del fracaso de la proctocolectomía restauradora en la tasa de natalidad en mujeres y hombres, junto con la incidencia y el éxito de la fertilización in vitro.Estudio de cohorte retrospectivo basado en el registro de más de 17 años.Los registros de crianza de un niño se cruzaron con los registros de pacientes. En las mujeres, los registros de fertilización in vitro se cruzarón. Todos los datos se regitraron de forma prospectiva.Los pacientes de edad fértil con colitis ulcerosa entre 1994-2010 fueron identificados en las bases de datos nacionales danesas. Los pacientes con proctocolectomía restauradora y fracaso de la proctocolectomía restauradora se identificaron como subgrupos.Tasas de natalidad e incidencia y éxito de la fertilización in vitro.Se incluyeron 11939 mujeres y 13569 hombres con colitis ulcerosa. 711 mujeres y 730 hombres tuvieron proctocolectomía restauradora; 114 mujeres y 90 hombres tuvieron fracaso. La tasa de natalidad en las mujeres con fracaso se redujo significativamente en comparación con las mujeres sin fracaso (tasa de natalidad: 0,50; IC del 95% [0,29; 0,82]). En los hombres con fracaso, la tasa de natalidad tendió a ser más baja en comparación con los hombres sin fracaso (tasa de natalidad: 0,74; IC del 95% [0,51; 1,05]). La incidencia de fertilización in vitro fue similar con y sin falla (aHR: 0.98, IC 95% [0.58; 1.67]). El éxito de la fertilización in vitro fue significativamente menor con el fracaso en comparación con la colitis ulcerosa (aOR: 0.36 IC 95% [0.4; 0.92]).Falta información sobre los pacientes que conducen al fracaso de la proctocolectomía restauradora. Los pacientes con fracaso pueden haber tenido hijos durante un período con función de bolsa. Por lo tanto, el impacto del fracaso puede ser subestimado.El fracaso de la proctocolectomía restauradora afecta la tasa de natalidad, principalmente en mujeres. Aunque la incidencia de la fertilización in vitro es similar en las mujeres con y sin fracaso, la probabilidad de dar a luz después de la fertilización in vitro se reduce. Consulte Video Resumen en http://links.lww.com/DCR/B202. (Traducción-Dr Gonzalo Hagerman).
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de Oliveira V, Schaefer J, Abu-Rafea B, Vilos GA, Vilos AG, Bhattacharya M, Radovick S, Babwah AV. Uterine aquaporin expression is dynamically regulated by estradiol and progesterone and ovarian stimulation disrupts embryo implantation without affecting luminal closure. Mol Hum Reprod 2020; 26:154-166. [PMID: 31977023 PMCID: PMC7103570 DOI: 10.1093/molehr/gaaa007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/18/2019] [Accepted: 01/10/2020] [Indexed: 01/01/2023] Open
Abstract
The study investigated the effect of normal and supraphysiological (resulting from gonadotropin-dependent ovarian stimulation) levels of estradiol (E2) and progesterone (P4) on mouse uterine aquaporin gene/protein (Aqp/AQP) expression on Day 1 (D1) and D4 of pregnancy. The study also examined the effect of ovarian stimulation on uterine luminal closure and uterine receptivity on D4 of pregnancy and embryo implantation on D5 and D7 of pregnancy. These analyses revealed that the expression of Aqp3, Aqp4, Aqp5 and Aqp8 is induced by E2 while the expression of Aqp1 and Aqp11 is induced by P4. Additionally, P4 inhibits E2 induction of Aqp3 and Aqp4 expression while E2 inhibits Aqp1 and Aqp11 expression. Aqp9, however, is constitutively expressed. Ovarian stimulation disrupts Aqp3, Aqp5 and Aqp8 expression on D4 and AQP1, AQP3 and AQP5 spatial expression on both D1 and D4, strikingly so in the myometrium. Interestingly, while ovarian stimulation has no overt effect on luminal closure and uterine receptivity, it reduces implantation events, likely through a disruption in myometrial activity and embryo development. The wider implication of this study is that ovarian stimulation, which results in supraphysiological levels of E2 and P4 and changes (depending on the degree of stimulation) in the E2:P4 ratio, triggers abnormal expression of uterine AQP during pregnancy, and this is associated with implantation failure. These findings lead us to recognize that abnormal expression would also occur under any pathological state (such as endometriosis) that is associated with changes in the normal E2:P4 ratio. Thus, infertility among these patients might in part be linked to abnormal uterine AQP expression.
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Affiliation(s)
- Vanessa de Oliveira
- Laboratory of Human Growth and Reproductive Development, Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Jennifer Schaefer
- Laboratory of Human Growth and Reproductive Development, Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
- School of Graduate Studies, Joint Graduate Program in Toxicology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Basim Abu-Rafea
- Department of Obstetrics and Gynaecology, Division of Reproductive Endocrinology and Infertility, University of Western Ontario, London, Ontario, Canada
| | - George A Vilos
- Department of Obstetrics and Gynaecology, Division of Reproductive Endocrinology and Infertility, University of Western Ontario, London, Ontario, Canada
| | - Angelos G Vilos
- Department of Obstetrics and Gynaecology, Division of Reproductive Endocrinology and Infertility, University of Western Ontario, London, Ontario, Canada
| | - Moshmi Bhattacharya
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
- Child Health Institute of New Jersey, New Brunswick, NJ, USA
| | - Sally Radovick
- Laboratory of Human Growth and Reproductive Development, Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
- Child Health Institute of New Jersey, New Brunswick, NJ, USA
| | - Andy V Babwah
- Laboratory of Human Growth and Reproductive Development, Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
- School of Graduate Studies, Joint Graduate Program in Toxicology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
- Child Health Institute of New Jersey, New Brunswick, NJ, USA
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Huang L, Lu Q, Du J, Lv H, Tao S, Chen S, Li X, Han X, Zhou K, Xu B, Liu X, Ma H, Xia Y, Jin G, Shen H, Ling X, Hu Z, Tan J, Diao F. Cumulative live birth rates of in vitro fertilization/intracytoplasmic sperm injection after multiple complete cycles in China. J Biomed Res 2020; 34:361-368. [PMID: 32981896 PMCID: PMC7540236 DOI: 10.7555/jbr.34.20200035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
There were few studies of cumulative live birth rates (CLBRs) based on multicenter reproductive clinical data from the general Chinese population. Here we report a retrospective cohort study, including 14 311 women with 17 315 cycles, in three reproductive centers to evaluate two estimated parameters of CLBRs with multiple transfer cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in a Chinese population. We found that CLBRs were related to female age and endometrial thickness. By the fourth transfer cycle, the conservative and optimal estimates of CLBRs were 52.95% and 77.30% in women under 30 years of age, and 18.17% and 26.51% in those 37 years of age or older, respectively. The two estimates were 44.70% and 63.15% in women with endometrial thickness more than 7 mm, and 32.05% and 46.18% in those with less than 7 mm, respectively. In addition, body mass index (BMI), duration of infertility, and infertility diagnoses may also be related to CLBRs on certain conditions. The findings from this study on CLBRs after multiple transfer cycles of IVF/ICSI treatment on different conditions in the Chinese population should be beneficial to both infertile couples and clinicians.
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Affiliation(s)
- Lei Huang
- State Key Laboratory of Reproductive Medicine
| | - Qun Lu
- State Key Laboratory of Reproductive Medicine
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine
| | - Shiyao Tao
- State Key Laboratory of Reproductive Medicine
| | - Shiyao Chen
- State Key Laboratory of Reproductive Medicine
| | - Xiuzhu Li
- State Key Laboratory of Reproductive Medicine
| | - Xiumei Han
- State Key Laboratory of Reproductive Medicine
| | - Kun Zhou
- State Key Laboratory of Reproductive Medicine
| | - Bo Xu
- State Key Laboratory of Reproductive Medicine
| | - Xiaoyu Liu
- State Key Laboratory of Reproductive Medicine
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine
| | - Guangfu Jin
- State Key Laboratory of Reproductive Medicine
| | | | - Xiufeng Ling
- State Key Laboratory of Reproductive Medicine.,Department of Reproduction, the Affiliated Nanjing Maternity and Child Health Hospital of Nanjing Medical University, Nanjing, Jiangsu 210004, China
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine
| | - Jichun Tan
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110022, China
| | - Feiyang Diao
- State Key Laboratory of Reproductive Medicine.,Department of Reproduction, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
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Which Low-Abundance Proteins are Present in the Human Milieu of Gamete/Embryo Maternal Interaction? Int J Mol Sci 2019; 20:ijms20215305. [PMID: 31653120 PMCID: PMC6861935 DOI: 10.3390/ijms20215305] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 02/07/2023] Open
Abstract
The improvement of the embryo culture media is of high relevance due to its influence on successful implantation rates, pregnancy, neonatal outcomes, and potential effects in adult life. The ideal conditions for embryo development are those naturally occurring in the female reproductive tract, i.e., the oviductal and uterine fluids. To shed light on the differences between chemical and natural media, we performed the first comparative study of the low abundance proteins in plasma, uterine, and oviductal fluid collected, simultaneously, from healthy and fertile women that underwent a salpingectomy. The rationale for this design derives from the fact that high-abundant proteins in these fluids are usually those coming from blood serum and frequently mask the detection of low abundant proteins with a potentially significant role in specific processes related to the embryo–maternal interaction. The proteomic analysis by 1D-nano LC ESI-MSMS detected several proteins in higher amounts in oviductal fluid when compared to uterine and plasma samples (RL3, GSTA1, EZRI, DPYSL3, GARS, HSP90A). Such oviductal fluid proteins could be a target to improve fertilization rates and early embryo development if used in the culture media. In conclusion, this study presents a high-throughput analysis of female reproductive tract fluids and contributes to the knowledge of oviductal and uterine secretome.
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Yang X, Zhu L, Le F, Lou H, Zhao W, Pan P, Zou Y, Jin F. Proximal Fallopian Tubal Embolization by Interventional Radiology prior to Embryo Transfer in Infertile Patients with Hydrosalpinx: A Prospective Study of an Off-label Treatment. J Minim Invasive Gynecol 2019; 27:107-115. [PMID: 31580926 DOI: 10.1016/j.jmig.2019.02.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/23/2019] [Accepted: 02/27/2019] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE To evaluate in vitro fertilization (IVF) outcomes of proximal fallopian tube embolization by interventional radiology compared with laparoscopic salpingectomy before embryo transfer (ET) in patients with hydrosalpinx. DESIGN A single-center, off-label, nonrandomized prospective study. SETTING Academic university hospital. PATIENTS One hundred fifty-five patients with hydrosalpinx were identified on ultrasound or hysterosalpingography desiring IVF between April 2016 and December 2017. INTERVENTIONS Radiologically guided tubal occlusion with embolization microcoils (RTO-EM) and laparoscopic salpingectomy. MEASUREMENTS AND MAIN RESULTS Of the 155 analyzed patients, 42 were treated with RTO-EM and 113 with laparoscopic salpingectomy. The subsequent IVF outcomes, including implantation, clinical pregnancy, miscarriage, ectopic pregnancy, and ongoing pregnancy (i.e., a fetal heartbeat on ultrasound beyond 10 weeks) were compared between the 2 groups. Implantation and clinical pregnancy per ET cycle in the RTO-EM group were similar to that of the salpingectomy group (26.7% vs 30.2% [p = .51] and 39.0% vs 45.3% [p = .40], respectively), with a similar miscarriage rate. There was no statistically significant difference in ectopic pregnancies between the 2 groups. Moreover, no difference was detected in ongoing pregnancy per cycle between the 2 groups (33.9% vs 41.2%; p = .32). The ongoing-pregnancy rate per patient following RTO-EM was 47.6% (20 of 42) compared with 61.9% (70 of 113) following salpingectomy (odds ratio, 0.56; 95% confidence interval, 0.27-1.14; p = .11). CONCLUSION Pregnancy in the RTO-EM group was comparable to the salpingectomy group in patients with hydrosalpinx before ET treatment. RTO-EMs may be an alternative to salpingectomy for patients with hydrosalpinx planning for IVF-ET.
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Affiliation(s)
- Xinyun Yang
- Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine (Drs. Yang, Zhu, Le, Lou, Zhao, Pan, and Jin); Department of Reproductive Endocrinology, Hangzhou Women's Hospital (Dr. Zhu); Department of Radiology, Women's Hospital, Zhejiang University School of Medicine (Dr. Zou), Hangzhou, Zhejiang, P.R. China
| | - Linling Zhu
- Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine (Drs. Yang, Zhu, Le, Lou, Zhao, Pan, and Jin); Department of Reproductive Endocrinology, Hangzhou Women's Hospital (Dr. Zhu); Department of Radiology, Women's Hospital, Zhejiang University School of Medicine (Dr. Zou), Hangzhou, Zhejiang, P.R. China
| | - Fang Le
- Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine (Drs. Yang, Zhu, Le, Lou, Zhao, Pan, and Jin); Department of Reproductive Endocrinology, Hangzhou Women's Hospital (Dr. Zhu); Department of Radiology, Women's Hospital, Zhejiang University School of Medicine (Dr. Zou), Hangzhou, Zhejiang, P.R. China
| | - Hangying Lou
- Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine (Drs. Yang, Zhu, Le, Lou, Zhao, Pan, and Jin); Department of Reproductive Endocrinology, Hangzhou Women's Hospital (Dr. Zhu); Department of Radiology, Women's Hospital, Zhejiang University School of Medicine (Dr. Zou), Hangzhou, Zhejiang, P.R. China
| | - Wei Zhao
- Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine (Drs. Yang, Zhu, Le, Lou, Zhao, Pan, and Jin); Department of Reproductive Endocrinology, Hangzhou Women's Hospital (Dr. Zhu); Department of Radiology, Women's Hospital, Zhejiang University School of Medicine (Dr. Zou), Hangzhou, Zhejiang, P.R. China
| | - Peipei Pan
- Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine (Drs. Yang, Zhu, Le, Lou, Zhao, Pan, and Jin); Department of Reproductive Endocrinology, Hangzhou Women's Hospital (Dr. Zhu); Department of Radiology, Women's Hospital, Zhejiang University School of Medicine (Dr. Zou), Hangzhou, Zhejiang, P.R. China
| | - Yu Zou
- Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine (Drs. Yang, Zhu, Le, Lou, Zhao, Pan, and Jin); Department of Reproductive Endocrinology, Hangzhou Women's Hospital (Dr. Zhu); Department of Radiology, Women's Hospital, Zhejiang University School of Medicine (Dr. Zou), Hangzhou, Zhejiang, P.R. China.
| | - Fan Jin
- Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine (Drs. Yang, Zhu, Le, Lou, Zhao, Pan, and Jin); Department of Reproductive Endocrinology, Hangzhou Women's Hospital (Dr. Zhu); Department of Radiology, Women's Hospital, Zhejiang University School of Medicine (Dr. Zou), Hangzhou, Zhejiang, P.R. China.
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Yohannes E, Kazanjian AA, Lindsay ME, Fujii DT, Ieronimakis N, Chow GE, Beesley RD, Heitmann RJ, Burney RO. The human tubal lavage proteome reveals biological processes that may govern the pathology of hydrosalpinx. Sci Rep 2019; 9:8980. [PMID: 31222072 PMCID: PMC6586608 DOI: 10.1038/s41598-019-44962-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 05/24/2019] [Indexed: 12/12/2022] Open
Abstract
Hydrosalpinx, the blockage of fallopian tubes, can result from pelvic inflammatory disease. Hydrosalpinx is a cause of infertility and negatively impacts in vitro fertilization. To better understand the pathobiology of hydrosalpinx, we compared the proteome of lavages from disease vs. healthy fallopian tubes. Results indicate a disruption of redox homeostasis and activation of the complement system, immune cell infiltration, and phagocytosis; pathways that may drive tubal injury. To our surprise among the most prominent proteins with hydrosalpinx was mesothelin (MSLN), which until now has only been associated with epithelial malignancies. Analogous to mesothelioma and ovarian carcinoma, a significant increase of MSLN was detected in plasma from patients with hydrosalpinx. This finding suggests MSLN may provide clinical diagnosis in lieu of the current approaches that require invasive imaging. Importantly, these findings implicate MSLN in a benign disease, indicating that the activation and role of MSLN is not restricted to cancer.
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Affiliation(s)
- Elizabeth Yohannes
- Department of Clinical Investigation, Division of Graduate Medical Education, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA.
| | - Avedis A Kazanjian
- Department of Clinical Investigation, Division of Graduate Medical Education, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Morgan E Lindsay
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Dennis T Fujii
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Nicholas Ieronimakis
- Department of Clinical Investigation, Division of Graduate Medical Education, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Gregory E Chow
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Ronald D Beesley
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Ryan J Heitmann
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Richard O Burney
- Department of Clinical Investigation, Division of Graduate Medical Education, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA.,Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
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Cai HL, Pan LY, Wang SF, Tian Y, Zheng XZ, Yang Y, Li K. Discussion on operative skills in the embolization of hydrosalpinx by hysteroscopic placement of a microcoil. Medicine (Baltimore) 2019; 98:e14721. [PMID: 30882637 PMCID: PMC6426551 DOI: 10.1097/md.0000000000014721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study aims to discuss the operative skills of hysteroscopic tubal embolization and reduce the occurrence of complications.Ninety-four patients were divided into group A and group B. The main surgical technique in group A: when the inner sleeve is sent to the fallopian tube and no longer accessible (but no >3 cm), remove the guide wire and put into the microcoil. But in group B, there are four major surgical techniques. First, the depth at which the guide wire enters the tube was controlled at 2 cm. Second, the inner diameter of the fallopian tube must be explored to determine the type and shape of the coils. Third, saline should be used to separate the catheter. Fourth, it is to control the release speed of the coils. The superiority of the improved operation method was confirmed by comparing the surgical failure rate, incidence of complications, and cost of surgery before and after the procedure.The reoperation rate of group A was 10% (3/30), while that of group B was 2.68% (3/112). The ectopic microcoils rate of group A was 6.67% (2/30), while that of group B was 0.89% (1/112). The microcoil damages rate of group 23.33% (7/30), while that of group B was 8.04% (9/112). All P values were <.01, and the difference was statistically significant.Hysteroscopic tubal embolization is currently a new surgical procedure to block the fallopian tubes and prevent the reverse flow of fluid in the fallopian tubes into the uterine cavity. After we improved surgical techniques, the surgical failure rate, complication rate, and operation cost of fallopian tube embolization were significantly lower than before the improved method was applied. The improved techniques led to a higher success rate.
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Affiliation(s)
- Hua-Lei Cai
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Guizhou Medical University
| | - Le-Yun Pan
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Shun-Fang Wang
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Yu Tian
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Xiao-Zhu Zheng
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Yan Yang
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Kun Li
- Department of Surgical, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
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Alalfy M, Elgazzar A, Ghamry N, Elsawah H, Azkalani A, El Lithy A, Hammam M, Gaafar H, Elshenofy H, Nagy O, Abdella R, Lasheen Y, Soliman M, Wahba A, Haggag H, Hany A, Farouk D, Sharaf M, Al Arshal AH. Physical endometrial manipulation and its impact on success rate and live birth rate in ICSI in patients with unexplained infertility after recurrent ICSI failure, a double blinded randomized controlled trial. J Matern Fetal Neonatal Med 2019; 33:2983-2989. [PMID: 30624997 DOI: 10.1080/14767058.2019.1566897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Unexplained infertility is a rising problem and endometrial manipulation could be one of the solutions for enhancing the pregnancy rate and live birth rate in such circumstances.Aims: To evaluate the influence of local endometrial physical manipulation with specializd method for endometrial and tubal hydration (Elgazzar and Alalfy technique) on ICSI outcome and in increasing chemical, clinical, and live birth rate in ICSI after previous recurrent ICSI failure in patients with unexplained infertility.Results: When comparing group 1 (hydrotubation group) and group 2 (the control group with no intervention) with regards to the biochemical, clinical, and live birth rate, the hydrotubation group revealed higher rates and a better ICSI outcome.Conclusion: Hydrotubation is useful in increasing biochemical, clinical, and live birth rates after recurrent failed ICSI trials with a specialized method for hydration of endometrium and tubes (Elgazzar and Alalfy technique).
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Affiliation(s)
- Mahmoud Alalfy
- Reproductive Health and Family Planning Department, National Research Centre, Aljazeerah Hospital, CAIFM, Cairo, Egypt
| | - Ahmed Elgazzar
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Nevein Ghamry
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Heba Elsawah
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Ahmed Azkalani
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Ahmed El Lithy
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Mohamed Hammam
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Hassan Gaafar
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Hossam Elshenofy
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Omar Nagy
- Reproductive Health and Family Planning Department, National Research Centre, Aljazeerah Hospital, CAIFM, Cairo, Egypt
| | - Rana Abdella
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Yossra Lasheen
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Mahmoud Soliman
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Amr Wahba
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Hisham Haggag
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Ayman Hany
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Dalia Farouk
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
| | - Marwa Sharaf
- Obstetrics and Gynecology Department, Kasralainy, Cairo University, Cairo, Egypt
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Laadraoui J, Aboufatima R, El Gabbas Z, Ferehan H, Bezza K, Ait Laaradia M, Marhoume F, Wakrim EM, Chait A. Effect of Artemisia herba-alba consumption during pregnancy on fertility, morphological and behaviors of mice offspring. JOURNAL OF ETHNOPHARMACOLOGY 2018; 226:105-110. [PMID: 30118834 DOI: 10.1016/j.jep.2018.08.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/28/2018] [Accepted: 08/13/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Pregnant women prefer herbal medicines more than pharmaceutical drugs due to the cultural belief that herbs are more suffer during pregnancy for an accurate foetus development. Artemisia herba-alba (Asteraceae) is one of the most used plants in the Mediterranean region to treat various diseases including diabetes, hypertension, spasmodic dysphonia and some bacterial infection. AIM OF THE STUDY The present study aimed to investigate the effect of Artemisia herba-alba consumption during pregnancy on fertility, physical and behavior developments of mice offspring from birth-to-weaning days. MATERIALS AND METHODS Female pregnant mice were divided into three groups and orally administrated with 80 and 150 mg/kg/day of the methanol extract of Artemisia h.a respectively, during the entire period of gestation. At birth, total fertility rate was counted. Body development; neuromotor reflex and behavior were also examined in mice offspring RESULTS: Artemisia h.a (Aha) exposure significantly decreased the fertility ratio in both Aha-treated groups and increased the weight and length of mice offspring in 80 mg/kg/day Aha-exposed group. Moreover, Aha administration prolonged the time of completing the reflex response of surface righting, negative geotaxis, cliff avoidance and jumping test of mice offspring in Aha-exposed groups. CONCLUSION The present study provides strong evidence that discourage the use of Artemisia h.a during gestation period.
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Affiliation(s)
- Jawad Laadraoui
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Rachida Aboufatima
- Laboratory of Génie Biologique, Sultan Moulay Slimane University, Faculty of Sciences and Techniques, Béni Mellal, Morocco
| | - Zineb El Gabbas
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Hind Ferehan
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Kenza Bezza
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Mehdi Ait Laaradia
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Fatimazahra Marhoume
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - El Mehdi Wakrim
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Abderrahman Chait
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco.
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Cohen A, Almog B, Tulandi T. Hydrosalpinx Sclerotherapy Before In Vitro Fertilization: Systematic Review and Meta-analysis. J Minim Invasive Gynecol 2018; 25:600-607. [DOI: 10.1016/j.jmig.2017.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/21/2017] [Accepted: 12/07/2017] [Indexed: 10/18/2022]
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Zhang Y, Wang Q, Wang H, Duan E. Uterine Fluid in Pregnancy: A Biological and Clinical Outlook. Trends Mol Med 2017. [DOI: 10.1016/j.molmed.2017.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Pregnancy outcome of in vitro fertilization after Essure and laparoscopic management of hydrosalpinx: a systematic review and meta-analysis. Fertil Steril 2017; 108:84-95.e5. [DOI: 10.1016/j.fertnstert.2017.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 04/23/2017] [Accepted: 05/03/2017] [Indexed: 11/17/2022]
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Investigation of the microbiota of the reproductive tract in women undergoing a total hysterectomy and bilateral salpingo-oopherectomy. Fertil Steril 2017; 107:813-820.e1. [DOI: 10.1016/j.fertnstert.2016.11.028] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 11/24/2022]
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Gynecological and obstetrical outcomes after laparoscopic repair of a cesarean scar defect in a series of 38 women. Fertil Steril 2016; 107:289-296.e2. [PMID: 27816234 DOI: 10.1016/j.fertnstert.2016.09.033] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/15/2016] [Accepted: 09/15/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To evaluate gynecological and obstetrical outcomes, as well as remaining myometrial thickness, after laparoscopic repair of a cesarean scar. DESIGN Observational study and prospective evaluation of the remaining myometrium before and after repair. SETTING Academic department in a university hospital. PATIENT(S) A series of 38 symptomatic women with cesarean scar defects and remaining myometrial thickness of less than 3 mm, according to magnetic resonance imaging. INTERVENTION(S) Laparoscopic repair of the defect. MAIN OUTCOMES MEASURE(S) Increase in myometrial thickness at the site of cesarean section, gynecological and obstetrical outcomes, and histological analysis of the defect after excision. RESULT(S) The mean thickness of the myometrium increased significantly from 1.43 ± 0.7 mm before surgery to 9.62 ± 1.8 mm after surgery. All but three patients were free of symptoms. Among the 18 women with infertility, eight (44%) became pregnant and delivered healthy babies by cesarean section at 38-39 weeks of gestation. Histological analysis, performed in all 38 cases, revealed the presence of endometriosis in eight women (21.1%). Muscle fiber density was significantly lower compared with adjacent myometrium. CONCLUSION(S) In symptomatic women with residual myometrial thickness of less than 3 mm who wish to conceive, laparoscopic repair could be considered an appropriate approach.
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Song XM, Jiang H, Zhang WX, Zhou Y, Ni F, Wang XM. Ultrasound sclerotherapy pretreatment could obtain a similar effect to surgical intervention on improving the outcomes of in vitro fertilization for patients with hydrosalpinx. J Obstet Gynaecol Res 2016; 43:122-127. [PMID: 27762465 DOI: 10.1111/jog.13152] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/19/2016] [Accepted: 08/07/2016] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to compare the clinical outcomes of in vitro fertilization (IVF) for patients with hydrosalpinx between ultrasound sclerotherapy and surgical intervention. METHODS The data of 482 IVF/intracytoplasmic sperm injection (ICSI) cycles were divided into three groups according to different intervention protocols before IVF/ICSI. Group A included 265 cycles in which ultrasound sclerotherapy pretreatment was carried out before controlled ovarian hyperstimulation. Group B included 109 cycles in which hydrosalpinx aspiration was carried out under ultrasound guidance on the day of oocyte retrieval. Croup C included 108 cycles in which bilateral salpingectomy was carried out before IVF/ICSI. RESULTS The rates of embryo implantation, biochemical pregnancy, clinical pregnancy, multiple pregnancy, and early abortion showed no significant differences between groups A and C (P > 0.05); whereas the rates of embryo implantation, biochemical pregnancy, and clinical pregnancy in group B were significantly lower than those in groups A and C (P < 0.05), and that of early abortion in group B was significantly higher than that in groups A and C (P < 0.05). CONCLUSION Ultrasound sclerotherapy on patients with hydrosalpinx before IVF-embryo transfer could obtain a similar clinical outcome to surgical intervention.
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Affiliation(s)
- Xiao-Min Song
- The Reproductive Medicine Center, Clinical College of People's Liberation Army Affiliated to Anhui Medical University, Hefei, Anhui, China.,105 Hospital of People's Liberation Army, Hefei, Anhui, China
| | - Hong Jiang
- The Reproductive Medicine Center, Clinical College of People's Liberation Army Affiliated to Anhui Medical University, Hefei, Anhui, China.,105 Hospital of People's Liberation Army, Hefei, Anhui, China
| | - Wen-Xiang Zhang
- The Reproductive Medicine Center, Clinical College of People's Liberation Army Affiliated to Anhui Medical University, Hefei, Anhui, China.,105 Hospital of People's Liberation Army, Hefei, Anhui, China
| | - Yun Zhou
- The Reproductive Medicine Center, Clinical College of People's Liberation Army Affiliated to Anhui Medical University, Hefei, Anhui, China.,105 Hospital of People's Liberation Army, Hefei, Anhui, China
| | - Feng Ni
- The Reproductive Medicine Center, Clinical College of People's Liberation Army Affiliated to Anhui Medical University, Hefei, Anhui, China.,105 Hospital of People's Liberation Army, Hefei, Anhui, China
| | - Xue-Mei Wang
- The Reproductive Medicine Center, Clinical College of People's Liberation Army Affiliated to Anhui Medical University, Hefei, Anhui, China
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Yoon SH, Lee JY, Kim SN, Chung HW, Park SY, Lee C. Does salpingectomy have a deleterious impact on ovarian response in in vitro fertilization cycles? Fertil Steril 2016; 106:1083-1092.e5. [DOI: 10.1016/j.fertnstert.2016.05.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/23/2016] [Accepted: 05/31/2016] [Indexed: 11/17/2022]
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Feasibility and Safety of Laparoscopic-Assisted Bowel Segmental Resection for Deep Infiltrating Endometriosis: A Retrospective Cohort Study With Description of Technique. J Minim Invasive Gynecol 2016; 23:512-25. [DOI: 10.1016/j.jmig.2015.09.024] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 09/22/2015] [Accepted: 09/24/2015] [Indexed: 01/31/2023]
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de Ziegler D, Pirtea P, Galliano D, Cicinelli E, Meldrum D. Optimal uterine anatomy and physiology necessary for normal implantation and placentation. Fertil Steril 2016; 105:844-54. [PMID: 26926252 DOI: 10.1016/j.fertnstert.2016.02.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 02/02/2016] [Accepted: 02/11/2016] [Indexed: 12/11/2022]
Abstract
The authors review aberrations of uterine anatomy and physiology affecting pregnancy outcomes with IVF. In the case of endometriosis and hydrosalpinx, pathologies outside of the uterus alter the uterine endometrium. In the case of endometriosis, Dominique de Ziegler outlines the numerous changes in gene expression and the central role of inflammation in causing progesterone resistance. With endometriosis, the absence of ovarian function inherent in deferred transfer, with or without a more lengthy suppression of ovarian function, appears to be sufficient to restore normal function of eutopic endometrium. Because laparoscopy is no longer routine in the evaluation of infertility, unrecognized endometriosis then becomes irrelevant in the context of assisted reproductive technology. With hydrosalpinx and submucus myomas, the implantation factor HOXA-10 is suppressed in the endometrium and, with myomas, even in areas of the uterus not directly affected. Daniela Galliano reviews various uterine pathologies, the most enigmatic being adenomyosis, where the endometrium also manifests many of the changes seen in endometriosis and deferred transfer with extended suppression appears to provide the best outcomes. Ettore Cicinelli's group has extensively studied the diagnosis and treatment of endometritis, and although more definitive diagnosis and care of this covert disorder may await techniques such as sequencing of the endometrial microbiome, it undoubtedly is an important factor in implantation failure, deserving our attention and treatment.
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Affiliation(s)
- Dominique de Ziegler
- Department of Obstetrics, Gynecology, and Reproductive Medicine, Université Paris Descartes, Paris Sorbonne Cité-Assistance Publique Hôpitaux de Paris, CHU Cochin, Paris, France.
| | - Paul Pirtea
- Department of Obstetrics, Gynecology, and Reproductive Medicine, Université Paris Descartes, Paris Sorbonne Cité-Assistance Publique Hôpitaux de Paris, CHU Cochin, Paris, France
| | - Daniela Galliano
- Instituto Valenciano de Infertilidad (IVI), Rome, Italy and Barcelona, Spain; IVI Foundation, Valencia, Spain
| | - Ettore Cicinelli
- 2nd Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, Bari, Italy
| | - David Meldrum
- Reproductive Partners San Diego, Division of Reproductive Endocrinology, University of California, San Diego, California
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Lorente González J, Ríos Castillo JE, Pomares Toro E, Romero Nieto MI, Castelo-Branco C, Arjona Berral JE. Essure a novel option for the treatment of hydrosalpinx: a case series and literature review. Gynecol Endocrinol 2016; 32:166-70. [PMID: 26513546 DOI: 10.3109/09513590.2015.1103221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the use of hysteroscopic Essure device placement for the treatment of hydrosalpinx (HS)-related infertility in patients with laparoscopic contraindications and compared their pregnancy outcomes following IVF-ICSI treatment with those patients having had laparoscopic tubal occlusion (LTO). PATIENTS From 2008 to 2014 a total of 50 patients were diagnosed with unilateral or bilateral hydrosalpinges: 29 patients had laparoscopic contraindications and were treated hysteroscopically and 21 patients were treated with laparoscopical salpingectomy. RESULTS Of the 29 patients who underwent treatment with Essure(®), 21 began a cycle of in vitro fertilization (IVF), and 13 finished in embryo transfer that resulted in seven clinical pregnancies. Furthermore, in the group of women treated with salpingectomy, 17 started an IVF cycle that resulted in 12 clinical pregnancies. The clinical pregnancy rate per patient with an IVF cycle started was 33.3% and 70.6%, the live-birth rate per patient was 14.3% and 52.9%, the miscarriage rate was 57.1% and 18.2%, and the implantation rate was 16.3% and 34.1% for hysteroscopy and laparoscopy, respectively. CONCLUSION Essure(®) placement is an alternative method for occlusion of hydrosalpinges before IVF. Monitoring the live-birth rate confirms that this option may be considered when laparoscopy is impossible or contraindicated.
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Affiliation(s)
- Juan Lorente González
- a Department of Obstetrics and Gynecology , ''Reina Sofia'' University Hospital , Cordoba , Spain and
| | | | - Elvira Pomares Toro
- a Department of Obstetrics and Gynecology , ''Reina Sofia'' University Hospital , Cordoba , Spain and
| | | | - Camil Castelo-Branco
- b Faculty of Medicine , Institut Clinic of Gynecology, Obstetrics and Neonatology, University of Barcelona, Hospital Clinic-Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) , Barcelona , Spain
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Liu S, Shi L, Shi J. Impact of endometrial cavity fluid on assisted reproductive technology outcomes. Int J Gynaecol Obstet 2015; 132:278-83. [PMID: 26792140 DOI: 10.1016/j.ijgo.2015.07.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 07/12/2015] [Accepted: 11/20/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND The impact of endometrial cavity fluid (ECF) on assisted reproductive technology (ART) outcomes has not been evaluated in a meta-analysis. OBJECTIVES To evaluate the impact of ECF on the outcome of ART cycles. SEARCH STRATEGY PubMed, China Academic Journals Full-text Database, and China Doctoral/Masters Dissertations Full-text Databases were searched for reports published in any language before January 1, 2015, using relevant keywords. SELECTION CRITERIA Studies were included if they compared the outcome of ART in women with and without ECF. DATA COLLECTION AND ANALYSIS Background information, participants' characteristics, and study outcomes were recorded. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel method. MAIN RESULTS Six studies evaluating 5928 ART cycles were included. The pregnancy rate was significantly lower in the group with ECF than in the group without ECF (OR 0.74, 95% CI 0.55-0.98; P=0.03). The same association was observed if the analysis included only patients with hydrosalpinx (OR 0.36, 95% CI 0.15-0.86; P=0.02). CONCLUSIONS The clinical pregnancy rate after ART is significantly lower among patients with ECF than among those without ECF. In addition, if ECF is found in patients with hydrosalpinx, ART cycles should be cancelled after oocyte retrieval.
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Affiliation(s)
- Shan Liu
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
| | - Lin Shi
- Department of Immunology and Microbiology, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Juanzi Shi
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China.
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Tanimura S, Funamoto H, Hosono T, Shitano Y, Nakashima M, Ametani Y, Nakano T. New diagnostic criteria and operative strategy for cesarean scar syndrome: Endoscopic repair for secondary infertility caused by cesarean scar defect. J Obstet Gynaecol Res 2015; 41:1363-9. [DOI: 10.1111/jog.12738] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 03/15/2015] [Accepted: 03/24/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Satoshi Tanimura
- Department of Obstetrics and Gynecology; Toyama Central Prefectural Hospital; Toyama Japan
| | - Hiroshi Funamoto
- Department of Obstetrics and Gynecology; Toyama Central Prefectural Hospital; Toyama Japan
| | - Takashi Hosono
- Department of Obstetrics and Gynecology; Toyama Central Prefectural Hospital; Toyama Japan
| | - Yasushi Shitano
- Department of Obstetrics and Gynecology; Toyama Central Prefectural Hospital; Toyama Japan
| | - Masao Nakashima
- Department of Obstetrics and Gynecology; Toyama Central Prefectural Hospital; Toyama Japan
| | - Yuka Ametani
- Department of Obstetrics and Gynecology; Toyama Central Prefectural Hospital; Toyama Japan
| | - Takashi Nakano
- Department of Obstetrics and Gynecology; Toyama Central Prefectural Hospital; Toyama Japan
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Occlusion d’hydrosalpinx à l’aide de micro-implants posés par hystéroscopie chez des patientes sous immunosuppresseurs. ACTA ACUST UNITED AC 2015; 43:397-8. [DOI: 10.1016/j.gyobfe.2015.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 10/09/2014] [Indexed: 11/18/2022]
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Ozgur K, Bulut H, Berkkanoglu M, Coetzee K, Kaya G. ICSI pregnancy outcomes following hysteroscopic placement of Essure devices for hydrosalpinx in laparoscopic contraindicated patients. Reprod Biomed Online 2014; 29:113-8. [DOI: 10.1016/j.rbmo.2014.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 02/27/2014] [Accepted: 03/06/2014] [Indexed: 10/25/2022]
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Transient intrauterine fluid accumulation not due to hydrosalpinx or any identifiable pelvic pathology is not detrimental to IVF outcome. Arch Gynecol Obstet 2014; 290:569-73. [PMID: 24748281 DOI: 10.1007/s00404-014-3245-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 04/01/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This study is to assess whether transient intrauterine fluid accumulation (IUFA) first noted during controlled ovarian hyperstimulation that does not persist on the day of embryo transfer not due to any identifiable pelvic pathology has any detrimental effect on in vitro fertilization (IVF) outcome. METHODS From a database of 16,900 cycles, 144 patients with transient "physiological" IUFA were recruited. Four hundred fifty-one consecutive patients who had male factor infertility served as the control group. The amount of IUFA classified as largest dimension in the antero-posterior (AP) plane; ≤2, 3-5 or >5 mm. RESULTS The mean female age, the mean number of embryos transferred and endometrial thickness on the day of hCG administration were comparable among the study and control groups. Similarly, clinical pregnancy, ongoing pregnancy and implantation rates were comparable among the study and control groups. Female age was noted to be the only significant independent predictor of ongoing pregnancy. The AP dimension of IUFA did not have any impact on pregnancy and implantation rates. CONCLUSIONS Transient IUFA not due to hydrosalpinx or any identifiable pelvic pathology has no detrimental effect on IVF pregnancy rates. Hence, cycle cancellation should be avoided in such cycles.
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Zhang WX, Jiang H, Wang XM, Wang L. Pregnancy and perinatal outcomes of interventional ultrasound sclerotherapy with 98% ethanol on women with hydrosalpinx before in vitro fertilization and embryo transfer. Am J Obstet Gynecol 2014; 210:250.e1-5. [PMID: 24246526 DOI: 10.1016/j.ajog.2013.11.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 10/21/2013] [Accepted: 11/12/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the pregnancy and perinatal outcomes of ultrasound sclerotherapy with 98% ethanol on women with hydrosalpinx before in vitro fertilization and embryo transfer. STUDY DESIGN A total of 339 women were divided into 4 groups. Group A without a recurrent hydrosalpinx after sclerotherapy (n = 123, 130 cycles), group B having a recurrence of hydrosalpinx after sclerotherapy (n = 34, 39 cycles), group C (n = 47, 50 cycles) with no prophylactic intervention for hydrosalpinx, whereas group D with nonhydrosalpinx tubal factor infertility was served as control group (n = 135, 145 cycles). Pulsatility index, resistance index, the ratio between peak systolic flow and lowest diastolic flow of the uterine arcuate artery on the day of human chorionic gonadotropin administration, and pregnancy and perinatal outcomes were assessed. RESULTS Thirty-four women (21.7%) experienced hydrosalpinx recurrence after sclerotherapy. The rates of embryo implantation (8.8%), clinical pregnancy (16.0%), and live birth (10.0%) in group C were significantly lower than those in group A (26.4%, 43.1%, 33.8%), group B (24.5%, 38.5%, 28.2%), and group D (30.0%, 50.3%, 39.3%), respectively. The pulsatility index, resistance index, and the ratio between peak systolic flow and lowest diastolic flow of the uterine arcuate artery in group C were significantly higher than those in the other 3 groups. No significant differences in the rate of preterm birth, the rate of low birthweight newborns, and birth defects were found among the 4 groups. CONCLUSION Ultrasound sclerotherapy on women with hydrosalpinx could improve the outcomes of in vitro fertilization embryo transfer by improving the blood flow of the uterine arcuate artery. Interventional ultrasound sclerotherapy has no adverse effect on perinatal outcomes.
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Abstract
Assisted reproductive technologies (ART) encompass fertility treatments, which involve manipulations of both oocyte and sperm in vitro. This chapter provides a brief overview of ART, including indications for treatment, ovarian reserve testing, selection of controlled ovarian hyperstimulation (COH) protocols, laboratory techniques of ART including in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), embryo transfer techniques, and luteal phase support. This chapter also discusses potential complications of ART, namely ovarian hyperstimulation syndrome (OHSS) and multiple gestations, and the perinatal outcomes of ART.
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Lu S, Peng H, Zhang H, Zhang L, Cao Q, Li R, Zhang Y, Yan L, Duan E, Qiao J. Excessive intrauterine fluid cause aberrant implantation and pregnancy outcome in mice. PLoS One 2013; 8:e78446. [PMID: 24194934 PMCID: PMC3806840 DOI: 10.1371/journal.pone.0078446] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 09/11/2013] [Indexed: 11/18/2022] Open
Abstract
The normal intrauterine fluid environment is essential for embryo implantation. In hydrosalpinx patients, the implantation and pregnancy rates are markedly decreased after IVF-embryo transfer, while salpingectomy could significantly improve the pregnancy rates. The leakage of hydrosalpinx fluid into the endometrial cavity was supposed to be the major cause for impaired fertility. However, the underlying mechanisms of hydrosalpinx fluids on implantation and ongoing pregnancy were not fully understood and remain controversial regarding its toxicity. In present study, by infusing different volume of non-toxic fluid (0.9% saline) into uterine lumen before embryo implantation in mice (Day4 08:30), we found that while the embryos were not "flushed out" from the uteri, the timing of implantation was deferred and normal intrauterine distribution (embryo spacing) was disrupted. The abnormal implantation at early pregnancy further lead to embryo growth retardation, miscarriage and increased pregnancy loss, which is similar to the adverse effects observed in hydrosalpinx patients undergoing IVF-ET. We further examined uterine receptivity related gene expression reported to be involved in human hydrosalpinx (Lif, Hoxa10, Integrin α(v) and β(3)). The results showed that expression of integrin α(v) and β(3) were increased in the fluid infused mouse uteri, implicating a compensatory effect to cope with the excessive fluid environment. Our data suggested that the adverse effects of excessive non-toxic luminal fluid on pregnancy are primarily due to the mechanical interference for normal timing and location of embryo apposition, which might be the major cause of decreased implantation rate in IVF-ET patients with hydrosalpinx.
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Affiliation(s)
- Shan Lu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Hongying Peng
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - He Zhang
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Li Zhang
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Qichen Cao
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Rong Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, The People’s Republic of China
| | - Ying Zhang
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- * E-mail: (YZ); (LY)
| | - Liying Yan
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- * E-mail: (YZ); (LY)
| | - Enkui Duan
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Jie Qiao
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, The People’s Republic of China
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47
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Grynnerup AGA, Lindhard A, Sørensen S. Anti-Müllerian hormone levels in salpingectomized compared with nonsalpingectomized women with tubal factor infertility and women with unexplained infertility. Acta Obstet Gynecol Scand 2013; 92:1297-303. [DOI: 10.1111/aogs.12234] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 07/22/2013] [Indexed: 12/15/2022]
Affiliation(s)
| | - Anette Lindhard
- Fertility Unit; Copenhagen University Hospital Roskilde; Roskilde; Denmark
| | - Steen Sørensen
- Department of Clinical Biochemistry; Copenhagen University Hospital Hvidovre; Copenhagen; Denmark
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48
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Chen Q, Zhang Y, Elad D, Jaffa AJ, Cao Y, Ye X, Duan E. Navigating the site for embryo implantation: Biomechanical and molecular regulation of intrauterine embryo distribution. Mol Aspects Med 2013; 34:1024-42. [DOI: 10.1016/j.mam.2012.07.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 07/31/2012] [Indexed: 01/03/2023]
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49
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Diao H, Xiao S, Howerth EW, Zhao F, Li R, Ard MB, Ye X. Broad gap junction blocker carbenoxolone disrupts uterine preparation for embryo implantation in mice. Biol Reprod 2013; 89:31. [PMID: 23843229 DOI: 10.1095/biolreprod.113.110106] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Gap junctions have an important role in cell-to-cell communication, a process obviously required for embryo implantation. Uterine luminal epithelium (LE) is the first contact for an implanting embryo and is critical for the establishment of uterine receptivity. Microarray analysis of the LE from peri-implantation mouse uterus showed low-level expression of 19 gap junction proteins in preimplantation LE and upregulation of gap junction protein, beta 2 (GJB2, connexin 26, Cx26) in postimplantation LE. Time course study using in situ hybridization and immunofluorescence revealed upregulation of GJB2 in the LE surrounding the implantation site before decidualization. Similar dynamic expression of GJB2 was observed in the LE of artificially decidualized mice but not pseudopregnant mice. To determine the potential function of uterine gap junctions in embryo implantation, carbenoxolone (CBX), a broad gap junction blocker, was injected i.p. (100 mg/kg) or via local uterine fat pad (10 mg/kg) into pregnant mice on Gestation Day 3 at 1800 h, a few hours before embryo attachment to the LE. These CBX treatments disrupted embryo implantation, suggesting local effects of CBX in the uterus. However, i.p. injection of glycyrrhizic acid (100 mg/kg), which shares similar structure and multiple properties with CBX but is ineffective in blocking gap junctions, did not affect embryo implantation. Carbenoxolone also inhibited oil-induced artificial decidualization, concomitant with suppressed molecular changes and ultrastructural transformations associated with uterine preparation for embryo implantation, underscoring the adverse effect of CBX on uterine preparation for embryo implantation. These data demonstrate that uterine gap junctions are important for embryo implantation.
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Affiliation(s)
- Honglu Diao
- Department of Physiology and Pharmacology, College of Veterinary Medicine, The University of Georgia, Athens, Georgia 30602, USA
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50
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Salleh N, Helmy MM, Fadila KN, Yeong SO. Isoflavone genistein induces fluid secretion and morphological changes in the uteri of post-pubertal rats. Int J Med Sci 2013; 10:665-75. [PMID: 23569430 PMCID: PMC3619115 DOI: 10.7150/ijms.5207] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 03/04/2013] [Indexed: 02/03/2023] Open
Abstract
UNLABELLED A reported increase in the incidence of infertility following high genistein intake could be related to alteration in the normal fluid volume and morphology of the uterus in adult female. In view of this, we investigated the effect of this compound on fluid secretion, fluid volume and morphology of the uterus in post-pubertal rats. METHODS Ovariectomised SD rats were treated with 17-β oestradiol (E) (0.8 X 10(-4) mg/kg/day) and genistein (0.5, 5, 10, 25, 50 and 100 mg/kg/day) for three days. Following drug treatment, in-vivo uterine perfusion was performed and the rate of fluid secretion and the volume of fluid in the uterus were determined via changes in weight (μl/min) and F-dextran concentration of the perfusate respectively. The animals were then sacrificed and the uteri were removed for weight determination, morphological analyses and proliferative cell nuclear antigen (PCNA) expression analyses by Western blotting. RESULTS Subcutaneous genistein treatment resulted in a dose-dependent increase in fluid secretion rate, fluid volume and uterine wet weight. Treatment with 100 mg/kg/day genistein resulted in a remarkable increase in the rate of uterine fluid secretion, the volume of the uterine luminal fluid as well as the circumference of the uterine and uterine glandular lumen suggesting an excessive fluid accumulation. Meanwhile, there were evidence of glandular hyperplasia and an increase in the expression of PCNA following treatment with 50 and 100 mg/kg/day genistein. CONCLUSION High genistein intake could potentially cause adverse effects on the uterus by inducing excessive fluid secretion and accumulation as well as hyperplasia.
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Affiliation(s)
- Naguib Salleh
- Department of Physiology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia.
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