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Tremellen K, Alfer J, Cotán D, Pérez-Sánchez M, Harvey AJ, Gardner DK. Effect of a novel copper chloride gel on endometrial growth and function in healthy volunteers. Reprod Biomed Online 2024; 49:104107. [PMID: 39067212 DOI: 10.1016/j.rbmo.2024.104107] [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: 02/07/2024] [Revised: 04/10/2024] [Accepted: 05/07/2024] [Indexed: 07/30/2024]
Abstract
RESEARCH QUESTION Does the application of a micro-dose of copper chloride gel increase endometrial production of vascular endothelial growth factor (VEGF) without compromising endometrial function or producing embryo toxicity? DESIGN An estimate of optimal dose was made based on cell culture studies. Ten healthy participants received an initial uterine application of placebo gel, followed by copper chloride gel (37.5 μM, 75 μM, or 150 μM dose) in a later hormone replacement cycle. Endometrial biopsies (day 5.5 luteal) and pelvic ultrasound were carried out during each cycle to evaluate endometrial function and growth. Uterine fluid was assessed for residual copper levels on the day of biopsy, and copper chloride gel underwent mouse embryos assay assessment for potential embryo toxicity. RESULTS The copper gel significantly increased endometrial VEGF expression (quantitative polymerase chain reaction), and also increasing endometrial thickness by an average of 2.2 mm compared with matched control cycles. The copper gel did not adversely affect endometrial morphology or maturation (histological dating and molecular receptivity testing), and mouse embryos assay studies showed no evidence of embryo toxicity. Furthermore, uterine cavity flush samples mostly lacked copper, with only negligible amounts present in one sample. CONCLUSION Applying copper chloride gel to the uterine cavity upregulated endometrial VEGF and significantly increased endometrial thickness and volume. No adverse effects on the endometrium or embryos were observed. Copper chloride gels show promise for treating suboptimal endometrial thickness if the results of this study are confirmed by larger randomized controlled trials.
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Affiliation(s)
- Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, South Australia; Repromed, Dulwich, South Australia.
| | | | | | | | | | - David K Gardner
- School of Biosciences, University of Melbourne, Victoria, Australia
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Bui BN, Kukushkina V, Meltsov A, Olsen C, van Hoogenhuijze N, Altmäe S, Mol F, Teklenburg G, de Bruin J, Besselink D, Stevens Brentjens L, Obukhova D, Zamani Esteki M, van Golde R, Romano A, Laisk T, Steba G, Mackens S, Salumets A, Broekmans F. The endometrial transcriptome of infertile women with and without implantation failure. Acta Obstet Gynecol Scand 2024; 103:1348-1365. [PMID: 38520066 PMCID: PMC11168281 DOI: 10.1111/aogs.14822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 01/26/2024] [Accepted: 02/16/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Implantation failure after transferring morphologically "good-quality" embryos in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) may be explained by impaired endometrial receptivity. Analyzing the endometrial transcriptome analysis may reveal the underlying processes and could help in guiding prognosis and using targeted interventions for infertility. This exploratory study investigated whether the endometrial transcriptome profile was associated with short-term or long-term implantation outcomes (ie success or failure). MATERIAL AND METHODS Mid-luteal phase endometrial biopsies of 107 infertile women with one full failed IVF/ICSI cycle, obtained within an endometrial scratching trial, were subjected to RNA-sequencing and differentially expressed genes analysis with covariate adjustment (age, body mass index, luteinizing hormone [LH]-day). Endometrial transcriptomes were compared between implantation failure and success groups in the short term (after the second fresh IVF/ICSI cycle) and long term (including all fresh and frozen cycles within 12 months). The short-term analysis included 85/107 women (33 ongoing pregnancy vs 52 no pregnancy), excluding 22/107 women. The long-term analysis included 46/107 women (23 'fertile' group, ie infertile women with a live birth after ≤3 embryos transferred vs 23 recurrent implantation failure group, ie no live birth after ≥3 good quality embryos transferred), excluding 61/107 women not fitting these categories. As both analyses drew from the same pool of 107 samples, there was some sample overlap. Additionally, cell type enrichment scores and endometrial receptivity were analyzed, and an endometrial development pseudo-timeline was constructed to estimate transcriptomic deviations from the optimum receptivity day (LH + 7), denoted as ΔWOI (window of implantation). RESULTS There were no significantly differentially expressed genes between implantation failure and success groups in either the short-term or long-term analyses. Principal component analysis initially showed two clusters in the long-term analysis, unrelated to clinical phenotype and no longer distinct following covariate adjustment. Cell type enrichment scores did not differ significantly between groups in both analyses. However, endometrial receptivity analysis demonstrated a potentially significant displacement of the WOI in the non-pregnant group compared with the ongoing pregnant group in the short-term analysis. CONCLUSIONS No distinct endometrial transcriptome profile was associated with either implantation failure or success in infertile women. However, there may be differences in the extent to which the WOI is displaced.
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Affiliation(s)
- Bich Ngoc Bui
- Department of Gynecology and Reproductive MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
| | | | - Alvin Meltsov
- Competence Center on Health TechnologiesTartuEstonia
- Department of Obstetrics and Gynecology, GROW, School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Catharina Olsen
- Center for Medical Genetics, Research Group Reproduction and GeneticsVrije Universiteit BrusselBrusselsBelgium
- Brussels Interuniversity Genomics High Throughput Core (BRIGHTcore)VUB‐ULBBrusselsBelgium
- Interuniversity Institute of Bioinformatics in Brussels (IB)BrusselsBelgium
| | - Nienke van Hoogenhuijze
- Department of Gynecology and Reproductive MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Signe Altmäe
- Department of Biochemistry and Molecular Biology, Faculty of SciencesUniversity of GranadaGranadaSpain
- Instituto de Investigación Biosanitaria, ibs.GRANADAGranadaSpain
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska Institute and Karolinska University HospitalStockholmSweden
| | - Femke Mol
- Center for Reproductive Medicine, Reproduction and Development, Amsterdam University Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| | | | - Jan‐Peter de Bruin
- Department of Obstetrics and GynecologyJeroen Bosch Hospital‘s‐HertogenboschThe Netherlands
| | - Dagmar Besselink
- Department of Obstetrics and GynecologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Linda Stevens Brentjens
- Department of Obstetrics and Gynecology, GROW, School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Darina Obukhova
- Department of Clinical GeneticsMaastricht University Medical CenterMaastrichtThe Netherlands
- Department of Genetics and Cell Biology, GROW School for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | - Masoud Zamani Esteki
- Department of Clinical GeneticsMaastricht University Medical CenterMaastrichtThe Netherlands
- Department of Genetics and Cell Biology, GROW School for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | - Ron van Golde
- Department of Obstetrics and Gynecology, GROW, School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Andrea Romano
- Department of Obstetrics and Gynecology, GROW, School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Triin Laisk
- Estonian Genome Center, Institute of GenomicsUniversity of TartuTartuEstonia
| | - Gaby Steba
- Department of Gynecology and Reproductive MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Shari Mackens
- Brussels IVFUniversitair Ziekenhuis Brussel, Vrije Universiteit BrusselBrusselsBelgium
| | - Andres Salumets
- Competence Center on Health TechnologiesTartuEstonia
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska Institute and Karolinska University HospitalStockholmSweden
- Department of Obstetrics and Gynecology, Institute of Clinical MedicineUniversity of TartuTartuEstonia
| | - Frank Broekmans
- Department of Gynecology and Reproductive MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
- Center for Infertility Care, Dijklander HospitalPurmerendThe Netherlands
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van Hoogenhuijze N, Broekmans F. Reply. The role of endometrial scratching in IVF/ICSI: a critical appraisal of individual participant data meta-analysis. Hum Reprod Update 2024:dmae017. [PMID: 38908017 DOI: 10.1093/humupd/dmae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Indexed: 06/24/2024] Open
Affiliation(s)
- Nienke van Hoogenhuijze
- Department of Gynaecology & Reproductive Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Frank Broekmans
- Department of Gynaecology & Reproductive Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
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Van Hoogenhuijze N, Broekmans F. Reply. How much evidence is needed to stop calling endometrial scratching 'controversial'? Hum Reprod Update 2024:dmae019. [PMID: 38908021 DOI: 10.1093/humupd/dmae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Indexed: 06/24/2024] Open
Affiliation(s)
- Nienke Van Hoogenhuijze
- Department of Gynaecology & Reproductive Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Frank Broekmans
- Department of Gynaecology & Reproductive Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
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Ata B, Kalafat E. Does the holy grail of the evidence pyramid vindicate the controversial practice of endometrial scratching or is there room for healthy skepticism? Hum Reprod Update 2024:dmae018. [PMID: 38908016 DOI: 10.1093/humupd/dmae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Indexed: 06/24/2024] Open
Affiliation(s)
- Baris Ata
- Department of Obstetrics and Gynecology, Koç University School of Medicine, Istanbul, Turkiye
- ART Fertility Clinics, Dubai, United Arab Emirates
| | - Erkan Kalafat
- Department of Obstetrics and Gynecology, Koç University School of Medicine, Istanbul, Turkiye
- ART Fertility Clinics, Dubai, United Arab Emirates
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Aktoz F. The role of endometrial scratching in IVF/ICSI: a critical appraisal of individual participant data meta-analysis. Hum Reprod Update 2024:dmae016. [PMID: 38908019 DOI: 10.1093/humupd/dmae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Indexed: 06/24/2024] Open
Affiliation(s)
- Fatih Aktoz
- Department of Obstetrics and Gyneceology, American Hospital, Istanbul, Turkey
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Vitagliano A, Cicinelli E, Laganà AS, Favilli A, Vitale SG, Noventa M, Damiani GR, Dellino M, Nicolì P, D'Amato A, Bettocchi S, Matteo M, Palomba S. Endometrial scratching: the light at the end of the tunnel. Hum Reprod Update 2024; 30:238-239. [PMID: 38281106 DOI: 10.1093/humupd/dmad037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Indexed: 01/29/2024] Open
Affiliation(s)
- Amerigo Vitagliano
- Department of Interdisciplinary Medicine (DIM), 1st Unit of Obstetrics and Gynecology, University of Bari, Bari, BA, Italy
| | - Ettore Cicinelli
- Department of Interdisciplinary Medicine (DIM), 1st Unit of Obstetrics and Gynecology, University of Bari, Bari, BA, Italy
| | - Antonio Simone Laganà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", University of Palermo, Palermo, Italy
| | - Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Salvatore Giovanni Vitale
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Marco Noventa
- Gynaecologic and Obstetrics Clinic, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Gianluca Raffaello Damiani
- Department of Interdisciplinary Medicine (DIM), 1st Unit of Obstetrics and Gynecology, University of Bari, Bari, BA, Italy
| | - Miriam Dellino
- Department of Interdisciplinary Medicine (DIM), 1st Unit of Obstetrics and Gynecology, University of Bari, Bari, BA, Italy
| | - Pierpaolo Nicolì
- Department of Interdisciplinary Medicine (DIM), 1st Unit of Obstetrics and Gynecology, University of Bari, Bari, BA, Italy
| | - Antonio D'Amato
- Department of Interdisciplinary Medicine (DIM), 1st Unit of Obstetrics and Gynecology, University of Bari, Bari, BA, Italy
| | - Stefano Bettocchi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Maria Matteo
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Stefano Palomba
- Department of Medical and Surgical Sciences, Sapienza University of Rome, Rome, Italy
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Cellier M, Werlen S, Lionel M, Genod A, Felloni B, Semay T, Trombert B, Chauleur C, Raia-Barjat T. Endometrial biopsy performed before the first in vitro fertilization does not impact the early pregnancy rate. Sci Rep 2024; 14:1153. [PMID: 38212636 PMCID: PMC10784516 DOI: 10.1038/s41598-023-50715-y] [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: 06/15/2023] [Accepted: 12/23/2023] [Indexed: 01/13/2024] Open
Abstract
Endometrial biopsy (EB) has been showed to increase the rate of clinical pregnancy in patients who underwent in vitro fertilization (IVF) failures. The purpose of this work was to assess the impact of an EB performed before the first in IVF on the early pregnancy rate. Be One study is a prospective, single-centre, randomized, open-label study. In this parallel study, patients were evenly split into two groups. In one group, patients underwent an EB between days 17 and 22 of the menstrual cycle that precedes the ovarian stimulation. In the other group (control), no EB was performed. The hCG-positive rate (early pregnancy rate) was evaluated on day 14 after the ovarian puncture. In total, 157 patients were randomized in the EB group and 154 patients were in the control group. The early pregnancy rate was 33.1% (52/157) in the EB group and 29.9% (46/154) in the control group (p = 0.54). Other parameters, including perforation, endometritis, or pain level were reassuring. An EB performed during the luteal phase of the menstrual cycle preceding the stimulation of the first IVF did not increase early pregnancy rate.
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Affiliation(s)
- Mathilde Cellier
- Department of Gynecology and Obstetrics, Hôpital Nord, University Hospital, Avenue Albert Raimond, Saint Priest en Jarez, 42270, Saint-Étienne, France
| | - Sophie Werlen
- Department of Gynecology and Obstetrics, Hôpital Privé de la Loire, Saint-Étienne, France
| | - Mery Lionel
- Department of Reproductive Biology, University Hospital Saint Etienne, Saint-Étienne, France
| | - Anne Genod
- Department of Gynecology and Obstetrics, Hôpital Privé de la Loire, Saint-Étienne, France
| | - Bertrand Felloni
- Department of Gynecology and Obstetrics, Hôpital Nord, University Hospital, Avenue Albert Raimond, Saint Priest en Jarez, 42270, Saint-Étienne, France
| | - Tiphaine Semay
- Department of Gynecology and Obstetrics, Hôpital Nord, University Hospital, Avenue Albert Raimond, Saint Priest en Jarez, 42270, Saint-Étienne, France
| | - Béatrice Trombert
- Department of Public Health, University Hospital, Saint-Étienne, France
| | - Céline Chauleur
- Department of Gynecology and Obstetrics, Hôpital Nord, University Hospital, Avenue Albert Raimond, Saint Priest en Jarez, 42270, Saint-Étienne, France
- Jean Monet Saint-Etienne University, INSERM, SAINBIOSE (SAnte, INgénierie, BIOlogie, Saint- Etienne) U1059, Saint-Étienne, France
| | - Tiphaine Raia-Barjat
- Department of Gynecology and Obstetrics, Hôpital Nord, University Hospital, Avenue Albert Raimond, Saint Priest en Jarez, 42270, Saint-Étienne, France.
- Jean Monet Saint-Etienne University, INSERM, SAINBIOSE (SAnte, INgénierie, BIOlogie, Saint- Etienne) U1059, Saint-Étienne, France.
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van Wely M, Hastings JM, Tarlatzis B, Sunde A. Is it new, is it true and do we care-the role of prospective review registration. Hum Reprod Update 2023; 29:519-520. [PMID: 37667981 DOI: 10.1093/humupd/dmad022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Indexed: 09/06/2023] Open
Affiliation(s)
| | | | | | - Arne Sunde
- Editor-in-Chief, Human Reproduction Update
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