scholarly journals Luteal progesterone level correlated with immunotherapy success of patients with repeated implantation failures

2019 ◽  
Author(s):  
Omar Sefrioui ◽  
Aicha Madkour ◽  
Nouzha Bouamoud ◽  
Ismail Kaarouch ◽  
Brahim Saadani ◽  
...  
Keyword(s):  
Corpus Luteum ◽  
Clinical Outcomes ◽  
Embryo Transfer ◽  
Mononuclear Cells ◽  
Test Group ◽  
Clinical Pregnancy ◽  
Progesterone Level ◽  
Controlled Study ◽  
Fresh Embryo Transfer ◽  
Peripheral Blood Mononuclear

AbstractImmunotherapy using PBMC administration demonstrated relatively its effectiveness to treat RIF patients but it still unclear to explain some miscarriages. Luteal progesterone level (LPL) issued from corpus luteum after embryo implantation stage could be informative basis data to personalize immunotherapy for RIF patients predicting clinical outcomes. This randomized controlled study included 70 patients undergoing ICSI program presenting at least 3 RIF: 39 for Control of untreated patients and 31 for PBMC-test concerning treated patients with immunotherapy. For PBMC-test group, Peripheral Blood Mononuclear Cells (PBMCs) were isolated from patients on ovulation induction day and cultured three days to be administered to intrauterine cavity of patients two days before fresh embryo transfer. LPL was analyzed at day 15 after embryo transfer and clinical outcomes were calculated including implantation, clinical pregnancy and miscarriage rates. Clinical outcomes were doubly improved after immunotherapy including implantation and clinical pregnancy rates comparing Control versus PBMC-test (10% and 21% vs 24% and 45%). In the other hand, this strategy showed an increase over double in LPL (4ng/ml for Control vs 9ng/ml for PBMC-test) while the latter was correlated to clinical pregnancy. Bypassing the effectiveness of this immunotherapy approach for RIF patients, it is directly correlated to LPL proving the interactive reaction between immune profile of the treated patients and progesterone synthesis by corpus luteum.

Intrauterine insemination of cultured peripheral blood mononuclear cells prior to embryo transfer improves clinical outcome for patients with repeated implantation failures

Zygote ◽  
2015 ◽  
Vol 24 (1) ◽  
pp. 58-69 ◽  
Author(s):  
Aicha Madkour ◽  
Nouzha Bouamoud ◽  
Noureddine Louanjli ◽  
Ismail Kaarouch ◽  
Henri Copin ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Peripheral Blood Mononuclear Cells ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Limiting Factor ◽  
Implantation Failure ◽  
Fresh Embryo Transfer ◽  
Peripheral Blood Mononuclear ◽  
Blood Mononuclear Cells ◽  
Implantation Success

SummaryImplantation failure is a major limiting factor in assisted reproduction improvement. Dysfunction of embryo–maternal immuno-tolerance pathways may be responsible for repeated implantation failures. This fact is supported by immunotropic theory stipulating that maternal immune cells, essentially uterine CD56+ natural killer cells, are determinants of implantation success. In order to test this hypothesis, we applied endometrium immuno-modulation prior to fresh embryo transfer for patients with repeated implantation failures. Peripheral blood mononuclear cells were isolated from repeated implantation failure patients undergoing assisted reproductive technology cycles. On the day of ovulation induction, cells were isolated and then cultured for 3 days and transferred into the endometrium cavity prior to fresh embryo transfer. This immunotherapy was performed on 27 patients with repeated implantation failures and compared with another 27 patients who served as controls. Implantation and clinical pregnancy were increased significantly in the peripheral blood mononuclear cell test versus control (21.54, 44.44 vs. 8.62, 14.81%). This finding suggests a clear role for endometrium immuno-modulation and the inflammation process in implantation success. Our study showed the feasibility of intrauterine administration of autologous peripheral blood mononuclear cells as an effective therapy to improve clinical outcomes for patients with repeated implantation failures and who are undergoing in vitro fertilization cycles.

P–162 Laser-assisted collapse of blastocysts prior to vitrification improves clinical outcomes

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Ten ◽  
J Guerrero ◽  
A Rodríguez-Arnedo ◽  
L Martí ◽  
M Herreros ◽  
...  
Keyword(s):  
Survival Rate ◽  
Clinical Outcomes ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Embryo Survival ◽  
Artificial Shrinkage

Abstract Study question What is the effect of artificial laser-assisted collapse before vitrification on pregnancy and implantation rates after transfer of vitrified-warmed blastocysts? Summary answer The artificial shrinkage by laser-induced collapse before vitrification significantly increased the implantation and clinical pregnancy rates after single thawed embryo transfer. What is known already Freeze all, cycle segmentation and, in general, single embryo transfer (SET) strategies (for example trophectoderm biopsy-based aneuploidy testing) have targeted blastocysts vitrification as the best option for reproductive practice worldwide. Artificial shrinkage seems to be a pre-vitrification parameter associated with an increased embryo survival after warming and implantation rate. However, the available medical evidence shows controversial results with only a limited number of prospective studies assessing the subject. Study design, size, duration This prospective cohort study evaluated 394 women who underwent a frozen blastocyst transfer at Instituto Bernabeu between July and December 2020. All patients were prepared with substitutive cycle and received single blastocyst embryo transfers. Participants/materials, setting, methods Before embryo vitrification on day 5 of development, some expanded and/or early hatching blastocysts (A/B ASEBIR categories) were artificial laser-assisted collapsed. (n = 83, study group). 311 embryos of the same quality and day of development were not collapsed (control group). We compared the embryo survival rate, clinical, implantation and miscarriage rates between groups. The statistical analysis was performed using SPSS (version 20.0). Main results and the role of chance The two groups were comparable in terms of maternal age (39.79 ± 3.83, control group; 40.21 ± 4.45, study group; p = 0.341). Embryo survival rate resulted in 100% in both groups. Regarding clinical outcomes, collapsed blastocysts significantly increased the positive pregnancy test and the clinical pregnancy and implantation rate compared to the control group, respectively (positive test: 69,9% vs 43,4%, p = 0.000018, odds ratio (OR)= 3.02 [95% CI 1.80–5.08]; clinical pregnancy and implantation: 56,6% vs 35,4%, p = 0.000041, OR = 2.39 [95% CI 1.46–3.90]). The miscarriage rate was not affected by the blastocyst collapse effect (23,6% in the control group vs 27,6% in the study group, p = 0.593, OR = 1.23 [95% CI 0.57–2.68]). Limitations, reasons for caution This is a non-randomized controlled study. Additional RCTs are warranted to corroborate our findings. Wider implications of the findings: Considering the large number of blastocyst vitrification cycles that are carried out worldwide, artificial laser-assisted collapse before vitrification has the potential to increase the clinical results in benefit of many patients. Trial registration number Not applicable

Efficacy of intrauterine administration of autologous peripheral blood mononuclear cells prior to embryo transfer in patients with recurrent implantation failures in assisted reproductive technology programmes

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 28-33
Author(s):  
T S Amyan ◽  
S G Perminova ◽  
L V Krechetova ◽  
V V Vtorushina
Keyword(s):  
Embryo Transfer ◽  
Peripheral Blood Mononuclear Cells ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Peripheral Blood Mononuclear ◽  
Study Objective ◽  
Study Results ◽  
Blood Mononuclear Cells ◽  
History Of ◽  
Group 2

Study objective. To evaluate the efficacy of intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) prior to embryo transfer in patients with recurrent implantation failures in IVF program. Materials and methods. The study enrolled 129 patients with recurrent implantation failures in an IVF programme. Group 1 - 42 patients who had intrauterine administration of autologous PBMC activated with hCG (Pregnyl 500 IU). Group 2 - 42 patients who had intrauterine administration of autologous PBMC without hCG activation. Group 3 (placebo) - 45 patients who had intrauterine administration of saline. Study results. In the hCG-activated PBMC group, the rates of positive blood hCG tests, implantation, and clinical pregnancy were significantly higher than the respective rates in the non-activated PBMC group and in the placebo group, both in a stimulated cycle and in an FET cycle (р≤0.05). Conclusion. Intrauterine administration of autologous PBMC prior to embryo transfer in an IVF/ICSI programme increases the efficacy of IVF program in patients with a history of recurrent implantation failures.

scholarly journals Live Birth Rate of Fresh Embryo Transfer with GnRH Agonist Long Protocol is Higher Than Frozen Embryo Transfer

2020 ◽  
Author(s):  
Xiaoyan Ding ◽  
Jingwei Yang ◽  
Lan Li ◽  
Na Yang ◽  
Ling Lan ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Live Birth ◽  
Pregnancy Loss ◽  
Birth Rate ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Clinical Pregnancy ◽  
Fresh Embryo Transfer ◽  
Long Protocol

Abstract Background: Along with progress in embryo cryopreservation, especially in vitrification has made freeze all strategy more acceptable. Some studies found comparable or higher live birth rate with frozen embryo transfer (FET) than with fresh embryo transfer（ET）in gonadotropin releasing hormone antagonist (GnRH-ant) protocol. But there were no reports about live birth rate differences between fresh ET and FET with gonadotropin releasing hormone agonist (GnRH-a) long protocol. The aim of this study is to analyze whether patients benefit from freeze all strategy in GnRH-a protocol from real-world data.Methods: This is a retrospective cohort study, in which women undergoing fresh ET or FET with GnRH-a long protocol at Chongqing Reproductive and Genetics Institute from January 2016 to December 2018 were evaluated. The primary outcome was live birth rate. The secondary outcomes were implantation rate, clinical pregnancy rate, pregnancy loss and ectopic pregnancy rate.Results: A total of 7,814 patients met inclusion criteria, implementing 5,216 fresh ET cycles and 2,598 FET cycles, respectively. The demographic characteristics of the patients were significantly different between two groups, except BMI. After controlling for a broad range of potential confounders (including age, infertility duration, BMI, AMH, no. of oocytes retrieved and no. of available embryos), multivariate logistic regression analysis demonstrated that there was no significant difference in terms of clinical pregnancy rate, ectopic pregnancy rate and pregnancy loss rate between two groups (all P>0.05). However, the implantation rate and live birth rate of fresh ET group were significantly higher than FET group (P<0.001 and P=0.012, respectively).Conclusion: Compared to FET, fresh ET following GnRH-a long protocol could lead to higher implantation rate and live birth rate in infertile patients underwent in vitro fertilization (IVF). The freeze all strategy should be individualized and made with caution especially with GnRH-a long protocol.

scholarly journals Coordinated In Vitro Release of Granulysin, Perforin and IFN-γ in TB and HIV/TB Co-Infection Associated with Clinical Outcomes before and after Anti-TB Treatment

Pathogens ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 655
Author(s):  
Nada Pitabut ◽  
Panadda Dhepakson ◽  
Shinsaku Sakurada ◽  
Naoto Keicho ◽  
Srisin Khusmith
Keyword(s):  
Clinical Outcomes ◽  
Mononuclear Cells ◽  
Granzyme B ◽  
In Vitro Release ◽  
Peripheral Blood Mononuclear ◽  
Purified Protein Derivative ◽  
Tb Treatment ◽  
Before And After ◽  
Ifn Γ

Granule-associated killing molecules released from cytotoxic T lymphocytes participate as a crucial step in immunity against tuberculosis (TB), but the role of coordinated production remains controversial. Coordinated release of effector molecules in vitro after stimulating peripheral blood mononuclear cells (PBMCs) of active TB or HIV/TB coinfection patients with PPD, purified protein derivative of tuberculin and avirulent Mtb, H37Ra, an attenuated strain were investigated in association with clinical outcomes. Perforin, granzyme-B, granulysin and IFN-γ were measured using ELISA. Before anti-TB treatment, PBMCs of TB stimulated with PPD or H37Ra released higher perforin, granzyme-B, and granulysin levels than in HIV/TB and released significantly higher IFN-γ (p = 0.045, p = 0.022). Granulysin positively correlated with perforin in TB (p = 0.042, r = 0.385), HIV/TB coinfection (p = 0.003, r = 0.941) after PPD stimulation, and after H37Ra stimulation in TB (p = 0.005, r = 0.549), but negatively correlated with granzyme B in TB (p = 0.042, r = −0.386), HIV/TB coinfection (p = 0.042, r = 0.754) were noted. After anti-TB treatment, increased levels of perforin, granulysin and IFN-γ in TB or HIV/TB upon PPD or H37Ra stimulation, and decreased granzyme-B levels after PPD (p = 0.003) or H37Ra (p = 0.028) stimulation in TB were observed. These results suggest that granulysin may act synergistic with perforin and IFN-γ in TB, indicating its crucial function in host immunity to tuberculosis. Future studies with larger numbers of patients ought to be conducted in the future.

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