scholarly journals Alterations of Uterine Blood Flow During the Follicular Phase in Patients With Recurrent Implantation Failure: A Doppler Ultrasonographic Study

2021 ◽  
Vol 9 (3) ◽  
pp. 217-221
Author(s):  
Marjan Amini ◽  
Mahnaz Ranjkesh ◽  
Saba Nikanfar ◽  
Amir Fattahi ◽  
Laya Farzadi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Color Doppler ◽  
Follicular Phase ◽  
Control Group ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
History Of ◽  
Uterine Perfusion ◽  
Endometrial Blood Flow ◽  
Fertile Women

Objectives: The dynamics of blood flow in the endometrium plays a crucial role during the implantation process. This study aimed to assess the uterine perfusion during the follicular phase in patients with a history of recurrent implantation failure (RIF) and healthy fertile women using the transvaginal ultrasound color Doppler method. Materials and Methods: To this end, 50 patients with RIF and 50 age-matched healthy fertile women were recruited in this case-control study. The transvaginal color Doppler ultrasonography was used to evaluate the pulsatility index (PI) and resistance index (RI) of the uterine, arcuate, and sub-endometrial arteries during the follicular phase in both groups. Results: The RI and PI of both right and left uterine arteries were higher in the RIF group compared to the fertile women (P<0.05). Our results showed that the PI and RI of sub-endometrial blood flow and the RI of arcuate arteries were substantially higher in the group with a history of RIF in comparison with the control group. However, the PI of arcuate arteries was not significantly different between the groups. Conclusions: Adequate uterine perfusion and sub-endometrial blood flow are necessary to achieve successful implantation and pregnancy since our results demonstrated the higher resistance of uterine and sub-endometrial arteries in patients with a history of RIF. Thus, the assessments of uterine perfusion indices during the follicular phase could be used as a non-invasive method in the evaluation of patients with RIF.

scholarly journals Effect of nitric oxide donors on uterine and sub-endometrial blood flow in patients with unexplained infertility: a randomized controlled trial

2021 ◽  
Vol 10 (6) ◽  
pp. 2178
Author(s):  
Mohamed A. Abdel Hafeez ◽  
Ashraf M. F. Kortam ◽  
Alaa M. A. Youssef ◽  
Ahmed Reda ◽  
Rehab M. Abdelrahman
Keyword(s):  
Blood Flow ◽  
Uterine Artery ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Unexplained Infertility ◽  
Control Group ◽  
Artery Blood Flow ◽  
Randomized Controlled ◽  
Endometrial Blood Flow ◽  
Fertile Women

Background: Impaired sub-endometrial perfusion might reduce endometrial receptivity and possibly contribute to unexplained infertility. A favorable effect on sub-endometrial blood flow has been demonstrated with nitric oxide.Methods: This randomized controlled trial evaluated the effect of nitroglycerine on uterine and sub-endometrial blood flow in women with unexplained infertility. Sixty women were randomized into 2 equal groups. The study group received 5mg nitroglycerine patch daily from day 2 of the cycle till the evaluation day and the control group received no treatment. Independent of the study arms, 30 parous women were included as the fertile group. Six to eight days after detecting luteinizing hormone surge, women were assessed for endometrial thickness, uterine artery blood flow with color Doppler and sub-endometrial blood flow with three-dimensional power Doppler.Results: Compared to fertile women, cases with unexplained infertility (control group) had a significantly thinner endometrium, higher uterine artery Doppler indices and lower sub-endometrial blood flow. Women who received nitroglycerin showed a significant improvement in sub-endometrial blood flow while uterine artery blood flow did not show a significant difference; however, the values were also comparable to fertile women. In addition, no effect on endometrial thickness was found with nitroglycerin treatment. Nitroglycerin treatment side effects were headache, blurring of vision and hypotension. These adverse effects were not significant compared to controls.Conclusions: In women with unexplained infertility, nitroglycerin significantly improved the sub-endometrial blood flow but did not affect the endometrial thickness.

The role of antioxidants in the complex therapy of patients with endometriosis-associated infertility

2020 ◽  
Vol 19 (6) ◽  
pp. 28-33
Author(s):  
M.G. Khatlamadzhiyan ◽  
◽  
E.V. Kharitonova ◽  
L.N. Shcherbakova ◽  
E.I. Kalenikova ◽  
...  
Keyword(s):  
Blood Flow ◽  
Reproductive Function ◽  
Control Group ◽  
Complex Therapy ◽  
Endometrium Receptivity ◽  
Infertile Patients ◽  
Subendometrial Blood Flow ◽  
Endometrial Blood Flow ◽  
Fertile Women

Objective. To study the role of antioxidants in the complex therapy of patients with endometriosis-associated infertility on the example of evaluating the effectiveness of ubidecarenone. Patients and methods. Forty-three patients with endometriosis-associated infertility and nineteen fertile women with complete reproductive function were examined. In order to improve the receptivity of endometrium and correct the antioxidant status in infertile patients with endometriosis after laparoscopy, therapy with Synergin® was administered at a dosage of 2 capsules per day for 3 months. After therapy, an assessment of endometrium and intrauterine perfusion was made. Results. There was a significant decrease in intrauterine perfusion in patients with endometriosis-associated infertility compared to the control group. However, after therapy with Synergin® within 3 months and correction of endothelial dysfunction in infertile patients with endometriosis, an improvement in intrauterine perfusion was revealed. Thus, prior to therapy, subendometrial blood flow was assessed in 13% of patients as satisfactory, in 77% – it was reduced, in 10% – it was absent; after therapy, 86% of patients showed satisfactory blood flow and 14% had decreased blood flow. Endometrial blood flow was reduced in 32% of patients and in 68% were absent prior to treatment, and after treatment, it was assessed as satisfactory in 45% and was reduced in 55%. Conclusion. Pathogenetic antioxidant therapy is necessary in the complex therapy of infertility in patients with external genital endometriosis after surgical treatment. Key words: α-Tocopherol, infertility, coenzyme Q10, endometrium receptivity, endometriosis

scholarly journals The Expression of miR-31 and its Target Gene FOXP3 in Recurrent Implantation Failure Patients

2020 ◽  
Vol 8 (4) ◽  
pp. 389-395
Author(s):  
Azita Azarpoor ◽  
Abdolreza Ardeshirylajimi ◽  
Samira Mohammadi Yeganeh ◽  
Elham Pour matrood ◽  
Zeinab Dehghan ◽  
...  
Keyword(s):  
Gene Expression ◽  
Target Gene ◽  
Control Group ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
Tissue Samples ◽  
Significant Difference ◽  
Immunological Disorder ◽  
Recurrent Abortions ◽  
Fertile Women

Objectives: Endometrial receptivity is a complex event that occurs during the midluteal phase of the menstrual cycle known as the "window of implantation". During this period, the endometrium develops characteristics that allow the adhesion and invasion of the embryo to the uterine epithelium. Accordingly, the expressions of miR-31 and its target gene were evaluated to study the effect of miR-31 on FOPX3 gene expression in recurrent implantation failure (RIF) patients and normal fertile women. More precisely, the aim of this study was to understand the expression of miR-31 as one of the important regulators of the FOXP3 gene in the endometrium of RIF patients versus receptive endometria from fertile patients. Materials and Methods: This case-control study was conducted on 20 endometrial tissue samples of normal fertile women and RIF patients in order to evaluate miR-31 and its target gene expression. Results: According to the results of this study, a significant difference existed between RIF patients and normal fertile women (control group). The expression of the FOXP3 gene was more significant in the control group. miR-31 was also significantly expressed, which was due to the endometrial immunological disorder leading to the decreased expression of its target gene (FOXP3). Conclusions: In general, implant abnormalities and recurrent abortions were observed in RIF patients due to the decreased expression of the FOXP3 gene resulting from the inhibitory effects of miR-31.

scholarly journals ERAP, KIR, and HLA-C Profile in Recurrent Implantation Failure

2021 ◽  
Vol 12 ◽  
Author(s):  
Karolina Piekarska ◽  
Paweł Radwan ◽  
Agnieszka Tarnowska ◽  
Andrzej Wiśniewski ◽  
Michał Radwan ◽  
...  
Keyword(s):  
Nk Cells ◽  
Killer Cell ◽  
Hla Class I ◽  
Class I ◽  
Extravillous Trophoblast ◽  
Control Group ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
Fertile Women

The mother’s uterine immune system is dominated by uterine natural killer (NK) cells during the first trimester of pregnancy. These cells express killer cell immunoglobulin-like receptors (KIRs) of inhibitory or activating function. Invading extravillous trophoblast cells express HLA-C molecules, and both maternal and paternal HLA-C allotypes are presented to KIRs. Endoplasmic reticulum aminopeptidase 1 (ERAP1) and 2 (ERAP2) shape the HLA class I immunopeptidome. The ERAPs remove N-terminal residues from antigenic precursor peptides and generate optimal-length peptides to fit into the HLA class I groove. The inability to form the correct HLA class I complexes with the appropriate peptides may result in a lack of immune response by NK cells. The aim of this study was to investigate the role of ERAP1 and ERAP2 polymorphisms in the context of KIR and HLA-C genes in recurrent implantation failure (RIF). In addition, for the first time, we showed the results of ERAP1 and ERAP2 secretion into the peripheral blood of patients and fertile women. We tested a total of 881 women. Four hundred ninety-six females were patients who, together with their partners, participated in in vitro fertilization (IVF). A group of 385 fertile women constituted the control group. Women positive for KIR genes in the Tel AA region and HLA-C2C2 were more prevalent in the RIF group than in fertile women (p/pcorr. = 0.004/0.012, OR = 2.321). Of the ERAP polymorphisms studied, two of them (rs26653 and rs26618) appear to affect RIF susceptibility in HLA-C2-positive patients. Moreover, fertile women who gave birth in the past secreted significantly more ERAP1 than IVF women and control pregnant women (p &lt; 0.0001 and p = 0.0005, respectively). In the case of ERAP2, the opposite result was observed; i.e., fertile women secreted far less ERAP2 than IVF patients (p = 0.0098). Patients who became pregnant after in vitro fertilization embryo transfer (IVF-ET) released far less ERAP2 than patients who miscarried (p = 0.0032). Receiver operating characteristic (ROC) analyses indicate a value of about 2.9 ng/ml of ERAP2 as a point of differentiation between patients who miscarried and those who gave birth to a healthy child. Our study indicates that both ERAP1 and ERAP2 may be involved in processes related to reproduction.

P–394 Intralipid infusion at time of embryo transfer in women with history of recurrent implantation failure: a systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M P Rimmer ◽  
N Black ◽  
S Keay ◽  
S Quenby ◽  
B. H.A Wattar
Keyword(s):  
Systematic Review ◽  
Embryo Transfer ◽  
Meta Analysis ◽  
Small Sample ◽  
Risk Of Bias ◽  
Population Characteristics ◽  
Implantation Failure ◽  
Randomised Trials ◽  
Recurrent Implantation Failure ◽  
History Of

Abstract Study question What is the effectiveness of IV Intralipid (IVI) in improving pregnancy rates in women undergoing IVF with history of Recurrent implantation failure (RIF) to improve reproductive outcomes. Summary answer The evidence to support the use of IVI at the time of embryo transfer in women with RIF is limited. More RCTs are needed. What is known already: Optimising the implantation process following embryo transfer remains a clinical challenge with 10% of couples undergoing IVF affected by (RIF). Immunotherapy could help to optimise endometrial receptivity and increase the chances for successful conception in women with history of RIF. Intra-venous Intralipid (IVI), a fat-based emulsion of soybean oil, glycerine, phospholipids, egg, and polyunsaturated fatty acids, has been evaluated in several trials as a potential intervention to downregulate the uNK cells and macrophages as well as inhibit the pro-inflammatory mediators including T1 helper cells. Evidence synthesis is needed to evaluate the effectiveness of this intervention. Study design, size, duration We performed this systematic review using a prospectively registered protocol (CRD42019148517) and reported in accordance with the PRISMA guidelines. Participants/materials, setting, methods: We searched MEDLINE, EMBASE and CENTRAL for any randomised trials evaluating the use of IVI at the time of embryo transfer in women undergoing assisted conception until September 2020. We extracted data in duplicate and assessed risk of bias using the Cochrane Risk of Bias tools. We meta-analysed data using a random effect model and reported on dichotomous outcomes using risk ratio (RR) and 95% confidence interval (CI). Main results and the role of chance We included five randomised trials reporting on 843 women with an overall moderate risk of bias. All trials used 20% IVI solution at the time of embryo transfer compared to normal saline infusion or no intervention (routine care). The IVI group had a higher chance of clinical pregnancy (172 vs 119, RR 1.55, 95%CI 1.16–2.07, I2 44.2%) and live birth (132 vs 73, RR 1.83, 95%CI 1.42–2.35, I2 0%) post treatment compared to no intervention. Limitations, reasons for caution Our findings are limited by the small sample size and the variations in treatment protocols and population characteristics. Wider implications of the findings: Our meta-analysis offers an overview on the value of IVI to help women affected by RIF. Given the limitations and the quality of included trials, adopting the use of IVI a-la-carte to couples undergoing IVF remains immature. IVI should not be offered until larger RCTs demonstrate a persistent benefit. Trial registration number CRD42019148517

scholarly journals THE POTENTIAL BENEFIT AND THE MECHANISM OF ACTION OF THYROXINE ON SERUM LIPIDS AND BLOOD FLOW INDEXES IN SUBCLINICAL HYPOTHYROIDISM WOMEN

2018 ◽  
Vol 11 (8) ◽  
pp. 491
Author(s):  
Sinaaabdul Amir Kadhim ◽  
Shaimaa Abdul Ameer Kadhum ◽  
Ali Jawad Hamza
Keyword(s):  
Blood Flow ◽  
Subclinical Hypothyroidism ◽  
Potential Benefit ◽  
Serum Lipids ◽  
Color Doppler ◽  
Resistance Index ◽  
Thyroid Stimulating Hormone ◽  
Follicular Phase ◽  
Intrauterine Death ◽  
Lipids Profile

Objective: Even previous reports mentioned that thyroxine has beneficial effects on subclinical hypothyroidism (SCH); however, the mechanism by which thyroxine mediated such effect still unclear. Thus, we aim to find out the potential benefit of thyroxine administration in women with SCH through assessment of lipids profile with evaluation of uterine and ovarian blood flow indexes.Methods: The current study included 80 women with SCH who had a history of recurrent intrauterine death. Those women were chosen from the cohort of pregnant ladies that routinely seek medical advice. For each woman, estimation of serum thyroid-stimulating hormone (TSH), serum lipids profile (low-density lipoprotein [LDL], total cholesterol [TC], and triglyceride [TG]), and also uterine and ovarian pulsatile index (PI) and resistance index (RI) using color Doppler ultrasound, was done at the beginning of study and then repeated following 2 months during which women were given oral thyroxine supplementation (50 μg/d). The study was carried out in Al-Diwaniyah Maternity and Child Teaching Hospital in Al-Diwaniyah province, Iraq and extended from September 2016 to January 2018.Results: Mean serum TSH, LDL, TG, and TC were significantly reduced (p<0.05). Mean early follicular phase ovarian RI and PI and uterine RI were significantly reduced (p<0.05). In addition, mean late follicular phase ovarian RI and PI and uterine RI were significantly reduced (p<0.05).Conclusion: Thyroxine administration to women with SCH significantly decreases serum lipids and increases uterine and ovarian blood flow by mechanism involving reduction in arterial RI and PI.

scholarly journals The Effects of Acupuncture on Pregnancy Outcomes of Recurrent Implantation Failure: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Menglin Li ◽  
Yunyun Liu ◽  
Haoran Wang ◽  
Shuzhen Zheng ◽  
Yinhe Deng ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Intervention Group ◽  
Control Group ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
The Difference ◽  
Ivf Et

Objective. To systematically evaluate the efficacy and safety of acupuncture for patients with recurrent implantation failure (RIF) undergoing in vitro fertilization-embryo transfer (IVF-ET) and hopefully provide reliable guidance for clinicians and patients. Methods. Through searching domestic and foreign medical journals, the literature of randomized controlled trials (RCTs) of acupuncture for RIF undergoing IVF-ET was collected. RevMan 5.3 software was used for meta-analysis and Cochrane’s risk of bias assessment tool was used to evaluate the quality of the included studies. Results. Seven documents meeting the criteria were finally included. The results showed that the intervention group contributes more in outcomes including clinical pregnancy rate (RR = 1.90, 95% CI (1.51, 2.40), P < 0.05 ), biochemical pregnancy rate (RR = 1.59, 95% CI (1.27, 1.99), P < 0.05 ), embryo implantation rate (RR = 1.89, 95% CI (1.47, 2.45), P < 0.05 ), and endometrial thickness (MD = 1.11, 95% CI (0.59, 1.63), P < 0.05 ) when compared with the control group, and the difference is statistically significant. In terms of the number of embryo transfers and the type of endometrium, the difference between the acupuncture group and the control group was not statistically significant. Conclusion. Acupuncture therapy on patients with RIF can improve the pregnancy outcome of patients. It is a relatively effective treatment with satisfactory safety and suitable for clinical application. However, as the quality of the included studies is not good enough, the conclusion of this meta-analysis should be treated with caution. More double-blind RCTs equipped with high quality and large samples are expected for the improvement of the level of evidence.

Sign in / Sign up

Export Citation Format

Share Document