Link between cesarean section (CS) delivery and secondary infertility. Uterine cavity evaluation in women undergoing fertility treatment using three dimensional (3D) saline infusion sono-hysterogaphy (SIS)

Abstract Background Thin endometrium adversely affects reproductive success rates with fertility treatment. Autologous transplantation of exogenously prepared endometrium can be a promising therapeutic option for thin endometrium; however, endometrial epithelial cells have limited expansion potential, which needs to be overcome in order to make regenerative medicine a therapeutic strategy for refractory thin endometrium. Here, we aimed to perform long-term culture of endometrial epithelial cells in vitro. Methods We prepared primary human endometrial epithelial cells and endometrial stromal cells and investigated whether endometrial stromal cells and human embryonic stem cell-derived feeder cells could support proliferation of endometrial epithelial cells. We also investigated whether three-dimensional culture can be achieved using thawed endometrial epithelial cells and endometrial stromal cells. Results Co-cultivation with the feeder cells dramatically increased the proliferation rate of the endometrial epithelial cells. We serially passaged the endometrial epithelial cells on mouse embryonic fibroblasts up to passage 6 for 4 months. Among the human-derived feeder cells, endometrial stromal cells exhibited the best feeder activity for proliferation of the endometrial epithelial cells. We continued to propagate the endometrial epithelial cells on endometrial stromal cells up to passage 5 for 81 days. Furthermore, endometrial epithelium and stroma, after the freeze-thaw procedure and sequential culture, were able to establish an endometrial three-dimensional model. Conclusions We herein established a model of in vitro cultured endometrium as a potential therapeutic option for refractory thin endometrium. The three-dimensional culture model with endometrial epithelial and stromal cell orchestration via cytokines, membrane-bound molecules, extracellular matrices, and gap junction will provide a new framework for exploring the mechanisms underlying the phenomenon of implantation. Additionally, modified embryo culture, so-called “in vitro implantation”, will be possible therapeutic approaches in fertility treatment.

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Hysteroscopic evaluation in infertility and abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180181 ◽

2018 ◽

Vol 7 (2) ◽

pp. 612

Author(s):

Navneet Kaur ◽

Ruby Bhatia ◽

Paramjit Kaur ◽

Surinder K. Bhopal

Keyword(s):

Endometrial Hyperplasia ◽

Uterine Cavity ◽

Invasive Procedure ◽

Abnormal Uterine Bleeding ◽

Endometrial Biopsy ◽

Uterine Bleeding ◽

Therapeutic Modality ◽

Secondary Infertility ◽

Endometrial Polyps ◽

Submucous Fibroid

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

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Three-dimensional saline infusion vaginography for sonographic assessment of the anterior vaginal wall and pelvic floor descent

Journal of Clinical Ultrasound ◽

10.1002/jcu.22105 ◽

2013 ◽

Vol 42 (3) ◽

pp. 150-155 ◽

Cited By ~ 1

Author(s):

Ohad Rotenberg ◽

Wilma Markus Greston ◽

Pe'er Dar

Keyword(s):

Pelvic Floor ◽

Three Dimensional ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Saline Infusion ◽

Sonographic Assessment ◽

Pelvic Floor Descent

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A Rare Case of Intrauterine Adhesion Caused by Intrauterine Fallopian Tube Incarceration

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v5i1.1773 ◽

2021 ◽

pp. 64-67

Author(s):

Yiran Liu ◽

Yugang Chi

Keyword(s):

Fallopian Tube ◽

Rare Case ◽

Early Recognition ◽

Uterine Cavity ◽

Uterine Perforation ◽

Secondary Infertility ◽

False Passage ◽

Intrauterine Adhesion ◽

Tubal Lumen ◽

The Right

Hysteroscopy is widely used for the detection and treatment of intrauterine adhesion. Such technique, however, sometimes has limitations and even second damages. We report a rare case of severe intrauterine adhesion caused by uterine perforation with a fallopian tube incarceration. A 24-year-old woman underwent severe intrauterine adhesion and secondary infertility caused by fallopian tube incaceration into the uterine cavity after postpartum curettage. First hysteroscopy created a false passage through the previous uterine perforation, entered into the cavity of incarcerated fallopian tube, and led to iatrogenic hydrosalpinx. Secondary hysteroscopy combined with laparoscopy revealed a connection between the right tubal lumen and the uterine cavity by the false passage, released the adhesion, and reconstructed the uterine cavity. Early recognition of uterine perforation or tissue incarcerarion is significant in preventing further damage.

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Postpartum endometritis prevention in abdominal delivery planning in pregnant with severe anaerobic vaginal dysbiosis

Kazan medical journal ◽

10.17750/kmj2015-005 ◽

2015 ◽

Vol 96 (1) ◽

pp. 5-9 ◽

Cited By ~ 1

Author(s):

K V Voronin ◽

A M Alale ◽

I I Alale ◽

R M Banakhevich

Keyword(s):

Cesarean Section ◽

Pregnant Women ◽

Vaginal Discharge ◽

Bacterial Flora ◽

Uterine Cavity ◽

Test System ◽

Control Group ◽

Study Group ◽

Septic Complications ◽

Ascending Infection

Aim. Prevention of purulent and septic complications in females after planned caesarean section.Methods. Out of 60 pregnant women, who underwent comprehensive examination during the trial, 35 (58.3%) were included in the study group and were delivered off by planned cesarean section; 25 (41.7%) pregnant women, included in the control group, were delivered off by urgent cesarean section. Considering the goal of the study, bacteriology of vaginal discharge, amniotic fluid and placental tissues, DNA detection of vaginal discharge bacterial flora before and after treatment (using «Femoflor-16» test system) according to classification by M.N. Boldyreva (2010), uterine cavity aspirate cytology according to classification by M.A. Kupert (2003), sonography of the uterus and uterine adnexa on the 4-5 day after the surgery according to classification of A.P. Milovanov were added to the training program for pregnant women. In the study group, pregnant patients with severe anaerobic vaginal dysbiosis at the 36-38 weeks of gestation were administered causal treatment of severe anaerobic vaginal dysbiosis, pregnant patients of the control group were not treated if severe anaerobic vaginal dysbiosis was diagnosed.Results. Performed correction of vaginal microbiota in the study group has significantly improved the course of postoperative period, reduced the incidence of uterine subinvolution, signs of chorioamnionitis as a manifestation of ascending infection compared to the control group. Postpartum endometritis has developed in 1 (2.8%) patient of the study group and in 5 (20.0%) cases in the control group. Offered method for preparing the patients with vaginal dysbiosis to cesarean section reduced the risk for postpartum endometritis by 6.8 times.Conclusion. Strategy of preparation for planned Caesarean section should include vaginal discharge bacteriology and treatment of severe anaerobic vaginal dysbiosis, which reduces the risk for postpartum endometritis by 6.8 times.

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Secondary infertility associated with a uterine niche after cesarean section

Voprosy ginekologii akušerstva i perinatologii ◽

10.20953/1726-1678-2020-5-95-101 ◽

2020 ◽

Vol 19 (5) ◽

pp. 95-101

Author(s):

M.A. Kurtser ◽

◽

N.M. Egikyan ◽

N.A. Savelyeva ◽

M.A. Vatagina ◽

...

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Key Words ◽

Assisted Reproductive Technologies ◽

Embryo Implantation ◽

Reproductive Technologies ◽

Psychological Factor ◽

Secondary Infertility ◽

Embryo Survival ◽

Abdominal Delivery

The frequency of abdominal delivery remains high and does not tend to decrease. This may lead to an increase in the number of complications associated with cesarean section, such as uterine niche. Considering the fact that literature data on uterine form of secondary infertility in patients with niches is lacking, and taking into account our own experience and observations made during laparoscopic and hysteroscopic metroplasty, we believe that it is necessary to discuss hypothetical mechanisms underlying the effects of uterine niches on: (1) natural embryo implantation or during an IVF program; (2) embryo survival (embryotoxicity); (3) quality and survival of spermatozoa (spermatoxicity). It is also important to analyze the psychological factor that decreases fertility in these patients. Key words: infertility; assisted reproductive technologies; isthmocele; caesarean section; niche; fertility

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