Study Objective: To investigate pregnancy and obstetric outcomes of patients with intrauterine adhesions (IUAs) after treatment with in vitro fertilization−intracytoplasmic sperm injection (IVF-ICSI) and fresh embryo transplantation after transcervical resection of adhesions (TCRA). Design: Retrospective cohort study. Setting: University-based reproductive medical center. Patients: A total of 535 patients with IUAs and with a history of TCRA and 1605 matched patients without a history of IUAs underwent IVF-ICSI and received fresh embryo transfers. Interventions: Between January 2014 and December 2018, all patients underwent IVF-ICSI treatment and received fresh embryo transfers. Measurements and Main Results: The patients in the TCRA group were matched with the control group according to strict criteria. Pregnancy and obstetric outcomes were compared. There were no significant differences in clinical pregnancies, ectopic pregnancies, live births, preterm births, and obstetric outcomes between the 2 groups (p >.05). However, the TCRA group had a higher risk of miscarriage than the control group (p = .048). Conclusion: TCRA improved the reproductive outcomes of patients with IUAs, but the risk of miscarriage was higher than that in the general population. To avoid miscarriage, careful monitoring is critical for pregnant patients with a history of TCRA who undergo embryo transfers during IVF treatment.
Background: The pregnancy outcome of infertile patients with endometrial cavity fluid undergoing fresh embryo transfer is controversial. We aimed to build a logistic regression model including age, ovarian function and ovarian stimulation protocols to predict the live birth rate of fresh embryo transfer in patients with endometrial cavity fluid.Methods: Patients underwent in vitro fertilization/intracytoplasmic sperm injectio were selected from January 2014 to September 2020 in the Reproductive Hospital affiliated to Shandong University, and the presence of endometrial cavity fluid was indicated by ultrasound before fresh embryo transfer. A total of 2383 patients with endometrial cavity fluid suggested by ultrasound before fresh embryo transfer were enrolled in this study. Clinical and laboratory parameters that may influence live birth rate were analysed. Univariate, multivariate analysis and Receiver operating characteristic curve were conducted to evaluate the relationship between the predictors and live birth rate.Results: The overall live birth rate was 1224/283 (51.38%), multivariate logistic analysis indicated that only transfer 2 embryos increased the probability of live birth (aOR: 2.274; 95%CI: 1.539- 3.361; P<0.01), other factors will reduce the chance of live birth, age≥35 (aOR: 0.509; 95%CI: 0.410-0.632; P<0.01), history of endometritis (aOR: 0.236; 95%CI: 0.076-0.729; P=0.012), Gonadotropin start-up dose>150IU (aOR: 0.785; 95% CI: 0.635-0.970; P=0.025), endometrial thickness on trigger day<8mm (aOR:0.286;95%CI:0.166-0.492;P<0.01), the gonadotropin releasing hormone agonist short regimen (aOR:0.611; 95%CI: 0.467-0.799; P<0.01). In addition, we found that hydrosalpinx did not significantly affect the live birth rate after fresh embryo transfer in endometrial cavity fluid patients.Conclusions: For infertile patients with endometrial cavity fluid before fresh embryo transfer, age <35 years, endometrial thickness ≥8mm on trigger day and transfer two embryos might obtain better pregnancy outcomes, and history of endometritis, gonadotropin releasing hormone agonist short regime and Gonadotropin start-up dose >150IU might be opposite.
Background: Recent studies have confirmed that endometriosis is a chronic inflammatory disease. In our previous work, we found that STING (stimulator of interferon genes) was differentially expressed in eutopic endometrium and controlled endometrium by proteomics.Method: we used the 11 pairs of samples to verify STING expression by WB and IHC experiments. We detected cells proliferation by EdU assays, cells invasion and migration by Transwell assays. The effect of signaling pathway in HESC was detected by WB and Elisa expreriments.Results: STING was significantly lower expressed in eutopic endometrium of endometriosis, while IHC results showed that STING was expressed in both stroma and glandular epithelium of normal endometrium, but in endometriosis, STING was mainly expressed in the stroma of eutopic endometrium, and mainly in glandular epithelium of ectopic endometrium. Further study on the role of STING on endometrial stromal cells showed that low expression of STING could promote the HESC proliferation by EdU experiments, invasion and migration by Transwell experiments. The effect of STING/IRF3/IFNb1 signaling pathway in HESC with low expression of STING was also reduced, mainly showed the decreased expression of phosphorylated IRF3 and TBK1, and the decreased secretion of IFNb1. In order to further study the effect of IFNb1, secreted by STING/ IRF3/IFNb1 signaling pathway, on stromal cells, we added exogenous IFNb1 to the HESC with low expression of STING, and found that IFNb1 could reverse the invasion and migration function of stromal cells, but little effect on cell proliferation.Conclusions: We clarified that STING expressed mainly in stromal tissues and lower in endometriosis eutopic endometrium compared to normal endometrium. Low expressed STING promoted stromal cells invasion and migration via STING/IRF3/IFNb1 signaling pathway.
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