Chronic endometritis was found in one-third of infertile women with RIF. The oral antibiotic treatment against CE might be a promising therapeutic option for infertile women with RIF.
Chronic endometritis (CE) is a local inflammatory disease characterized by unusual plasmacyte infiltration in the endometrial stromal areas. CE has been neglected in gynecologic practice, as it is a less symptomatic benign disease that requires demanding and time-consuming histopathologic examinations for the definite diagnosis. Recent studies, however, suggest the association of CE with infertility and obstetric and neonatal complications. In this review article, we aimed to update the knowledge on epidemiology, etiology, and pathogenesis of CE as well as discuss its clinical management from diagnosis to treatment.
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ObjectiveThe aim of the study was to assess the lower limits of midluteal plasma progesterone and estradiol concentrations in patients who achieved pregnancy with timed intercourse or intrauterine insemination without a human menopausal gonadotropin stimulation.ResultsWe included 297 pregnant cycles of 297 women and assessed midluteal plasma progesterone and estradiol concentrations and pregnancy outcomes, retrospectively. These cycles were compared with the non-pregnant cycles (406 cycles) of the same women who became pregnant. Mean midluteal plasma P4 and E2 concentrations were significantly (P < 0.01) higher in pregnant cycles (14.5 and 188.5 pg/mL) than in non-pregnant cycles (10.7 and 162.6 pg/mL). The 5 percentiles of progesterone and estradiol in pregnant cycles were 5.6 and 70.2 pg/mL, respectively. The lowest progesterone and estradiol levels in pregnant cycles were 2.3 and 23.4 pg/mL, respectively. In non-pregnant cycles, many women had low P4 levels that were less than 5.6 ng/mL. Subgroup analyses showed slight differences among the four groups, which may have been due to the ovarian function of each group. Miscarriage was not related to progesterone and estradiol concentrations. These values may be useful for the evaluation of necessary values for pregnancy with timed intercourse or intrauterine insemination.
Local endometrial injury (LEI) has been performed as a promising medical intervention to improve the pregnancy outcome in infertile women suffering from repeated implantation failure (RIF) in in vitro fertilization-embryo transfer cycles. The effect of LEI, however, remains controversial. The aim of this retrospective study was to identify the subgroups of patients with RIF who benefit from LEI. We compared the clinical parameters between the patients who had had a clinical pregnancy in the subsequent embryo transfer cycle following the LEI cycle (LEI-CP group, n = 94) and those who had resulted in negative pregnancy test (LEI-NP group, n = 114). The female age, basal follicle stimulating hormone concentration, number of past oocyte pickup cycles, and embryos/blastocysts transferred in the past three RIF cycles were significantly (p < 0.047) lower in the LEI-CP group than the LEI-NP group. The prevalence of polycystic ovarian syndrome was significantly (p = 0.0059) higher in the LEI-CP group than in the LEI-NP group. These findings suggest that LEI is most effective to improve the pregnancy outcome in patients undergoing RIF with uncompromised ovarian reserve, particularly in those with polycystic ovarian syndrome.
Purpose
To assess the clinical efficacy of personalized embryo transfer (pET) guided by a new endometrial receptivity test, ERPeak
SM
, in patients with recurrent implantation failure (RIF).
Methods
Recurrent implantation failure patients of all ages at two private Japanese clinics from April 2019 to June 2020 were retrospectively analyzed. The intervention group (
n
= 244) received pET in accordance with endometrial receptivity testing results and was compared to control group (
n
= 306) receiving standardized timing, non‐personalized embryo transfer (npET). In propensity score matching analysis, the clinical pregnancy rate (CPR) and live birth rate (LBR) were compared between groups, and a subanalysis of advanced maternal age (AMA) (≥38 years old) versus non‐AMA (<38 years old) patients was also conducted.
Results
The CPR and LBR of the pET group were significantly higher than those of the npET group (37.7% vs. 20.0%, adjusted OR: 2.64; 95%CI, 1.70–4.11,
p
< 0.001 and 29.9% vs. 9.7%, adjusted OR: 4.13; 95%CI, 2.40–7.13,
p
< 0.001, respectively). Furthermore, in the subanalyses, the CPR and LBR of the pET group were significantly higher than those of the npET group in both the AMA non‐AMA patients.
Conclusions
The new ERPeak
SM
endometrial receptivity test is a useful alternative diagnostic tool for poor‐prognosis patients, regardless of age.
formulations. 42 (48.3%) used cutaneous testosterone gels, while 23 (26.4%) used testosterone injections. 49 (56.3%) respondents found their patients to be satisfied ''most times'' and 30 (34.5%) said their patients are ''almost always'' satisfied with Testopel therapy. When Testopel therapy was discontinued, cost was cited as the most common reason.CONCLUSIONS: Testopel implantation appears to be a highly successful therapy for the treatment of hypogonadism. This study categorizes common practices that have yet to be standardized. Based on this specialty society questionnaire, management of hypogonadism may require 10 or more pellets in the majority of cases.
Kallmann syndrome (KS) is a genetic disorder characterized by hypogonadotropic hypogonadism, anosmia, and infertility, occurring in approximately one in 50,000 women. Here the authors present a unique case of successful ongoing pregnancy in an infertile KS woman with balanced reciprocal translocation [t(12;18)(q22;q21.1)]. The patient had a history of one sporadic miscarriage and low level of serum anti-Müllerian hormone, basal follicular stimulating hormone, luteinizing hormone, and estradiol concentration. She showed a good response to ovulation induction using human menopausal gonadotropin and chorionic gonadotropin and conceived in an in vitro fertilization and cryopreserved-thawed blastocyst transfer cycle.
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