Endometrial injury in women undergoing assisted reproductive techniques

Nastri, C.O.; Gibreel, Ahmed; Raine‐Fenning, Nick; Maheshwari, Abha; Ferriani, Rui Alberto; Bhattacharya, Siladitya; Martins, W.P.

doi:10.1002/14651858.cd009517

Cited by 107 publications

(175 citation statements)

References 5 publications

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“…Secondary outcomes that were assessed included: live birth/ongoing pregnancy and clinical pregnancy per ET. We preferentially used live birth, but when this was not reported we used data reported for ongoing pregnancy, which is also considered as a primary outcome for effectiveness; not including data from these studies would represent only a partial view of the available evidence. Pregnancy and delivery of twins/triplets counted as a single clinical pregnancy and ongoing pregnancy/live birth.…”

Section: Methodsmentioning

confidence: 99%

High miscarriage rate in women treated with Essure® for hydrosalpinx before embryo transfer: a systematic review and meta‐analysis

Barbosa

Sotiriadis

Papatheodorou

et al. 2016

Ultrasound in Obstet & Gyne

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The available evidence suggests that, although Essure prior to ET in women with hydrosalpinx improves the chance of achieving a clinical pregnancy compared with no intervention, it is associated with a higher rate of miscarriage when compared with the other interventions. Although this evidence is based on observational studies, we believe that salpingectomy should be the first option for women who are eligible for videolaparoscopy. However, it is still premature to make recommendations for women who are not eligible for surgery, and randomized controlled trials are needed to clarify which is the best treatment alternative in such a scenario. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Methodsmentioning

confidence: 99%

High miscarriage rate in women treated with Essure® for hydrosalpinx before embryo transfer: a systematic review and meta‐analysis

Barbosa

Sotiriadis

Papatheodorou

et al. 2016

Ultrasound in Obstet & Gyne

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“…However, no medical intervention is without risk and IVF adjuncts are no exception. Reassuringly, procedures such as endometrial scratching and endometrial receptivity array are minimally invasive and, despite reports of increased pain, pose little danger of procedural complications 22. It is, therefore, in the interest of patient safety to provide such additional tools in a controlled environment with high-grade hygiene and operator competence, rather than encourage reproductive tourism to destinations of unknown or questionable standards.…”

Section: Non-maleficencementioning

confidence: 99%

Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it?

Zemyarska

2019

J Med Ethics

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In vitro fertilisation (IVF) ‘add-ons’ are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical—namely, morally good and righteous, the question was considered in relation to three key values of medical ethics—autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child.

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“…Knowing that local endometrial injury by mechanical means may have an impact on endometrial receptivity—although new data have initiated a debate on the issue, we cannot exclude this possibility. However, current practice suggests local endometrial injury to be avoided during the transfer cycle since data show a worsening of reproductive outcomes in that case …”

Section: Discussionmentioning

confidence: 99%

Intrauterine CRH‐treated PBMC in repeated implantation failure

Makrigiannakis

Vrekoussis

Makrygiannakis

et al. 2019

Eur J Clin Investigation

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Background The intrauterine administration of activated autologous peripheral blood monocytes (PBMC) prior to embryo transfer seems to improve reproductive outcomes in women with repeated implantation failure (RIF). We have previously shown that the intrauterine administration of PBMC treated with corticotropin‐releasing hormone (CRH) prior to blastocyst transfer (day 5) improves significantly the clinical pregnancy rate of women with RIF. In the present crossover pilot study, we have investigated whether CRH‐PBMC treatment could be of benefit in case of fresh early cleavage stage embryo transfer (day 3) in women with RIF. Methods Twenty‐six (n = 26) women with at least three previous failed IVF attempts and no history of clinical pregnancy in the past were recruited in this study. Ovarian stimulation was performed following either the long or the short protocol. PBMC were collected during the oocyte retrieval, were treated with CRH, and transferred in the uterine cavity 2 days later. Good quality cleavage stage embryos were transferred at day 3, following oocyte retrieval. Results Following the intrauterine administration of CRH‐treated autologous PBMC, 15/26 clinical pregnancies occurred (57.69%). Compared to the null result of the same women prior to recruitment, this observation was considered significant (P < 10−2). Conclusion Our findings further support the role of the intrauterine administration of CRH‐treated PBMC as an effective approach when transferring cleavage stage embryos in women with RIF. Prospective randomized studies are needed to clarify whether such intervention could be of benefit in clinical practice.

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Endometrial injury in women undergoing assisted reproductive techniques

Cited by 107 publications

References 5 publications

High miscarriage rate in women treated with Essure® for hydrosalpinx before embryo transfer: a systematic review and meta‐analysis

High miscarriage rate in women treated with Essure® for hydrosalpinx before embryo transfer: a systematic review and meta‐analysis

Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it?

Intrauterine CRH‐treated PBMC in repeated implantation failure

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