Evidence-Based Management of Infertile Couples with Repeated Implantation Failure Following IVF

Ly, Kim Dao; Aziz, Nabil; Safi, Joelle; Agarwal, Ashok

doi:10.2174/157340410792007073

Cited by 23 publications

(7 citation statements)

References 367 publications

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“…Failed embryo implantation is one of the major limiting factors of successful IVF. Despite advances in techniques, there is an enduring problem of recurrent implantation failure (32). Successful implantation is dependent on the quality of embryos, receptivity of the endometrium, the influence of ovarian hormones, and the balance of the immune microenvironment (32, 33).…”

Section: Discussionmentioning

confidence: 99%

“…Despite advances in techniques, there is an enduring problem of recurrent implantation failure (32). Successful implantation is dependent on the quality of embryos, receptivity of the endometrium, the influence of ovarian hormones, and the balance of the immune microenvironment (32, 33). The regulatory milieu of genes encoding processes like cell adhesion, cell differentiation, cell proliferation, angiogenesis, responses to stress, and signal transduction are considered critical for successful implantation (34).…”

Section: Discussionmentioning

confidence: 99%

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Myeloid-Derived Suppressor Cells Are Regulated by Estradiol and Are a Predictive Marker for IVF Outcome

Pang

et al. 2019

Front. Endocrinol.

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In vitro fertilization (IVF) is an effective means to treat infertility, but the pregnancy rate is still unsatisfactory and reliable markers to predict pregnancy outcome are ill-defined. Myeloid-derived suppressor cell (MDSC) are critically involved in decisions related to the acceptance or rejection of foreign fetal antigens by the maternal immune system. However, factors that regulate peripheral blood MDSC during pre-pregnancy are poorly defined. Thus, the goal of this study was to assess the relationships among serum estradiol (E 2 ) and endothelial growth factor (VEGF) levels, MDSC ratios, and pregnancy outcome associated with IVF. Patients undergoing IVF treatment ( n = 54) were recruited from January to June 2018. Levels of E 2 and VEGF were measured by ELISA, MDSC ratios among peripheral blood mononuclear cells (PBMC) were detected by flow cytometry, and the crosstalk among these parameters was analyzed. A receiver operating characteristic curve (ROC) of MDSC levels was plotted to assess this measure as an independent predictive factor for pregnancy. In addition, we analyzed the possible involvement of molecular pathways by bioinformatics. When E 2 levels were <4,000 pg/ml, MDSC proportion was positively correlated with serum E 2 and VEGF levels. However, when E 2 levels were >4,000 pg/ml, MDSC ratio and VEGF levels were negatively correlated with E 2 . A ROC curve revealed that the percentage of MDSC had better sensitivity and specificity at a concentration of 8.22% (0.875 and 0.75, respectively; area under the curve (AUC) = 0.859) to predict pregnancy success, based on multiple logistic regression analysis. Furthermore, we found 12 target genes of E 2 and VEGF, and also functional genes related to MDSC, indicating potential protein–protein interactions underlying these associations. In summary, we showed that E 2 , depending on its concentration, might play a dichotomous role in influencing the MDSC proportion by regulating VEGF. In IVF patients, an increased MDSC ratio among PBMC was highly correlated with elevated pregnancy rates, independent of the effects of E 2 , which might provide new insight into immune-related miscarriage and IVF failure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Myeloid-Derived Suppressor Cells Are Regulated by Estradiol and Are a Predictive Marker for IVF Outcome

Pang

et al. 2019

Front. Endocrinol.

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“…The endometrium plays a crucial role during the implantation and the subsequent supplying of nutrients to guarantee a successful pregnancy (1). Recurrent implantation failure (RIF) is among the best-defined reproductive defects referring to the pregnancy failure after the transfers of 1-2 embryos of high quality during at least three consecutive in vitro fertilization (IVF) cycles (2).…”

Section: Introductionmentioning

confidence: 99%

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

Amini

Ranjkesh

Nikanfar

et al. 2021

International Journal of Women’s Health and Reproduction Scienc

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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.

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“…According to Coughlan et al (2014), recurrent implantation failure (RIF) is defined as failure to achieve clinical pregnancy after a minimum of three fresh or frozen transfer cycles in women under the age of 40 years verified within five weeks or more on transvaginal sonography (TVS). Lack of proper synchronization of the developing embryo with the endometrium plays an important role, regardless of other relevant causes of embryo implantation failure such as poor embryo quality, uterine anomaly, infection, immunological or thromboembolic factors and insufficient hormone levels (Coughlan et al, 2014;Richter et al, 2007;Simon & Laufer, 2012;Ly et al, 2010;Timeva et al, 2014). The techniques currently used to treat patients with RIF include blastocyst transfer, assisted hatching, salpingectomy, hysteroscopy, endometrial scratch, gamete donation, surrogacy, thrombophilia and immunologic treatment, and growing endometrial thickness (Coughlan et al, 2014;Simon & Laufer, 2012).…”

Section: Introductionmentioning

confidence: 99%

Using autologous intrauterine platelet-rich plasma to improve the reproductive outcomes of women with recurrent implantation failure

Aghajanzadeh¹,

Esmaeilzadeh²,

Basirat³

et al. 2020

JBRA Assisted Reproduction

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Objective: Reproductive clinics are often faced with cases of repeated implantation failure (RIF). This study evaluated whether platelet-rich plasma (PRP) might improve the implantation outcomes of patients suffering from RIF.Methods: Thirty women with RIF submitted to frozen-thawed embryo transfers were included in the study. Intrauterine infusions of autologous purified platelet preparations were administered 48 hours prior to embryo transfer. Differences in implantation, clinical pregnancy, and miscarriage rates of cycles with and without PRP infusions were analyzed.Results: The implantation rate seen in the PRP group was 6.7%. No significant difference was found the between the implantation, clinical pregnancy, ongoing pregnancy, and miscarriage rates of frozen-thawed embryo transfers with and without PRP infusion. However, the effect size of PRP infusion (Cohen's d=0.39) on implantation rates revealed a relationship in medium strength.Conclusion: Platelet-rich plasma might potentially yield beneficial effects as a safe therapeutic option offered alongside other treatments designed to improve the reproductive outcomes of women with repeated implantation failure.

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Evidence-Based Management of Infertile Couples with Repeated Implantation Failure Following IVF

Cited by 23 publications

References 367 publications

Myeloid-Derived Suppressor Cells Are Regulated by Estradiol and Are a Predictive Marker for IVF Outcome

Myeloid-Derived Suppressor Cells Are Regulated by Estradiol and Are a Predictive Marker for IVF Outcome

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

Using autologous intrauterine platelet-rich plasma to improve the reproductive outcomes of women with recurrent implantation failure

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