Intrauterine administration of autologous hCG- activated peripheral blood mononuclear cells improves pregnancy outcomes in patients with recurrent implantation failure; A double-blind, randomized control trial study

Pourmoghadam, Zahra; Soltani‐Zangbar, Mohammad Sadegh; Sheikhansari, Golshan; Azizi, Ramyar; Eghbal‐Fard, Shadi; Mohammadi, Hamed; Siahmansouri, Homayoon; Aghebati‐Maleki, Leili; Danaii, Shahla; Mehdizadeh, Amir; Hojjat‐Farsangi, Mohammad; Motavalli, Roza; Yousefi, Mehdi

doi:10.1016/j.jri.2020.103182

Cited by 33 publications

(38 citation statements)

References 66 publications

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“…The remaining 70 publications' full text was read, and 16 RCTs meeting the requirements were nally included (Figure 1). A total of 16 RCTs including 2008 participants were included [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Among them, 3 are LMWH, 6 are GCSF, 4 are PBMC, one is hCG, one is intralipid, and 2 are PRP.…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of immunotherapies for patients with repeated implantation failure: a systematic review and network meta-analysis

Liu¹,

Yuan²,

Yan³

et al. 2022

Preprint

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Background: This study compared clinical pregnancy outcomes of repeated implantation failure (RIF) patients treated with immunotherapies using a network meta-analysis.Methods: Publications are determined by searching the Pubmed, Embase and web of science databases. The search date is from the establishment of the database till August 2021. The outcomes were clinical pregnancy rate (CPR), live birth rate (LBR) and implantation rate (IR). The Cochrane bias risk assessment tool was applied to evaluate the quality of the study, and Stata 14.0 was used for the network meta-analysis.Results: A total of 16 RCTs including 2008 participants were included. The network meta-analysis results show that PBMC, PRP and SC-GCSF can significantly improve CPR compared with LMWH (PBMC: OR = 2.15; 95% CI, 1.21-3.83; PRP: OR = 2.38; 95% CI, 1.08-5.24; SC-GCSF: OR = 2.46; 95% CI, 1.05-5.72). The LBR of PRP was significantly higher than IU-GCSF (OR = 3.81; 95% CI, 1.22-11.86), LMWH (OR = 4.38; 95% CI, 1.50-12.90) and Intralipid (OR = 3.85; 95% CI, 1.03-14.29), and the LBR of PBMC was also significantly better than that of LMWH (OR = 2.35; 95% CI, 1.14-4.85). Furthermore, PRP treatment significantly improved IR compared with LMWH treatment (OR = 2.81; 95% CI, 1.07-7.4).Discussion: Based on the limited evidence from existing RCTs, PBMC and PRP seem to be the best therapeutic options for RIF patients. However, due to research quantity restrictions, more top-quality researches are required in the future to obtain additional high-level evidence.

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Section: Resultsmentioning

confidence: 99%

The effectiveness of immunotherapies for patients with repeated implantation failure: a systematic review and network meta-analysis

Liu¹,

Yuan²,

Yan³

et al. 2022

Preprint

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show abstract

“…It was suggested that, when co-cultured with PBMCs, hCG could balance the immunologic response to PBMCs. Several clinical studies, with different study designs, have tested this hypothesis with relatively good results [106].…”

Section: Infusion Of Hcg During Embryo Transfermentioning

confidence: 99%

“…To increase the success rates of embryo transfer during IVF, isolated hCG intrauterine infusion has been suggested but the results of the studies are questionable [105,106,[109][110][111][112][113][114].…”

Section: Infusion Of Hcg During Embryo Transfermentioning

confidence: 99%

Human Chorionic Gonadotropin and Early Embryogenesis: Review

d'HAUTERIVE

Gridelet

et al. 2022

IJMS

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Human chorionic gonadotropin (hCG) has four major isoforms: classical hCG, hyperglycosylated hCG, free β subunit, and sulphated hCG. Classical hCG is the first molecule synthesized by the embryo. Its RNA is transcribed as early as the eight-cell stage and the blastocyst produces the protein before its implantation. This review synthetizes everything currently known on this multi-effect hormone: hCG levels, angiogenetic activity, immunological actions, and effects on miscarriages and thyroid function.

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“…The published studies (summarized in Table 3), differ in terms of (a) population characteristics (infertile vs. exclusively RIF patients), (b) the transferred embryos (cleavage embryos vs. blastocysts, fresh vs. frozen embryos), c) the PBMC activation protocol (no-activation, activation by HCG, activation by corticotropin-releasing hormone-CRH). A critical approach in the published literature reveals the fact that although the randomized controlled trials (mainly focusing at RIF) performed (Madkour et al, 2016;Yu et al, 2016;Nobijari et al, 2019;Pourmoghadam et al, 2020b) are comparable to non-randomized trials (Yoshioka et al, 2006;Okitsu et al, 2011;Makrigiannakis et al, 2015;Li et al, 2017b;Makrigiannakis et al, 2019) in terms of quantity, the pooled number of participants is greater for the non-randomized trials. This may question the level of the overall evidence produced.…”

Section: Intra-uterine Administration Of Peripheral Blood Mononuclearmentioning

confidence: 99%

Approaches to Improve Endometrial Receptivity in Case of Repeated Implantation Failures

Makrigiannakis

Makrygiannakis

Vrekoussis

2021

Front. Cell Dev. Biol.

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Repeated implantation failures are a constant challenge in reproductive medicine with a significant impact both on health providers and on infertile couples. Several approaches have been proposed so far as effective; however, accumulative data have clarified that most of the treatment options do not have the evidence base for a generalized application to be suggested by the relevant societies. Implantation failures are attributed to either poor quality embryos or to defected endometrial receptivity. The current review aims to summarize in a systematic way all the new trends in managing RIF via interference with endometrial receptivity. The authors focus mainly, but not exclusively, on endometrial injury prior to embryo transfer and endometrial priming with autologous cells or biological agents. To this direction, a systematic search of the Pubmed database has been conducted taking into account the emerged evidence of the last two decades. All the suggested interventions are herein presented and analyzed in terms of reproductive outcomes. It is evident that properly powered and designed randomized trials are needed to support a new standard approach in RIF treatment that will safely be incorporated in national and international guidelines.

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Intrauterine administration of autologous hCG- activated peripheral blood mononuclear cells improves pregnancy outcomes in patients with recurrent implantation failure; A double-blind, randomized control trial study

Cited by 33 publications

References 66 publications

The effectiveness of immunotherapies for patients with repeated implantation failure: a systematic review and network meta-analysis

The effectiveness of immunotherapies for patients with repeated implantation failure: a systematic review and network meta-analysis

Human Chorionic Gonadotropin and Early Embryogenesis: Review

Approaches to Improve Endometrial Receptivity in Case of Repeated Implantation Failures

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