Repeated implantation failure at the crossroad between statistics, clinics and over-diagnosis

Somigliana, Edgardo; Viganò, Paola; Busnelli, Andrea; Paffoni, Alessio; Vegetti, Walter; Vercellini, Paolo

doi:10.1016/j.rbmo.2017.09.012

Cited by 62 publications

(47 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite advances in ART, recurrent implantation failure (RIF) still occurs and affects ∼10% of women who have undergone several in vitro fertilization embryo transfers (IVF-ETs) (2,3). The definition of RIF is still not well-defined (2)(3)(4)(5)(6) and is described as a lack of pregnancy after at least two consecutive cycles (4), or three embryo transfers (2,7,8), or four and more good-quality embryos in a minimum of three fresh or frozen cycles in a woman under the age of 40 years (9), or more than 12 embryos (6). Therefore, a non-invasive biomarker is needed that will indicate as soon as possible whether the embryo transfer is successful or not, or whether there are complications resulting in a miscarriage.…”

Section: Introductionmentioning

confidence: 99%

Association of Soluble HLA-G Plasma Level and HLA-G Genetic Polymorphism With Pregnancy Outcome of Patients Undergoing in vitro Fertilization Embryo Transfer

Nowak

Wilczyńska

Radwan³

et al. 2020

Front. Immunol.

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Association of Soluble HLA-G Plasma Level and HLA-G Genetic Polymorphism With Pregnancy Outcome of Patients Undergoing in vitro Fertilization Embryo Transfer

Nowak

Wilczyńska

Radwan³

et al. 2020

Front. Immunol.

View full text Add to dashboard Cite

“…If three IVF attempts are unsuccessful, a diagnosis of repeated (or recurrent) implantation failure (RIF) is often made 142,143 . However, some data suggest that a reliable diagnosis of RIF cannot be made after three IVF cycles, and that diagnosis is likely to be more reliable and cost-effective after six IVF cycles, especially in women with a poor prognosis and in centres with lower IVF success rates 144 Cohort data support a change to the definition of RIF, as the live birth rate associated with the 4 th embryo transfer cycle was not significantly different from the rate associated with the 3 rd cycle 135 . Women with RIF can be offered further investigations to establish causation, including endometrial receptivity tests, pre-implantation genetic screening, time-lapse imaging and immunological tests, but these tests can be invasive and costly.…”

Section: [H1] Managementmentioning

confidence: 99%

Female subfertility

2019

Nat Rev Dis Primers

View full text Add to dashboard Cite

Subfertility is common, and affects one in six couples, half of whom lack an explanation for their delay in conceiving. Developments in the diagnosis and treatment of subfertility over the past 50 years have been truly remarkable. Indeed, current generations of couples with subfertility are more fortunate than previous generations as they have many more opportunities to become parents. The timely access to effective treatment for subfertility is important, as many couples have a narrow window of opportunity before the age-related effects of subfertility limit the likelihood of success. Assisted reproduction can overcome the barriers to fertility caused by tubal disease and low sperm counts, but little progress has been made in reducing the effect of increasing age on ovarian function. The next 5-10 years will likely see further increases in birth rates in women with subfertility, greater awareness of lifestyle factors and possible refinement of current assisted reproduction techniques and development of new ones. Such progress will bring challenging questions regarding the potential benefits and harms of treatments involving germ-cell manipulation, artificial gametes, genetic screening of embryos, and gene editing of embryos. We hope to see a major increase in fertility awareness, access to safe and cost-effective fertility care in low-income countries, and a reduction in the current disparity of access to fertility care.

show abstract

“…While assisted reproductive technology (ART) has made considerable advances in the decades since its inception, the current success rate is still under 30 % [1] and implantation failure remains a significant obstacle [2]. Repeated implantation failure (RIF) is diagnosed when a woman under the age of 40 is unable to achieve a pregnancy after the transfer of at least three good-quality embryos over a minimum of three fresh or frozen cycles [3].…”

Section: Introductionmentioning

confidence: 99%

Tacrolimus Improves the Implantation Rate in Patients with Elevated Th1/2 Helper Cell Ratio and Repeated Implantation Failure (RIF)

Bahrami-Asl

Farzadi

Fattahi

et al. 2020

Geburtshilfe Frauenheilkd

View full text Add to dashboard Cite

Introduction An abnormal endometrial immune response is involved in the pathogenesis of repeated implantation failure (RIF), so we investigated the effectiveness of tacrolimus treatment on the endometrium of RIF patients. Materials and Methods Ten RIF patients with elevated T-helper 1/T-helper 2 (Th1/Th2) cell ratios were recruited into a clinical study. The expression of p53, leukemia inhibitory factor (LIF), interleukin (IL)-4, IL-10, IL-17, and interferon gamma (IFN-γ) in the endometrium of patients with and without tacrolimus treatment and the association of these factors with assisted reproductive technology (ART) outcomes were investigated. Results Tacrolimus significantly increased the expression of LIF, IL-10, and IL-17 and decreased the expression of IL-4, IFN-γ, and the IFN-γ/IL-10 ratio in RIF patients. Tacrolimus treatment resulted in an implantation rate of 40%, a clinical pregnancy rate of 50%, and a live birth rate of 35% in RIF patients with elevated Th1/Th2 ratios who had previously failed to become pregnant despite at least three transfers of embryos. We also found a significant positive correlation between IL-10 levels and the implantation rate. Conclusions Our findings suggest that RIF patients with a higher Th1/Th2 ratio could be candidates for tacrolimus therapy and that this immunosuppressive drug could be acting through upregulation of LIF, IL-10, and IL-17.

show abstract

Repeated implantation failure at the crossroad between statistics, clinics and over-diagnosis

Cited by 62 publications

References 29 publications

Association of Soluble HLA-G Plasma Level and HLA-G Genetic Polymorphism With Pregnancy Outcome of Patients Undergoing in vitro Fertilization Embryo Transfer

Association of Soluble HLA-G Plasma Level and HLA-G Genetic Polymorphism With Pregnancy Outcome of Patients Undergoing in vitro Fertilization Embryo Transfer

Female subfertility

Tacrolimus Improves the Implantation Rate in Patients with Elevated Th1/2 Helper Cell Ratio and Repeated Implantation Failure (RIF)

Contact Info

Product

Resources

About