The impact of intentional endometrial injury on reproductive outcomes: a systematic review and meta-analysis

Nahshon, Chen; Sagi‐Dain, Lena; Wiener-Megnazi, Zofnat; Dirnfeld, Martha

doi:10.1093/humupd/dmy034

Cited by 49 publications

(42 citation statements)

References 92 publications

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“…The nucleolar stress activated by canonical inducer, such as low dose of ActD, may have a beneficial effect on patients with poor endometrium receptivity which is the leading cause of female infertility, including recurrent implantation failure 43,44 . Furthermore, the increasing evidence demonstrates that an improvement in implantation rates or clinical pregnancy rate was showed in patients with a history of recurrent pregnancy loss or unexplained miscarriage who received endometrial scratch injury 45,46 . A similarity between nucleolar stress and endometrial scratch injury is that they are both effective only in patients with poor endometrium receptivity.…”

Section: Discussionmentioning

confidence: 99%

Nucleolar stress regulation of endometrial receptivity in mouse models and human cell lines

Liang

Luo

et al. 2019

Cell Death Dis

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Embryo implantation is essential to the successful establishment of pregnancy. A previous study has demonstrated that actinomycin D (ActD) could initiate the activation of mouse delayed implantation. However, the mechanism underlying this activation remains to be elucidated. A low dose of ActD is an inducer of nucleolar stress. This study was to examine whether nucleolar stress is involved in embryo implantation. We showed that nucleolar stress occurred when delayed implantation was activated by ActD in mice. ActD treatment also stimulated the Lif-STAT3 pathway. During early pregnancy, nucleolar stress was detected in the luminal epithelial cells during the receptive phase. Blastocyst-derived lactate could induce nucleolar stress in cultured luminal epithelial cells. The inhibition of nucleophosmin1 (NPM1), which was a marker of nucleolar stress, compromised uterine receptivity and decreased the implantation rates in pregnant mice. To translate these mouse data into humans, we examined nucleolar stress in human endometrium. Our data demonstrated that ActD-induced nucleolar stress had positive effects on the embryo attachment by upregulating IL32 expression in non-receptive epithelial cells rather than receptive epithelial cells. Our data should be the first to demonstrate that nucleolar stress is present during early pregnancy and is able to induce embryo implantation in both mice and humans.

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Section: Discussionmentioning

confidence: 99%

Nucleolar stress regulation of endometrial receptivity in mouse models and human cell lines

Liang

Luo

et al. 2019

Cell Death Dis

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“…This is an updated meta-analysis, conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, 18 with search strategies, data extraction, and synthesis thoroughly described in our former paper. 8 Study protocol, as previously described, is available at PROSPERO International prospective register of systematic reviews (registration number CRD42018092773). As no substantial changes were made, a new protocol was not required.…”

Section: Materials S and Me Thodsmentioning

confidence: 99%

“…The hope that an endometrial biopsy may help these couples has encouraged many physicians to examine it. 37 The effect of EI on reproductive outcomes has been repeatedly studied; even since our recent meta-analysis, 8 however, it has been shown that the age-related decline in female fertility is mostly related to oocyte quality rather than endometrial receptivity. 38,39 Hysteroscopy has been studied to have an independent EI effect, thus subgroup analyses omitting studies that included hysteroscopy as part of the treatment or protocol were conducted.…”

Section: Main Findingsmentioning

confidence: 99%

“…6,7 Our recently published meta-analysis of randomized controlled trials (RCT) studied the EI effect in women with a least one previous failed IVF cycle. 8 We showed that improved clinical pregnancy rates (CPR) and live birth rates (LBR) were apparent mainly in younger patients. However, in the subgroup of women with at least two previous failed cycles, the EI effect was not found beneficial.…”

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confidence: 99%

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The impact of endometrial injury on reproductive outcomes: results of an updated meta‐analysis

Nahshon

Sagi‐Dain

Dirnfeld

2020

Reprod Medicine & Biology

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Implantation success following in vitro fertilization (IVF) relays on several factors, including embryonic quality and endometrial receptivity. 1,2 Repeated implantation failure (RIF) after IVF and embryo transfer (ET) is a frequent problem many patients struggle with. Two definitions of RIF are acceptable in the academic and clinical fields. The recent definition refers to RIF as failure to achieve a pregnancy after transferring at least four good-quality embryos in a minimum of three cycles in a woman under the age of 40 years. 3 This annotation differs from the former definition that described RIF as failure to achieve pregnancy following two to six IVF cycles, with at least ten good-quality embryos transferred. 4 Endometrial injury (EI) was first described as a beneficial procedure for women with RIF during IVF treatments by Barash et al. in 2003. 5 In this procedure, also known as endometrial scratching, the

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“…Cochrane analysis by Nastri, et al [17] as well as by Vitagliano, et al [19], revealed that endometrial injury is associated with an improvement in live birth and clinical pregnancy rates in women with more than two previous failing embryo transfers. Sar-Shalom, et al [20] showed that endometrial injury during the luteal phase of the preceding cycle, improved IVF success in younger patients (age ≤30 years) who had undergone no more than two previous failing cycles, whereas, in the older group, in whom quality of embryos is lower, the effect was not signifi cant.…”

mentioning

confidence: 99%

Endometrial local injury, a simple procedure that improves IVF outcome in a selected population of patients

Granot¹,

Dekel²

2020

J Gynecol Res Obstet

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The impact of intentional endometrial injury on reproductive outcomes: a systematic review and meta-analysis

Cited by 49 publications

References 92 publications

Nucleolar stress regulation of endometrial receptivity in mouse models and human cell lines

Nucleolar stress regulation of endometrial receptivity in mouse models and human cell lines

The impact of endometrial injury on reproductive outcomes: results of an updated meta‐analysis

Endometrial local injury, a simple procedure that improves IVF outcome in a selected population of patients

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