1
|
Ji X, Hu Q, Yang C, Huang L, Huang Y, Deng L, Song X, Zhang Y, Wang Y. Modified Hongteng Baijiang decoction enema improves sequelae of pelvic inflammatory disease by regulating the LIF/JAK2/STAT3 pathway and gut microbiota. Immun Inflamm Dis 2024; 12:e1300. [PMID: 38896093 PMCID: PMC11186298 DOI: 10.1002/iid3.1300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 04/17/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE The sequelae of pelvic inflammatory disease (SPID) are major causes of secondary infertility. Modified Hongteng Baijiang decoction (MHTBD) has produced positive results in the treatment of patients with chronic pelvic inflammatory disease; however, its role in SPID remains elusive. Therefore, this study clarified the role of MHTBD in SPID pathogenesis. METHODS The main components in MHTBD were analyzed by using liquid chromatography‒mass spectrometry (LC/MS). An SPID rat model was established, and the rats were treated with different doses of MHTBD (0.504 g of raw drug/kg, 1.008 g of raw drug/kg, and 2.016 g of raw drug/kg). Endometrial pinopodes were observed via scanning electron microscopy, endometrial thickness and inflammatory cell infiltration were assessed via HE staining, and the expression of estrogen receptor (ER), progesterone receptor (PR), integrin β3 (ITGB3), and CD31 in the endometrium was detected by using immunohistochemistry. Western blot analysis was used to detect the protein expression of LIF, JAK2, p-JAK2, STAT3, and p-STAT3 in the endometrium. Moreover, the changes in the gut microbiota were analyzed via 16S rRNA sequencing. RESULTS MHTBD improved endometrial receptivity, attenuated endometrial pathologic damage, reduced inflammatory cell infiltration, decreased ER and PR expression in the endometrium, and promoted the expression of LIF, p-JAK2, and p-STAT3 in the endometrium (p < .05) in SPID rats. Additionally, MHTBD treatment affected the composition of the gut microbiota in SPID rats. Furthermore, MHTBD attenuated endometrial receptivity and pathological damage in SPID rats by promoting the LIF/JAK2/STAT3 pathway. CONCLUSION MHTBD attenuates SPID in rats by promoting the LIF/JAK2/STAT3 pathway and improving the composition of the gut microbiota. MHTBD may be a valuable drug for SPID therapy.
Collapse
Affiliation(s)
- Xiaoli Ji
- Department of GynecologyHospital of Chengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Quan Hu
- Department of GeriatricsHospital of Chengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Chengcheng Yang
- Department of GynecologyHospital of Chengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Li Huang
- Department of GynecologyHospital of Chengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Yefang Huang
- Department of GynecologyHospital of Chengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Linwen Deng
- Department of GynecologyHospital of Chengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Xiaoqing Song
- Department of GynecologyHospital of Chengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Yongqing Zhang
- Department of GynecologyHospital of Chengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Yan Wang
- Department of GynecologyHospital of Chengdu University of Traditional Chinese MedicineChengduSichuanChina
| |
Collapse
|
2
|
Su Q, Pan Z, Yin R, Li X. The value of G-CSF in women experienced at least one implantation failure: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1370114. [PMID: 38694938 PMCID: PMC11061619 DOI: 10.3389/fendo.2024.1370114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/22/2024] [Indexed: 05/04/2024] Open
Abstract
Objective Despite the developments of in vitro fertilization (IVF) protocols, implantation failure remains a challenging problem, owing to the unbalance between the embryo, endometrium, and immune system interactions. Effective treatments are urgently required to improve successful implantation. Recently, many researchers have focused on granulocyte colony-stimulating factor (G-CSF) to regulate immune response and embryo-endometrium cross-talk. However, previous studies have reported inconsistent findings on the efficacy of G-CSF therapy on implantation failure. The objective of this review was to further explore the effects of G-CSF according to administration dosage and timing among women who experienced at least one implantation failure. Methods We systematically searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Scopus, and Web of Science for randomized controlled trials of G-CSF on implantation failure up to July 21, 2023. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and the heterogeneity of the studies with the I2 index was analyzed. Results We identified a total of 2031 studies and finally included 10 studies in the systematic review and meta-analysis. G-CSF administration improved the clinical pregnancy rate (CPR), implantation rate (IR), biochemical pregnancy rate (BPR), and live birth rate (LBR) in women with at least one implantation failure. Subgroup analyses showed that G-CSF treatment could exert good advantages in improving CPR [OR=2.49, 95%CI (1.56, 3.98), I2 = 0%], IR [OR=2.82, 95%CI (1.29, 6.15)], BPR [OR=3.30, 95%CI (1.42, 7.67)] and LBR [OR=3.16, 95%CI (1.61, 6.22), I2 = 0%] compared with the blank control group. However, compared with placebo controls, G-CSF showed beneficial effects on CPR [OR=1.71, 95%CI (1.04, 2.84), I2 = 38%] and IR [OR=2.01, 95%CI (1.29, 3.15), I2 = 24%], but not on LBR. In addition, >150μg of G-CSF treatment increased CPR [OR=2.22, 95%CI (1.47, 3.35), I2 = 0%], IR [OR=2.67, 95%CI (1.47, 4.82), I2 = 0%] and BPR [OR=2.02, 95%CI (1.17, 3.47), I2 = 22%], while ≤150μg of G-CSF treatment improved miscarriage rate (MR) [OR=0.14, 95%CI (0.05, 0.38), I2 = 0%] and LBR [OR=2.65, 95%CI (1.56, 4.51), I2 = 0%]. Moreover, G-CSF administration on the day of embryo transfer (ET) could increase CPR [OR=2.81, 95%CI (1.37, 5.75), I2 = 0%], but not on the day of ovum pick-up (OPU) or human chorionic gonadotropin (HCG) injection. Conclusion G-CSF has a beneficial effect on pregnancy outcomes to some extent among women who experienced at least one implantation failure, and the administration dosage and timing influence the effect size.Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023447046.
Collapse
Affiliation(s)
- Qing Su
- Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China
| | - Zhuo Pan
- Center for Reproductive Medicine, Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproduction Genetics Institute, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Rong Yin
- Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China
| | - Xuemei Li
- Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China
| |
Collapse
|
3
|
Maged AM, El-Mazny A, Kamal N, Mahmoud SI, Fouad M, El-Nassery N, Kotb A, Ragab WS, Ogila AI, Metwally AA, Fahmy RM, Saad H, Shaeer EK, Salah N, Lasheen Y. The value of platelet-rich plasma in women with previous implantation failure: a systematic review and meta-analysis. J Assist Reprod Genet 2023; 40:969-983. [PMID: 37010710 PMCID: PMC10239431 DOI: 10.1007/s10815-023-02781-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/17/2023] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVE To assess the value of intrauterine PRP to improve IVF outcome in women with previous implantation failure. METHODS Screening of Pubmed, Web of Science, and other databases from inception to August 2022 using the keywords related to "platelet-rich plasma" OR "PRP" AND "IVF" "implantation failure." Twenty-nine studies (3308 participants) were included in our analysis, 13 were RCTs, 6 were prospective cohorts, 4 were prospective single arm, and 6 were retrospective analyses. Extracted data included settings of the study, study type, sample size, participants' characteristics, route, volume, timing of PRP administration, and outcome parameters. RESULTS Implantation rate was reported in 6 RCTs (886 participants) and 4 non-RCTs (732 participants). The odds ratio (OR) effect estimate was 2.62 and 2.06, with 95% CI of 1.83, 3.76, and 1.03-4.11, respectively. Endometrial thickness was compared in 4 RCTs (307 participants) and 9 non-RCTs (675 participants), which showed a mean difference of 0.93 and 1.16, with 0.59-1.27 and 0.68-1.65 95% CI, respectively. CONCLUSION PRP administration improves implantation, clinical pregnancy, chemical pregnancy, ongoing pregnancy, live birth rates, and endometrial thickness in women with previous implantation failure.
Collapse
Affiliation(s)
- Ahmed M Maged
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
| | - Akmal El-Mazny
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Nada Kamal
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Safaa I Mahmoud
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Mona Fouad
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Noura El-Nassery
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Amal Kotb
- Department of Obstetrics and Gynecology, Beni-Suef University, Beni-Suef, Egypt
| | - Wael S Ragab
- Department of Obstetrics and Gynecology, Fayoum University, Fayoum, Egypt
| | - Asmaa I Ogila
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Ahmed A Metwally
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Radwa M Fahmy
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Hany Saad
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Eman K Shaeer
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Noha Salah
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| | - Yossra Lasheen
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
| |
Collapse
|
4
|
Wang W, Ge L, Zhang LL, Wang LR, Lu YY, Gou L, Gou RQ, Xu TY, Ma XL, Zhang XH. Mechanism of human chorionic gonadotropin in endometrial receptivity via the miR-126-3p/PI3K/Akt/eNOS axis. Kaohsiung J Med Sci 2023; 39:468-477. [PMID: 36912344 DOI: 10.1002/kjm2.12672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 03/14/2023] Open
Abstract
Human chorionic gonadotropin (hCG) might affect endometrial receptivity, exerting integral roles in embryo implantation. This study explored the action of hCG in endometrial receptivity via the miR-126-3p/PIK3R2/PI3K/Akt/eNOS axis. The embryo implantation dysfunction (EID) mouse models were established by administrating mifepristone and human endometrial epithelial cells (EECs) were used for in vivo experiments, both followed by hCG treatment. Expression level of CD105 and protein levels of cadherin CD144 and CD146 in mice were determined by immunohistochemistry and Western blot. The levels of miR-126-3p and PIK3R2 mRNA and PIK3R2, p-PI3K p85 α, PI3K p110 α, p-Akt, Akt, p-eNOS, and eNOS protein levels were measured. Cell proliferation was evaluated by CCK-8 and EdU assays. The binding sites of miR-126-3p and PIK3R2 were predicted and verified. hCG-treated EECs were further transfected with miR-126-inhibitor for functional rescue experiments. hCG ameliorated endometrial receptivity in EID mice. Moreover, hCG promoted miR-126-3p and suppressed PIK3R2 in EID mice and EECs. miR-126-3p targeted PIK3R2. EEC proliferation was enhanced after hCG treatment but inhibited by miR-126-3p downregulation. Both in vivo and in vitro experiments validated that hCG activated the PI3K/Akt/eNOS pathway through the miR-126-3p/PIK3R2 axis. Collectively, hCG improves endometrial receptivity by activating the PI3K/Akt/eNOS pathway via regulating miR-126-3p/PIK3R2.
Collapse
Affiliation(s)
- Wei Wang
- The Reproductive Medicine Center of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - Liang Ge
- Department of Anesthesiology, Gansu Province Maternity and Child-care Hospital, Lanzhou, Gansu, China
| | - Li-Li Zhang
- The Reproductive Medicine Center of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - Li-Rong Wang
- The Reproductive Medicine Center of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - Yong-Yan Lu
- Department of Clinical Medicine, The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
| | - Li Gou
- Department of Clinical Medicine, The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
| | - Rui-Qiang Gou
- Department of Clinical Medicine, The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
| | - Tong-Yu Xu
- Department of Clinical Medicine, The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
| | - Xiao-Ling Ma
- The Reproductive Medicine Center of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - Xue-Hong Zhang
- The Reproductive Medicine Center of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| |
Collapse
|
5
|
Akbari Asbagh F, Ghasemzadeh F, Ebrahimi M, Davari-Tanha F, Feizabad E, Akbari Asbagh P, Hosseini Quchani S. Effect of intramuscular injection of human chorionic gonadotropin on endometrium preparation in frozen-thawed embryo transfer cycle: A randomized clinical trial. CASPIAN JOURNAL OF INTERNAL MEDICINE 2023; 14:185-191. [PMID: 37223296 PMCID: PMC10201127 DOI: 10.22088/cjim.14.2.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/14/2022] [Accepted: 09/05/2022] [Indexed: 05/25/2023]
Abstract
Background Assisted reproductive therapy (ART) has been developed remarkably in these decades; however, the rate of unsuccessful embryo implantation especially in the frozen-thawed embryo transfer (FET) cycles remains high and is reported up to 70%. The current study was designed to compare the effect of intramuscular injection of hCG on endometrium preparation and embryo implantation, in women undergoing FET compared to the control group. Methods This clinical trial was done on 140 infertile women that underwent FET. The study sample was randomly allocated to the intervention group (two 5000 unit ampoules of hCG were injected intramuscularly before the first dose of progesterone administration) and the control group (without hCG injection). In both groups, 4 days after progesterone administration, the cleavage stage embryos were transferred. The study outcomes were biochemical pregnancy, clinical pregnancy and abortion rate. Results The average age of intervention and control group was 32.65±6.05 and 33.11±5.36 years, respectively. The basic information between two study groups did not differ significantly. The chemical (30% vs. 17.1%, P=0.073, relative risk (RR)=0.57) and clinical (28.6% vs. 14.3%, P=0.039, RR=0.50) pregnancy rates were higher in the intervention group compared to the control group; these higher ratios were only significant in clinical pregnancy rate. Abortion rate was not significantly (P=0.620) different between the intervention and control groups (4.3% vs. 1.4%, respectively). Conclusion This study showed that intramuscular injection of 10000 IU hCG before the endometrial secretory transformation phase in cleavage-stage embryo, improves IVF cycle outcomes.
Collapse
Affiliation(s)
- Firoozeh Akbari Asbagh
- Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ghasemzadeh
- Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbod Ebrahimi
- Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Davari-Tanha
- Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Feizabad
- Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Akbari Asbagh
- Department of Pediatrics, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
6
|
Ye H, Shi L, Quan X, Xue X, Qian Y, Tian H, Xue S, Sun L. Frozen-thawed embryo transfer in modified natural cycles: a retrospective analysis of pregnancy outcomes in ovulatory women with vs. without spontaneous luteinizing hormone surge. BMC Pregnancy Childbirth 2022; 22:814. [PMCID: PMC9635083 DOI: 10.1186/s12884-022-05161-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background Timing of frozen embryo transfer (FET) in natural endometrial preparation cycles is often based on luteinizing hormone (LH) surge. However, some patients do not show spontaneous LH surge despite follicular maturation. The objective of this study was to evaluate the impact of spontaneous LH surge on pregnancy outcomes in modified natural cycles (mNC). Methods This retrospective analysis included 1897 FET cycles with modified natural endometrial preparation in normo-ovulatory women between January 1, 2015, to December 31, 2019, at our center: 920 cycles with spontaneous LH surge (≥ 20 IU/L) and 977 without. For cleavage embryos, FET was conducted 4 and 5 days after hCG injection in women with and without LH surge, respectively. For blastocysts, FET was conducted 6 and 7 days after hCG injection in women with and without LH surge, respectively. Multivariate regression was conducted to examine the factors associated with live birth. Results Live birth rate was 43.7% in patients with spontaneous LH surge vs. 43.8% in women without LH surge (P = 0.961). The two groups also had similar implantation rate (36.2% vs. 36.7%, P = 0.772), biochemical pregnancy rate (54.8% vs. 55.4%, P = 0.796) and clinical pregnancy rate (50.9% vs. 51.7%, P = 0.721). In multivariate regression, live birth was not associated with LH surge (aOR, 0.947, 95% CI, 0.769, 1.166). Conclusion Pregnancy outcomes were similar in mNC-FET in cycles with vs. without spontaneous LH surge if FET timing is adjusted.
Collapse
Affiliation(s)
- Hongjuan Ye
- grid.24516.340000000123704535School of Life Sciences and Technology, Tongji University, Shanghai, China ,grid.24516.340000000123704535Department of Reproductive Medicine Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Liya Shi
- grid.24516.340000000123704535Department of Reproductive Medicine Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xinxin Quan
- grid.24516.340000000123704535Department of Reproductive Medicine Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xue Xue
- grid.24516.340000000123704535Department of Reproductive Medicine Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ying Qian
- grid.24516.340000000123704535Department of Reproductive Medicine Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hui Tian
- grid.24516.340000000123704535Department of Reproductive Medicine Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Songguo Xue
- grid.24516.340000000123704535Department of Reproductive Medicine Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lihua Sun
- grid.24516.340000000123704535Department of Reproductive Medicine Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| |
Collapse
|
7
|
Kalakota NR, George LC, Morelli SS, Douglas NC, Babwah AV. Towards an Improved Understanding of the Effects of Elevated Progesterone Levels on Human Endometrial Receptivity and Oocyte/Embryo Quality during Assisted Reproductive Technologies. Cells 2022; 11:cells11091405. [PMID: 35563710 PMCID: PMC9105155 DOI: 10.3390/cells11091405] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 01/25/2023] Open
Abstract
Ovarian stimulation is an indispensable part of IVF and is employed to produce multiple ovarian follicles. In women who undergo ovarian stimulation with gonadotropins, supraphysiological levels of estradiol, as well as a premature rise in progesterone levels, can be seen on the day of hCG administration. These alterations in hormone levels are associated with reduced embryo implantation and pregnancy rates in IVF cycles with a fresh embryo transfer. This article aims to improve the reader’s understanding of the effects of elevated progesterone levels on human endometrial receptivity and oocyte/embryo quality. Based on current clinical data, it appears that the premature rise in progesterone levels exerts minimal or no effects on oocyte/embryo quality, while advancing the histological development of the secretory endometrium and displacing the window of implantation. These clinical findings strongly suggest that reduced implantation and pregnancy rates are the result of a negatively affected endometrium rather than poor oocyte/embryo quality. Understanding the potential negative impact of elevated progesterone levels on the endometrium is crucial to improving implantation rates following a fresh embryo transfer. Clinical studies conducted over the past three decades, many of which have been reviewed here, have greatly advanced our knowledge in this important area.
Collapse
Affiliation(s)
- Nischelle R. Kalakota
- Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, Rutgers University, Newark, NJ 07107, USA; (L.C.G.); (S.S.M.); (N.C.D.)
- Correspondence: ; Tel.: +1-993-972-5136
| | - Lea C. George
- Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, Rutgers University, Newark, NJ 07107, USA; (L.C.G.); (S.S.M.); (N.C.D.)
| | - Sara S. Morelli
- Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, Rutgers University, Newark, NJ 07107, USA; (L.C.G.); (S.S.M.); (N.C.D.)
| | - Nataki C. Douglas
- Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, Rutgers University, Newark, NJ 07107, USA; (L.C.G.); (S.S.M.); (N.C.D.)
- Center for Immunity and Inflammation, Rutgers Biomedical and Health Sciences, Rutgers University, Newark, NJ 07107, USA
| | - Andy V. Babwah
- Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers Biomedical and Health Sciences, Rutgers University, Newark, NJ 07107, USA;
| |
Collapse
|