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Fabregues F, Antonio García-Velasco J, Llácer J, Requena A, Ángel Checa M, Bellver J, José Espinós J. The role of thrombophilias in reproduction: A swot analysis. Eur J Obstet Gynecol Reprod Biol 2023; 280:12-21. [PMID: 36375360 DOI: 10.1016/j.ejogrb.2022.10.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/25/2022] [Indexed: 12/27/2022]
Abstract
Thrombophilia is a group of inherited or acquired coagulation disorders that have been associated with reproductive failure. However, there are still no clear recommendations on whether its inclusion in the initial study of the infertile couple or patients with recurrent implantation failure is necessary. In this discussion paper, based on a SWOT (strengths, weaknesses, opportunities, threats) analysis, the different aspects of the repercussions of thrombophilia screening and treatment in reproduction are evaluated. To avoid possible subjectivity in the analysis and results of this study, researchers followed Oxford criteria for the evaluation of evidence. The results from the evaluation of the reviewed bibliography seem to indicate that, pending new evidence, it would be advisable not to include thrombophilia screening in the initial baseline study of the infertile couple. There is no evidence to support a clear association between thrombophilia and implantation failure or infertility. Thrombophilia testing in this setting may increase cost, with minimal potential benefit and lead to inappropriate use of anticoagulants with possible deleterious adverse effects. Future well-designed studies are needed to assess the possible benefit of anticoagulant therapy in infertile thrombophilic patients with implantation failure.
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Affiliation(s)
- Francisco Fabregues
- Institut Clinic Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic, C/Villarroel 160, Barcelona 08036, Spain.
| | | | - Joaquín Llácer
- Ginefiv-GeneraLife, Calle José Silva 18, Madrid 28043, Spain
| | - Antonio Requena
- Ginefiv-GeneraLife, Calle José Silva 18, Madrid 28043, Spain
| | - Miguel Ángel Checa
- Hospital del Mar-Parc de Salut Mar, Paseo Maritimo 25-29, Barcelona 08005, Spain; Fundación Fertty, Ausiàs March 25, Barcelona 08010, Spain
| | - José Bellver
- Departamento de Pediatría, Obstetricia y Ginecología, Facultad de Medicina, Universidad de Valencia, Spain; Instituto Valenciano de Infertilidad (IVI-RMA) Valencia, Plaza de la Policía Local, 3, Valencia 46015, Spain; Fundación FIVI, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Juan José Espinós
- Fundación Fertty, Ausiàs March 25, Barcelona 08010, Spain; Universidad Autónoma de Barcelona. Campus de la UAB, Plaza Cívica, s/n, Bellaterra (Barcelona) 08193, Spain
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Lu YJ, Li Q, Chen LX, Tian T, Kang J, Hao YX, Zhou JS, Wang YY, Yan LY, Li R, Chang L, Qiao J. Association between maternal MTHFR C677T/A1298C combination polymorphisms and IVF/ICSI outcomes: a retrospective cohort study. Hum Reprod Open 2022; 2023:hoac055. [PMID: 36531663 PMCID: PMC9749479 DOI: 10.1093/hropen/hoac055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/10/2022] [Indexed: 10/11/2023] Open
Abstract
STUDY QUESTION What are the roles of maternal 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T/A1298C combination polymorphisms on the embryological and clinical outcomes of IVF/ICSI? SUMMARY ANSWER Our study reveals for the first time that the oocyte maturation potential gradually decreases with a reduction of maternal MTHFR activity determined by combined C677T/A1298C polymorphisms, while embryo quality was worse in women with intermediate MTHFR activity. WHAT IS KNOWN ALREADY Although many previous studies have explored the association between MTHFR polymorphisms and IVF/ICSI outcomes, the results remain contradictory due to inadequate samples, no adjustment for potential confounders and/or the study of C677T and A1298C separately. Few studies have systematically investigated the exact role of MTHFR activity determined by combined C677T/A1298C polymorphisms on the embryological and clinical outcomes of IVF/ICSI. STUDY DESIGN SIZE DURATION This is a retrospective cohort study investigating 1160 women who were referred for MTHFR genotyping and IVF/ICSI treatment at Peking University Third Hospital from May 2017 to May 2020. PARTICIPANTS/MATERIALS SETTING METHODS Women who were referred for MTHFR genotyping and their first IVF/ICSI treatment at our hospital were included and those undergoing preimplantation genetic testing cycles were excluded. The included women were divided into different cohorts according to their C677T, A1298C and combined C677T/A1298C genotypes. The embryological outcomes, including oocytes retrieved, metaphase II oocytes, oocyte maturation rate, normal fertilization rate and transplantable embryo rate, were evaluated by generalized linear regression models. The clinical outcomes, including biochemical pregnancy rate, clinical pregnancy rate and live birth rate, were evaluated by log-binomial regression models. All outcomes were adjusted for potential confounders. MAIN RESULTS AND THE ROLE OF CHANCE Women with the combined 677TT/1298AA genotype (hereafter abbreviated as TT/AA, as with other combined genotypes), whose enzyme activity was the lowest, had a lower oocyte maturation rate compared with those with the wild-type genotype (P = 0.007). Moreover, the oocyte maturation rate decreased linearly with the decline in MTHFR enzyme activity determined by combined C677T/A1298C genotypes (P-trend = 0.001). The combined CC/AC, CC/CC&CT/AA and CT/AC genotypes with intermediate enzyme activity were associated with a lower transplantable embryo rate (P = 0.013, 0.030 and 0.039, respectively). The differences in clinical outcomes between women with wild-type genotype and combined C677T/A1298C variant genotypes were not significant. LIMITATIONS REASONS FOR CAUTION Our study population had comparable embryological outcomes but worse clinical outcomes than other women undergoing IVF/ICSI treatment at our hospital. Therefore, the results related to the clinical outcomes should be generalized with caution. In addition, we did not detect the folate concentration of each patient during pregnancy. However, this might not have much influence on our results because almost all of our study participants took sufficient folic acid around pregnancy. WIDER IMPLICATIONS OF THE FINDINGS We provide a holistic view of the effect of MTHFR C677T and A1298C polymorphisms on the IVF/ICSI outcomes, which can contribute to providing reasonable folic acid supplementation suggestions for women with different MTHFR genotypes, especially for those with a low oocyte maturation rate and/or low embryo quality. STUDY FUNDING/COMPETING INTERESTS This work was funded by the National Natural Science Foundation of China (31871447, and 82101677), the National Key Research and Development Program (2019YFA0801400) and the Natural Science Foundation of Beijing Municipality (7202226). The authors declare that they have no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Yong-Jie Lu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Qin Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Li-Xue Chen
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Tian Tian
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Jia Kang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Yong-Xiu Hao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Jian-Suo Zhou
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, China
| | - Yuan-Yuan Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Li-Ying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Liang Chang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
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Pirtea P, de Ziegler D, Marin D, Sun L, Tao X, Ayoubi JM, Franasiak J, Scott RT. Gonadotropin receptor polymorphisms (FSHR N680S and LHCGR N312S) are not predictive of clinical outcome and live birth in assisted reproductive technology. Fertil Steril 2022; 118:494-503. [PMID: 35842313 DOI: 10.1016/j.fertnstert.2022.06.011] [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: 03/21/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To study the consequences of specific genotype profiles of follicle-stimulating hormone receptor (FSHR) and luteinizing hormone choriogonadotropin receptor (LHCGR) on assisted reproductive technology outcomes when preimplantation genetic testing for aneuploidy is used for controlling the embryo ploidy status. The most common reported single-nucleotide polymorphisms in the amino acid position for the FSHR (N680S; N: asparagine, S: serine; [rs6166]) and the LHCGR (N312S variant; N: asparagine, S: serine [rs2293275]) were chosen for this study. DESIGN Retrospective cohort study. SETTING Private Fertility Clinic. PATIENT(S) All women aged 18-40 years undergoing their first assisted reproductive technology cycle with aneuploidy screening between 2006 and 2017 with body mass index of >18 and <40 kg/m2 were included. INTERVENTION(S) All patients received both recombinant follicle-stimulating hormone and human menopausal gonadotropin or low dose human chorionic gonadotropin. Genomic DNA was isolated from patients' blood. Genotyping of the FSHR and LHCGR polymorphisms was performed using TaqMan genotyping assays. Associations between both receptor genotypes and clinical outcomes were assessed using generalized regression and ANOVA. MAIN OUTCOMES MEASURE(S) Live birth rate was the primary outcome. Secondary outcomes included oocyte yield, mature oocytes, blastulation rate, usable blastocyst rate, and implantation rate. RESULT(S) A total of 1,183 patients met the inclusion criteria and generated reliable genotype results. The overall genotype frequencies in the study population for the FSHR gene were as follows: 21.7% homozygous for S in codon 680, 29.2% homozygous for N680, and 48.1% heterozygous (N680S). As for the LHCGR, 15.6% were homozygous for N312, 38.5% homozygous for S312 and 45.9% heterozygous (N312S). Our study population consisted of 53.8% non-Hispanic white; 6.1% Hispanic white; 4.1% Afro-American; 15.4% Asian; and 20.6% other or unknown. No significant association was found with any of the studied variables (oocyte yield, usable blastocyst rate, implantation rate, live birth) when genotypes were analyzed per receptor or in combination with one another. There was a statistically significant but clinically irrelevant difference in the rate of mature oocytes across different variant combinations. CONCLUSION(S) Our findings suggest that the presence of gonadotropin receptor polymorphisms in both FSHR N680S and LHCGR N312S are not associated with assisted reproductive technology outcomes; therefore, these variants should not be considered reproductive predictors.
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Affiliation(s)
- Paul Pirtea
- Hôpital FOCH, Suresnes, France; Instituto Valenciano de Infertilidad Reproductive Medicine Associates, Basking Ridge, New Jersey.
| | | | - Diego Marin
- Instituto Valenciano de Infertilidad Reproductive Medicine Associates, Basking Ridge, New Jersey; Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Li Sun
- Foundation for Embryonic Competence, Basking Ridge, New Jersey
| | - Xin Tao
- Foundation for Embryonic Competence, Basking Ridge, New Jersey
| | | | - Jason Franasiak
- Instituto Valenciano de Infertilidad Reproductive Medicine Associates, Basking Ridge, New Jersey; Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Richard T Scott
- Instituto Valenciano de Infertilidad Reproductive Medicine Associates, Basking Ridge, New Jersey; Thomas Jefferson University, Philadelphia, Pennsylvania
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Filip C, Covali R, Socolov D, Carauleanu A, Tanasa IA, Scripcariu IS, Ciuhodaru M, Butureanu T, Pavaleanu I, Akad M, Boiculese LV, Socolov R. The postpartum uterine ultrasonographic scale in assessment of uterine involution after cesarean section in treated thrombophilia pregnant patients at term. J Clin Lab Anal 2022; 36:e24645. [PMID: 36082463 PMCID: PMC9459266 DOI: 10.1002/jcla.24645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 11/06/2022] Open
Abstract
Background Pregnancy is a prothrombotic condition which can be abnormally exaggerated in women with thrombophilia. Methods In a prospective study, patients who delivered at term, by cesarean section, between 1 October 2017 and 1 December 2021, who already had a diagnosis of thrombophilia before coming to our hospital, were included in the study group (n = 80). A similar number of nonthrombophilia patients (n = 80) without any history of thrombotic events, age‐ and para‐matched with the study group, were included in the control group. The postpartum uterine ultrasonographic scale (PUUS) values, in the first 24–48 h, were correlated with the patients' data. Results The P‐LCR (platelet large cell ratio), was significantly higher in the treated thrombophilia group (p = 0.042). There was no correlation between PUUS and complete blood count values, coagulation factors, maternal characteristics, or fetal outcomes, except for postpartum neutrophils (p = 0.047) and postpartum platelet count (p = 0.046). Conclusions Postpartum uterine involution was not significantly different, after cesarean section, between treated thrombophilia patients and nonthrombophilia patients. Involution correlated only with postpartum neutrophils and postpartum platelet count.
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Affiliation(s)
- Catalina Filip
- Department of Vascular Surgery, Faculty of Medicine Grigore T. Popa University of Medicine and Pharmacy Iasi Romania
| | - Roxana Covali
- Department of Radiology, Biomedical Engineering Faculty, Grigore T. Popa University of Medicine and Pharmacy Iasi Elena Doamna Obstetrics and Gynecology University Hospital Iasi Romania
| | - Demetra Socolov
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi Cuza Voda Obstetrics and Gynecology University Hospital Iasi Romania
| | - Alexandru Carauleanu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi Cuza Voda Obstetrics and Gynecology University Hospital Iasi Romania
| | - Ingrid Andrada Tanasa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi Cuza Voda Obstetrics and Gynecology University Hospital Iasi Romania
| | - Ioana Sadyie Scripcariu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi Cuza Voda Obstetrics and Gynecology University Hospital Iasi Romania
| | - Madalina Ciuhodaru
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi Elena Doamna Obstetrics and Gynecology University Hospital Iasi Romania
| | - Tudor Butureanu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi Elena Doamna Obstetrics and Gynecology University Hospital Iasi Romania
| | - Ioana Pavaleanu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi Elena Doamna Obstetrics and Gynecology University Hospital Iasi Romania
| | - Mona Akad
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi Elena Doamna Obstetrics and Gynecology University Hospital Iasi Romania
| | | | - Razvan Socolov
- Department of Obstetrics and Gynecology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi Elena Doamna Obstetrics and Gynecology University Hospital Iasi Romania
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Zeng H, Liu Z, Zhang L, Liu N. MTHFR 677TT is associated with decreased number of embryos and cumulative live birth rate in patients undergoing GnRHa short protocol: a retrospective study. BMC Pregnancy Childbirth 2022; 22:170. [PMID: 35232413 PMCID: PMC8887009 DOI: 10.1186/s12884-022-04506-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 02/21/2022] [Indexed: 12/02/2022] Open
Abstract
Background Whether MTHFR C677T genotype affects pregnancy outcomes following assisted reproductive technology is conflicting. And the role of MTHFR C677T genotype on cumulative live birth has not been reported. This study aims to investigate the effect of MTHFR C677T genotype on cumulative live birth following in-vitro fertilization and embryo transfer (IVF-ET). Methods This is a retrospective cohort study that includes 1173 women undergoing their first IVF-ET. We retrospectively compared the reproductive outcomes among the groups stratified by MTHFR C677T genotypes (677CC, 677CT, 677TT). We performed interaction analysis to detect the factor that interacts with the MTHFR C677T genotype. Poisson regression analyses were used to evaluate the associations between MTHFR C677T genotypes with the number of transferable embryos and the number of good-quality embryos. Cox regression analysis was used to evaluate the association between MTHFR C677T genotypes with cumulative live birth. All regression analyses were adjusted with the confounding factors which may independently impact reproductive outcomes. Results There is a significant interactive effect of MTHFR 677TT genotype with GnRHa protocol on reproductive outcomes (P for interaction<0.05). MTHFR 677TT homozygous mutation was found to impact reproductive outcomes under GnRHa short protocol but not GnRHa long protocol. MTHFR 677TT is significantly associated with decreased number of transferable embryos (p-value=0.028), decreased number of good-quality embryos (p-value=0.005), and decreased cumulative live birth rate (p-value=0.024) in patients undergoing GnRHa short protocol. However, the clinical pregnancy rate, miscarriage rate and live birth rate at the first embryo transfer cycle were not significantly different between the groups under both protocols (p-values>0.05). Conclusions MTHFR 677TT genotype is associated with decreased number of transferable embryos, decreased number of good-quality embryos, and decreased cumulative live birth rate in the first complete cycle in patients undergoing GnRHa short protocol. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04506-4.
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Affiliation(s)
- Hong Zeng
- Department of Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.,Department of Reproductive Medicine Center, Foshan Maternal and Child Health Care Hospital, Southern Medical University, Foshan, 528000, Guangdong, China.,Department of Reproductive Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Zefu Liu
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, China
| | - Lei Zhang
- Department of Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Nenghui Liu
- Department of Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Dabbagh Rezaeiye R, Mehrara A, Ali Pour AM, Fallahi J, Forouhari S. Impact of Various Parameters as Predictors of The Success Rate of In Vitro Fertilization. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2022; 16:76-84. [PMID: 35639653 PMCID: PMC9108295 DOI: 10.22074/ijfs.2021.531672.1134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022]
Abstract
Infertility is one of the major problems faced in medicine. There are numerous factors that play a role in infertility. For example, numerous studies mention the impact of the quantity and quality of mitochondria in sexual gametes. This is a narrative review of the effects of the mitochondrial genome on fertility. We searched the PubMed, Science Direct, SID, Google Scholar, and Scopus databases for articles related to “Fertility, Infertility, Miscarriage, Mitochondria, Sperm, mtDNA, Oocytes” and other synonymous keywords from 2000 to 2020. The mitochondrial genome affects infertility in both male and female gametes; in sperm, it mainly releases free radicals. In the oocyte, a mutation in this genome can affect the amount of energy required after fertilisation, leading to gestation failure. In both cases, infertile cells have substantially less mitochondrial DNA (mtDNA) copies. The effects of mtDNA on gamete fertility occur via changes in oxidative phosphorylation and cellular energy production. Also, a reduction in the number of mtDNA copies is directly associated with sex cell infertility. Therefore, evaluation of the mitochondrial genome can be an excellent diagnostic option for couples who have children with neonatal disorders, infertile couples who seek assisted reproductive treatment, and those in whom assisted reproductive techniques have failed.
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Affiliation(s)
| | - Arian Mehrara
- Student Research Committee, Ramsar International Branch, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Jafar Fallahi
- Department of Molecular Medicine, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedighe Forouhari
- Infertility Research Center, Research Center of Quran, Hadith and Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Shahrokhi SZ, Kazerouni F, Ghaffari F, Hadizadeh M, Zolfaghary Z. The effect of A1298c polymorphism of the MTHFR gene on anti-Müllerian hormone levels: experimental and Web-based analysis. J Clin Lab Anal 2021; 35:e23948. [PMID: 34369004 PMCID: PMC8418515 DOI: 10.1002/jcla.23948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/21/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background The 5,10‐methylenetetrahydrofolate reductase (MTHFR) is an important enzyme of folate and methionine metabolism, which is expressed in human oocytes and preimplantation. Due to the involvement of MTHFR in female reproduction, we tend to evaluate the influence of MTHFR A1298C polymorphism on ovarian marker reserves such as serum anti‐Müllerian hormone (AMH) levels in women after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Methods A total of 100 women, who underwent ART treatment due to male factor infertility, were recruited into this study. MTHFR A1298C polymorphism was detected by polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) technique, and serum AMH concentrations were measured by an ultrasensitive enzyme‐linked immunosorbent assay (ELISA). Results Women with the CC genotype had higher AMH levels (4.15 ± 1.67 ng/ml), albeit not significant, than carriers with other genotypes after ovarian stimulation. No significant differences existed in terms of miscarriage and live birth rates among different genotype groups. Conclusion The presence of the C mutant allele of the 1298 polymorphism in the MTHFR gene led to an increasing trend in serum AMH concentrations; however, the numbers of oocytes retrieved decreased in women with mutated genotypes. The influence of the MTHFR C677T polymorphism on embryo quality and pregnancy rate after ART cycles remains unclear.
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Affiliation(s)
- Seyedeh Zahra Shahrokhi
- Department of Laboratory Medicine, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faranak Kazerouni
- Department of Laboratory Medicine, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Firouzeh Ghaffari
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Morteza Hadizadeh
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Zolfaghary
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Morales R, Lledó B, Ortiz JA, Cascales A, Codina H, Rodríguez-Arnedo A, Llácer J, Bernabeu A, Bernabeu R. Methylenetetrahydrofolate reductase gene polymorphisms are not associated with embryo chromosomal abnormalities and IVF outcomes. Syst Biol Reprod Med 2021; 67:270-280. [PMID: 34053384 DOI: 10.1080/19396368.2021.1923861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of our study was to investigate the effect of maternal and embryo MTHFR C677T and A1298C polymorphisms on embryo aneuploidies and mosaicism and the correlation between these genetic variants in transferred euploid embryos and IVF outcomes. MTHFR genotype was analyzed in 77 women who performed an IVF/ICSI cycle with PGT-A. Moreover, to evaluate the effect of embryo MTHFR polymorphisms on embryo aneuploidies and mosaicism, the MTHFR genotype was analyzed in 191 biopsied embryos from the PGT-A cycles of these patients. Additionally, 218 DNA samples from trophectoderm biopsies belonging to a different group of patients were also genotyped. MTHFR polymorphisms were analyzed in a total amount of 409 trophectoderm samples. The main parameters analyzed were embryo aneuploidy and mosaicism rates. Finally, the IVF outcomes of 241 single euploid embryo transfers were assessed and compared between different MTHFR embryo genotypes. The aneuploidy rates were similar in embryos from homozygous normal women and women with at least one mutated allele (54.7% vs. 30.2% in 677C>T and 37.8% vs. 42.7% in 1298A>C). Furthermore, no differences were observed in the mosaicism rate (24.0% vs. 13.8% in 677C>T and 17.1% vs. 17.3% in 1298A>C). A similar analysis was performed, taking into account the embryo genotype results. No differences in aneuploidy rate were observed between the study groups. The only significant difference was the mosaicism rate among 677C>T genotype (13.5% in 677CC group vs. 5.4% in 677CT/TT; p = 0.019). Implantation rate, biochemical and clinical miscarriage rates, and ongoing pregnancy rate were compared between different embryo genotypes, and no statistically significant differences were found. In conclusion, the maternal MTHFR genotype did not influence embryo chromosomal abnormalities. Moreover, the embryo MTHFR genotype was not associated with embryo aneuploidy or IVF outcomes such as implantation, pregnancy loss, and ongoing pregnancy when euploid embryos were transferred.Abbreviations: MTHFR: methylenetetrahydrofolate reductase; IVF: in vitro fertilization; PGT-A: preimplantation genetic testing for aneuploidies; SAM: S-adenosyl methionine; SNP: single nucleotide polymorphism; SPSS: Statistical Package for Social Sciences; RIF: recurrent implantation failure; RPL: recurrent pregnancy loss; hCG: human chorionic gonadotropin; PBS: phosphate buffered saline; CGH: comparative genomic hybridization; NGS: next generation sequencing.
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Affiliation(s)
- Ruth Morales
- Molecular Biology, Instituto Bernabeu, Alicante, Spain
| | - Belén Lledó
- Molecular Biology, Instituto Bernabeu, Alicante, Spain
| | - José A Ortiz
- Molecular Biology, Instituto Bernabeu, Alicante, Spain
| | - Alba Cascales
- Molecular Biology, Instituto Bernabeu, Alicante, Spain
| | - Helena Codina
- Molecular Biology, Instituto Bernabeu, Alicante, Spain
| | | | - Joaquin Llácer
- Reproductive Medicine, Instituto Bernabeu, Alicante, Spain
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9
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Effect of polymorphisms of MTHFR in controlled ovarian stimulation: a systematic review and meta-analysis. J Assist Reprod Genet 2021; 38:2237-2249. [PMID: 34032987 DOI: 10.1007/s10815-021-02236-8] [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: 04/14/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Although several studies have reported a potential impact of methylenetetrahydrofolate reductase (MTHFR) polymorphisms on controlled ovarian stimulation (COS), the results remain controversial. The aim of the systematic review and meta-analysis was to evaluate the effect of MTHFR polymorphism on COS outcomes. METHODS PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials databases were searched up to December 2, 2020. COS clinical outcomes based on gene polymorphisms were included. Two reviewers independently extracted the data. The primary outcome was the number of oocytes retrieved. The secondary outcomes were the number of metaphase II (MII) oocytes, stimulation duration, basal follicle-stimulating hormone (FSH) level, FSH dosage, positive pregnancy test, ongoing pregnancy rate, clinical pregnancy rate, miscarriage rate, and live birth rate. Meta-analysis was performed using a fixed-effect model or random-effect model with Review Man 5.3.5. Mean difference (MD) with 95% confidence intervals (95%CIs) was calculated for continuous outcomes. The quality assessment of included studies was evaluated by using the Newcastle-Ottawa Scale. RESULTS Eleven studies were included in the systematic review, and seven studies with 2015 participants were included in the meta-analysis. Basal FSH level was significantly lower in CC homozygotes than TT homozygotes (four studies, 867 participants, MD - 0.54, 95%CI - 0.85 to - 0.23, P = 0.0006; I2 = 0%) of MTHFR (rs1801133). FSH dose was significantly fewer in CC homozygotes compared with CT heterogeneous (three studies, 949 participants, MD - 75.78, 95%CI - 135.23 to - 16.33, P = 0.01; I2 = 32%) or CT/TT model (three studies, 1097 participants, MD - 80.18, 95%CI - 135.54 to - 24.81, P = 0.005; I2 = 42%). Differences in the oocytes retrieved and stimulation duration were insignificant. Gene variants on MTHFR (rs1801133) and MTHFR (rs1801131) were reported in ongoing pregnancy rate, clinical pregnancy rate, and live birth rate. CONCLUSION Studies to date indicate that polymorphisms of MTHFR could influence basal FSH level and FSH dose. The results could be useful to promote clinical practice on COS protocols. Further studies are needed to evaluate the clinical relevance of the multigene combination on COS.
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Abstract
Alongside an interplay of a multitude of factors, attainment of a favorable pregnancy outcome is predicated on successful implantation, which in itself is a complex process anchored by balanced interchange with the hemostatic system. Among other etiologies, failure of implantation can result in infertility, and lead affected couples to consider assisted reproductive technology (ART) in an effort to fulfill their desire for procreation. Given the critical role of the hemostatic system in the process of implantation, documentation of a hypercoagulable state during controlled ovarian stimulation in the context of in vitro fertilization, as well as the potential association of its derangement in the setting of thrombophilia, with infertility, ART, ovarian hyperstimulation syndrome, and failure of implantation are explored. Additionally, current evidence addressing the relationship between ART and thromboembolism is examined, as is the role of therapy with heparin and aspirin to decrease thrombotic risk and improve ART-related pregnancy outcomes. Evidence-based recommendations from relevant professional societies are summarized.
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Affiliation(s)
- Ann Kinga Malinowski
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Canada
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11
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Interaction of thrombophilic SNPs in patients with unexplained infertility-multifactor dimensionality reduction (MDR) model analysis. J Assist Reprod Genet 2020; 37:1449-1458. [PMID: 32399796 PMCID: PMC7311584 DOI: 10.1007/s10815-020-01808-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/01/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Our aim was to evaluate the frequency and SNP-SNP interactions between factor V Leiden (FVL) G1691A, prothrombin G20210A mutation, and C677T MTHFR and PAI-1 4G/5G gene polymorphisms in female IVF patients with unexplained infertility (UI) by using a multifactor dimensionality reduction (MDR) model analysis. METHODS A total of 225 subjects were enrolled in the study. There were 105 females in UI group and 120 healthy controls. Designated SNPs were determined by using allele-specific PCR methods. The difference in thrombophilia prevalence was assessed by a chi-square test and logistic regression analysis. Four-locus SNP interaction model was tested using the MDR approach. A ten-fold cross-validation consistency (CVC) and permutation testing were performed. RESULTS There was a significant difference of MTHFR C677T polymorphism frequency between the groups. Significantly less UI patients had MTHFR CC genotype (p = 0.005), while the risk allele T was more frequent (OR = 1.83, p = 0.0018). Logistic regression determined a significant association only for MTHFR C677T in our patients (TT genotype OR = 2.99). The MDR analysis confirmed the significance of a single-locus model for MTHFR C677T polymorphism (p = 0.015; OR = 2.93). However, the best, significant predictive model was the two-locus model comprising MTHFR C677T and FVL (CVC = 10/10, testing accuracy = 60.95%, p = 0.013; OR = 3.02). CONCLUSION The MTHFR C677T polymorphism was significantly associated with UI, with minor allele T being more frequent. Additionally, there was a significantly increased presence of MTHFR C677T with FVL mutation in these patients. Therefore, MTHFR and its interaction with FVL should be recognized as contributing factors in the pathogenesis of infertility.
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12
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Allam MM, El‐Zawawy HT, Barakat SS, Ahmed SM, Saleh RNM. A hidden cause of infertility in hypothyroid patients. Clin Case Rep 2020; 8:374-378. [PMID: 32128192 PMCID: PMC7044389 DOI: 10.1002/ccr3.2654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/04/2019] [Accepted: 12/14/2019] [Indexed: 12/18/2022] Open
Abstract
Methylene tetrahydrofolate reductase (MTHFR) gene mutations could be the cause of infertility in hypothyroid patients. Hence, it is worthy to screen for MTHFR gene mutations in infertile hypothyroid females and their partners if infertility persists after optimizing thyroid function.
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Affiliation(s)
- Magdy Mohamed Allam
- Internal Medicine Department, Endocrinology UnitAlexandria University Student Hospital (AUSH)AlexandriaEgypt
| | | | - Sherine Samir Barakat
- Internal Medicine DepartmentHaematology UnitAlexandria University Student Hospital (AUSH)AlexandriaEgypt
| | - Soha Magdy Ahmed
- Internal Medicine Department, Endocrinology UnitAlexandria University Student Hospital (AUSH)AlexandriaEgypt
| | - Rasha Noureldin M. Saleh
- Clinical Pathology DepartmentFaculty of MedicineAlexandria UniversityAlexandriaEgypt
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
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13
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Xia JY, Tian W, Yin GH, Yan H. Association of Rs13405728, Rs12478601, and Rs2479106 single nucleotide polymorphisms and in vitro fertilization and embryo transfer efficacy in patients with polycystic ovarian syndrome: A case control genome-wide association study. Kaohsiung J Med Sci 2019; 35:49-55. [PMID: 30844144 DOI: 10.1002/kjm2.12008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 11/22/2018] [Indexed: 12/21/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common female endocrine disorder that has a detriment impact on female health. Herein, the study used a case-control analysis to sought to explore the association of rs13405728, rs12478601, and rs2479106 single nucleotide polymorphisms (SNPs) with in vitro fertilization and embryo transfer (IVF-ET) efficacy in treating PCOS. A total of 163 PCOS patients (52 cycles) were selected as the PCOS group and 171 patients with tubal factor infertility without PCOS (68 cycles) were selected as the control group. Polymerase chain reaction was used to amplify genome DNA and direct sequencing to detect SNPs. The LHCGR rs13405728, THADA rs12478601, and DENND1A rs2479106 genotypes were subsequently tested. Logistic regression analysis was conducted to analyze the risk factors influencing the occurrence of PCOS as well as those influencing the efficacy of IVF-ET. rs13405728, rs12478601, and family history of DM were influencing factors for the occurrence of PCOS. The rate of abortion and number of oocytes retrieved of patients with the THADA rs12478601 CC genotype increased but the rate of clinical gestation decreased. Patients with AG + GG genotype of the DENND1A rs2479106 had increased number of oocytes retrieved, rate of abortion and incidence of gestational DM. rs13405728, rs12478601, serum E2 value as well as fertility rate were influencing factors for efficacy of IVF-ET. It was suggested that the TT genotype of LHCGR rs13405728, CC genotype of THADA rs12478601 and AG + GG genotype of DENND1A rs2479106 had poor outcomes of IVF-ET in treating PCOS.
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Affiliation(s)
- Jia-Yu Xia
- Department of Gynaecology and Obstetrics, Linyi Central Hospital, Linyi, P. R. China
| | - Wei Tian
- Statistical Analysis Centre, Linyi Central Hospital, Linyi, P. R. China
| | - Gui-Hua Yin
- ICU, Linyi Central Hospital, Linyi, P. R. China
| | - Hua Yan
- Department of Gynaecology and Obstetrics, Linyi Central Hospital, Linyi, P. R. China
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14
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Di Nisio M, Ponzano A, Tiboni GM, Guglielmi MD, Rutjes AWS, Porreca E. Effects of multiple inherited and acquired thrombophilia on outcomes of in-vitro fertilization. Thromb Res 2018; 167:26-31. [PMID: 29772490 DOI: 10.1016/j.thromres.2018.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/24/2018] [Accepted: 05/06/2018] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The effects of multiple inherited and acquired thrombophilic defects on the outcome of in-vitro fertilization (IVF) remain unexplored. The aim of this study was to evaluate the association between multiple thrombophilia and clinical outcomes in a large prospective cohort of women undergoing IVF. MATERIALS AND METHODS Consecutive women scheduled for IVF were eligible. The primary study outcome was live birth. Secondary outcomes included spontaneous abortion, clinical pregnancy, and symptomatic venous thromboembolism. RESULTS 687 women with a mean age of 34.6 (±3.2) years were included. Overall, 22 women (3.2%) had two or more thrombophilic defects. The probability of live birth was not statistically significantly different between women with ≥2 thrombophilia (odds ratio [OR] 0.62; 95% confidence interval [CI], 0.18 to 2.11) or ≥1 thrombophilia (OR 0.67;95% CI, 0.41 to 1.09) and women without any thrombophilia. None of the individual inherited thrombophilia nor positivity to antiphospholipid antibodies or lupus anticoagulant were associated with live birth. Single positivity for lupus anticoagulant carried a more than threefold higher risk of abortion (OR 3.74; 95% CI, 1.30 to 10.75). There were no statistically significant associations between individual or multiple thrombophilic defects and clinical pregnancy or pregnancy test results. No woman had a history of venous thromboembolism and none developed a thrombotic event during the study. CONCLUSIONS In women undergoing IVF, the presence of two or more thrombophilic defects was rare and showed no statistically significant associations with IVF outcomes.
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Affiliation(s)
- Marcello Di Nisio
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands; Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy.
| | - Adalisa Ponzano
- Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy; Unit of Assisted Reproductive Technology, Ortona General Hospital, Ortona, Chieti, Italy
| | - Gian Mario Tiboni
- Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy; Unit of Assisted Reproductive Technology, Ortona General Hospital, Ortona, Chieti, Italy.
| | | | - Anne Wilhelmina Saskia Rutjes
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
| | - Ettore Porreca
- Department of Medical, Oral and Biotechnological Sciences, Gabriele D'Annunzio University, Chieti, Italy.
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15
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Franasiak JM, Scott RT. Contribution of immunology to implantation failure of euploid embryos. Fertil Steril 2017; 107:1279-1283. [DOI: 10.1016/j.fertnstert.2017.04.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 11/28/2022]
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16
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Vlachadis N, Tsamadias V, Vrachnis N, Kaparos G, Vitoratos N, Kouskouni E, Economou E. Associations of combined polymorphisms of the platelet membrane glycoproteins Ia and IIIa and the platelet-endothelial cell adhesion molecule-1 and P-Selectin genes with IVF implantation failures. J OBSTET GYNAECOL 2017; 37:363-369. [PMID: 28388872 DOI: 10.1080/01443615.2016.1256978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The aim of the study was to investigate the combined impact of the genetic heterogeneity of the glycoproteins Ia (GpIa) and IIIa (GpIIIa) and the platelet-endothelial cell adhesion molecule-1 (PECAM-1) and P-Selectin genes on IVF embryo transfer implantation failures (IVF-ET failures). Sixty nulligravida women with previous IVF-ET failures and 60 fertile controls were genotyped for the GpIa-C807T, GpIIIa-PlA1/PA2, PECAM-1-C373G (Leu125Val) and P-Selectin-A37674C (Thr715Pro) polymorphisms by pyrosequencing. Compared with wild-type combined homozygotes, carriers of combinations of risk alleles in two gene loci were at significantly increased risk for IVF-ET failure, whereas carriers of the combination of GpIa-807T, GpIIIa-PlA2 and PECAM-1-373G alleles had OR = 52.50 (95%CI: 4.05-680.95, p < .001). The area under the receiver-operating characteristic curve (AUC) based on the number of polymorphisms and the number of risk alleles per subject was 75.4% (95%CI: 66.7%-82.8%, p < .001) and 72.5% (95%CI: 63.6%-80.3%, p < .001), respectively. The OR per polymorphism and risk allele increase was 4.26 (95%CI: 2.15-8.41, p < .001) and 2.85 (95%CI: 1.71-4.76, p < .001), respectively. The above associations were more robust among younger women. The combined analysis of these polymorphisms revealed strong association of combined carriers with IVF-ET failures especially for younger women and provided a genetic risk score with good diagnostic accuracy in the prediction of IVF-ET failures.
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Affiliation(s)
- Nikolaos Vlachadis
- a Clinical Laboratory of Therapeutic Individualization, Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Vasileios Tsamadias
- a Clinical Laboratory of Therapeutic Individualization, Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Nikolaos Vrachnis
- b Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Georgios Kaparos
- c Department of Microbiology and Biochemistry , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Nikolaos Vitoratos
- b Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Evaggelia Kouskouni
- a Clinical Laboratory of Therapeutic Individualization, Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece.,c Department of Microbiology and Biochemistry , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Emmanuel Economou
- a Clinical Laboratory of Therapeutic Individualization, Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
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Tan X, Yu Z, Sao J, Chen L, Shen Y, Ding J, Shi W. Association between in vitro fertilization outcomes and inherited thrombophilias: a meta-analysis. J Assist Reprod Genet 2016; 33:1093-8. [PMID: 27216921 DOI: 10.1007/s10815-016-0726-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/28/2016] [Indexed: 01/07/2023] Open
Abstract
PURPOSE The aim of this study was to determine whether in vitro fertilization (IVF) outcomes are associated with inherited thrombophilias. METHODS Several databases including PubMed, Embase, and Cochrane Library were retrieved up to 12 January 2016. The quality of the included studies was assessed by two authors. The associations of the following mutations in inherited thrombophilias and IVF outcomes were explored: factor V Leiden (FVL), prothrombin gene G20210A mutation (PGM), 5,10-methylentetrahydrofolate reductase (MTHFR) C677T, MTHFR (A1298C) and activated protein C resistance (APCR). The main outcome measures included CPR and implantation rate (IR). The relative risk (RR) and its 95 % confidence interval (CI) were calculated for effect index. Heterogeneity test was evaluated by Chi-square based on Q statistic and I (2) statistics. RESULTS A total of seven articles published between 2007 and 2015 with the ages of subjects between 30.9 and 36.2 were included. For subgroups analysis of CPR or IR, there were no significant differences in MTHFR (C377T), MTHFR (A1298C), FVL, PGM, and FVL/PGM mutation were found between the mutation group and control group (P > 0. 05). CONCLUSIONS IVF outcomes are not associated with FVL, PGM, MTHFR (C677T), MTHFR (A1298C), and APCR mutation in inherited thrombophilias.
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Affiliation(s)
- Xiaofang Tan
- Maternal and child health care hospital of Nantong City, No. 399 Century Avenue, Nantong, 226006, China
| | - Zhenbo Yu
- First Maternity and Infant Hospital of Shanghai City, Pudong, China
| | - Jun Sao
- Maternal and child health care hospital of Nantong City, No. 399 Century Avenue, Nantong, 226006, China
| | - Li Chen
- Maternal and child health care hospital of Nantong City, No. 399 Century Avenue, Nantong, 226006, China
| | - Ya Shen
- Maternal and child health care hospital of Nantong City, No. 399 Century Avenue, Nantong, 226006, China
| | - Jiayi Ding
- Maternal and child health care hospital of Nantong City, No. 399 Century Avenue, Nantong, 226006, China
| | - Weihong Shi
- Maternal and child health care hospital of Nantong City, No. 399 Century Avenue, Nantong, 226006, China.
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The PlA2 variant of the platelet glycoprotein IIIa as a genetic risk factor for IVF implantation failure: accumulating evidence. J Assist Reprod Genet 2016; 33:967-8. [PMID: 27131499 DOI: 10.1007/s10815-016-0722-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022] Open
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