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Ji XW, Wang J, Wang L, Cao X, Ran XX, Dong X, Liu SY. Clinical efficacy of blastocyst culture supernatant transfer in hormone replacement freeze-thaw embryo transfer cycles: A prospective double-blind randomized controlled study. Transpl Immunol 2022; 72:101595. [DOI: 10.1016/j.trim.2022.101595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
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Siristatidis CS, Sertedaki E, Karageorgiou V, Vaidakis D. Endometrial injection of embryo culture supernatant for subfertile women in assisted reproduction. Cochrane Database Syst Rev 2020; 8:CD013063. [PMID: 32797689 PMCID: PMC8094452 DOI: 10.1002/14651858.cd013063.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite substantial improvements in the success of assisted reproduction techniques (ART), live birth rates may remain consistently low, and practitioners may look for innovative treatments to improve the outcomes. The injection of embryo culture supernatant in the endometrial cavity can be undertaken at various time intervals before embryo transfer. It provides an altered endometrial environment through the secretion of factors considered to facilitate implantation. It is proposed that injection of the supernatant into the endometrial cavity prior to embryo transfer will stimulate the endometrium and provide better conditions for implantation to take place. An increased implantation rate would subsequently increase rates of clinical pregnancy and live birth, but current robust evidence on the efficacy of injected embryo culture supernatant is lacking. OBJECTIVES To evaluate the effectiveness and safety of endometrial injection of embryo culture supernatant before embryo transfer in women undergoing ART. SEARCH METHODS Our search strategies were designed with the help of the Cochrane Gynaecology and Fertility Group Information Specialist. We sought to identify all published and unpublished randomised controlled trials (RCTs) meeting inclusion criteria. Searches were performed on 2 December 2019. We searched the Cochrane Gynaecology and Fertility Group Specialised Register of controlled trials, CENTRAL, MEDLINE, Embase, CINAHL, trials registries and grey literature. We made further searches in the UK National Institute for Health and Care Excellence (NICE) fertility assessment and treatment guidelines. We handsearched reference lists of relevant systematic reviews and RCTs, together with searches of PubMed and Google for any recent trials that have not yet been indexed in the major databases. We had no language or location restrictions. SELECTION CRITERIA We included RCTs testing the use of endometrial injection of embryo culture supernatant before embryo transfer during an ART cycle, compared with the non-use of this intervention, the use of placebo or the use of any other similar drug. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, assessed risk of bias, extracted data from studies and attempted to contact the authors where data were missing. We pooled studies using a fixed-effect model. Our primary outcomes were live birth/ongoing pregnancy and miscarriage. We performed statistical analysis using Review Manager 5. We assessed evidence quality using GRADE methods. MAIN RESULTS We found five RCTs suitable for inclusion in the review (526 women analysed). We made two comparisons: embryo culture supernatant use versus standard care or no intervention; and embryo culture supernatant use versus culture medium. All studies were published as full-text articles. Data derived from the reports or through direct communication with investigators were available for the final meta-analysis performed. The GRADE evidence quality of studies ranged from very low-quality to moderate-quality. Factors reducing evidence quality included high risk of bias due to lack of blinding, unclear risk of publication bias and selective outcome reporting, serious inconsistency among study outcomes, and serious imprecision due to wide confidence intervals (CIs) and low numbers of events. Comparison 1. Endometrial injection of embryo culture supernatant before embryo transfer versus standard care or no intervention: One study reported live birth only and two reported the composite outcome live birth and ongoing pregnancy. We are uncertain whether endometrial injection of embryo culture supernatant before embryo transfer during an ART cycle improves live birth/ongoing pregnancy rates compared to no intervention (odds ratio (OR) 1.11, 95% CI 0.73 to 1.70; 3 RCTs; n = 340, I2 = 84%; very low-quality evidence). Results suggest that if the chance of live birth/ongoing pregnancy following placebo or no treatment is assumed to be 42%, the chance following the endometrial injection of embryo culture supernatant before embryo transfer would vary between 22% and 81%. We are also uncertain whether the endometrial injection of embryo culture supernatant could decrease miscarriage rates, compared to no intervention (OR 0.89, 95% CI 0.44 to 1.78, 4 RCTs, n = 430, I2 = 58%, very low-quality evidence). Results suggest that if the chance of miscarriage following placebo or no treatment is assumed to be 9%, the chance following injection of embryo culture supernatant would vary between 3% and 30%. Concerning the secondary outcomes, we are uncertain whether the injection of embryo culture supernatant prior to embryo transfer could increase clinical pregnancy rates (OR 1.13, 95% CI 0.80 to 1.61; 5 RCTs; n = 526, I2 = 0%; very low-quality evidence), decrease ectopic pregnancy rates (OR 0.32, 95% CI 0.01 to 8.24; n = 250; 2 RCTs; I2 = 41%; very low-quality evidence), decrease multiple pregnancy rates (OR 0.70, 95% CI 0.26 to 1.83; 2 RCTs; n = 150; I2 = 63%; very low-quality evidence), or decrease preterm delivery rates (OR 0.63, 95% CI 0.17 to 2.42; 1 RCT; n = 90; I2 = 0%; very low-quality evidence), compared to no intervention. Finally, there may have been little or no difference in foetal abnormality rates between the two groups (OR 3.10, 95% CI 0.12 to 79.23; 1 RCT; n = 60; I2 = 0%; low-quality evidence). Comparison 2. Endometrial injection of embryo culture supernatant versus endometrial injection of culture medium before embryo transfer We are uncertain whether the use of embryo culture supernatant improves clinical pregnancy rates, compared to the use of culture medium (OR 1.09, 95% CI 0.48 to 2.46; n = 96; 1 RCT; very low-quality evidence). No study reported live birth/ongoing pregnancy, miscarriage, ectopic or multiple pregnancy, preterm delivery or foetal abnormalities. AUTHORS' CONCLUSIONS We are uncertain whether the addition of endometrial injection of embryo culture supernatant before embryo transfer as a routine method for the treatment of women undergoing ART can improve pregnancy outcomes. This conclusion is based on current available data from five RCTs, with evidence quality ranging from very low to moderate across studies. Further large well-designed RCTs reporting on live births and adverse clinical outcomes are still required to clarify the exact role of endometrial injection of embryo culture supernatant before embryo transfer.
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Affiliation(s)
- Charalampos S Siristatidis
- Assisted Reproduction Unit, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Vasilios Karageorgiou
- Second Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dennis Vaidakis
- Obstetrics and Gynaecology Department, Larnaca General Hospital, Larnaca, Cyprus
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Kamath MS, Mascarenhas M, Kirubakaran R, Nair R, Kulkarni A. Use of embryo culture supernatant to improve clinical outcomes in assisted reproductive technology: a systematic review and meta-analysis. HUM FERTIL 2017; 21:90-97. [DOI: 10.1080/14647273.2017.1319078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Richard Kirubakaran
- Cochrane South Asia, Prof. BV Moses Center for Evidence-Informed Health Care and Health Policy, Christian Medical College, Vellore, India
| | - Raju Nair
- Department of Reproductive Medicine, Matha Hospital, Kottayam, India
| | - Abhijit Kulkarni
- Homerton Fertility Center, Homerton University Hospital, London, UK
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Inoue T, Yonezawa Y, Sugimoto H, Uemura M, Ono Y, Kishi J, Emi N, Ono Y. Percentage of motile spermatozoa at 22 hours after swim-up procedure: An indicator for intracytoplasmic sperm injection? Clin Exp Reprod Med 2016; 43:157-63. [PMID: 27689038 PMCID: PMC5039308 DOI: 10.5653/cerm.2016.43.3.157] [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: 05/05/2016] [Revised: 07/26/2016] [Accepted: 08/08/2016] [Indexed: 11/06/2022] Open
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
- Taketo Inoue
- Ono Ladies Clinic, Ono, Japan
- Department of Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | | | | | - Mikiko Uemura
- Department of Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Kamath MS, Mascarenhas M, B K, Vasani NN, Joshi A, K M, George K. Uterine flushing with supernatant embryo culture medium in vitrified warmed blastocyst transfer cycles: a randomized controlled trial. J Assist Reprod Genet 2014; 32:225-31. [PMID: 25428435 DOI: 10.1007/s10815-014-0385-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 11/03/2014] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Does transfer of supernatant embryo culture fluid (stimulation of endometrial embryo transfer - SEET) prior to vitrified warmed blastocyst transfer result in better clinical pregnancy and live birth rates than direct vitrified warmed blastocyst transfer? METHODS This randomized controlled trial compared SEET group and direct transfer group (control) in 60 women undergoing vitrified warmed blastocyst transfers. The duration of the study was 3 years. The patients were undergoing vitrified warmed blastocyst transfer at university level infertility centre. Sixty women were randomized to SEET (n = 30) or control (n = 30). RESULTS Data was available for analysis from all the 30 women in the SEET group and 30 women in the control group. There were no drop outs in the trial. The implantation rate was significantly lower in the SEET group compared to the control group (27 vs. 44 %, P = 0.018). The clinical pregnancy rates were similar in both the groups (47 vs. 53 %) but the live birth rate was also significantly lower in SEET group (23 vs. 50 %, P = 0.03). LIMITATIONS The sample size based on clinical pregnancy rates was small and hence not adequately powered to detect differences in live birth rates. Lack of blinding leading to possible bias cannot be ruled out. CONCLUSION There was no evidence of an improvement in clinical pregnancy rate following SEET in vitrified warmed blastocyst transfer compared to direct transfer.
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Affiliation(s)
- Mohan S Kamath
- Reproductive Medicine Unit, Christian Medical College Hospital, Vellore, Tamil Nadu, 632004, India
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Hashish NM, Badway HS, Abdelmoty HI, Mowafy A, Youssef MAFM. Does flushing the endometrial cavity with follicular fluid after oocyte retrieval affect pregnancy rates in subfertile women undergoing intracytoplasmic sperm injection? A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 2014; 176:153-7. [PMID: 24630572 DOI: 10.1016/j.ejogrb.2014.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 10/26/2013] [Accepted: 02/02/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Follicular fluid of mature oocytes is rich in growth factors and cytokines that may exert paracrine and autocrine effects on implantation. The aim of this study was to investigate if flushing the endometrial cavity with follicular fluid after oocyte retrieval improved pregnancy rates in subfertile women undergoing intracytoplasmic sperm injection (ICSI). STUDY DESIGN One hundred subfertile women undergoing ICSI between April 2012 and September 2012 at the centre for reproductive medicine, Cairo University, Egypt were enrolled in this open label, parallel randomized controlled study. Patients were randomized into two groups at the start of treatment using a computer-generated programme and sealed opaque envelopes: the follicular fluid group (n=50) and the control group (n=50). Inclusion criteria were: age 20-38 years; basal follicle-stimulating hormone <10mIU/ml; body mass index <35kg/m(2); and ostradiol >1000pg/ml and <4000pg/ml on the day of human chorionic gonadotrophin administration. Exclusion criteria were: evidence of endometriosis; uterine myoma; hydrosalpinges; endocrinological disorders; history of implantation failure in previous in-vitro fertilization/ICSI cycles; and severe male factor infertility. RESULTS Clinical pregnancy and implantation rates were higher in the follicular fluid group compared with the control group [354% (17/48) vs 319% (15/47); p=0718] and (18.6% vs 11.3%; p=0.153), respectively. However, the difference was not statistically significant. CONCLUSION Flushing the endometrial cavity with follicular fluid after oocyte retrieval neither improved nor adversely affected clinical pregnancy and implantation rates in subfertile women undergoing ICSI.
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Affiliation(s)
- N M Hashish
- Department of Obstetrics and Gynaecology, Assisted Reproduction Unit, Faculty of Medicine, Cairo University, Egypt
| | - H S Badway
- Department of Obstetrics and Gynaecology, Assisted Reproduction Unit, Faculty of Medicine, Cairo University, Egypt
| | - H I Abdelmoty
- Department of Obstetrics and Gynaecology, Assisted Reproduction Unit, Faculty of Medicine, Cairo University, Egypt
| | - A Mowafy
- Department of Obstetrics and Gynaecology, Assisted Reproduction Unit, Faculty of Medicine, Cairo University, Egypt
| | - M A F M Youssef
- Department of Obstetrics and Gynaecology, Assisted Reproduction Unit, Faculty of Medicine, Cairo University, Egypt; Egyptian International Fertility IVF-ET Centre, Cairo, Egypt.
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Baston-Büst DM, Schanz A, Böddeker SJ, Altergot-Ahmad O, Krüssel JS, Rein D, Hess AP. CXCL1 expression in human decidua in vitro is mediated via the MAPK signalling cascade. Cytokine 2013; 64:79-85. [DOI: 10.1016/j.cyto.2013.07.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 07/18/2013] [Accepted: 07/21/2013] [Indexed: 12/26/2022]
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Deng SR, Li J, Zhang ZQ, Li B, Sheng LL, Zeng JW, Liu YP, An SL, Wu YX. DS147 improves pregnancy in mice with embryo implantation dysfunction induced by controlled ovarian stimulation. ACTA ACUST UNITED AC 2013; 33:573-580. [PMID: 23904380 DOI: 10.1007/s11596-013-1161-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/04/2013] [Indexed: 12/27/2022]
Abstract
The study examined the effect of DS147, the bioactive component of the traditional herbal recipe Bangdeyun, on pregnancy in mice with embryo implantation dysfunction induced by controlled ovarian stimulation (COS), and the underlying mechanisms. Female mice were superovulated by intraperitoneal injection of 7.5 IU of pregnant mare serum gonadotropin (PMSG) followed by an additional injection of 7.5 IU hCG 48 h later to establish embryo implantation dysfunction (EID) model. Pregnant mice were randomly divided into normal control group, COS group and DS147-treated groups. The pregnancy rate and the average implantation site were obtained on pregnancy day 8 (PD8). The side effect of 200 mg/kg of DS147 on naturally pregnant mice was also observed. Further, the uterine and ovarian tissue samples were collected on PD5 for measuring their weights, observing the development of the endometrium and ovary, and detecting the endometrial expression of MMP-2, TIMP-2, CD34 and angiogenin (ANG). The female mice treated with DS147 at doses of 100 to 800 mg/kg showed a higher pregnancy rate than those in COS group, and the highest pregnancy rate of 83.3% occurred in the 200 mg/kg DS147-treated group. Moreover, no obvious side effect was found in mice treated with 200 mg/kg DS147 on PD8 and PD16. The ovarian and uterine weights, and the expression levels of MMP-2, ANG and CD34 were significantly increased in DS147-treated groups when compared with COS group. The TIMP-2 expression level was much lower in DS147-treated mice than in COS mice and the ratio of MMP-2/TIMP-2 was much higher in DS147-treated group than in COS group, and even higher than normal control group. In all, these findings suggest that DS147 may improve pregnancy in mice with COS-induced EID by promoting matrix degradation and angiogenesis, and improving the development of corpus luteum and endometrial decidualization around the implantation window.
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Affiliation(s)
- Shao-Rong Deng
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resources Evaluation, Department of Traditional Chinese Herbs, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jing Li
- Department of Pathology, Hubei General Hospital of Chinese People's Armed Police Forces, Wuhan, 430060, China
| | - Zhi-Qiang Zhang
- Department of Pathology, Hubei General Hospital of Chinese People's Armed Police Forces, Wuhan, 430060, China
| | - Bing Li
- Department of Pathology, Hubei General Hospital of Chinese People's Armed Police Forces, Wuhan, 430060, China
| | - Li-Li Sheng
- Department of Pathology, Hubei General Hospital of Chinese People's Armed Police Forces, Wuhan, 430060, China
| | - Jian-Wu Zeng
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resources Evaluation, Department of Traditional Chinese Herbs, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ya-Ping Liu
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resources Evaluation, Department of Traditional Chinese Herbs, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Song-Lin An
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resources Evaluation, Department of Traditional Chinese Herbs, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yun-Xia Wu
- Hubei Key Laboratory of Natural Medicinal Chemistry and Resources Evaluation, Department of Traditional Chinese Herbs, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Yoshii N, Hamatani T, Inagaki N, Hosaka T, Inoue O, Yamada M, Machiya R, Yoshimura Y, Odawara Y. Successful implantation after reducing matrix metalloproteinase activity in the uterine cavity. Reprod Biol Endocrinol 2013; 11:37. [PMID: 23663265 PMCID: PMC3655829 DOI: 10.1186/1477-7827-11-37] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 05/06/2013] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Recently, the concept of recurrent implantation failure (RIF) in assisted reproductive technology has been enlarged. Chronic uterine inflammation is a known cause of implantation failure and is associated with high matrix metalloproteinase (MMP) activity in uterine cavity flushing. MMP activity of women with RIF has been reported to be higher than that of fertile women. In the present retrospective study we evaluated the efficacy of treatment for high MMP activity in the uterine cavity of patients with RIF. METHODS Of the 597 patients recruited to the study, 360 patients underwent MMP measurements and 237 patients did not (control group). All patients had failed to become pregnant, despite at least two transfers of good-quality embryos. Gelatinase MMP-2 and MMP-9 activity in uterine flushing fluid was detected by enzymology (MMP test). All samples were classified into two groups (positive or negative) based on the intensity of the bands on the enzyme zymogram, which represents the degree of MMP activity. Patients who tested positive on the initial test were treated for 2 weeks with a quinolone antibiotic and a corticosteroid, and subsequently underwent a second MMP test. Negative results on the second MMP tests after treatment and subsequent rates of pregnancy and miscarriage were used to evaluate the efficacy of treatment. Data were analyzed by the Mann-Whitney U-test and the chi-square test. RESULTS Of the patients who underwent the MMP test, 15.6% had positive results (high MMP activity). After treatment, 89.3% of patients had negative results on the second MMP test. These patients had a significantly better pregnancy rate (42.0%) than the control group (26.6%), as well as a lower miscarriage rate (28.5% vs 36.5%, respectively). CONCLUSIONS A 2-week course of antibiotics and corticosteroids effectively improves the uterine environment underlying RIF by reducing MMP activity.
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Affiliation(s)
- Noriko Yoshii
- Fertility Clinic Tokyo, 2-11-16 Ebisu-Nishi Shibuya-ku, Tokyo 150-0021, Japan
| | - Toshio Hamatani
- Fertility Clinic Tokyo, 2-11-16 Ebisu-Nishi Shibuya-ku, Tokyo 150-0021, Japan
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Noboru Inagaki
- Saint Women’s Clinic, 9–1 Higashi-Takasagocho, Urawa-ku, Saitama 330-0055, Japan
| | - Takeshi Hosaka
- Fertility Clinic Tokyo, 2-11-16 Ebisu-Nishi Shibuya-ku, Tokyo 150-0021, Japan
| | - Osamu Inoue
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Mitsutoshi Yamada
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Rei Machiya
- Fertility Clinic Tokyo, 2-11-16 Ebisu-Nishi Shibuya-ku, Tokyo 150-0021, Japan
| | - Yasunori Yoshimura
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yasushi Odawara
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan
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Tehraninejad ES, Tanha FD, Ghajarzadeh M, Zandieh Z, Aziminekoo E, Zanjani HR. Stimulation of the endometrium with high-grade blastocyst culture supernatant (SEHB) can improve pregnancy outcome for couples undergoing intracytoplasmic sperm injection (ICSI): a randomized clinical trial. Arch Gynecol Obstet 2011; 285:1167-71. [PMID: 22101499 DOI: 10.1007/s00404-011-2143-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2011] [Accepted: 11/07/2011] [Indexed: 01/01/2023]
Abstract
PURPOSE To evaluate the impact of stimulating the endometrium with high-grade blastocyst culture supernatant (SEHB) perfusion before blastocyst transfer (BT) on implantation rate, pregnancy rate, and pregnancy outcome in ICSI cycles. MATERIALS AND METHODS Ninety-four infertile couples who were referred to the Valiasr department of Imam Hospital complex between January 2010 and March 2011 enrolled in this randomized clinical trial. They were randomly divided into only BT or SEHB groups. Implantation rates, pregnancy rates, abortion, preterm and term delivery rates were compared between the two groups. RESULTS Implantation rates and pregnancy rates did not differ significantly between the two groups. The abortion rate was significantly higher in the BT only group while term delivery was significantly higher in SEHB group. Odds ratios of term delivery and abortion were 4.5 (p = 0.001) and 0.3 (p = 0.04), respectively. CONCLUSION The SEHB application may improve pregnancy outcome in infertile couples who are candidates for the ICSI reproductive method.
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Affiliation(s)
- Ensieh Shahrokhe Tehraninejad
- Department of Endocrinology and Female Infertility, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Okitsu O, Kiyokawa M, Oda T, Miyake K, Sato Y, Fujiwara H. Intrauterine administration of autologous peripheral blood mononuclear cells increases clinical pregnancy rates in frozen/thawed embryo transfer cycles of patients with repeated implantation failure. J Reprod Immunol 2011; 92:82-7. [PMID: 22035703 DOI: 10.1016/j.jri.2011.07.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 07/18/2011] [Accepted: 07/29/2011] [Indexed: 11/17/2022]
Abstract
Intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) activated by HCG in vitro are reported to improve implantation rates in patients with repeated failure of IVF-ET. In this study, we examined the effects of intrauterine administration of freshly isolated PBMC on clinical pregnancy and the implantation rates of patients who received frozen/thawed embryo transfer by prospective cohort study. Patients who had not achieved a successful pregnancy despite at least one or more IVF-ET sessions were enrolled in this study (n = 253, 253 cycles). Based on the patient's treatment preferences, PBMC were freshly isolated from each patient and then administered to the intrauterine cavity of that patient. Frozen/thawed embryo transfer was performed and the success of implantation in the PBMC-treated group (n = 83, 83 cycles) was compared with that in the non-treated control groups (n = 170, 170 cycles). There were no significant differences in the clinical pregnancy rate (34.9% vs. 32.9%), implantation rate (21.6% vs. 21.1%) and live birth delivery rate (21.7% vs. 21.8%) between PBMC-treated and non-treated groups. However, when the analyses were restricted to patients who had three or more implantation failures, the clinical pregnancy rate and the implantation rate in the PBMC-treated group (42.1% and 25.0%, p<0.05; n = 19 and 32, respectively) were significantly higher than those in the non-treated group (16.7% and 9.4%, p<0.05; n = 36 and 64, respectively). These findings indicate that intrauterine administration of autologous PBMC freshly isolated from patients, effectively improves embryo implantation in patients with three or more IVF failures.
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Affiliation(s)
- Osamu Okitsu
- Center for Reproductive Medicine, Miyake Clinic, 369-8 Ofuku, Minami-ku, Okayama 701-0204, Japan.
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Hur YS, Park JH, Ryu EK, Yoon HJ, Yoon SH, Hur CY, Lee WD, Lim JH. Effect of artificial shrinkage on clinical outcome in fresh blastocyst transfer cycles. Clin Exp Reprod Med 2011; 38:87-92. [PMID: 22384424 PMCID: PMC3283060 DOI: 10.5653/cerm.2011.38.2.87] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 06/01/2011] [Accepted: 06/08/2011] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to determine the safety and clinical effect of artificial shrinkage (AS) in terms of assisted hatching of fresh blastocysts. Also, we evaluated the correlation between patient age and the effect of AS on clinical outcome. METHODS Two AS methods, using a 29-gauge needle and laser pulse, were compared. Seventy-three blastocysts were shrunk using a 29-gauge needle and the same number of other blastocysts were shrunk by a laser pulse. We evaluated the shrunken blastocysts hourly and considered them viable if they re-expanded >70%. Blastocyst transfer cycles (n=134) were divided into two groups: a control group consisted of the cycles whose intact embryos were transferred (n=100), while the AS group consisted of the cycles whose embryos were replaced following AS (n=34). The implantation and pregnancy rates of the control group and AS group were compared (p<0.05). RESULTS The re-expansion rates of the 29-gauge needle and laser pulse AS groups were similar (56 [76.7%] vs. 62 [84.9%], respectively). All of the remaining shrunken blastocysts were re-expanded within 2 hours. There was no degeneration of shrunken blastocysts. The total and clinical pregnancy rate of the AS group (23 [67.6%]; 20 [58.8%], respectively) was significantly higher than that of the control group (47 [47.0%]; 39 [39.0%], respectively). In the older patient group, there was no difference in the clinical outcomes between the AS and control groups. CONCLUSION These results suggest that AS of blastocoele cavity, followed by the transfer, would be a useful approach to improve the clinical outcome in cycles in which fresh blastocyst stage embryos are transferred.
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Affiliation(s)
- Yong Soo Hur
- Maria Fertility Hospital, Seoul, Korea
- Department of Anatomy, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jeong Hyun Park
- Department of Anatomy, Kangwon National University School of Medicine, Chuncheon, Korea
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