1
|
Liu Z, Liu X, Li F, Sun Y, Yu L, Zhang W, Zhu P, Ma D, Wang X, Lai S, Bao H. Overexpression of hypoxia-inducible factor 1α and excessive vascularization in the peri-implantation endometrium of infertile women with chronic endometritis. Front Endocrinol (Lausanne) 2022; 13:1001437. [PMID: 36531509 PMCID: PMC9751377 DOI: 10.3389/fendo.2022.1001437] [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: 07/23/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Chronic endometritis (CE) contributes to impaired endometrial receptivity and is closely associated with poor in vitro fertilization (IVF) outcomes. However, the mechanisms underlying CE are unclear. Here, we investigated the role of the hypoxic microenvironment and endometrial vascularization in the peri-implantation endometrium of infertile women with CE. METHODS This retrospective study involved 15 fertile women and 77 infertile patients diagnosed with CE based on CD138+ ≥1/10 high-power fields (HPFs). The CE patients were divided into Group 1 (CD138+ 1-4/10 HPFs, 53 cases) and Group 2 (CD138+ ≥5/10 HPFs, 24 cases). The expression levels of hypoxia-inducible factor 1α (HIF1α), vascular endothelial growth factor A (VEGFA), and vascular endothelial growth factor receptor 2 (VEGFR2) in peri-implantation endometrium were assessed by qRT-PCR and western blot analyses. Spatial levels of HIF1α, VEGFA, and VEGFR2 in various endometrial compartments was determined using immunohistochemistry and H-score analysis. Microvascular density (MVD) was determined using CD34 staining and scored using Image J. Finally, we used qRT-PCR to assess changes in the expression of HIF1α, VEGFA, and VEGFR2 in CE patients after treatment with first-line antibiotics. RESULTS Relative to Group 1 and control group, during the implantation window, protein and mRNA levels of HIF1α, VEGFA, and VEGFR2 were markedly high in Group 2 (P<0.05). H-score analysis showed that HIF1α, VEGFA, and VEGFR2 in the luminal, glandular epithelium, and stromal compartments were markedly elevated in Group 2, comparing to control group and Group 1 (P<0.05). Moreover, markedly elevated MVD levels were observed in Group 2. Notably, the above indexes did not differ significantly in the control group versus Group 1. Treatment with antibiotics significantly suppressed the endometrial HIF1α and VEGFA levels in CE-cured patients. CONCLUSIONS Here, we for the first time report the upregulation of HIF1α, VEGFA, and VEGFR2, as well as excessive endometrial vascularization in the peri-implantation endometrium of CE patients. Our findings offer new insights into reduced endometrial receptivity in CE-associated infertility.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Shoucui Lai
- *Correspondence: Shoucui Lai, ; Hongchu Bao,
| | - Hongchu Bao
- *Correspondence: Shoucui Lai, ; Hongchu Bao,
| |
Collapse
|
2
|
Yang W, Wu Z, Yu M, Peng X, Lu W, Feng W, Kang X. Characteristics of midluteal phase uterine artery hemodynamics in patients with recurrent pregnancy loss. J Obstet Gynaecol Res 2019; 45:1230-1235. [PMID: 30977230 DOI: 10.1111/jog.13944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 02/02/2019] [Indexed: 11/30/2022]
Abstract
AIM To study the association in resistance to uterine artery blood flow and recurrent pregnancy loss (RPL) and find its potential influencing factors. METHODS A retrospective study was conducted in 870 RPL and 237 non-RPL patients visiting to the Clinic from January 2014 to February 2018. All participants underwent comprehensive examinations and were scanned by transvaginal Doppler ultrasonography during the midluteal phase to measure the pulsatility index (PI), resistance index (RI) and systolic/diastolic ratio (S/D) values of the left and right main uterine arteries. P value less than 0.05 was considered statistically significant. RESULTS The mean PI, RI and S/D values for uterine arteries were significantly higher in RPL patients than in non-RPL patients (P < 0.001). When subjects were grouped according to the different etiologies of RPL, significant higher indices of uterine arteries were found in RPL patients with antiphospholipid syndrome (P < 0.001), autoimmune diseases (P < 0.001), endocrinological abnormalities (P < 0.05), thrombophilia (P < 0.001), uterine anomalies (P < 0.01) and unexplained RPL (P < 0.001). No differences were found between patients with chromosomal anomalies and uterine arteries blood flow (P > 0.05). In RPL patients, mean PI, mean RI and mean S/D values shows no difference among groups (P > 0.05). The Similar results were observed in age and number of spontaneous abortion (P > 0.05). CONCLUSION Impaired uterine artery blood perfusion may be an underlying pathology to RPL, and it can be used as an independent risk factor for pregnancy failure.
Collapse
Affiliation(s)
- Wen Yang
- Department of Gynecology, The People's Hospital of Lianyungang, Lianyungang, China
| | - Ze Wu
- Department of Reproductive Medical Center, The First People's Hospital of Yunnan Province, Kunming, China
| | - Ming Yu
- Department of Gynecology, The People's Hospital of Lianyungang, Lianyungang, China
| | - Xuenan Peng
- School of Medicine, Suzhou University, Suzhou, China
| | - Wei Lu
- Department of Gynecology, The People's Hospital of Lianyungang, Lianyungang, China
| | - Wen Feng
- Department of Gynecology, The People's Hospital of Lianyungang, Lianyungang, China
| | - Xiaomin Kang
- Department of Reproductive Medical Center, The First People's Hospital of Yunnan Province, Kunming, China
| |
Collapse
|
3
|
Kim SG, Paek MY, Ko I. Peripheral blood level of natural killer cells in pregnant women with recurrent spontaneous abortion during the 6–12 weeks gestation. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2019. [DOI: 10.4103/amhs.amhs_23_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
4
|
Santos TDS, Ieque AL, de Carvalho HC, Sell AM, Lonardoni MVC, Demarchi IG, de Lima Neto QA, Teixeira JJV. Antiphospholipid syndrome and recurrent miscarriage: A systematic review and meta-analysis. J Reprod Immunol 2017; 123:78-87. [PMID: 28985591 DOI: 10.1016/j.jri.2017.09.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
Abstract
Antiphospholipid syndrome (APS) is an autoimmune condition that is associated with thrombosis and morbidity in pregnancy. The exact mechanisms by which these associations occur appear to be heterogeneous and are not yet well understood. The aim of this study was to identify and analyze publications in recent years to better understand the diagnosis and its contribution to monitoring APS among women with recurrent miscarriage (RM). This systematic review and meta-analysis was conducted using the PubMed and Web of Knowledge databases, with articles published between 2010 and 2014, according to the PRISMA statement. Of the 85 identified studies, nine were selected. Most of the studies reported an association between recurrent miscarriage and specific antiphospholipid antibodies, as anticardiolipin antibodies (aCL), lupus anticoagulant (LA), anti-β2-glycoprotein I antibodies (aβ2GPI) and antiphosphatidylserine (aPS), which showed a relationship with RM. The main result of the meta-analysis revealed association between antiphospholipid antibodies (aPLs) and/or APS compared to the patients with RM (OR: 0.279; 95% CI: 0.212-0.366) and APS cases compared to the patients with RM (OR: 0.083; 95% CI: 0.036-0.189). High heterogeneity among these studies (I2=100.0%, p <0.001) was observed. In addition, there was no significant publication bias across studies according to Begg's test (p=0.230), although Egger's test (p=0.037) suggests significant publication bias. The funnel plot was slightly asymmetrical. Systematic review and meta-analysis demonstrated a positive association between antiphospholipid antibodies and/or antiphospholipid syndrome in patients with recurrent miscarriage.
Collapse
Affiliation(s)
- Thaís da Silva Santos
- Postgraduate Program in Biosciences and Physiopathology, State University Maringa, 5790 Colombo Avenue, 87020-900, Maringa, Brazil
| | - Andressa Lorena Ieque
- Postgraduate Program in Health Sciences, State University Maringa, 5790 Colombo Avenue, 87020-900 Maringa, Brazil
| | - Hayalla Corrêa de Carvalho
- Postgraduate Program in Biosciences and Physiopathology, State University Maringa, 5790 Colombo Avenue, 87020-900, Maringa, Brazil
| | - Ana Maria Sell
- Department of Cell Biology and Genetics, Center of Biological Sciences, State University Maringa,5790 Colombo Avenue, 87020-900 Maringa, Brazil
| | | | - Izabel Galhardo Demarchi
- Department of Clinical Analyses and Biomedicine, State University Maringa, 5790 Colombo Avenue, 87020-900 Maringa, Brazil
| | - Quirino Alves de Lima Neto
- Department of Basic Health Sciences, State University Maringa,5790 Colombo Avenue, 87020-900 Maringa, Brazil
| | - Jorge Juarez Vieira Teixeira
- Postgraduate Program in Biosciences and Physiopathology, Department of Clinical Analyses and Biomedicine, State University Maringa, 5790 Colombo Avenue, 87020-900 Maringa, Brazil.
| |
Collapse
|
5
|
Chen X, Saravelos SH, Liu Y, Huang J, Wang CC, Li TC. Correlation between three-dimensional power Doppler and morphometric measurement of endometrial vascularity at the time of embryo implantation in women with unexplained recurrent miscarriage. J Mol Histol 2017; 48:235-242. [PMID: 28451773 DOI: 10.1007/s10735-017-9722-7] [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] [Received: 02/16/2017] [Accepted: 04/12/2017] [Indexed: 10/19/2022]
Abstract
Power Doppler in combination with three-dimensional (3D-PD) ultrasonography has been used as a noninvasive tool to evaluate the vascularity. However, it is unclear whether 3D-PD can accurately reflect endometrial vascularization and replace the invasive endometrial biopsy. This study aims to investigate the correlation between 3D-PD and micro vessel morphometric measurement of endometrial vascularity. Twenty-five women with unexplained recurrent miscarriage were recruited for 3D-PD and endometrial biopsy on precisely day LH + 7. Immunohistochemistry using vWF was employed to identify micro vessels in endometrial biopsy specimens followed by the use of morphometric technique to measure the mean vessel diameter and volume fractions. The vascularization index (VI), flow index (FI) and vascularization flow index (VFI) assessed by 3D-PD were calculated for both the endometrial and sub-endometrial regions. There were no significant correlations between any of the ultrasonographic measurements (endometrial thickness, endometrial volume, endometrial VI/FI/VFI, sub-endometrial volume, sub-endometrial VI/FI/VFI) and morphometric features (number of micro vessel, mean diameter of micro vessel and volume fraction measurement of vessel). This study indicates that endometrial vascularity assessed by 3D-PD could not be used to reflect changes in micro vessels of the endometrium at the time of embryo implantation in women with unexplained recurrent miscarriage.
Collapse
Affiliation(s)
- Xiaoyan Chen
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Sotirios H Saravelos
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Obstetrics and Gynaecology, Imperial College London, London, UK
| | - Yingyu Liu
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jin Huang
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.,Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong.,School of Biomedical Science, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Tin Chiu Li
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, Hong Kong.
| |
Collapse
|
6
|
Ding JL, Diao LH, Yin TL, Huang CY, Yin B, Chen C, Zhang Y, Li J, Cheng YX, Zeng Y, Yang J. Aberrant expressions of endometrial Id3 and CTLA-4 are associated with unexplained repeated implantation failure and recurrent miscarriage. Am J Reprod Immunol 2017; 78. [PMID: 28224680 DOI: 10.1111/aji.12632] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 01/02/2017] [Indexed: 12/17/2022] Open
Abstract
Inhibitor of DNA-binding protein 3 (Id3) is required for tumor angiogenesis and regulatory T-cell generation. However, the involvement of Id3 in unexplained repeated implantation failure (RIF) and recurrent miscarriage (RM) remains poorly understood. Immunohistochemistry was used to identify Id3, CD34, CTLA-4, and FOXP3 in the endometrium taken from the women with RIF (n=16), RM (n=16) and matched controls (n=8). The images were acquired and analyzed by the Vectra® automated quantitative pathology imaging system. Percentage of Id3+ cells was significantly higher in the endometrium of women with RIF and RM compared with controls. The numbers of Id3+ and CD34+ vessels in the endometrium were positively correlated in control but not in RIF or RM. Percentages of CTLA-4+ cells, but not FOXP3+ cells, were significantly increased in the endometrium of RIF and RM women than those in controls. We found aberrant expressions of endometrial Id3 and CTLA-4 in peri-implantation endometrium of women with RIF and RM, suggesting the negative roles of these angiogenesis and immune tolerance markers involving in regulating endometrium receptivity.
Collapse
Affiliation(s)
- Jin-Li Ding
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Liang-Hui Diao
- Shenzhen Key Laboratory for Reproductive Immunology of Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Tai-Lang Yin
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chun-Yu Huang
- Shenzhen Key Laboratory for Reproductive Immunology of Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Biao Yin
- Shenzhen Key Laboratory for Reproductive Immunology of Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Cong Chen
- Shenzhen Key Laboratory for Reproductive Immunology of Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Yi Zhang
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jie Li
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yan-Xiang Cheng
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yong Zeng
- Shenzhen Key Laboratory for Reproductive Immunology of Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Jing Yang
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
7
|
Chen X, Jiang L, Wang CC, Huang J, Li TC. Hypoxia inducible factor and microvessels in peri-implantation endometrium of women with recurrent miscarriage. Fertil Steril 2016; 105:1496-1502.e4. [PMID: 27018158 DOI: 10.1016/j.fertnstert.2016.02.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/05/2016] [Accepted: 02/22/2016] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To compare the expression of hypoxia inducible factor 1α (HIF1α) and micro-blood vessels in endometrium around the time of embryo implantation in women with recurrent miscarriage and fertile controls. DESIGN Retrospective study. SETTING University hospitals. PATIENT(S) Sixty women: 24 with recurrent miscarriage and 36 with proven fertility. INTERVENTION(S) Endometrial biopsy samples obtained precisely 7 days after luteinization hormone (LH) surge in a natural cycle. MAIN OUTCOME MEASURE(S) Immunohistochemical analysis to determine expression of HIF1α and micro-blood vessels as identified by von Willebrand factor (vWF) in endometrium; semiquantitative analysis using H-score analysis of staining intensity for HIF1α in the luminal epithelium, glandular epithelium, and stroma, separately; number, diameter, and volume of vWF-positive endometrial micro-vessels as counted by Image J software. RESULT(S) The luminal epithelial and stromal expression of HIF1α in women with recurrent miscarriage was higher than found in the fertile controls, with the change in the luminal epithelium reaching the highest statistical significance. There was no statistically significant difference in HIF1α expression in glandular epithelium between the two groups. An increased number as well as volume of micro-blood vessels was observed in women with recurrent miscarriage although the mean diameter of the micro-blood vessels did not statistically significantly differ between the two groups. CONCLUSION(S) We have found an aberrant expression of HIF1α and micro-vessel number and volume in the peri-implantation endometrium of women with recurrent miscarriage, suggesting that altered hypoxia and vascularization status may account for the endometrial contribution to recurrent miscarriage.
Collapse
Affiliation(s)
- Xiaoyan Chen
- Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China
| | - Lingming Jiang
- Department of Obstetrics and Gynaecology, Shenzhen People's Hospital, Second Affiliated Hospital of Jinan University, Shenzhen, People's Republic of China
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong; School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jin Huang
- Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China
| | - Tin Chiu Li
- Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China.
| |
Collapse
|
8
|
Triggianese P, Perricone C, Conigliaro P, Chimenti MS, Perricone R, De Carolis C. Peripheral blood natural killer cells and mild thyroid abnormalities in women with reproductive failure. Int J Immunopathol Pharmacol 2015; 29:65-75. [PMID: 26657164 DOI: 10.1177/0394632015615130] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/24/2015] [Indexed: 12/27/2022] Open
Abstract
Abnormalities in peripheral blood natural killer (NK) cells have been reported in women with primary infertility and recurrent spontaneous abortion (RSA) and several studies have been presented to define cutoff values for abnormal peripheral blood NK cell levels in this context. Elevated levels of NK cells were observed in infertile/RSA women in the presence of thyroid autoimmunity (TAI), while no studies have been carried out, to date, on NK cells in infertile/RSA women with non-autoimmune thyroid diseases. The contribution of this study is two-fold: (1) the evaluation of peripheral blood NK cell levels in a cohort of infertile/RSA women, in order to confirm related data from the literature; and (2) the assessment of NK cell levels in the presence of both TAI and subclinical hypothyroidism (SCH) in order to explore the possibility that the association between NK cells and thyroid function is not only restricted to TAI but also to SCH. In a retrospective study, 259 age-matched women (primary infertility [n = 49], primary RSA [n = 145], and secondary RSA [n = 65]) were evaluated for CD56+CD16+NK cells by flow cytometry. Women were stratified according to thyroid status: TAI, SCH, and without thyroid diseases (ET). Fertile women (n = 45) were used as controls. Infertile/RSA women showed higher mean NK cell levels than controls. The cutoff value determining the abnormal NK cell levels resulted ⩾15% in all the groups of women. Among the infertile/RSA women, SCH resulted the most frequently associated thyroid disorder while no difference resulted in the prevalence of TAI and ET women between patients and controls. A higher prevalence of women with NK cell levels ⩾15% was observed in infertile/RSA women with SCH when compared to TAI/ET women. According to our data, NK cell assessment could be used as a diagnostic tool in women with reproductive failure and we suggest that the possible association between NK cell levels and thyroid function can be described not only in the presence of TAI but also in the presence of non-autoimmune thyroid disorders.
Collapse
Affiliation(s)
- P Triggianese
- University of Rome Tor Vergata, Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", Rome, Italy
| | - C Perricone
- Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - P Conigliaro
- University of Rome Tor Vergata, Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", Rome, Italy
| | - M S Chimenti
- University of Rome Tor Vergata, Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", Rome, Italy
| | - R Perricone
- University of Rome Tor Vergata, Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", Rome, Italy
| | - C De Carolis
- Gynaecology and Obstetrics II, San Giovanni-Addolorata Hospital, Rome, Italy
| |
Collapse
|
9
|
Mayer RB, Ebner T, Yaman C, Hartl J, Sir A, Krain V, Oppelt P, Shebl O. Influence of intracervical and intravaginal seminal plasma on the endometrium in assisted reproduction: a double-blind, placebo-controlled, randomized study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2015; 45:132-138. [PMID: 25265096 DOI: 10.1002/uog.14669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 08/27/2014] [Accepted: 09/04/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To investigate the effect of intracervical and intravaginal application of seminal plasma on the endometrium, as assessed by endometrial/subendometrial vascularization and endometrial volume between the day of oocyte retrieval and the day of embryo transfer in an in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle. METHODS This was a double-blind, placebo-controlled, randomized study including patients undergoing a first or second IVF/ICSI cycle. Homologous seminal plasma or placebo (sodium chloride) was injected into the cervix and posterior vaginal fornix just after follicle aspiration. Three-dimensional power Doppler examination was performed 30 min before oocyte retrieval and 30 min before embryo transfer. Main outcome measures were changes in vascularization flow index (VFI), flow index (FI) and vascularization index (VI) of the endometrium/subendometrium using VOCAL™ (Virtual Organ Computer-aided AnaLysis) and endometrial volume. RESULTS One hundred patients agreed to participate in the study. Twenty-three patients were excluded, mainly as a result of canceled embryo transfer. Data were analyzed from 40 patients receiving seminal plasma and 37 receiving placebo. No significant differences between the two groups were seen in VFI, FI or VI of the endometrium or subendometrium or in endometrial volume on the day of oocyte pick-up and on the day of embryo transfer. CONCLUSION Neither endometrial/subendometrial vascularization parameters nor endometrial volume seem to be affected by the application of seminal plasma in patients undergoing their first or second IVF/ICSI cycle.
Collapse
Affiliation(s)
- R B Mayer
- Landes Frauen und Kinderklinik Linz, Medizinische Fakultät Universität Linz, Linz, Austria
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Kwak-Kim J, Agcaoili MSL, Aleta L, Liao A, Ota K, Dambaeva S, Beaman K, Kim JW, Gilman-Sachs A. Management of women with recurrent pregnancy losses and antiphospholipid antibody syndrome. Am J Reprod Immunol 2013; 69:596-607. [PMID: 23521391 DOI: 10.1111/aji.12114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 02/20/2013] [Indexed: 02/06/2023] Open
Abstract
Antiphospholipid antibodies (aPL) have been associated with recurrent pregnancy losses (RPL) and other obstetrical complications. The diagnostic criteria for the classical antiphospholipid antibody syndrome (APS) have been utilized for the detection of obstetrical APS in women with RPL. However, laboratory findings and immunopathology of obstetrical APS are significantly different from those of classical APS. In addition, many women with RPL who have positive aPL do not have symptoms consistent with the current APS criteria. The induction of a proinflammatory immune response from trophoblasts and complement activation by aPL rather than thromboembolic changes has been reported as a major immunopathological feature of obstetrical APS. Heparin treatment has been reported to be effective in prevention of early pregnancy loss with APS but not for the late pregnancy loss or complications. The complex effects of heparin may explain the limited efficacy of heparin treatment in RPL. New diagnostic criteria for obstetrical APS are needed urgently, and new therapeutic approaches should be explored further.
Collapse
Affiliation(s)
- Joanne Kwak-Kim
- Reproductive Medicine, Department of Obstetrics and Gynecology, The Chicago Medical School at Rosalind Franklin University of Medicine and Science, Vernon Hills, IL 60061, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|