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Guo Y, Dai F, Zheng B, Tao L, Cui T. Which transfer day results in the highest live birth rate for PCOS patients undergoing in vitro fertilization? BMC Pregnancy Childbirth 2023; 23:865. [PMID: 38104082 PMCID: PMC10724904 DOI: 10.1186/s12884-023-06173-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) has unusual levels of hormones. The hormone receptors in the endometrium have a hostile effect and make the microenvironment unfavorable for embryo implantation. The use of gonadotropin stimulation during in vitro fertilization (IVF) may have an impact on embryo implantation and live birth rate. According to recent data, the clinical results of day 4 embryo transfer (D4 transfer) were on par with those of day 5 embryo transfer (D5 transfer) in IVF-ET. There are few studies comparing the outcomes of transplants with various etiologies and days. The purpose of this study was to determine which transfer day had the best result for PCOS patients undergoing IVF. METHODS This retrospective cohort study was conducted in the Xingtai Infertility Specialist Hospital between January 2017 and November 2021. A total of 1,664 fresh ART cycles met inclusion criteria, including 242 PCOS transfers and 1422 tubal factor infertility transfers. CONCLUSIONS PCOS individuals had the highest live birth rate on D4 transferred. It was not need to culture embryos to blastocysts to optimize embryo transfer for PCOS women. This could be a novel approach to transplantation for PCOS.
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Affiliation(s)
- Yuying Guo
- Xingtai Infertility Specialist Hospital/Xingtai Reproduction and Genetics Specialist Hospital, Xingtai City, Hebei Province, China.
| | - Fangfang Dai
- Xingtai Infertility Specialist Hospital/Xingtai Reproduction and Genetics Specialist Hospital, Xingtai City, Hebei Province, China
| | - Bo Zheng
- Xingtai Infertility Specialist Hospital/Xingtai Reproduction and Genetics Specialist Hospital, Xingtai City, Hebei Province, China
| | - Linlin Tao
- Xingtai Infertility Specialist Hospital/Xingtai Reproduction and Genetics Specialist Hospital, Xingtai City, Hebei Province, China
| | - Tieqing Cui
- HEBEI INSTITUTE OF MECHANICAL AND ELECTRICAL TECHNOLOGY, Xingtai City, Hebei Province, China
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2
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Pathare ADS, Hinduja I, Mahadik RC. Basic aspects of endometrial receptivity in PCOS patients. Mol Biol Rep 2022; 49:1519-1528. [PMID: 34988892 DOI: 10.1007/s11033-021-06976-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 11/17/2021] [Indexed: 12/12/2022]
Abstract
Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder commonly affecting the reproductive capacity of women leading to infertility. PCOS-related infertility is majorly due to anovulation; however, it is not the only cause. The defective endometrium causing recurrent miscarriage and implantation failure can also be accountable for infertility in PCOS women. The unusual levels of hormones and their receptors in the PCOS endometrium have a hostile effect during WOI, making the microenvironment unfavorable for embryo implantation. To date, many studies have been performed to determine the role of candidate genes in endometrial receptivity but very limited data is available using whole genome approach. This review aims at summarizing the existing studies on the basic aspects of endometrial receptivity in PCOS. The review focuses on aberrant levels of hormones and their receptors in the endometrium, affecting the receptivity. Additionally, it explores the novel approach reviewing the effect on treatment options administered for ovulation induction in PCOS on their endometrial receptivity. Overall, this review will help us to understand the molecular milieu in PCOS endometrium and its effect on the receptivity potential. However, to have a thorough understanding of the mechanistic approach of hormonal imbalance in PCOS on endometrial receptivity, there is a need to give more weightage to genome-wide studies in the future. The current review will further guide us to formulate future studies using whole genome technologies for the assessment of endometrial receptivity in different cohorts of PCOS women, which may have future diagnostic implementations.
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Affiliation(s)
- Amruta D S Pathare
- Department of IVF and Research, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, 400016, India
| | - Indira Hinduja
- Department of IVF and Research, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, 400016, India.
| | - Roshani C Mahadik
- Department of IVF and Research, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, 400016, India
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3
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Sutaji Z, Elias MH, Ahmad MF, Karim AKA, Abu MA. A Systematic Review and Integrated Bioinformatic Analysis of Candidate Genes and Pathways in the Endometrium of Patients With Polycystic Ovary Syndrome During the Implantation Window. Front Endocrinol (Lausanne) 2022; 13:900767. [PMID: 35860699 PMCID: PMC9289743 DOI: 10.3389/fendo.2022.900767] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common disorder with wide-ranging clinical heterogeneity that causes infertility. However, the comprehensive molecular mechanisms of PCOS in causing infertility is remaining unclear. Hence, a comprehensive literature search was conducted using PubMed, Scopus, EBSCOhost, and Science Direct. Medical Subject Heading (MeSH) terms like PCOS, gene expression, implantation window and endometrium were used as the keywords. From 138 studies retrieved, original articles with RNA profiling on human endometrial tissues in PCOS women during the implantation window were included. Study design, sample size, sample type, method, and differentially expressed genes (DEGs) were identified from all publications. The DEGs were analyzed using the software packages DAVID, STRING, and Cytoscape. Three studies that met inclusion criteria were included, and 368 DEGs were identified. Twelve significant clusters from the protein-protein interaction network (PPI) complex were found, and cluster 1 showed very high intermolecular interactions. Five candidate genes (AURKA, CDC25C, KIF23, KIF2C, and NDC80) were identified from the systematic review and integrated bioinformatics analysis. It is concluded that cell cycle is the fundamental biological processes that were dysregulated in the endometrium of PCOS women, affecting decidualization progression in the endometrium during the implantation window.
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Affiliation(s)
- Zulazmi Sutaji
- Department of Obstetrics & Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Faculty of Medicine & Health Sciences, Universiti Sains Islam Malaysia, Bandar Baru Nilai, Malaysia
| | - Marjanu Hikmah Elias
- Faculty of Medicine & Health Sciences, Universiti Sains Islam Malaysia, Bandar Baru Nilai, Malaysia
| | - Mohd Faizal Ahmad
- Department of Obstetrics & Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Abdul Kadir Abdul Karim
- Department of Obstetrics & Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Muhammad Azrai Abu
- Department of Obstetrics & Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Muhammad Azrai Abu,
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4
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Budihastuti UR, Melinawati E, Anggraini NWP, Anggraeni A, Yuliantara EE, Sulistyowati S, Hadi C, Nurwati I, Yulyanti, Octavia DE, Wesliaprilius TA, Murti B. Electroacupuncture to Improve Endometrial Receptivity and Folliculogenesis in Polycystic Ovary Syndrome. Med Acupunct 2021; 33:428-434. [PMID: 34976276 DOI: 10.1089/acu.2020.1503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting folliculogenesis and endometrial receptivity. PCOS causes low fertility due to failures in folliculogenesis and ovulation. Electroacupuncture (EA) may help improve folliculogenesis and endometrial receptivity. EA can decrease tonic activity in the sympathetic vasoconstrictor pathway to the uterus. This study was conducted to determine the effect of the addition of EA therapy on folliculogenesis and endometrial receptivity in women with PCOS. Materials and Methods: This case-control study was conducted at the Dr. Moewardi General Hospital, in Jawa Tengah, Indonesia. The subjects were women with PCOS, ages 20-45, who were infertile. They were divided into a control group (17 women) and an experimental group (17 women). The control group received letrozole therapy, and the experimental group received EA + letrozole therapy. Folliculogenesis is determined by measuring the growth of follicle diameter on days 2, 6, 8, 10, and 12 of the menstrual cycle. Endometrial receptivity is determined by resistance index (RI) and pulsatility index (PI) examinations on days 19 and 21; endometrial thickness is measured on day 12. Results: There was a significant difference in folliculogenesis on days 2, 6, 8, 10, and 12. Folliculogenesis with letrozole versus EA + letrozole, respectively, were: day 2 = 5.59 ± 1.06 versus 7.01 ± 1.53, P = 0.004; day 6 = 6.71 ± 1.59 versus 9.11 ± 1.23, P < 0.001; day 8 = 9.51 ± 2.68 versus 12.44 ± 1.49, P < 0.001; day 10 = 11.30 ± 3.08 versus 15.53 ± 2.34, P < 0.001; and day 12 = 13.92 ± 3.61 versus 19.86 ± 0.75, P < 0.001. RI value with letrozole versus EA + letrozole were, respectively, day 19 = 0.91 ± 0.07 versus 0.88 ± 0.07, P = 0.150; day 21 = 0.88 ± 0.07 versus 0.79 ± 0.09, P < 0.001. PI value with letrozole versus EA + letrozole were respectively, day 19 = 3.00 ± 0.89 versus 2.30 ± 0.65, P = 0.009; and day 21 = 2.72 ± 0.88 versus 2.02 ± 0.55, P = 0.009. Endometrial thickness with letrozole versus EA + letrozole were, respectively, day 12 = 6.95 ± 1.82 versus 8.22 ± 1.76, P = 0.005. Conclusions: The addition of EA to letrozole therapy improved folliculogenesis, RI, PI, and endometrial thickness in patients with PCOS. Further studies are needed to gain a better understanding of the dosage and timing of this therapy and its potential synergy with other current treatments.
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Affiliation(s)
- Uki Retno Budihastuti
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia.,Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Public Health Science Study Program, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Doctoral Program in Medical Science, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Eriana Melinawati
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia.,Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Nutria Widya Purnama Anggraini
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia.,Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Asih Anggraeni
- Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Universitas Sebelas Maret Hospital, Jawa Tengah, Indonesia
| | - Eric Edwin Yuliantara
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia.,Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Sri Sulistyowati
- Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Doctoral Program in Medical Science, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Universitas Sebelas Maret Hospital, Jawa Tengah, Indonesia
| | - Cahyono Hadi
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Ida Nurwati
- Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Doctoral Program in Medical Science, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Yulyanti
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Dhamayanti Eka Octavia
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Todung Antony Wesliaprilius
- Department of Obstetrics and Gynecology, Medical Faculty of Universitas Sebelas Maret/Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Bhisma Murti
- Medical Faculty Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Public Health Science Study Program, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Doctoral Program in Medical Science, Postgraduate Program, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
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Pathare ADS, Hinduja I. Endometrial Expression of Cell Adhesion Genes in Recurrent Implantation Failure Patients in Ongoing IVF Cycle. Reprod Sci 2021; 29:513-523. [PMID: 34410653 DOI: 10.1007/s43032-021-00708-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/30/2021] [Indexed: 11/28/2022]
Abstract
Recurrent implantation failure (RIF) is one of the major obstacles in IVF. Transcriptomic literature has revealed the various biological processes involved in endometrial receptivity (ER) under different physiological circumstances, especially in natural cycle. We intended to determine the function-specific ER profile under controlled ovarian stimulation (COS) cycle. This can help to back trace the genomic impairment in RIF patients during the IVF cycle and to validate the genes involved in enriched pathways. In our study, retrospective gene expression microarray dataset was reanalysed after the follow-up, in classic non pregnant RIF (cases) vs fertile women (controls) under COS (n = 5/group). Reanalysis of microarray revealed significant downregulation of cell adhesion function (P:3.11E-05) with the maximum gene count. For validation purpose, downregulation of eight genes (COMP, HABP2, ITGAD, CDH3, COL22A1, MFAP4, THBS1and CD300A) involved in enriched cell adhesion pathway having fold change > 3 were assessed by real-time PCR in independent cohorts of cases and controls (n = 24, each). Downregulation of six out of eight genes (COMP, HABP2, ITGAD, CDH3, MFAP4 and THBS1) were confirmed by real-time PCR (P < 0.05) with fold change > 2. This indicates the importance of analysed genes in the ER mechanism under COS, thus mimicking the fresh embryo transfer. The further analysis in larger cohorts would substantiate the study findings in RIF patients undergoing IVF cycle.
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Affiliation(s)
- Amruta D S Pathare
- Department of IVF and Research, P.D. Hinduja Hospital and Medical Research Centre, Mumbai, 400016, Maharashtra, India
| | - Indira Hinduja
- Department of IVF and Research, P.D. Hinduja Hospital and Medical Research Centre, Mumbai, 400016, Maharashtra, India.
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Makker A, Goel MM, Nigam D, Bhatia V, Mahdi AA, Das V, Pandey A. Endometrial Expression of Homeobox Genes and Cell Adhesion Molecules in Infertile Women With Intramural Fibroids During Window of Implantation. Reprod Sci 2016; 24:435-444. [PMID: 27407137 DOI: 10.1177/1933719116657196] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study was designed to examine the expression and cellular distribution of homeobox ( HOX) genes ( HOXA10 and HOXA11) and cell adhesion molecules (E-cadherin, N-cadherin, and β-catenin) during the window of implantation in infertile women with noncavity-distorting intramural (IM) fibroids (n = 18) and in fertile controls (n = 12). Quantitative real-time polymerase chain reaction and immunohistochemistry were used to evaluate the messenger RNA (mRNA) levels and protein expression, respectively. When compared to fertile controls, reduced HOXA10 and HOXA11 transcript and protein levels were observed in infertile women. However, changes only in the expression of HOXA10 mRNA (-1.72-fold; P = .03) and stromal protein ( P = .001) were statistically significant. Significantly lower E-cadherin mRNA (-10.97-fold; P = .02) and protein levels were seen in infertile patients. E-cadherin immunostaining was significantly reduced both in the luminal ( P = .048) and in the glandular ( P = .014) epithelium of endometrium from infertile patients when compared to controls. No significant change was observed either in the mRNA levels or in the immunoexpression of N-cadherin and β-catenin. However, a trend toward lower N-cadherin expression in the luminal epithelium ( P = .054) and decreased β-catenin expression in the glandular epithelium ( P = .070) was observed in infertile patients. The present findings suggest that altered endometrial HOXA10 and E-cadherin mRNA and protein expression observed in infertile women with IM fibroids during the mid-secretory phase might impair endometrial receptivity leading to infertility in these patients.
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Affiliation(s)
- Annu Makker
- 1 Post-Graduate Department of Pathology, King George's Medical University-UP, Lucknow, Uttar Pradesh, India
| | - Madhu Mati Goel
- 1 Post-Graduate Department of Pathology, King George's Medical University-UP, Lucknow, Uttar Pradesh, India
| | - Dipti Nigam
- 1 Post-Graduate Department of Pathology, King George's Medical University-UP, Lucknow, Uttar Pradesh, India
| | - Vikram Bhatia
- 1 Post-Graduate Department of Pathology, King George's Medical University-UP, Lucknow, Uttar Pradesh, India
| | - Abbas Ali Mahdi
- 2 Department of Biochemistry, King George's Medical University-UP, Lucknow, Uttar Pradesh, India
| | - Vinita Das
- 3 Department of Obstetrics and Gynecology, King George's Medical University-UP, Lucknow, Uttar Pradesh, India
| | - Amita Pandey
- 3 Department of Obstetrics and Gynecology, King George's Medical University-UP, Lucknow, Uttar Pradesh, India
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