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Li J, Mo S, Lin Z, Mo F, Shi Q. Proximal tubal occlusion first or oocyte retrieval first for patients with hydrosalpinx? Arch Gynecol Obstet 2024; 309:1597-1608. [PMID: 38308732 DOI: 10.1007/s00404-023-07359-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/21/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE Our study aimed to investigate the best time to manage hydrosalpinx to improve pregnancy outcomes during in vitro fertilization-embryo transfer (IVF-ET). METHODS Patients with hydrosalpinx who received IVF treatment were analyzed retrospectively. And two groups were included to compare the effects of different timing treatment of hydrosalpinx on IVF pregnancy outcomes, "Proximal Tubal Occlusion First Group" (Group Ligation-COH) and "Oocyte Retrieval First Group" (Group COH-Ligation). The main outcome measures included: ovarian response indexes, laboratory indexes and clinical pregnancy outcomes. Univariate and multivariate Logistic regression analysis was performed for outcome indicators, and the odds ratios (OR) and 95% confidence interval (CI) were used. RESULTS A total of 1490 patients were included (n = 976 Ligation-COH and n = 514 COH-Ligation). The Gn starting dose and MII rate in group Ligation-COH were significantly higher than those in group COH-Ligation (203.33 ± 58.20 vs. 203.33 ± 58.20, 81.58% vs. 80.28%, P < 0.05). The number of oocytes obtained and the number of available D3 embryos in group COH-Ligation were higher than those in group Ligation-COH (15.10 ± 7.58 vs. 13.45 ± 6.42, 10.92 ± 5.81 vs. 9.94 ± 5.15, P < 0.05). Although the number of ET cycles per IVF cycle in group COH-Ligation was higher than that in group Ligation-COH (1.88 ± 1.00 vs. 1.48 ± 0.70, P < 0.05), the biochemical pregnancy rate, clinical pregnancy rate, multiple pregnancy rate, live birth rate and cumulative live birth rate in group Ligation-COH were significantly higher than those in group COH-Ligation (60.83% vs. 46.27% for biochemical pregnancy, 55.69% vs. 38.5% for clinical pregnancy, 26.18% vs. 17.74% for multiple pregnancy, 47.08% vs. 25.26% for live birth, 69.47% vs. 47.47% for cumulative live birth, P < 0.05), and the miscarriage rate in group Ligation-COH was lower than that in group COH-Ligation (10.47% vs. 17.20 for early abortion, 4.49% vs. 15.86% for late abortion, P < 0.05). In logistic regression analysis, after adjustment for age and multiple factors, the above results were still statistically significant differences (P < 0.001). For elderly patients, the clinical pregnancy rate, multiple birth rate and live birth rate in group Ligation-COH were also higher than those in group COH-Ligation (P < 0.001). No significant differences were detected for patients with diminished ovarian reserve. CONCLUSIONS For the choice of ligation operation time, we recommend that patients choose tubal ligation first and then ovulation induction and oocyte retrieval treatment.
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Affiliation(s)
- Jie Li
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
- Reproductive Medicine Department, The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Sien Mo
- Reproductive Medicine Department, The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zhong Lin
- Reproductive Medicine Department, The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Fuhua Mo
- Reproductive Medicine Department, The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Qiuling Shi
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China.
- School of Public Health, Chongqing Medical University, Chongqing, China.
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Nguyen V, Jackson A, Gale J. Live birth rates after resolution of endometrial cavity fluid in frozen embryo transfer cycles. Reprod Biol Endocrinol 2023; 21:100. [PMID: 37891659 PMCID: PMC10605945 DOI: 10.1186/s12958-023-01149-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
RESEARCH QUESTION Are live birth rates affected in frozen embryo transfer cycles that develop transient endometrial cavity fluid that resolves by day of embryo transfer? DESIGN The first frozen blastocyst transfer cycle between January 1st, 2016 and December 31st, 2019 were included in this retrospective cohort study at an academic fertility center. The presence or absence of endometrial cavity fluid (ECF) detected on initial ultrasound and at time of transfer was recorded. Patients who had persistent ECF at time of transfer were excluded from the study. The primary outcome was live birth rate in the group with resolved ECF relative to the group without ECF. RESULTS A total of 1034 frozen blastocyst transfer cycles were included, 54 with resolved ECF and 980 without ECF. Adjusted analyses were performed using a log-binomial regression model. Live birth rates were 35.2% and 34.2%, adjusted risk ratio 1.00 [95% CI 0.70-1.50] in the two groups, respectively. CONCLUSION Live birth rates in frozen embryo transfer cycles are equivalent between patients with resolved endometrial cavity fluid compared to those who never had endometrial cavity fluid. Our findings suggest that the presence of endometrial cavity fluid is likely not detrimental to live birth rates if the fluid spontaneously resolves by the time of embryo transfer.
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Affiliation(s)
- Vincent Nguyen
- Dept of Obstetrics and Gynecology, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
| | - Aaron Jackson
- Dept of Obstetrics and Gynecology, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8M5, Canada
- Ottawa Fertility Centre, Green Valley Crescent, Ottawa, ON, 100-955, K2C 3V4, Canada
| | - Jenna Gale
- Dept of Obstetrics and Gynecology, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8M5, Canada
- Ottawa Fertility Centre, Green Valley Crescent, Ottawa, ON, 100-955, K2C 3V4, Canada
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Saad AS, Mohamed KAA. Aspiration with Diosmin Intake in Endometrial Cavity Fluid Accumulation in ART Cycles: A Randomized Controlled Trial. J Obstet Gynaecol India 2023; 73:336-342. [PMID: 37701088 PMCID: PMC10492724 DOI: 10.1007/s13224-023-01791-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 06/05/2023] [Indexed: 09/14/2023] Open
Abstract
Background This was a prospective randomized controlled trial in 200 cases presented with endometrial cavity fluid at the day of oocyte retrieval at a private fertility center from 2013 to 2021. The cases were randomized at day of ovum pickup into 2 groups: Group 1 (control group) (n = 100): conventional management with follow-up and reassessment by transvaginal ultrasound on day 5. Group 2 (interventional group) (n = 100): aspiration of the fluid was done and cases were given diosmin 500 mg 3 times per day till reassessment at embryo transfer day. In both groups, we proceeded with fresh embryo transfer if no fluid is present on day 5 or freeze-all policy if persistent fluid was detected. Results Endometrial fluid on the 5th day was significantly higher in the control group (28.0%) than in the interventional group (6.0%) (P < 0.001). Regarding pregnancy rate, although being higher in the interventional group (54.3% vs 50.0%), the difference was not statistically significant (P = 0.5). It was found that the intervention was associated with risk reduction of endometrial fluid (OR = 0.168, 95% CI = 0.065-0.429, P < 0.001. Conclusion Aspiration of endometrial cavity fluid with diosmin intake increased the likelihood of fresh embryo transfer and with a slightly better pregnancy rate compared to conservative management.Clinical trial number: NCT02158000, Date of registration: 6/6/2014, Date of initial enrollment (first patient recruiting): 1/11/2014, URL: https://clinicaltrials.gov/ct2/show/NCT02158000.
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Affiliation(s)
- Ahmed Samy Saad
- Obstetrics and Gynecology Department, Faculty of Medicine, Hawaa Fertility Center, Benha University, Benha, 13512 Egypt
| | - Khalid Abd Aziz Mohamed
- Obstetrics and Gynecology Department, Faculty of Medicine, Hawaa Fertility Center, Benha University, Benha, 13512 Egypt
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Cai M, Pan X, Xia W, Liang X, Yang X. Intra-cavitary fluid resulted from caesarean section but not isthmocele compromised clinical pregnancy after IVF/ICSI treatment. Arch Gynecol Obstet 2022; 306:229-237. [PMID: 35347382 PMCID: PMC9300527 DOI: 10.1007/s00404-022-06436-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 02/04/2022] [Indexed: 11/02/2022]
Abstract
AbstractThe aim of this study was to explore whether the presence of intra-cavitary fluid (ICF) influences the pregnancy outcomes of patients with caesarean section (CS) in embryo transfer cycles. A total of 8494 transferred cycles of 4924 women were enrolled in this retrospective study and separated into three subgroups by previous delivery method and the presence of intra-cavity fluid, a caesarean group with ICF (CS-ICF, n = 649), a caesarean group without ICF (CS-noICF, n = 3207), and the remaining 4638 cycles without ICF were included in the vaginal delivered group (VD, n = 4638). Baseline characteristics and clinical outcome were compared. Propensity score matching (PSM) was conducted to adjust confounding factors between groups. Patients in the CS-ICF group were of younger age (36.49 ± 4.19 vs 37.34 ± 4.25, 37.32 ± 4.86, P < 0.001), had better ovary reserve, and had more blastocyst transferred compared with the CS-noICF and VD groups. However, cycles in the CS-ICF group achieved unsatisfactory clinical pregnancy outcomes. PSM analysis for comparability and differences in clinical outcomes still existed. The clinical pregnancy rate was significantly lower in the CS-ICF group than in the CS-noICF group (35.1% vs 41.7% for CS-noICF group, 48.1% for VD group, P < 0.001). Subgroup analysis of fresh embryo transferred cycles, the differences in clinical outcomes disappeared after PSM analysis, while the clinical pregnancy rate was still lowest among the three matched groups of FET cycles (36.4% vs 50.3% for VD group, P < 0.001). The presence of intra-cavitary fluid (ICF), but not necessarily the isthmocele, significantly compromises the clinical pregnancy rate in patients with previous CS undergoing IVF/ICSI treatment.
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Huang L, Huang S, Yuan Y, Li Y, Chen M, Zhou C. Reduced pregnancy and live birth rates after in vitro fertilization in women with cesarean section scar diverticulum: A retrospective cohort study. J Obstet Gynaecol Res 2021; 48:146-154. [PMID: 34734456 DOI: 10.1111/jog.15061] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 08/15/2021] [Accepted: 10/03/2021] [Indexed: 11/30/2022]
Abstract
AIM The primary aim of the study was to investigate the effect of cesarean scar diverticulum on the reproductive outcome of embryo transfer. The secondary aim was to assess the impact of endometrial cavity fluid on the reproductive outcome of embryo transfer among patients with a cesarean scar diverticulum. METHODS This was a retrospective cohort study. The study included 1538 patients, of whom 215 patients with an existing cesarean scar diverticulum and 1323 patients without cesarean scar diverticulum. A subgroup analysis of the impact of endometrial cavity fluid on the reproductive outcome of frozen embryo transfers among patients with a cesarean scar diverticulum was also conducted. RESULTS The odds of clinical pregnancy in the noncesarean section diverticulum group was higher than that in the diverticulum group (odds ratio [OR]: 1.72, 95% confidence interval [CI]: 1.27-2.34 and adjusted OR: 1.71, 95% CI: 1.25-2.34). The odds of live birth in the noncesarean section diverticulum group was also significantly higher than that in the cesarean section diverticulum group (OR: 1.61, 95% CI: 1.15-2.24 and adjusted OR: 1.59, 95% CI: 1.14-2.23). The existence of endometrial cavity fluid during endometrial preparation significantly reduced the pregnancy and live birth rate of frozen embryo transfer among the patients with cesarean section diverticulum. CONCLUSION The presence of cesarean section scar diverticulum had an adverse impact on the pregnancy and live birth rate after in vitro fertilization. The endometrial cavity fluid among the patients with cesarean section scar diverticulum accounted for the reduced pregnancy and live birth rate partly.
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Affiliation(s)
- Ling Huang
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Sunxing Huang
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Yuan Yuan
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Yubin Li
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Minghui Chen
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Canquan Zhou
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
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Abstract
PURPOSE OF REVIEW Recurrent implantation failure (RIF) refers to the absence of implantation after repeated transfer of good embryos into a normal uterus. This review discusses the diagnostic criteria and cause of RIF. RECENT FINDINGS Regardless of the advancements in IVF practice, RIF is still a challenge that has to be solved. Exact definition of RIF is lacking today. For the initial evaluation, a rigorous algorithmic evaluation should be compromised with an individualized principle. Factors that might affect the number and quality of the oocyte and sperm cells should be investigated in order to obtain a good-quality embryo. Embryo assessment should be performed under ideal laboratory circumstances. The uterine environment should be carefully evaluated and the embryo should be transferred into the uterus at the most receptive time. Some of the newly introduced diseases and empirical treatment strategies, such as chronic endometritis, vaginal microbiota, immunologic profile and immunomodulator treatments, can be discussed with the couple under the light of adequate evidence-based information. SUMMARY New diagnostic and treatment modalities are needed to be introduced, which would be safe, efficient and efficacious after well-designed randomized controlled trials.
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Goyal N, Jayakrishnan K. Successful Pregnancy after Frozen Embryo Transfer after Recurrent Endometrial Collection in a Patient with Mosaic Turner Syndrome. J Hum Reprod Sci 2021; 14:91-93. [PMID: 34083999 PMCID: PMC8057145 DOI: 10.4103/jhrs.jhrs_83_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/10/2020] [Accepted: 12/23/2020] [Indexed: 11/21/2022] Open
Abstract
A 36-year-old female with Mosaic Turner Syndrome presented for oocyte donation program. She developed endometrial collection each time she was started on estradiol valerate for endometrial preparation. All causes of the endometrial collection were ruled out and empirical antibiotics given. Finally, the patient developed a satisfactory endometrium of 5.7 mm with no endometrial collection after being given low dose estradiol-estrogel (Transdermal application) and five doses of subcutaneous injections on granulocyte-colony-stimulating factor. The patient conceived after embryo transfer and is in follow-up.
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Affiliation(s)
- Nidhi Goyal
- Fertility Research Centre, KJK Hospital, Thiruvananthapuram, Kerala, India
| | - K Jayakrishnan
- Fertility Research Centre, KJK Hospital, Thiruvananthapuram, Kerala, India
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Zhang WX, Cao LB, Zhao Y, Li J, Li BF, Lv JN, Yan L, Ma JL. Endometrial cavity fluid is associated with deleterious pregnancy outcomes in patients undergoing in vitro fertilization/intracytoplasmic sperm injection: a retrospective cohort study. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:9. [PMID: 33553302 PMCID: PMC7859802 DOI: 10.21037/atm-20-3623] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The effects of endometrial cavity fluid (ECF) on in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) pregnancy outcomes following embryo transfer (ET) are still controversial. We conducted the present study to investigate whether the presence of ECF in infertile patients scheduled to undergo IVF or ICSI was associated with pregnancy outcomes. Methods A retrospective cohort study design was used. Among infertile patients undergoing IVF/ICSI, those with and without ECF were matched 1:1 using propensity score matching (PSM). After ensuring that the baseline levels of the two matched groups were consistent, the pregnancy and obstetrical outcomes of the two groups were compared. Results Patients with ECF had significantly lower clinical rates of pregnancy (1,061/1,862, 57% vs. 1,182/1,862, 63.5%; P<0.001), live birth (902/1,862, 48.4% vs. 1,033/1,862, 55.5%; P<0.001), biochemical pregnancy (1,182/1,862, 63.5% vs. 1,288/1,862, 69.2%; P<0.001), and embryo implantation (1,500/3,740, 40.1% vs. 1,661/3,740, 44.4%, P<0.001) than patients without ECF. Also, patients with ECF had a higher incidence of gestational diabetes (17/78, 22% vs. 8/94, 9%, P=0.014). However, there were no differences in gestational weeks at delivery or birth weight between the two groups. Conclusions ECF was significantly associated with adverse pregnancy outcomes but showed no significant association with adverse obstetric outcomes (except for gestational diabetes).
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Affiliation(s)
- Wen-Xiu Zhang
- Qilu Hospitai (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China.,School of Medcine, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China
| | - Lian-Bao Cao
- School of Medcine, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China
| | - Ying Zhao
- School of Medcine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jing Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bo-Feng Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jia-Nan Lv
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lei Yan
- School of Medcine, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China.,Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Jin-Long Ma
- School of Medcine, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.,The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, China
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Van Voorhis BJ, Mejia RB, Schlaff WD, Hurst BS. Is removal of hydrosalpinges prior to in vitro fertilization the standard of care? Fertil Steril 2019; 111:652-656. [PMID: 30929723 DOI: 10.1016/j.fertnstert.2019.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Bradley J Van Voorhis
- Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Rachel B Mejia
- Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - William D Schlaff
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Bradley S Hurst
- Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, North Carolina
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Long J, Yang CS, He JL, Liu XQ, Ding YB, Chen XM, Tong C, Peng C, Wang YX, Gao RF. FOXO3a is essential for murine endometrial decidualization through cell apoptosis during early pregnancy. J Cell Physiol 2018; 234:4154-4166. [PMID: 30132880 DOI: 10.1002/jcp.27167] [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: 04/12/2018] [Accepted: 07/17/2018] [Indexed: 12/19/2022]
Abstract
Embryo implantation is essential for normal pregnancy, and the process of decidualization is critical for embryo implantation. However, the mechanism of decidualization during early pregnancy is still unknown. Forkhead box O3a (FOXO3a) is the most important functional transcription factor of the forkhead box family and is a highly conserved transcription factor of apoptosis-related genes. In the mouse uterus, FOXO3a was found to be expressed regularly from Days 1-7 of early pregnancy. Upon further exploration, it was found that FOXO3a was expressed at significantly higher levels at the implantation site than at the interimplantation site on Days 5-7 of pregnancy. Under artificial decidualization, FOXO3a was highly expressed in the first and second decidual zones. After decidualization, the expression of FOXO3a was significantly increased both in vivo and vitro. In primary stromal cells, apoptosis was reduced by decreased expression of FOXO3a after inducing decidualization. Moreover, when FOXO3a-small interfering RNA was transfected into the uteri of mice, the expression of decidualization- and apoptosis-related factors was impaired. Thus, FOXO3a might play an important role in decidualization during early pregnancy, and cell apoptosis might be one of pathways for FOXO3a-regulated decidualization.
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Affiliation(s)
- Jing Long
- Laboratory of Reproductive Biology, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, China
| | - Cheng-Shun Yang
- Laboratory of Reproductive Biology, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, China
| | - Jun-Lin He
- Laboratory of Reproductive Biology, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, China
| | - Xue-Qing Liu
- Laboratory of Reproductive Biology, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, China
| | - Yu-Bin Ding
- Laboratory of Reproductive Biology, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, China
| | - Xue-Mei Chen
- Laboratory of Reproductive Biology, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, China
| | - Chao Tong
- Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, China.,Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chuan Peng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Laboratory of Maternal and Fetal Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying-Xiong Wang
- Laboratory of Reproductive Biology, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, China
| | - Ru-Fei Gao
- Laboratory of Reproductive Biology, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, China
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