1
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Wang Y, Tang Z, Teng X. New advances in the treatment of thin endometrium. Front Endocrinol (Lausanne) 2024; 15:1269382. [PMID: 38745960 PMCID: PMC11092375 DOI: 10.3389/fendo.2024.1269382] [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: 07/29/2023] [Accepted: 03/22/2024] [Indexed: 05/16/2024] Open
Abstract
Thin endometrium (TE) is defined as a mid-luteal endometrial thickness ≤7mm. TE can affect endometrial tolerance, leading to lower embryo implantation rates and clinical pregnancy rates, and is also associated with impaired outcomes from assisted reproductive treatment. Herein, we systematically review TE causes, mechanisms, and treatments. TE pathogenesis has multiple causes, with the endometrium becoming thinner with age under hormonal influence. In addition, uterine cavity factors are important, as the inflammatory environment may affect expressions of certain genes thereby inhibiting endometrial stromal cell proliferation and promoting apoptosis. Long-term oral contraceptive use or the use of ovulation-promoting drugs are also definite factors contributing to endometrial thinning. Other patients have primary factors, for which the clinical etiology remains unknown. The main therapeutic strategies available for TE are pharmacological (including hormonal and vasoactive drugs), regenerative medicine, intrauterine infusion of growth factor-granulocyte colony-stimulating factor, autologous platelet-rich plasma, and complementary alternative therapies (including traditional Chinese herbal medicine and acupuncture). However, the associated mechanisms of action are currently unclear. Clinical scholars have proposed various approaches to improve treatment outcomes in patients with TE, and are exploring the principles of efficacy, offering potentials for novel treatments. It is hoped that this will improve TE tolerance, increase embryo implantation rates, and help more couples with infertility with effective treatments.
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Affiliation(s)
- Yidi Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Zunhao Tang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xiuxiang Teng
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
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2
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Buigues A, Ramírez-Martin N, Martínez J, Pellicer N, Meseguer M, Pellicer A, Herraiz S. Systemic changes induced by autologous stem cell ovarian transplant in plasma proteome of women with impaired ovarian reserves. Aging (Albany NY) 2023; 15:14553-14573. [PMID: 38149997 PMCID: PMC10781467 DOI: 10.18632/aging.205400] [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: 06/15/2023] [Accepted: 11/10/2023] [Indexed: 12/28/2023]
Abstract
Patients with poor ovarian response (POR) and premature ovarian insufficiency (POI) are challenging to treat, with oocyte donation remaining as the only feasible option to achieve pregnancy in some cases. The Autologous stem cell ovarian transplantation (ASCOT) technique allows follicle development, enabling pregnancies and births of healthy babies in these patients. Previous results suggest that growth factors and cytokines secreted by stem cells are partially responsible for their regenerative properties. Indeed, ASCOT beneficial effects associate with the presence of different bone marrow derived stem cell- secreted factors in plasma. Therefore, the aim of this study was to assess whether ASCOT induce any modifications in the plasma proteomic profile of patients with impaired ovarian reserves. Discriminant analysis highlighted clear distinctions between the plasma proteome before (PRE), during stem cell mobilization and collection (APHERESIS) and three months after ASCOT (POST) in patients with POR and POI. Both the stem cell mobilization and ASCOT technique induced statistically significant modifications in the plasma composition, reversing some age-related protein expression changes. In the POR group, functional analysis revealed an enrichment in processes related to the complement cascade, immune system, and platelet degranulation, while in the POI group, enriched processes were also associated with responses to oxygen-containing compounds and growth hormones, and blood vessel maturation. In conclusion, our findings highlight the potential proteins and biological processes that may promote the follicle activation and growth observed after ASCOT. Identifying plasma proteins that regenerate aged or damaged ovaries could lead to more effective, targeted and/or preventive therapies for patients.
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Affiliation(s)
- Anna Buigues
- IVIRMA Global Research Alliance, IVI Foundation - Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia 46026, Spain
| | - Noelia Ramírez-Martin
- IVIRMA Global Research Alliance, IVI Foundation - Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia 46026, Spain
| | - Jessica Martínez
- IVIRMA Global Research Alliance, IVI Foundation - Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia 46026, Spain
| | - Nuria Pellicer
- IVIRMA Global Research Alliance, IVI Foundation - Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia 46026, Spain
- IVIRMA Global Research Alliance, IVIRMA Valencia, Valencia 46015, Spain
| | - Marcos Meseguer
- IVIRMA Global Research Alliance, IVI Foundation - Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia 46026, Spain
- IVIRMA Global Research Alliance, IVIRMA Valencia, Valencia 46015, Spain
| | - Antonio Pellicer
- IVIRMA Global Research Alliance, IVI Foundation - Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia 46026, Spain
- IVIRMA Global Research Alliance, IVIRMA Rome, Rome 00197, Italy
| | - Sonia Herraiz
- IVIRMA Global Research Alliance, IVI Foundation - Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia 46026, Spain
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3
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Lyu M, Su A, Zhang L, Gao W, Liu K, Yue F, Jing Y, Ma X, Liu L. Recombinant human granulocyte colony stimulating factor (rhG-CSF) participates in the progression of implantation via the hsa_circ_0001550-miRNA-mRNA interaction network. HUM FERTIL 2023; 26:1061-1072. [PMID: 35791760 DOI: 10.1080/14647273.2022.2093137] [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: 05/08/2021] [Accepted: 02/17/2022] [Indexed: 11/04/2022]
Abstract
Inadequate endometrial receptivity is a key factor affecting the successful implantation of embryos. Recombinant human granulocyte colony stimulating factor (rhG-CSF) can increase endometrial thickness and improve the outcomes of assisted reproductive technologies (ARTs). In this preliminary study, the function and possible molecular mechanisms of recombinant human granulocyte colony stimulating factor (rhG-CSF) which affects endometrial receptivity and implantation in human Embryonic Stem Cells (hESCs) were investigated. The cell viability of endometrial stromal cells treated with rhG-CSF 0.5 ng/ml for 24 h was significantly increased. Moreover, the expression of hsa_circ_0001550 was downregulated in endometrial stromal cells treated with rhG-CSF. Furthermore, the hsa_circ_0001550-miRNA-mRNA network was constructed and the downstream target genes (including 4 miRNAs and 117 mRNAs) of hsa_circ_0001550 were mainly involved in the cAMP and calcium signalling pathways, which play important roles in regulating endometrial receptivity and embryo implantation. We conclude that rhG-CSF participates in the regulation of embryo implantation by regulating the hsa_circ_0001550-miRNA-mRNA interaction network.
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Affiliation(s)
- Meng Lyu
- The First school of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Anchen Su
- The First school of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Lili Zhang
- The Reproductive Medicine Center, First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory of Reproductive Medicine and Embryo, Lanzhou, China
| | - Wenxin Gao
- The First school of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Kun Liu
- The Reproductive Medicine Center, First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory of Reproductive Medicine and Embryo, Lanzhou, China
| | - Feng Yue
- The Reproductive Medicine Center, First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory of Reproductive Medicine and Embryo, Lanzhou, China
| | - Yuanxue Jing
- The Reproductive Medicine Center, First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory of Reproductive Medicine and Embryo, Lanzhou, China
| | - Xiaoling Ma
- The First school of Clinical Medicine, Lanzhou University, Lanzhou, China
- The Reproductive Medicine Center, First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory of Reproductive Medicine and Embryo, Lanzhou, China
| | - Lin Liu
- The First school of Clinical Medicine, Lanzhou University, Lanzhou, China
- The Reproductive Medicine Center, First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory of Reproductive Medicine and Embryo, Lanzhou, China
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4
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Ding J, Wang J, Cai X, Yin T, Zhang Y, Yang C, Yang J. Granulocyte colony-stimulating factor in reproductive-related disease: Function, regulation and therapeutic effect. Biomed Pharmacother 2022; 150:112903. [PMID: 35430390 DOI: 10.1016/j.biopha.2022.112903] [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: 02/02/2022] [Revised: 03/14/2022] [Accepted: 03/27/2022] [Indexed: 11/16/2022] Open
Abstract
Granulocyte colony-stimulating factor (G-CSF) is one of the cytokines which plays important roles in embryo implantation and normal pregnancy. At the maternal-fetal interface, G-CSF can be synthesized by multiple cells, and participates in regulation of trophoblast development, endometrial decidualization, placental metabolism and angiogenesis. Moreover, as an important medium of intercellular communication, G-CSF has also been shown to exert key roles in crosstalk between cellular components at the maternal-fetal interface. Recently, our study demonstrated that G-CSF derived from M2 macrophage could promote trophoblasts invasion and migration through activating PI3K/AKT/Erk1/2 pathway, thereby involving in normal pregnancy program. Herein, we will summarize the role and regulation of G-CSF in normal pregnancy and reproductive-related disease, and the clinical applications of G-CSF in patients undergoing in vitro fertilization with thin endometrium, repeated implantation failure, and women suffered with recurrent spontaneous abortion.
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Affiliation(s)
- Jinli Ding
- Reproductive Medical Center, Renmin Hospital of Wuhan University & Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan 430060, China
| | - Jing Wang
- Reproductive Medical Center, Renmin Hospital of Wuhan University & Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan 430060, China
| | - Xiaopeng Cai
- Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University & Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center & The Clinical Medical Research Center of Peritoneal Cancer of Wuhan, Wuhan 430071, China
| | - Tailang Yin
- Reproductive Medical Center, Renmin Hospital of Wuhan University & Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan 430060, China
| | - Yan Zhang
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Chaogang Yang
- Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University & Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center & The Clinical Medical Research Center of Peritoneal Cancer of Wuhan, Wuhan 430071, China.
| | - Jing Yang
- Reproductive Medical Center, Renmin Hospital of Wuhan University & Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan 430060, China.
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5
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Samare-Najaf M, Zal F, Safari S, Koohpeyma F, Jamali N. Stereological and histopathological evaluation of doxorubicin-induced toxicity in female rats' ovary and uterus and palliative effects of quercetin and vitamin E. Hum Exp Toxicol 2020; 39:1710-1724. [PMID: 32666839 DOI: 10.1177/0960327120937329] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Doxorubicin (DOX) is a widely used chemotherapeutic agent with demonstrated reproductive toxicity. This study sought to determine the DOX-induced toxicity in the ovary and uterus and the preventive effects of quercetin (QCT) and vitamin E (Vit.E). Female rats were divided into six groups as follows: control, QCT (20 mg/kg), Vit.E (200 mg/kg), DOX (accumulative 15 mg/kg), DOX/QCT, and DOX/Vit.E. After 3 weeks, the toxicity of DOX in ovarian and uterine tissues and the potential palliative effects of QCT and Vit.E were evaluated by histopathological-stereological methods. The findings indicate a dramatic decline in the number of ovarian follicles (p < 0.001), ovarian and its associated structures volume, the volume of the uterus, its layers, and related structures (p < 0.05). Coadministration of QCT and Vit.E with DOX-treated rats demonstrated an alleviative effect on most of the studied parameters. Nevertheless, few adverse effects were recognized concerning these antioxidants administration (p < 0.05). In conclusion, the findings of this study support the protective role of these dietary supplements in the prevention of DOX-induced toxicity in uterine and ovarian tissues.
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Affiliation(s)
- M Samare-Najaf
- Department of Biochemistry, School of Medicine, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - F Zal
- Department of Biochemistry, School of Medicine, 48435Shiraz University of Medical Sciences, Shiraz, Iran.,Infertility Research Centre, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Safari
- Department of Pathology, Marvdasht Martyr Motahari Hospital, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - F Koohpeyma
- Endocrinology and Metabolism Research Center, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - N Jamali
- Department of Biochemistry, School of Medicine, 48435Shiraz University of Medical Sciences, Shiraz, Iran
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6
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Miralaei S, Ashrafi M, Arabipoor A, Zolfaghari Z, Taghvaei S. The incidence rate of unresponsive thin endometrium in frozen embryo transfer cycles: A case-series of therapy with granulocyte colony stimulating factor. Int J Reprod Biomed 2019; 17:923-928. [PMID: 31970314 PMCID: PMC6943793 DOI: 10.18502/ijrm.v17i12.5797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 06/03/2019] [Accepted: 08/14/2019] [Indexed: 12/15/2022] Open
Abstract
Background Treatment-resistant thin endometrium (TTE) during in-vitro fertilization is a relatively uncommon and challenging problem.
Objective The primary aim of the study was to assess the TTE rate during frozen embryo transfer (FET) cycles and the secondary aim was to evaluate the effect of intrauterine instillation of granulocyte colony stimulating factor (G-CSF) in these cases. Materials and Methods In this cross-sectional study, all of the women who underwent FET cycles with hormonal endometrial preparation in Royan Institute from June 2015 to March 2018 were evaluated and all of the cases with TTE diagnosis (endometrial thickness < 7 mm after using high doses of estradiol) were included. In the eligible cases, 300 μgr of G-CSF was infused intrauterine. If the endometrium had not reached at least a 7-mm, a second infusion was prescribed within 48 hr later. Results During the study, 8,363 of FET cycles were evaluated and a total of 30 infertile patients (0.35%) with TTE diagnosis were detected. Finally, 20 eligible patients were included. The changes of endometrial thickness after G-CSF therapy were significant (p < 0.001); however, the endometrial thickness did not reach 7 mm in nine patients (45%) and the embryo transfer was canceled. Conclusion It was found that the rate of TTE during the FET cycle is very low and intrauterine perfusion of G-CSF has a potential effect to increase the endometrial thickness in these patients; however, the rate of cancellation was still high and poor pregnancy outcomes were observed.
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Affiliation(s)
- Shokouhosadat Miralaei
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahnaz Ashrafi
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran.,Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Science (IUMS), Tehran, Iran
| | - Arezoo Arabipoor
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Zahra Zolfaghari
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Saeideh Taghvaei
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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7
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Wang T, Duan YM, Fu Q, Liu T, Yu JC, Sui ZY, Huang L, Wen GQ. IM-12 activates the Wnt-β-catenin signaling pathway and attenuates rtPA-induced hemorrhagic transformation in rats after acute ischemic stroke. Biochem Cell Biol 2019; 97:702-708. [PMID: 31770017 DOI: 10.1139/bcb-2018-0384] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Hemorrhagic transformation (HT) is a devastating complication for patients with acute ischemic stroke (AIS) who are treated with tissue plasminogen activator (tPA). HT is associated with high morbidity and mortality, but no effective treatments are currently available to reduce the risk of HT. Therefore, methods to prevent HT are urgently needed. In this study, we used IM-12, an inhibitor of glycogen synthase kinase 3β (GSK-3β), to evaluate the role of the Wnt-β-catenin signaling pathway in recombinant tPA (rtPA)-induced HT. Sprague-Dawley rats were subjected to a middle cerebral artery occlusion (MCAO) model of ischemic stroke, and then were either administered rtPA, rtPA combined with IM-12, or the vehicle at 4 h after stroke was induced. Our results indicate that rats subjected to HT had more severe neurological deficits, brain edema, and blood-brain barrier (BBB) breakdown, and had a greater infarction volume than the control group. Rats treated with IM-12 had improved outcomes compared with those of rats treated with rtPA alone. Moreover, IM-12 increased the protein expression of β-catenin and downstream proteins while suppressing the expression of GSK-3β. These results suggest that IM-12 reduces rtPA-induced HT and attenuates BBB disruption, possibly through activation of the Wnt-β-catenin signaling pathway, and provides a potential therapeutic strategy for preventing tPA-induced HT after AIS.
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Affiliation(s)
- Ting Wang
- Department of Neurology, Hainan General Hospital Affiliated to University of South China, Haikou 570311, Hainan Province, China
| | - Yu-Mei Duan
- Department of Neurology, Hainan General Hospital Affiliated to University of South China, Haikou 570311, Hainan Province, China
| | - Qiao Fu
- Department of Rehabilitation Medicine, Hainan General Hospital, Haikou 570311, Hainan Province, China
| | - Tao Liu
- Department of Neurology, Hainan General Hospital, Haikou 570311, Hainan Province, China
| | - Jin-Cheng Yu
- Department of Rehabilitation Medicine, Hainan General Hospital, Haikou 570311, Hainan Province, China
| | - Zhi-Yan Sui
- Department of Neurology, Hainan General Hospital, Haikou 570311, Hainan Province, China
| | - Li Huang
- Department of Neurology, Hainan General Hospital, Haikou 570311, Hainan Province, China
| | - Guo-Qiang Wen
- Department of Neurology, Hainan General Hospital, Haikou 570311, Hainan Province, China
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8
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Embryo transfer strategy and therapeutic options in infertile patients with thin endometrium: a systematic review. J Assist Reprod Genet 2019; 36:2217-2231. [PMID: 31502111 DOI: 10.1007/s10815-019-01576-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022] Open
Abstract
Human endometrium has a key role in implantation process. The measurement of endometrial thickness is the most commonly used in clinical practice. Managing patients with thin endometrium still represents a major challenge for clinicians. The objective of this systematic review was to investigate all available interventions to improve endometrial thickness (EMT) in women with history of thin endometrium undergoing fresh or frozen-thawed embryo transfers (ET). We performed a comprehensive search of relevant studies from January 1978 to February 2018. The different strategies were categorized as hormonal, vascular, and growth factor approaches and specifically analyzed according to the type of ET. Thirty-one studies were included. Overall, quality of the evidence ranged from very low to moderate, with only few randomized controlled trials that support the use of either GnRH analogues in fresh ET or sildenafil in frozen ET for enhancing endometrial growth. Besides, intensified estradiol administration is a common approach that might improve EMT in frozen ET. The present review evidences the paucity of reliable data regarding the efficiency of different interventions aiming at increasing EMT before fresh or frozen-thawed ET. Robust and high-quality randomized controlled trials are still needed before guidelines can be established.
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9
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Robert CA, Abbas MK, Zaidi ARZ, Thiha S, Malik BH. Mediator in the Embryo-endometrium Cross-talk: Granulocyte Colony-stimulating Factor in Infertility. Cureus 2019; 11:e5390. [PMID: 31428551 PMCID: PMC6695290 DOI: 10.7759/cureus.5390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Successful implantation requires a receptive endometrium and a good quality egg. The challenges a physician encounters with regard to this in assisted reproductive technology are obtaining good quality embryo, achieving optimal endometrial thickness (EMT), and subsequently implantation, which is denotive of a receptive endometrium. Granulocyte colony-stimulating factor (G-CSF) has been observed to be a biomarker of oocyte quality and has been shown to enhance EMT and implantation because of its immunological effects. A systematic search for all relevant articles on G-CSF in follicular fluid and its therapeutic benefit in thin endometrium and recurrent implantation failure was performed, and peer-reviewed, full-text articles related to humans were included in the study. As a tool to determine the potentiality of oocyte, G-CSF shows promise with its predictability increasing in combination with morphological embryo scoring or interleukin 15. For the thin endometrium, G-CSF is especially useful in patients who are refractory to other treatment modalities. In recurrent implantation failure (RIF), G-CSF showed potential in a subset of patients with immunological deficiency lacking killer cell immunoglobulin-like receptor genes. This review highlights the various forms of usage of G-CSF and the effectiveness of G-CSF in infertility. G-CSF equips embryologists with a tool to determine the potentiality of oocyte and physicians with therapy for thin endometrium and RIF, especially since the available treatment options are ineffective.
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Affiliation(s)
- Chris A Robert
- Obstetrics & Gynecology, California Institute of Behavioral Neurosciences and Psychology, California, USA
| | - Mohammed K Abbas
- Internal Medicine, California Instititute of Behavioral Neurosciences and Psychology, California, USA
| | - Abdul Rehman Z Zaidi
- Research, California Institute of Behavioral Neurosciences and Psychology, California, USA
| | - Suyeewin Thiha
- Internal Medicine, California Institute of Behavioural Neurosciences and Psychology, California, USA
| | - Bilal Haider Malik
- Medicine, California Institute of Behavioral Neurosciences and Psychology, California, USA
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10
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Nazari L, Salehpour S, Hoseini S, Zadehmodarres S, Azargashb E. Effects of autologous platelet-rich plasma on endometrial expansion in patients undergoing frozen-thawed embryo transfer: A double-blind RCT. Int J Reprod Biomed 2019; 17:443-448. [PMID: 31508569 PMCID: PMC6719514 DOI: 10.18502/ijrm.v17i6.4816] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/25/2018] [Accepted: 01/30/2019] [Indexed: 12/29/2022] Open
Abstract
Background Adequate endometrial growth is principal for implantation and pregnancy. Thin endometrium is associated with lower pregnancy rate in assisted reproductive technology. Some frozen-thawed embryo transfer cycles are cancelled due to inadequate endometrial growth. Objective To assess the effectiveness of autologous platelet-rich plasma (PRP) intrauterine infusion for the treatment of thin endometrium. Materials and Methods A total of 72 patients who had a history of cancelled frozen-thawed embryo transfer cycle due to the thin endometrium ( < 7mm) were assessed for the eligibility to enter the study between 2016 and 2017. Twelve patients were excluded for different reasons, and 60 included patients were randomly assigned to PRP or sham-catheter groups in a double-blind manner. Hormone replacement therapy was administered for endometrial preparation in all participants. PRP intrauterine infusion or shamcatheter was performed on day 11-12 due to the thin endometrium and it was repeated after 48 hr if necessary. Results Endometrial thickness increased at 48 hr after the first intervention in both groups. All participants needed second intervention due to an inadequate endometrial expansion. After second intervention, endometrial thickness was 7.21 ± 0.18 and 5.76 ± 0.97 mm in the PRP group and sham-catheter group, respectively. There was a significant difference between the two groups. (p < 0.001). Embryo transfer was done for all patients in PRP group and just in six cases in the sham-catheter group. Chemical pregnancy was reported in twelve cases in the PRP group and two cases in the sham-catheter group. Conclusion According to this trial, PRP was effective in endometrial expansion in patients with refractory thin endometrium.
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Affiliation(s)
- Leila Nazari
- Department of Obstetrics and Gynecology, School of Medicine, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saghar Salehpour
- Department of Obstetrics and Gynecology, School of Medicine, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedighe Hoseini
- Department of Obstetrics and Gynecology, School of Medicine, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Zadehmodarres
- Department of Obstetrics and Gynecology, School of Medicine, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Eznoallah Azargashb
- Department of Health and Social Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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11
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Liu KE, Hartman M, Hartman A. Management of thin endometrium in assisted reproduction: a clinical practice guideline from the Canadian Fertility and Andrology Society. Reprod Biomed Online 2019; 39:49-62. [PMID: 31029557 DOI: 10.1016/j.rbmo.2019.02.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/12/2019] [Indexed: 02/03/2023]
Abstract
The impact and management of thin endometrium is a common challenge for patients undergoing assisted reproduction. The objective of this Canadian Fertility and Andrology Society (CFAS) guideline is to provide evidence-based recommendations using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework on the assessment, impact and management of thin endometrium in assisted reproduction. The effect of endometrial thickness on pregnancy and live birth outcomes in ovarian stimulation and IVF (fresh and frozen cycles) is addressed. In addition, recommendations on the use of adjuvants to improve endometrial thickness and pregnancy outcomes are provided.
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Affiliation(s)
- Kimberly E Liu
- Mount Sinai Fertility, 250 Dundas St. W, Suite 700, Dept of Obstetrics and Gynecology, Mount Sinai Hospital, 600 University Ave., University of Toronto, Toronto ON, M5T 2Z5, Canada.
| | - Michael Hartman
- Trio Fertility, 655 Bay St., Suite 1101, Toronto ON, M5G 2K4, Canada
| | - Alex Hartman
- True North Imaging, 7330 Yonge St., Suite 120, Thornhill ON, L4J 7Y7, Canada
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12
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Wang Y, Sun Y, Di W, Kuang YP, Xu B. Association between induced abortion history and later in vitro fertilization outcomes. Int J Gynaecol Obstet 2018; 141:321-326. [PMID: 29508914 DOI: 10.1002/ijgo.12481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 12/19/2017] [Accepted: 03/01/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Yao Wang
- Department of Assisted Reproduction; Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Yun Sun
- Center for Reproductive Medicine; Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics; Renji Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Wen Di
- Department of Gynecology and Obstetrics; Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Yan-ping Kuang
- Department of Assisted Reproduction; Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Bing Xu
- Center for Reproductive Medicine; Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics; Renji Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
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Zhu M, Huang X, Yi S, Sun H, Zhou J. High granulocytic myeloid-derived suppressor cell levels in the peripheral blood predict a better IVF treatment outcome. J Matern Fetal Neonatal Med 2017; 32:1092-1097. [PMID: 29092663 DOI: 10.1080/14767058.2017.1400002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mengchen Zhu
- Reproductive Medicine Center, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Xiaomin Huang
- Reproductive Medicine Center, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Shanling Yi
- Reproductive Medicine Center, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Haixiang Sun
- Reproductive Medicine Center, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
| | - Jianjun Zhou
- Reproductive Medicine Center, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
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Mouhayar Y, Sharara FI. G-CSF and stem cell therapy for the treatment of refractory thin lining in assisted reproductive technology. J Assist Reprod Genet 2017; 34:831-837. [PMID: 28405864 DOI: 10.1007/s10815-017-0922-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 04/05/2017] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The study aims to describe two promising therapeutic options for resistant "thin" endometrium in fertility treatment: granulocyte colony-stimulating factor (G-CSF) and stem cell therapy. METHODS A review of the scientific literature related to patients with thin endometrium undergoing fertility treatment. RESULTS Sufficient endometrial growth is fundamental for embryo implantation. Whether idiopathic or resulting from an underlying pathology, a thin endometrium of <7 mm is associated with lower probability of pregnancy; however, no specific thickness excludes the occurrence of pregnancy. We specifically reviewed two relatively new treatment options for resistant thin lining: intrauterine G-CSF and stem cell therapy. The majority of the reviewed trials showed a significant benefit for intrauterine G-CSF infusion in improving endometrial thickness and pregnancy rates. Early results of stem cell therapy trials seem promising. CONCLUSIONS EMT <7 mm is linked to lower probability of pregnancy in assisted reproductive technology. Intrauterine G-CSF infusion appears to be a potentially successful treatment option for resistant cases, while stem cell therapy seems to be a promising new treatment modality in severely refractory cases.
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Affiliation(s)
- Youssef Mouhayar
- Department of OB/GYN, University of Miami/Jackson Memorial Hospital, Miami, FL, USA
| | - Fady I Sharara
- Virginia Center for Reproductive Medicine, 11150 Sunset Hills Rd, Suite, Reston, VA, 100, USA. .,Depatment of OB/GYN, George Washington University, Washington, DC, USA.
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