Good practice recommendations on add-ons in reproductive medicine

Human Reproduction, Journal Year: 2023, Volume and Issue: 38(11), P. 2062 - 2104

Published: Sept. 25, 2023

Abstract STUDY QUESTION Which add-ons are safe and effective to be used in ART treatment? SUMMARY ANSWER Forty-two recommendations were formulated on the use of diagnosis fertility problems, IVF laboratory clinical management treatment. WHAT IS KNOWN ALREADY The innovative nature combined with extremely high motivation patients has opened door wide application what become known as ‘add-ons’ reproductive medicine. These supplementary options available addition standard procedures, typically incurring an additional cost. A diverse array is made available, encompassing tests, drugs, equipment, complementary or alternative therapies, surgical interventions. share common aim stating enhance pregnancy live birth rates, mitigate risk miscarriage, expedite time achieving pregnancy. DESIGN, SIZE, DURATION ESHRE aimed develop clinically relevant evidence-based focusing safety efficacy currently procedures order improve quality care for infertility. PARTICIPANTS/MATERIALS, SETTING, METHODS appointed a European multidisciplinary working group consisting practising clinicians, embryologists, researchers who have demonstrated leadership expertise research Patient representatives included group. To ensure that guidelines evidence-based, literature identified from systematic search was reviewed critically appraised. In absence any clear scientific evidence, based professional experience consensus thus best evidence expert agreement. Prior publication, by 46 independent international reviewers. total 272 comments received incorporated where relevant. MAIN RESULTS AND THE ROLE OF CHANCE 42 three sections; diagnostic tests interventions, management. LIMITATIONS, REASONS FOR CAUTION Of recommendations, none could high-quality only four moderate-quality implicating 95% supported low-quality randomized controlled trials, observational data, experience, development WIDER IMPLICATIONS FINDINGS offer valuable direction healthcare professionals responsible undergoing treatment Their purpose promote treatment, enabling make informed decisions realistic expectations. fully about various them likelihood test chance birth. FUNDING/COMPETING INTEREST(S) All costs relating process covered funds. There no external funding manuscript production. K.L. reports speakers fees Merck part study Vitrolife (unpaid). T.E. consulting Gynemed, Gynemed advisory board Hamilton Thorne. N.P.P. grants Serono, Ferring Pharmaceutical, Theramex, Gedeon Richter, Organon, Roche, IBSA Besins Healthcare, Healthcare. S.R.H. declares being managing director Fertility Europe, not-for-profit organization receiving financial support ESHRE. I.S. advisor stock Alife Health, co-founder IVFvision LTD (unpaid) speakers’ fee 2023 Young Leader Prestige workshop China. A.P. Pharmaceuticals A/S, Preglem, Novo Nordisk, Pharmaceuticals, Cryos Theramex travel Richter. other authors disclosed conflicts interest. DISCLAIMER This Good Practice Recommendations (GPRs) document represents views ESHRE, which result between stakeholders at preparation. GPRs should information educational purposes. They not interpreted setting bedeemedinclusive all proper methods care, exclusive reasonably directed obtaining same results.Theydo replace need judgement each individual presentation, variations locality facility type. Furthermore, do constitute imply endorsement, favouring, technologies

Language: Английский

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Does recurrent implantation failure exist? Prevalence and outcomes of five consecutive euploid blastocyst transfers in 123 987 patients

Human Reproduction, Journal Year: 2024, Volume and Issue: 39(5), P. 974 - 980

Published: March 7, 2024

Abstract STUDY QUESTION What are the clinical pregnancy and live birth rates in women who underwent up to two more euploid blastocyst transfers after three failures absence of another known factor that affects implantation? SUMMARY ANSWER The fourth fifth resulted similar 40% 53.3%, respectively, culminating a cumulative rate 98.1% (95% CI = 96.5–99.6%) five transfers. WHAT IS KNOWN ALREADY first blastocysts have implantation provide 92.6%. DESIGN, SIZE, DURATION An international multi-center retrospective study was conducted at 25 individual clinics. period spanned between January 2012 December 2022. A total 123 987 patients with 64 572 were screened for inclusion. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients history any embryo transfer clinic, unscreened participating clinics, parental karyotype abnormalities, use donor oocytes or gestational carrier, untreated intracavitary uterine pathology (e.g. polyp, leiomyoma), congenital anomalies, adenomyosis, communicating hydrosalpinx, endometrial thickness <6 mm prior initiating progesterone, testicular sperm due non-obstructive azoospermia male partner, an reported intermediate chromosome copy number (i.e. mosaic), preimplantation genetic testing cycles monogenic disorders, structural rearrangements excluded. Ovarian stimulation protocols embryology laboratory procedures including trophectoderm biopsy followed usual practice each center. ploidy status determined comprehensive screening. Endometrial preparation centers included programmed cycles, natural modified cycles. MAIN RESULTS AND THE ROLE OF CHANCE 105 (0.085% population) met criteria least one additional failing achieve positive test consecutive Outcomes across centers. Overall, (40% vs relative risk 1.33, 95% 0.93–1.9, P value 0.14). Sensitivity analyses excluding biopsied on Day 7 postfertilization, BMI >30 kg/m2, using non-ejaculate sperm, double-embryo which day receptivity assay result yielded results. Where data available, had (relative 0.84, 0.58–1.21, 0.29). 96.5–99.6%). LIMITATIONS, REASONS FOR CAUTION Retrospective design has its own inherent limitations. continuing further dropping out from treatment failed can be systematically different, perhaps regard ovarian reserve economic status. WIDER IMPLICATION FINDINGS Implantation failure seems mainly embryonic factors. Given stable high blastocysts, unexplained recurrent should prevalence <2%. Proceeding best next step once etiology is ruled out. FUNDING/COMPETING INTEREST(s) None. TRIAL REGISTRATION NUMBER N/A.

Language: Английский

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Time-series single-cell transcriptomic profiling of luteal-phase endometrium uncovers dynamic characteristics and its dysregulation in recurrent implantation failures

Nature Communications, Journal Year: 2025, Volume and Issue: 16(1)

Published: Jan. 2, 2025

Language: Английский

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Effect of Comprehensive Individualised Interventions on the Clinical Outcomes of Patients With Recurrent Implantation Failure: A Single‐Centre Retrospective Cohort Study

BJOG An International Journal of Obstetrics & Gynaecology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 11, 2025

ABSTRACT Objective The objective of this study is to evaluate the impact comprehensive individualised interventions on clinical outcomes patients with recurrent implantation failure (RIF), as few studies have evaluated their effectiveness. Design Retrospective cohort study. Setting Tertiary hospital, from June 2016 December 2022. Population Overall, 1546 RIF underwent endometrial biopsy during implantation. Methods were conducted basis histological dating, CD138 count, immune‐cell proportion and microbiota testing. Main Outcome Measures Cumulative ongoing pregnancy rate (cOPR). Results median number failed transfer cycles was 3 (range, 2–12), cOPR 58.0%. rates window (WOI) displacement, positivity, imbalanced proportion, testing, multiple factors unexplained 34.0%, 9.3%, 7.5%, 4.1%, 32.4% 12.7%, respectively. cOPRs frozen embryo transfers in having WOI 64.1%, 57.6%, 55.1%, 38%, 64.2% 34.5%, After adjusting for basic characteristics through logistic regression analysis, displacement group, positive group remained higher than that group. However, comparable between testing groups. Conclusion Comprehensive may improve RIF, warranting further investigation.

Language: Английский

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Causes of embryo implantation failure: A systematic review and metaanalysis of procedures to increase embryo implantation potential

Frontiers in Endocrinology, Journal Year: 2025, Volume and Issue: 15

Published: Feb. 14, 2025

Introduction Infertility is characterized by the failure to conceive after 12 months of unprotected sexual intercourse. In assisted reproduction technologies (ARTs), in-vitro fertilization and embryo transfer (IVF-ET) are pivotal, with quality essential for successful implantation. Objective This systematic review meta-analysis aimed explore prevalence embryonic factors involved in implantation process, concentrating on following research inquiries: 1) rates euploid versus untested transfers; 2) efficiency transferring good embryos different age groups; 3) impact transfers gestational carriers; 4) donated gametes/embryos. The goal identify critical points improve therapies. Methods A comprehensive literature search identified 1474 relevant papers, 11 which met inclusion criteria. information was gathered using a standardized form, risk bias evaluated. subgroups determine conducted synthesize results. Furthermore, data extracted from registries document persistent secondary role extraembryonic determinants Results demonstrated that preimplantation genetic testing aneuploidy (PGT-A) significantly increased odds Age found influence factors, older women experiencing reduced as carriers. However, overall incidence low. highlights need focus PGT-A, diagnostic hysteroscopy, endometrial receptivity improving rates. Conclusion Implantation success ARTs largely depends euploidy. While achieving three greatly increases rates, it challenging women. Extraembryonic although present, have marginal impact. Subsequent studies ought concentrate modulating responses immunologically developing algorithms precision predicting success; well timing occurrence dormant phenomena also warrants further investigation.

Language: Английский

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Is it justified to offer intrauterine infusion of autologous PRP in women with repeated implantation failure?

Human Reproduction, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 23, 2025

Abstract In recent years, an increased interest in the efficacy of intrauterine infusion autologous platelet-rich plasma (PRP) women with repeated implantation failure (RIF) has resulted publication 13 randomized controlled trials (RCTs) and 11 meta-analyses. Although these meta-analyses support increase pregnancy rates after PRP, low quality available original clinical studies along concerns regarding their trustworthiness seriously questions internal validity does not allow for definitive conclusions to be drawn. addition, variability definition RIF used individual limits external validity, renders pooling results problematic, and, overall, complicates extrapolation published. The been recently addressed by ESHRE, which published evidence-based facilitate evaluation interventions patients. Taking into consideration this definition, identifies a real problem, PRP literature so far performed explicitly patients RIF. potential improve outcomes remains important area research ART. However, current evidence is insufficient inform practice, highlighting need well-designed provide clearer guidance.

Language: Английский

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Role of HOXA10 in pathologies of the endometrium

Reviews in Endocrine and Metabolic Disorders, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 5, 2024

Language: Английский

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Chronic Endometritis and Uterine Endometrium Microbiota in Recurrent Implantation Failure and Recurrent Pregnancy Loss

Biomedicines, Journal Year: 2023, Volume and Issue: 11(9), P. 2391 - 2391

Published: Aug. 27, 2023

The aim of this study was to evaluate whether chronic endometritis (CE) and uterine endometrium microbiota were associated with repeated implantation failures (RIFs) recurrent pregnancy losses (RPLs). In prospective study, endometrial specimens obtained from 24 women RIF, 27 RPL, 29 fertile control women. Immunohistochemical staining CD138 for CE 16S ribosomal RNA (rRNA) sequencing analysis performed simultaneously. To assess CE, Liu’s method, McQueen scores plasma cell count/10 mm2 used. frequency (plasma cells > 5.15/10 mm2) higher in RPL (29.6%) than controls (6.8%, p < 0.05). (median 1.53, range 0–252.6, 0.01) RIF 0.6, 0–6.98, 0.05) 0, 0–29). or not significantly different that controls. However, the relative dominance rate Lactobacillus iners 4.7%, 0–99.9 vs. median 0%, 0–100, 0.001) positive Ureaplasma species (36.3% 8.6%, 11 69 without CE. results suggest may be involved pathophysiology RIF. etiology

Language: Английский

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The number of previous implantation failures is a critical determinant of intrauterine autologous platelet‐rich plasma infusion success in women with recurrent implantation failure

Reproductive Medicine and Biology, Journal Year: 2024, Volume and Issue: 23(1)

Published: Jan. 1, 2024

We aimed to identify factors influencing the reproductive outcomes of frozen-thawed embryo transfer (FET) with intrauterine autologous platelet-rich plasma (PRP) infusion in patients either a thin endometrium or recurrent implantation failure (RIF) despite normal endometrial appearance.

Language: Английский

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Uterus didelphys: the first case report on molecular profiling of endometrial tissue from both uterine cavities

Reproductive Biology and Endocrinology, Journal Year: 2025, Volume and Issue: 23(1)

Published: Jan. 4, 2025

Language: Английский

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