ESHRE good practice recommendations on recurrent implantation failure

Human Reproduction Open, Год журнала: 2023, Номер 2023(3)

Опубликована: Янв. 1, 2023

Abstract STUDY QUESTION How should recurrent implantation failure (RIF) in patients undergoing ART be defined and managed? SUMMARY ANSWER This is the first ESHRE good practice recommendations paper providing a definition for RIF together with on how to investigate causes contributing factors, improve chances of pregnancy. WHAT IS KNOWN ALREADY challenge clinic, multitude investigations interventions offered applied clinical practice, often without biological rationale or unequivocal evidence benefit. DESIGN, SIZE, DURATION document was developed according predefined methodology recommendations. Recommendations are supported by data from literature, if available, results previously published survey expertise working group. A literature search performed PubMed Cochrane focussing ‘recurrent reproductive failure’, ‘repeated failure’. PARTICIPANTS/MATERIALS, SETTING, METHODS The Working Group Recurrent Implantation Failure included eight members representing Special Interest Groups Early Pregnancy, Reproductive Endocrinology, Embryology, an independent chair expert statistics. were formulated based opinion group, while taking into consideration uptake practice. draft then open online peer review revised light comments received. MAIN RESULTS AND THE ROLE OF CHANCE group recommends considering as secondary phenomenon ART, it can only observed IVF, that following description adopted: ‘RIF describes scenario which transfer embryos considered viable has failed result positive pregnancy test sufficiently specific patient warrant further and/or interventions'. It agreed recommended threshold cumulative predicted chance identify purposes initiating investigation 60%. When couple have not had successful certain number embryo transfers associated greater than 60%, they counselled treatment options. term defines actions considered. Nineteen when suspected, 13 interventions. colour-coded whether investigations/interventions (green), (orange), recommended, i.e. routinely (red). LIMITATIONS, REASONS FOR CAUTION While awaiting studies trials, identifying individual restrict treatments those clear indicating their likely WIDER IMPLICATIONS FINDINGS article provides advice but also highlights need research. research, well-conducted, will key making progress management RIF. FUNDING/COMPETING INTEREST(S) meetings technical support this project funded ESHRE. N.M. declared consulting fees ArtPRED (The Netherlands) Freya Biosciences (Denmark); Honoraria lectures Gedeon Richter, Merck, Abbott, IBSA; being co-founder Verso Biosense. He Co-Chief Editor Biomedicine Online (RBMO). D.C. Associate Human Reproduction Update, honoraria Organon, IBSA, Fairtility; attending Cooper Surgical, Fujifilm Irvine Scientific. G.G. he his institution received financial non-financial lectures, workshops, advisory roles, travelling Ferring, Gedeon-Richter, PregLem, Vifor, MSD, Coopersurgical, ObsEVA, ReprodWissen. journals Archives Obstetrics Gynecology Online, Chief Journal Gynäkologische Endokrinologie. involved guideline developments quality control national international level. G.L. Vianex/Organon, MSD. immediate past Coordinator Endocrinology been Guideline Development fertility authorities. D.J.M. Open statistical Advisor Online. B.T. shareholder Reprognostics she her roles Exeltis, Merck Serono, Bayer, Teva, Theramex Novartis, Astropharm, Ferring. other authors nothing disclose. DISCLAIMER Good Practice (GPR) represents views ESHRE, consensus between relevant stakeholders scientific available at time preparation. GPRs used information educational purposes. They interpreted setting standard care deemed inclusive all proper methods care, exclusive reasonably directed obtaining same results. do replace application judgement each presentation, variations locality facility type. Furthermore, constitute imply endorsement, favouring, any technologies

Язык: Английский

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Challenges in Clinical Diagnosis and Management of Chronic Endometritis

Diagnostics, Год журнала: 2022, Номер 12(11), С. 2711 - 2711

Опубликована: Ноя. 5, 2022

Chronic endometritis (CE) is a local mucosal infectious and inflammatory disorder characterized by unusual filtration of CD138(+) endometrial stromal plasmacytes. CE attracting attention due to its potential association with infertility unknown etiology, repeated implantation failure, recurrent pregnancy loss, several maternal/neonatal complications. Due the variance in study design among researchers, universal diagnostic criteria remain be established for clinical diagnosis management CE. This review article aims summarize current knowledge provide insights into unsolved questions on establish guidelines disease from viewpoint human reproduction.

Язык: Английский

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Endometrial scratching before euploid embryo transfer: a case–control study

Journal of Assisted Reproduction and Genetics, Год журнала: 2025, Номер unknown

Опубликована: Янв. 17, 2025

Язык: Английский

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Clinical Management of Chronic Endometritis in Recurrent Pregnancy Loss

Early pregnancy, Год журнала: 2025, Номер unknown, С. 22 - 31

Опубликована: Апрель 16, 2025

Язык: Английский

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Exosomes secreted from adipose-derived stem cells inhibit M1 macrophage polarization ameliorate chronic endometritis by regulating SIRT2/NLRP3

Molecular and Cellular Biochemistry, Год журнала: 2025, Номер unknown

Опубликована: Апрель 21, 2025

Язык: Английский

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Precision Medicine for Chronic Endometritis: Computer-Aided Diagnosis Using Deep Learning Model

Diagnostics, Год журнала: 2023, Номер 13(5), С. 936 - 936

Опубликована: Март 1, 2023

Chronic endometritis (CE) is a localized mucosal infectious and inflammatory disorder marked by infiltration of CD138(+) endometrial stromal plasmacytes (ESPC). CE drawing interest in the field reproductive medicine because its association with female infertility unknown etiology, endometriosis, repeated implantation failure, recurrent pregnancy loss, multiple maternal/newborn complications. The diagnosis has long relied on somewhat painful biopsy histopathologic examinations combined immunohistochemistry for CD138 (IHC-CD138). With IHC-CD138 only, may be potentially over-diagnosed misidentification epithelial cells, which constitutively express CD138, as ESPCs. Fluid hysteroscopy emerging an alternative, less-invasive diagnostic tool that can visualize whole uterine cavity real-time enables detection several unique findings associated CE. biases hysteroscopic CE; however, are inter-observer intra-observer disagreements interpretation endoscopic findings. Additionally, due to variances study designs adopted criteria, there exists some dissociation among researchers. To address these questions, novel dual another plasmacyte marker myeloma oncogene 1 currently being tested. Furthermore, computer-aided using deep learning model developed more accurate These approaches have potential contribute reduction human errors biases, improvement performance CE, establishment unified criteria standardized clinical guidelines disease.

Язык: Английский

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Current perspectives on endometrial receptivity: A comprehensive overview of etiology and treatment

Journal of Obstetrics and Gynaecology Research, Год журнала: 2023, Номер 49(10), С. 2397 - 2409

Опубликована: Авг. 1, 2023

Abstract Recurrent implantation failure (RIF) remains a challenging problem in assisted reproductive technology (ART). Further insights into uterine abnormalities that can disturb embryo should be obtained. This review provides an overview of the effects organic and non‐organic disorders on endometrial receptivity. The results suggest various pathologies lead to defective via multiple mechanisms. In particular, adenomyosis dysregulates molecular cellular interactions are vital for successful with background chronic inflammation, which may alleviated by pretreatment gonadotropin‐releasing hormone agonist. Uterine myomas cause deformation adverse alterations contractility. Nonetheless, effectiveness myomectomy debated, polyp removal considered, particularly patients RIF. Chronic endometritis abrogates appropriate immunological environment critical implantation. Abnormal microbiota have been suggested influence receptivity; however, supporting evidence is currently scarce. Platelet‐rich plasma therapy potential treatment thin endometria; nevertheless, further validation required. Endometrial receptivity analysis detect dysregulation window implantation, new non‐invasive methods predicting recently proposed. However, numerous issues still need fully clarified. clinical basic studies necessary investigate pathophysiology identify optimal treatments undergoing ART, especially those

Язык: Английский

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Bridging the Diagnostic Gap between Histopathologic and Hysteroscopic Chronic Endometritis with Deep Learning Models

Medicina, Год журнала: 2024, Номер 60(6), С. 972 - 972

Опубликована: Июнь 12, 2024

Chronic endometritis (CE) is an inflammatory pathologic condition of the uterine mucosa characterized by unusual infiltration CD138(+) endometrial stromal plasmacytes (ESPCs). CE often identified in infertile women with unexplained etiology, tubal factors, endometriosis, repeated implantation failure, and recurrent pregnancy loss. Diagnosis has traditionally relied on biopsy histopathologic/immunohistochemistrical detection ESPCs. Endometrial biopsy, however, a somewhat painful procedure for subjects does not allow us to grasp whole picture this mucosal tissue. Meanwhile, fluid hysteroscopy been recently adopted as less-invasive diagnostic modality CE. We launched ARCHIPELAGO (ARChival Hysteroscopic Image-based Prediction histopathologic chronic Endometritis using deep LeArninG mOdel) study construct hysteroscopic finding-based prediction tools The development these learning-based novel models computer-aided detection/diagnosis systems potentially benefits suffering from elusive disease.

Язык: Английский

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Combined oral antibiotics and intrauterine perfusion can improve in vitro fertilization and embryo transfer pregnancy outcomes in patients with chronic endometritis and repeated embryo implantation failure

BMC Women s Health, Год журнала: 2023, Номер 23(1)

Опубликована: Июнь 30, 2023

Abstract Background The aim of this retrospective study was to investigate whether oral antibiotics (doxycycline and metronidazole) combined with intrauterine perfusion (gentamicin dexamethasone) are beneficial for patients repeated implantation failure (RIF) chronic endometritis (CE) improve clinical pregnancy outcomes. Methods Patients RIF CE were diagnosed using hysteroscopy histology together. A total 42 enrolled in the study. All received 22 underwent immediately after end antibiotic therapy. Pregnancy outcomes evaluated during first vitro fertilization (IVF) embryo transfer (ET) cycle. Results For D3 ET treatment dexamethasone), higher rate (30.95% vs. 26.67%, P = 0.0308), (30% 50%, < 0.001), live birth (33.33% 45.45%, 0.0001). No fetal malformations or ectopic pregnancies observed. Conclusion We report as a novel successful compared those alone.

Язык: Английский

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Narrative Review of Multifaceted Approaches to Managing Recurrent Implantation Failure: Insights and Innovations

Clinical and Experimental Obstetrics & Gynecology, Год журнала: 2024, Номер 51(4), С. 87 - 87

Опубликована: Март 27, 2024

Objective: We aimed to explore the multifaceted etiology of recurrent implantation failure (RIF) and evaluate efficacy various management strategies, with a focus on refining examination protocols treatment pathways improve success rates in patients undergoing vitro fertilization-embryo transfer. Mechanism: The development RIF can be attributed complex causal network factors. Chromosomal anomalies, such as aneuploidies, directly impact genetic viability embryos. Immune system dysregulation, marked by presence autoantibodies, disrupts normal immunological tolerance required for successful implantation. Endocrine disruptions interfere hormonal balance essential preparing endometrium Anatomical irregularities female reproductive tract physically impede embryo's ability implant. Lifestyle factors, including diet, stress, environmental exposures, influence both male health, affecting gamete quality potential. These diverse factors interact manner, making personalized diagnostic therapeutic approach addressing specific causes each case RIF. Findings brief: review synthesizes current understanding RIF's etiology, highlighting need innovative interventions adjustments clinical practice. It emphasizes significance highly managing RIF, incorporating refined tailor-made address unique combination present case. Conclusions: Effective requires shift practice towards care. Identifying gaps points clear direction future research, at improving outcomes patients. This contributes significantly broader field medicine, aiming alleviate psychological burdens

Язык: Английский

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