Immunological Risk Factors in Recurrent Pregnancy Loss: Guidelines Versus Current State of the Art

Journal of Clinical Medicine, Год журнала: 2021, Номер 10(4), С. 869 - 869

Опубликована: Фев. 20, 2021

Around 1-5% of all couples experience recurrent pregnancy loss (RPL). Established risk factors include anatomical, genetic, endocrine, and hemostatic alterations. With around 50% idiopathic cases, immunological are getting into the scientific focus, however international guidelines hardly take them account. Within this review, current state in RPL European Society Reproduction Embryology (ESHRE), American Reproductive Medicine (ASRM), German/Austrian/Swiss Obstetrics Gynecology (DGGG/OEGGG/SGGG) Royal College Obstetricians Gynecologists (RCOG) evaluated. Special attention was drawn to recommendations regarding diagnostic such as autoantibodies, natural killer cells, regulatory T dendritic plasma human leukocyte antigen system (HLA)-sharing well treatment options corticosteroids, intralipids, intravenous immunoglobulins, aspirin heparin RPL. Finally, art focusing on both therapeutic summarized.

Язык: Английский

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Approaches to Improve Endometrial Receptivity in Case of Repeated Implantation Failures

Frontiers in Cell and Developmental Biology, Год журнала: 2021, Номер 9

Опубликована: Март 16, 2021

Repeated implantation failures are a constant challenge in reproductive medicine with significant impact both on health providers and infertile couples. Several approaches have been proposed so far as effective; however, accumulative data clarified that most of the treatment options do not evidence base for generalized application to be suggested by relevant societies. Implantation attributed either poor quality embryos or defected endometrial receptivity. The current review aims summarize systematic way all new trends managing RIF via interference authors focus mainly, but exclusively, injury prior embryo transfer priming autologous cells biological agents. To this direction, search Pubmed database has conducted taking into account emerged last two decades. All interventions herein presented analyzed terms outcomes. It is evident properly powered designed randomized trials needed support standard approach will safely incorporated national international guidelines.

Язык: Английский

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Does antibiotic therapy for chronic endometritis improve clinical outcomes of patients with recurrent implantation failure in subsequent IVF cycles? A systematic review and meta-analysis

Journal of Assisted Reproduction and Genetics, Год журнала: 2022, Номер 39(8), С. 1797 - 1813

Опубликована: Июль 13, 2022

Язык: Английский

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Diagnosing chronic endometritis: when simplification fails to clarify

Human Reproduction Open, Год журнала: 2022, Номер 2022(3)

Опубликована: Янв. 1, 2022

Abstract Reproductive immunology has grown in importance recent years and even developed into a discipline of its own within the field reproductive medicine. Many aspects failure such as repeated implantation or recurrent miscarriages are, meanwhile, seen consequence aberrant expression immunological factors. This is reflected by increasing number tests for assessing quantifying different immune cell types well wide range therapies offered to clientele consisting desperate patients requesting additional ‘IVF tools’: first, what still usually disregarded enormous plasticity fluctuation most cells genital tract; second, their poorly characterized functions endometrial cycle: further, partially unknown role embryo establishing pregnancy; third, fact that one fundamental hypotheses immunology—of note—the Medawar concept ‘Medawar's Paradox’ semi-allogeneic graft embryo, based on an erroneous assumption, i.e. immunologic rejection tolerance embryo. In present opinion article, we comment diagnostic procedures therapy approaches chronic endometritis scope

Язык: Английский

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Endometrial factors and pregnancy loss frequency in recurrent pregnancy loss patients: comparing RT-PCR microbiology, microbial cultures, and immunohistochemistry of endometrium biopsy

Journal of Applied Genetics, Год журнала: 2025, Номер unknown

Опубликована: Фев. 20, 2025

Abstract The objective of this study is to investigate the presence bacteria in endometrial samples from patients with recurrent pregnancy loss (RPL) and explore potential correlations between bacterial presence, chronic endometritis, previous history. Endometrial 90 RPL were analysed using RT-PCR detect 10 specific species. A subgroup 65 underwent additional microbial culture immunohistochemistry for plasma cell identification. Correlations number losses evaluated. We detected at least one out chosen DNA by 24.4% (22/90) samples. Patients PCR-identified had a significantly higher (median 3 vs 2, p = 0.01). No correlation was observed endometritis diagnosis. significant found detection PCR ( 0.03), though methods fewer positive cases. In patients, detecting selected species correlates losses. However, does not correlate diagnosis based on CD138 immunohistochemistry-identified count. These findings suggest role that may be independent classical inflammatory response associated endometritis.

Язык: Английский

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Pelvic peritoneal endometriosis is linked to the endometrial inflammatory profile: a prospective cohort study

BMC Women s Health, Год журнала: 2025, Номер 25(1)

Опубликована: Март 3, 2025

Pelvic endometriosis is an estrogen-driven inflammatory syndrome of unknown origin that alters the peritoneal microenvironment and likely impairs endometrial receptivity, adversely affecting fertility. Chronic endometritis (CE) may be a potential contributing factor to reduced receptivity in endometriosis. The aim study was analyze correlation between pelvic CE. included women undergoing laparoscopy for suspected endometriosis, each underwent aspiration biopsy stage assessed intraoperatively, CE activity evaluated histopathologically immunohistochemically. associations selected clinical characteristics disease density plasma cells, immunohistochemical status, histopathological profile endometrium were analyzed. Stage III risk by 80% (OR = 0.18, p 0.037) when compared I. Peritoneal associated with 3.429-fold increase 3.429, 0.038). No significant found features cell or (all values > 0.05). differences observed IVF use (p 0.67), pregnancy rates 1), live birth 0.41) infertile without Should diagnosed during conducted treatment infertility, it advisable obtain evaluation, as this enhance efficacy therapeutic approach. hypothetical link endometriosis-related inflammation, its manifestations, requires further investigation. lack noninvasive marker grade limits results due reliance on surgical cases, highlighting need advanced research field diagnostic tools. NCT05824507 (registered April 20, 2023).

Язык: Английский

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Comparing the accuracy of Pipelle versus hysteroscopy and curettage in the diagnosis of chronic endometritis in women with recurrent implantation failure: A prospective cross-sectional study

PLoS ONE, Год журнала: 2025, Номер 20(3), С. e0319294 - e0319294

Опубликована: Март 21, 2025

Objectives Chronic endometritis (CE) is defined as chronic inflammation in the endometrium; when treated, implantations significantly improve. The standard test for CE confirmation an endometrial biopsy, but appropriate sampling method needs to be clarified. We conducted this study compare pipelle biopsy and hysteroscopy with curettage. Study design This a prospective cross-sectional all (40 patients) RIF patients under 40 referred our tertiary center between December 2021, 2022 who underwent curettage days twelve fifteen of their menstruation cycle. then compared diagnostic accuracy, demographics, previous IVF history non-CE groups. Results Patients had mean age 34 ( ± 5.4) years BMI 25.8 3.6). Thirteen (32.5%) were diagnosed CE. There was no significant difference groups regarding maternal or paternal age, BMI, number IVFs embryos, interval from last IVF. Pipelle 100% accuracy diagnosis, while sensitivity 92.3% (95% CI: 77.8% - 100%) specificity 100%. Based on McNemar’s test, two methods (P = 1.0 0.317, respectively). Conclusion diagnosis patients. Since more cost-effective has fewer complications than curettage, may replace diagnosis.

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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The role of endometrial B cells in normal endometrium and benign female reproductive pathologies: a systematic review

Human Reproduction Open, Год журнала: 2021, Номер 2022(1)

Опубликована: Дек. 22, 2021

What are the similarities and differences in endometrial B cells normal human endometrium benign reproductive pathologies?

Язык: Английский

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Impact of antibiotic treatment for chronic endometritis on pregnancy outcomes in women with reproductive failures (RIF and RPL): A systematic review and meta-analysis

Frontiers in Medicine, Год журнала: 2022, Номер 9

Опубликована: Ноя. 3, 2022

The aim of this study was to investigate the effect antibiotic treatment for chronic endometritis (CE) on reproductive outcomes. Systematic review and meta-analysis. Women with failures, including recurrent implantation failure (RIF), pregnancy loss (RPL). Literature searches were performed using three electronic databases (PubMed, Embase, Web Science) until 1 December 2021 (without date restriction). following comparators included: women CE receiving antibiotics vs. untreated controls; cured normal endometrial histology (negative CE); persistent (PCE). summary measures indicated as odds ratio (OR) a 95% confidence interval (CI). These include on-going rate/live birth rate (OPR/LBR), clinical (CPR), miscarriage rate/pregnancy (MR/PLR). A total 2,154 (from twelve studies) enrolled. Compared control group, did not show statistically significant difference in OPR/LBR (P = 0.09) CPR 0.36), although there lower MR 0.03). have higher (OR 1.57) 1.56) comparison those non-CE. There significantly 6.82, P < 0.00001) 9.75, CE. While is sensible option cure CE, more well-designed prospective studies are needed evaluate impact treatment. Cured provides high-quality maternal conditions subsequent embryo transfer successful pregnancy.

Язык: Английский

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