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Rev. bras. ginecol. obstet ; 43(6): 457-466, June 2021. tab, graf
Article in English | LILACS | ID: biblio-1341145


Abstract Objective Abnormalities in the eutopic endometrium of women with endometriosis may be related to disease-associated infertility. Although previous RNA-sequencing analysis did not show differential expression in endometrial transcripts of endometriosis patients, other molecular alterations could impact protein synthesis and endometrial receptivity. Our aim was to screen for functional mutations in the transcripts of eutopic endometria of infertile women with endometriosis and controls during the implantation window. Methods Data from RNA-Sequencing of endometrial biopsies collected during the implantation window from 17 patients (6 infertile women with endometriosis, 6 infertile controls, 5 fertile controls) were analyzed for variant discovery and identification of functional mutations. A targeted study of the alterations found was performed to understand the data into disease's context. Results None of the variants identified was common to other samples within the same group, and no mutation was repeated among patients with endometriosis, infertile and fertile controls. In the endometriosis group, nine predicted deleterious mutations were identified, but only one was previously associated to a clinical condition with no endometrial impact. When crossing the mutated genes with the descriptors endometriosis and/or endometrium, the gene CMKLR1 was associated either with inflammatory response in endometriosis or with endometrial processes for pregnancy establishment. Conclusion Despite no pattern of mutation having been found, we ponder the small sample size and the analysis on RNA-sequencing data. Considering the purpose of the study of screening and the importance of the CMKLR1 gene on endometrial

Resumo Objetivo Anormalidades no endométrio eutópico de mulheres com endometriose podem estar relacionadas à infertilidade associada à doença. Embora a análise prévia de sequenciamento de RNA não tenha evidenciado expressão diferencial em transcritos endometriais de pacientes com endometriose, outras alterações moleculares poderiam afetar a síntese de proteínas e a receptividade endometrial. Nosso objetivo foi rastrear mutações funcionais em transcritos de endométrios eutópicos de mulheres inférteis com endometriose e de controles durante a janela de implantação. Métodos Os dados do sequenciamento de RNA de biópsias endometriais coletados durante a janela de implantação de 17 pacientes (6 mulheres inférteis com endometriose, 6 controles inférteis, 5 controles férteis) foram analisados para a descoberta de variantes e a identificação de mutações funcionais. Um estudo direcionado das alterações encontradas foi realizado para compreender os dados no contexto da doença. Resultados Nenhuma das variantes identificadas foi comuma outras amostras dentro do mesmo grupo, assim como nenhuma mutação se repetiu entre pacientes com endometriose, controles inférteis e férteis. No grupo de endometriose, foram identificadas nove mutações deletérias preditas, mas apenas uma foi previamente associada a uma condição clínica sem impacto endometrial. Ao cruzar os genes mutados com os descritores endometriose e/ou endométrio, o gene CMKLR1 foi associado a resposta inflamatória na endometriose e a processos endometriais para estabelecimento da gravidez. Conclusão Apesar de nenhum padrão de mutação ter sido encontrado, ponderamos o pequeno tamanho da amostra e a análise dos dados de sequenciamento de RNA. Considerando o objetivo do estudo de triagem e a importância do gene CMKLR1 na modulação endometrial, este poderia ser um gene candidato para estudos adicionais que avaliem mutações no endométrio eutópico de pacientes com endometriose.

Humans , Female , Pregnancy , Embryo Implantation , Sequence Analysis, RNA , Endometriosis/complications , Endometriosis/genetics , Endometrium/metabolism , Infertility, Female/etiology , Mutation , Computer Simulation , Case-Control Studies , Prospective Studies , Receptors, Chemokine/genetics , Infertility, Female/metabolism
Rev. bras. ginecol. obstet ; 43(4): 304-310, Apr. 2021. graf
Article in English | LILACS | ID: biblio-1280037


Abstract Hydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF).We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal

Humans , Female , Pregnancy , Embryo Implantation , Fertilization in Vitro , Treatment Failure , Fallopian Tube Diseases/complications , Salpingectomy , Infertility, Female/therapy , Blastocyst/physiology , Gene Expression , Endometrium/physiopathology , Fallopian Tube Diseases/surgery , Fallopian Tube Diseases/physiopathology , Homeobox A10 Proteins/genetics , Infertility, Female/etiology
Acta Physiologica Sinica ; (6): 208-216, 2021.
Article in Chinese | WPRIM | ID: wpr-878249


The transcription factor X-box binding protein-1 (XBP1) plays a key role in unfolded protein reaction. This study was aimed to investigate the expression pattern and regulation of XBP1 in the mouse uterus during early pregnancy. The methods of immunohistochemistry (IHC) and real time quantitative RT-PCR were used to test XBP1 expression in early pregnancy, artificial decidualization, oestrous cycle and hormone-regulated mouse models. The results showed that XBP1 was spatiotemporally expressed in mouse uterus during early pregnancy. The XBP1 protein was mainly detected in the luminal and glandular epithelia on days 1-4 of pregnancy, and was strongly detected in the decidual area on days 5-8 of pregnancy. Similarly, XBP1 expression was also mainly expressed in decidual cells following artificial decidualization. During the oestrous cycle, Xbp1, Xbp1u, and Xbp1s mRNA was predominantly present in proestrus. In the ovariectomized uterus, the expression of XBP1 in luminal and glandular epithelia was up-regulated after estrogen treatment. These results suggest that XBP1 is associated with embryo implantation and decidualization during early pregnancy in mice, and the expression of XBP1 in luminal and glandular epithelia may be regulated by estrogen.

Animals , Decidua , Embryo Implantation , Estrogens , Female , Mice , Pregnancy , RNA, Messenger/genetics , Uterus
Prensa méd. argent ; 106(10): 605-610, 20200000. tab
Article in English | LILACS, BINACIS | ID: biblio-1362580


Introduction. Implantation failure appears to be a significant factor in Assisted reproductive technique (ART) procedures. Even a mature endometrium may be non-receptive, preventing implantation or rejection of implanted embryo in early months of pregnancy, resulting in miscarriage or unexplained infertility with or without other associated factors. Objective. To investigate causes of failed implantation inspite of uneventful Grade I embryo transfer in ART procedure Material and Method. 90 women aged range between 25-40 yr old who visited Department of Reproductive Medicine at Calcutta Fertility Mission, over a period of 24 months(January 2017 to December 2019) , satisfying the inclusion criteria, were enrolled in this observational study. Endometrial aspirate histopathology was done along with ∞5ß3 integrin expression. They were treated with natural micronized progesterone (NMP) or oral dydrogesterone and results of endometrial changes were statistically analyzed. Results. 28.89% and 31.11% of women were seen to have mid-secretory changes of the endometrium after being treated with NMP and dydrogesterone respectively. Integrins were expressed in only 59.26% of women with mid-secretory endometrium and 5.41% of early secretory endometrium, which was statistically significant (p value <0.001). Conclusion. About 70% patients even after treatment with estrogen and progestin did not have adequate response in endometrial maturation. Not all patients with mid-secretory endometrium had integrin positive, when tested. NMP and oral Dydrogesterone have similar effect in endometrial maturation as well as in yielding successful pregnancy in some patients with previously failed In-vitro fertilization embryo transfer (IVF-ET).

Humans , Female , Adult , Embryo Implantation , Progesterone/administration & dosage , Integrins , Reproductive Techniques, Assisted , Dydrogesterone/administration & dosage , Contraceptive Effectiveness , Infertility, Female/therapy
Arq. bras. med. vet. zootec. (Online) ; 72(1): 177-190, Jan.-Feb. 2020. tab, graf
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1088927


Estudou-se o efeito do hipotireoidismo materno na expressão espaço-temporal de mediadores imunológicos e na população de células natural killers (NK) na decídua e na glândula metrial de ratas durante a gestação. Avaliou-se a detecção imunoistoquímica de interferon γ (IFNγ), do fator inibidor de migração (MIF), da interleucina 15 (IL15), do óxido nítrico sintase induzível (iNOS), a marcação com lectina DBA para evidenciação das células NK uterinas DBA+ e a expressão gênica de Ifnγ e Nos2. O hipotireoidismo aumentou o iNOS aos sete dias, a IL15 e o MIF aos 10 e 12 dias, o IFNγ e o MIF aos 14 DG e a expressão dos transcritos gênicos para iNos aos 12 e 19 dias e para Ifnγ aos 14 DG. O hipotireoidismo reduziu a imunomarcação de MIF e lectina DBA aos sete dias, lectina DBA aos 10 e 14 DG, IFNγ aos 12 dias, e a expressão de Ifnγ aos 10 e 19 DG e de iNOS aos 12, 14 e 19 DG, bem como reduziu seus transcritos gênicos aos 10 e 14 DG. Conclui-se que o hipotireoidismo compromete o perfil imunológico na interface materno-fetal ao longo da gestação, particularmente por reduzir o fator anti-inflamatório iNOS e a população de células uNK DBA+.(AU)

The goal of this study was to evaluate the effect of maternal hypothyroidism on the spatiotemporal expression of immunological mediators and population of Natural Killers cells in decidua and metrial gland of rats. Interferon gamma (IFNγ), migration inhibitory factor (MIF), interleukin 15 (IL15), inducible nitric oxide synthase (iNOS), and DBA-Lectin labeling for evidence of uNK DBA+ cells in decidua and genetic expression of Ifnγ and iNos by real-time RT-PCR were evaluated. Hypothyroidism increased protein expression of iNOS at 7 days, IL15 and MIF at 10 and 12 days, IFNγ and MIF at 14 DG in the decidua and/or metrial gland and the gene transcripts for iNOS at 12 and 19 days and for Inf at 14 DG. In addition, hypothyroidism reduced the protein expression of MIF and DBA-Lectin at 7 days, DBA-Lectin at 10 and 14 DG, IFNγ at 12 days, and the gene transcript to Ifnγ at 10 and 19 DGs. Hypothyroidism also reduced the protein expression of iNOS at 12, 14 and 19 DG and reduced its gene transcripts at 10 and 14 DGs. It is concluded that hypothyroidism compromises the immunology profile at the maternal-fetal interface throughout pregnancy, particularly by reducing the anti-inflammatory factor iNOS and population of uNK DBA+ cells.(AU)

Animals , Female , Pregnancy , Rats , Embryo Implantation , Killer Cells, Natural , Hypothyroidism/veterinary , Metrial Gland
Article in Chinese | WPRIM | ID: wpr-826370


Endometrial receptivity has become the main cause of fertilization and pregnancy outcomes in infertile patients,bringing large psychological damage and economic loss to the patients and their family. In recent years,the role of non-coding RNA has increasingly been recognized. The relationship between non-coding RNA and endometrial receptivity is reviewed in this article.

Embryo Implantation , Endometrium , Physiology , Female , Fertilization in Vitro , Humans , Pregnancy , Pregnancy Outcome , RNA, Untranslated , Genetics
Bol. latinoam. Caribe plantas med. aromát ; 19(6): 591-600, 2020. tab, ilus
Article in English | LILACS | ID: biblio-1284301


To investigate the influence of Kuntai capsules on the expression level of leukemia inhibitory factor (LIF), insulin-like growth factor-I (IGF-1)and epidermal growth factor (EGF) during the mouse's implantation window of superovulation period and controlled ovarian hyperstimulation period. 90 female mice were randomly divided into six groups in control, superovulation and controlled ovarian hyperstimulation (COH) conditions. The RNA expression of EGF, LIF and IGF-1 in the endometrium on the 4th day of pregnancy was detected, and the relative expression was compared. mRNA expression of these three factors in endometrium was significantly lower in superovulation and COH groups than control group (p<0.001). mRNA expression of these three factors in endometrium remained obviously lower in superovulation plus kuntai capsule group and COH plus kuntai capsule group than control group (p<0.01). mRNA expression of these three factors in endometrium was lower in control group than in the NS plus kuntai capsule group (p<0.05). Kuntai capsule cannot completely reverse the endometrial damages caused by superovulation and COH. Thus Kuntai capsule could partially improve a mouse's endometrial receptivity during the implantation window.

Para investigar la influencia de las cápsulas de Kuntai en el nivel de expresión del factor inhibidor de la leucemia (LIF), el factor de crecimiento similar a la insulina I (IGF-1) y el factor de crecimiento epidérmico (EGF) durante la ventana de implantación del ratón del período de superovulación y la hiperestimulación ovárica controlada período, se dividieron aleatoriamente 90 ratones hembra en seis grupos en condiciones de control, superovulación e hiperestimulación ovárica controlada (COH). Se detectó la expresión de ARN de EGF, LIF e IGF-1en el endometrio al cuarto día de embarazo, y se comparó la expresión relativa. La expresión de ARNm de estos tres factores en el endometrio fue significativamente menor en los grupos de superovulación y COH que en el grupo control (p<0,001). La expresión de ARNm de estos tres factores en el endometrio permaneció más baja en el grupo de cápsulas de superovulación más Kuntai y en el grupo de cápsulas de COH más Kuntai respecto del grupo control (p<0,01). La expresión de ARNm de estos tres factores en el endometrio fue menor en el grupo control que en el grupo de cápsula NS más Kuntai (p<0,05). La cápsula de Kuntai no pudo revertir completamente los daños endometriales causados por la superovulación y la COH. Por lo tanto, se sugiere que la cápsula de Kuntai podría mejorar parcialmente la receptividad endometrial de un ratón durante la ventana de implantación.

Animals , Female , Mice , Ovulation Induction/methods , Somatomedins/drug effects , Drugs, Chinese Herbal/pharmacology , Epidermal Growth Factor/drug effects , Leukemia Inhibitory Factor/drug effects , Embryo Implantation , Superovulation , Somatomedins/genetics , Somatomedins/metabolism , Capsules , Polymerase Chain Reaction/methods , Electrophoresis , Epidermal Growth Factor/genetics , Epidermal Growth Factor/metabolism , Leukemia Inhibitory Factor/genetics , Leukemia Inhibitory Factor/metabolism
Int. braz. j. urol ; 45(4): 825-833, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019889


ABSTRACT Purpose No comprehensive information is available about uterus fatty acid (FA) change during implantation period and possible effects of the seminal vesicle secretion on it. Materials and Methods In this study, we evaluated FA composition of uterus phospholipids during the implantation period in intact and seminal vesicle-excised (SVX) mated female mice. Forty NMRI female mice were divided into control (mated with intact male) and seminal vesicle excised (SVX)-mated (mated with SVX-male) groups. The phospholipid fatty acids composition was monitored during the first five days of pregnancy using gas chromatography and also implantation rate was evaluated on fifth day of pregnancy. Results We found that levels of linoleic acid (LNA) and arachidonic acid (ARA) showed a decreasing trend from the first to the third day of pregnancy and then started to increase on the fourth day and peaked on the fifth day. In contrast, the level of saturated FA (SFA) increased on the second and third day of pregnancy compared to the first (p<0.05) and then decreased on the fourth and fifth. We also found that the seminal vesicle secretion could affect the levels of LNA, ARA, SFA, and PUFA in uterine phospholipids especially on second and third day. Moreover, there was a positive correlation between ARA level and implantation rate in control but not SVX-mated groups. Conclusions It can be concluded that several uterus FA that have important roles in early pregnancy could be affected by seminal vesicle secretion.

Animals , Male , Female , Embryo Implantation/physiology , Seminal Vesicles/metabolism , Uterus/chemistry , Models, Animal , Fatty Acids/chemistry , Organ Size/physiology , Reference Values , Time Factors , Pregnancy/metabolism , Random Allocation , Fatty Acids/analysis , Mice
Int. j. morphol ; 37(2): 397-405, June 2019. graf
Article in Spanish | LILACS | ID: biblio-1002234


Un embarazo exitoso requiere de una serie de interacciones mediadas por factores hormonales, moleculares y fenómenos de inmunomodulación. Una de estas interacciones es la que ocurre entre el endometrio y el blastocito, previo y durante el proceso de implantación. El objetivo de esta revisión bibliográfica es complementar lo descrito en la literatura clásica de embriología humana sobre interacción de endometrio-blastocito. La búsqueda bibliográfica se realizó en la base de datos MEDLINE usando los términos en inglés "implantation", "endometrium" y "embryo"; además se realizó una búsqueda manual, que incluyó artículos de revistas no indexadas, libros de texto y atlas. Se consideraron criterios de inclusión y exclusión para la selección de los artículos y otros recursos bibliográficos. Entre los criterios de inclusión se consideraron estudios realizados en humanos, artículos de revisión y experimentación, publicados en los últimos 5 años. Como criterios de exclusión se consideraron artículos que utilizaran animales, estudios sobre fertilidad in vitro, patologías asociadas y artículos no relacionados al tema. Una vez completada la selección, se examinaron los textos completos, en los cuales se aplicaron nuevamente los criterios de exclusión. La búsqueda arrojó un total de 560 artículos, cuyo análisis de los títulos y resúmenes resultó en 475 trabajos excluidos, a partir de los diferentes criterios de exclusión antes descritos. Por lo tanto, se obtuvieron 85 artículos, en los cuales se realizó el análisis del texto completo. De estos artículos, se obtuvieron un total de 34 estudios y los contenidos seleccionados en esta revisión fueron: Endometrio, Interacción endometrio trofoblasto, Aposición, Adhesión y Migración-Invasión. Durante la implantación se genera una interacción entre el endometrio y el trofoblasto, con la participación de moléculas reguladoras de proliferación y diferenciación, como factores hormonales, moleculares y de expresión génica. Sin embargo, los mecanismos específicos de acción e interacción deben continuar siendo investigados, para responder interrogantes en el ámbito del crecimiento y desarrollo humano.

A successful pregnancy requires a series of interactions, mediated by hormonal, molecular and immunomodulation phenomena. One of these interactions is between the endometrium and the blastocyst, before and during the implantation process. The objective of this literature review is to complement what is described in the classic human embryology literature on endometrial-blastocyst interaction. The bibliographic search was carried out in the MEDLINE database using the terms "implantation", "endometrium" and "embryo", and a manual search was carried out, which included articles from non-indexed journals, textbooks and atlases. Inclusion and exclusion criteria were considered for the selection of articles and other bibliographic resources, including human studies, review and experimentation articles, published in the last 5 years. Articles with animals as experimental subjects, in vitro fertility studies, associated pathologies and articles not related to the subject were excluded. When the selection was completed, the complete texts were examined, in which the exclusion criteria were applied again The search yielded a total of 560 articles, whose analysis of titles and abstracts resulted in 475 excluded works, in relation to different exclusion criteria described above. Therefore, 85 articles were obtained, in which the complete text analysis was performed. From these articles, a total of 34 studies were obtained and the contents selected in this review were: Endometrium, Endometrium trophoblast, Aposition, Adhesion and Migration-Invasion. During the implantation, aninteraction between the endometrium and the trophoblast is generated, with the participation of regulatory molecules of proliferation and differentiation, such as hormonal, molecular and gene expression factors. However, the specific mechanisms of action and interaction must continue to be investigated, to answer questions in the field of human growth and development.

Humans , Embryo Implantation , Blastocyst/physiology , Endometrium/physiology , Trophoblasts/physiology
Article in English | WPRIM | ID: wpr-760654


Recurrent pregnancy loss (RPL) is a common complication in obstetrics, affecting about 5% of women of childbearing age. An increase in the number of abortions results in escalation in the risk of miscarriage. Although concentrated research has identified numerous causes for RPL, about 50% of them remain unexplained. Pregnancy is a complex process, comprising fertilization, implantation, organ and tissue differentiation, and fetal growth, which is effectively controlled by a number of both maternal and fetal factors. An example is the immune response, in which T cells and natural killer cells participate, and inflammation mediated by tumor necrosis factor or colony-stimulating factor, which hinders embryo implantation. Furthermore, vitamin D affects glucose metabolism and inhibits embryonic development, whereas microRNA has a negative effect on the gene expression of embryo implantation and development. This review examines the causes of RPL from multiple perspectives, and focuses on the numerous factors that may result in RPL.

Abortion, Habitual , Abortion, Spontaneous , Colony-Stimulating Factors , Embryo Implantation , Embryonic Development , Female , Fertilization , Fetal Development , Gene Expression , Glucose , Humans , Inflammation , Killer Cells, Natural , Metabolism , MicroRNAs , Obstetrics , Pregnancy , Proteomics , T-Lymphocytes , Tumor Necrosis Factor-alpha , Vitamin D
Article in Chinese | WPRIM | ID: wpr-813023


To investigate whether intrauterine injection of human chorionic gonadotropin (hCG) before the embryo transfer in a frozen-thawed transfer cycle can improve the pregnancy outcome in the patients with repeated implantation failure (RIF).
 Methods: Prospective randomized-controlled trial was adopted. A total of 140 patients, who underwent thawed embryo transplantation and were in line with the diagnosis of RIF, were included. Other patients with some factors, such as uterine malformation, postoperative uterine cavity sticking, tubal effusion, endocrine diseases and endometriosis, were excluded. The patients were randomly divided into 2 groups through the computer random number table: an hCG intrauterine perfusion group and a control group. There was no significant difference in the age, the estradiol level, the number of transplanted embryos, the number of optimal embryos, and the thickness of the endometrium before transplantation between the 2 group (all P>0.05). The hCG+G2 fluid and the G2 fluid were prepared on the day of embryo transfer, and 40 μL of which was injected at an intrauterine site at 3 minutes before embryo transfer in the hCG intrauterine perfusion group and the control group, respectively. The clinical pregnancy rate and implantation rate in the 2 groups were compared.
 Results: The implantation rate and the clinical pregnancy rate in the hCG intrauterine perfusion group were higher than those in the control group (both P<0.05).
 Conclusion: The intrauterine injection of hCG can improve the implantation rate and pregnancy rate in cryopreserved embryo transfer in patients with RIF.

Chorionic Gonadotropin , Embryo Implantation , Embryo Transfer , Female , Humans , Pregnancy , Pregnancy Outcome , Prospective Studies
Acta bioeth ; 24(1): 75-83, jun. 2018.
Article in English | LILACS | ID: biblio-949310


Abstract: 14. The purpose of preimplantation genetic diagnosis by embryonary biopsy is to identify genetic alterations prior to the implantation of embryos produced by in vitro fertilization. The most important aim is the selection of genetically healthy embryos due to their genetic indemnity, but it can also be used to select the sex or, eventually, other detectable traits accrding to the wishes of the parents. This procedure has been the subject of scientific debates, in relation to the harm that it can cause to healthy embryos that are going to be implanted, and in relation to the interpretation of the genetic tests made. Ethical debates have also focused on the production of and respect for the life and the integrity of developing human beings. In this work, it is argued that most of the uses of PGD are morally reprehensible, because they are done with disregard to the dignity that should be granted to embryos as human persons.

Resumen: 18. El diagnóstico genético preimplantacional (DGP) mediante biopsia embrionaria tiene como objeto la detección de alteraciones genéticas previamente a la implantación de embriones producidos por fertilización in vitro (FIV). Su finalidad más significativa es la selección de embriones por su indemnidad genética. También se puede emplear para seleccionar el sexo o eventualmente otras características detectadas según el deseo de los padres. Este procedimiento ha sido objeto de debates en el ámbito científico, por el eventual daño que puede ocasionar la técnica en embriones sanos que serán implantados y por las interpretaciones de los exámenes genéticos realizados. También ha sido objeto de debates en el ámbito ético-antropológico, en cuanto a la producción y al respeto a la vida e integridad de los seres humanos en desarrollo. En este trabajo se argumenta que los usos que se hacen del DGP son, en su gran mayoría, moralmente reprochables, por hacerse con desprecio de la dignidad que debe darse al embrión como persona humana.

Resumo: 22. O Diagnóstico genético pré-implantacional (PGD) por meio de biópsia embrionária visa a identificação de alterações genéticas prévias à implantação de embriões produzidos por fertilização in vitro (FIV). Seu propósito mais significativo é a seleção de embriões por sua característica genética. Ele também pode ser usado para selecionar o sexo ou, eventualmente, outras características identificadas de acordo com os desejos dos pais. Este procedimento tem sido tema de debate em âmbito científico, por eventual dano que pode ocaciosionar a técnica em embriões saudáveis que serão implantados e pela interpretações dos exames genéricos realizados. Ele também tem sido objeto de debate na área ético-antropológica, no que concerne a produção e o respeito à vida e integridade do ser humano em desenvolvimento. Este artigo argumenta que os usos que são feitos do PGD são, em sua grande maioria, moralmente condenáveis, por ser instrumentalizado com desrespeito pela dignidade que deve ser dada ao embrião como uma pessoa humana.

Humans , Male , Female , Pregnancy , Genetic Testing/ethics , Preimplantation Diagnosis/ethics , Embryo Implantation , Fertilization in Vitro , Personhood
Article in Chinese | WPRIM | ID: wpr-690823


The research of acupuncture and moxibustion for endometrial receptivity in recent 10 years was reviewed. CNKI and PubMed databases were retrieved with "acupuncture" "moxibustion" and "endometrial receptivity" as key words. The retrieving time was from January of 2007 through December of 2016. As a result, 63 relevant papers were collected and 28 papers regarding clinical and experimental researches of acupuncture for endometrial receptivity were included into analysis. It was found that acupuncture and moxibustion could improve endometrial morphology (including the expression of pinopodes, endometrial thickness and the rate of endometrial type A), reduce the endometrial microcirculation (including endometrial pulsatility index, resistance index and hemodynamic index), increase the levels of estrogen and progesterone and the expressions of their receptors, and regulate the expression of molecular biological regulator (such as integrin, leukemia inhibitory factor, vascular endothelial growth factor and HOXA10). As a result, the endometrial receptivity was improved to provide good environment for embryo implantation and improve the pregnancy rate, which had significant advantage in the field of assisted reproductive technology. However, detections of pinopodes and integrin were invasive. Its application for clinical use had limitations. In addition, the evidence of acupuncture improving endometrial receptivity was still insufficient. By reviewing related research result, this paper further summarized and analyzed the action mechanism of acupuncture for endometrial receptivity to provide references for the clinical treatment.

Acupuncture Therapy , Embryo Implantation , Endometrium , Female , Humans , Moxibustion , Pregnancy , Pregnancy Rate
Article in English | WPRIM | ID: wpr-713116


OBJECTIVE: To compare human chorionic gonadotropin (HCG)-administered natural cycle with spontaneous ovulatory cycle in patients undergoing frozen-thawed embryo transfer (FTET) in natural cycles. METHODS: In this retrospective cohort study, we analyzed the clinical outcome of a total of 166 consecutive FTET cycles that were performed in either natural cycle controlled by HCG for ovulation triggering (HCG group, n=110) or natural cycle with spontaneous ovulation (control group, n=56) in 166 infertile patients between January 2009 and November 2013. RESULTS: There were no differences in patients' characteristics between the 2 groups. The numbers of oocytes retrieved, mature oocytes, fertilized oocytes, grade I or II embryos and frozen embryos in the previous in vitro fertilization (IVF) cycle in which embryos were frozen were comparable between the HCG and control groups. Significant differences were not also observed between the 2 groups in clinical pregnancy rate (CPR), embryo implantation rate, miscarriage rate, live birth rate and multiple CPR. However, the number of hospital visits for follicular monitoring was significantly fewer in the HCG group than in the control group (P < 0.001). CONCLUSION: Our results demonstrated that HCG administration for ovulation triggering in natural cycle reduces the number of hospital visits for follicular monitoring without any detrimental effect on FTET outcome when compared with spontaneous ovulatory cycles in infertile patients undergoing FTET in natural ovulatory cycles.

Abortion, Spontaneous , Cardiopulmonary Resuscitation , Chorion , Chorionic Gonadotropin , Cohort Studies , Embryo Implantation , Embryo Transfer , Embryonic Structures , Female , Fertilization in Vitro , Humans , Live Birth , Oocytes , Ovulation , Pregnancy , Pregnancy Rate , Retrospective Studies , Zygote
Article in Chinese | WPRIM | ID: wpr-776576


OBJECTIVE@#Through the establishment of abortion model caused by embryo implantation difficulties, exploring the role of Yun Kang oral liquid in protecting embryos.@*METHODS@#The pregnant rats were divided into 6 groups:normal control group (NC), model group (MG), dydrogesterone group (DT), and three dose groups of low, medium and high levels of Yun Kang oral liquid (YK-L, YK-M, YK-H), 11 in each group.From the first day of pregnancy, daily intragastric administration, the dose of DT group was 3.02 mg/kg, and the doses of Yun Kang oral liquid were 4, 6, and 9 ml/kg, respectively.The rats in NC and MG were treated with an equal volume of purified water for 10 days.On the third day of pregnancy, except for the NC group, the other groups were injected with mifepristone subcutaneously at the back of the neck at a dose of 5 mg/kg to cause an embryo implantation barrier model.On the 10th day of pregnancy, blood was collected from the abdominal aorta in each group.Serum follicle stimulating hormone (FSH), interferon-γ (IFN-γ) and interleukin (IL-4) were measured by enzyme-linked immunosorbent assay.The number of embryo implantation was observed in the uterus, and the pathological changes of the uterus were observed by HE staining.@*RESULTS@#Compared with the NC group, the number of embryo implantation and the serum levels of FSH and IL-4 in the MG group were decreased significantly (< 0.05, 0.01), and pathological changes such as uterine glandular epithelial hyperplasia and inflammatory cell infiltration in the glandular cavity were observed.Compared with MG group, the number of embryo implantation and serum FSH and IL-4 levels of rats in YK-M and YK-H groups were increased significantly (<0.05, 0.01).The pathological changes such as uterine glandular epithelial hyperplasia and inflammatory cell infiltration in the gland were also improved.There was no significant difference in serum IFN-γ levels between the groups.@*CONCLUSIONS@#Yun Kang oral liquid may improve the endometrial pathological changes and increase the number of embryo implantation by increasing the levels of serum sex hormone FSH and immune cytokine IL-4 in embryo implantation impediment rats.

Animals , Cytokines , Embryo Implantation , Female , Interferon-gamma , Pregnancy , Rats , Uterus
Rev. bras. ginecol. obstet ; 39(10): 541-544, Nov. 2017. tab
Article in English | LILACS | ID: biblio-898835


Abstract Sirtuin 1 has an important role in cellular processes, including apoptosis and cellular stress. The purpose of this study was to assess serum sirtuin 1 levels in women with recurrent implantation failure (RIF). In this cross-sectional study, we included 28 women with RIF, 29 healthy women who had conceived by in vitro fertilization (IVF), and 30 women with a 1-cycle failure of IVF as controls. Human serum nicotinamide adenine dinucleotide (NAD)-dependent deacetylase sirtuin-1 (SIRT1/SIRT2L1) levels were detected using a commercial colorimetric kit. Recurrent implantation failure patients have higher sirtuin 1 levels than non-pregnant women and healthy pregnant women, but this difference did not reach statistical significance due to the low number of patients in our study. These higher sirtuin 1 levels may result from the inflammation imbalance of RIF patients. The only statistically significant correlation found was between age and sirtuin (r = 0.277, p = 0.009).

Resumo A sirtuína 1 tem importante função nos processos celulares, incluindo a apoptose e o estresse celular. O objetivo deste estudo é o de avaliar níveis de sirtuína 1 em mulheres com falhas recorrentes de implantação (FRI). Neste estudo cruzado, incluímos 28 mulheres com FRI, 29 mulheres saudáveis que deram à luz por fertilização in vitro (FIV) bem-sucedida, e 30 mulheres com 1 ciclo de FIV malsucedido como controle. Os níveis de sirtuína 1 em soro humano de desacetilase dependente de dinucleotídeo de nicotinamida adenina (DNA) (SIRT1/SIRT2L1) foram detectados usando um kit colorimétrico comercial. Pacientes com FRI tiveram níveis de sirtuína 1 superiores às pacientes grávidas e aos controles, mas esta diferença não atingiu significância estatística devido ao baixo número de pacientes envolvidos. Estes níveis mais altos de sirtuína 1 podem ser resultado da inflamação desigual em pacientes com FRI. A única correlação estatisticamente significante encontrada foi entre idade e sirtuína (r = 0,277, p = 0,009).

Humans , Female , Adult , Embryo Implantation , Sirtuin 1/blood , Recurrence , Fertilization in Vitro , Cross-Sectional Studies , Treatment Failure
Rev. chil. obstet. ginecol. (En línea) ; 82(2): 147-151, abr. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-899892


Una de las principales causas de la falla de los ciclos de fecundación in vitro es la aneuploídia embrionaria. OBJETVO: determinar si las pruebas de tamizaje genético pre-implantacional favorece la posibilidad de embarazos MÉTODOS: Se realizó un revisión sistemática y meta-análisis. Buscamos en las bases PUBMED y EMBAS, estudios publicados entre 2006-2016, que compararan el número de embarazos en fecundación in vitro con y sin tamizeje genético preimplantaicon RESULTADOS: De los 115 artículos analizados, 4 cumplieron los criterios de selección. Evaluamos un total de 221 ciclos con tamizje y 592 sin. No encontramos diferencias en la posibilidad de embarazo (RR 0.88; IC95% 0.71-1.10; p=0.28). Al hacer análisis por subgrupo de técnica de tamizaje, encontramos que el uso de hibridación fluosrescente in situ se asoció a una disminución en la posibilidad de embarazo (3 estudios, RR 0.53; IC95% 0.36-0.77; p=0.0009); mientras que el uso de hibidración genómica comparativa se asoció a un aumeto (1 estudio, RR 1.58; IC 95% 1.24-2.00; p<0.001). CONCLUSION: La eficacia de las pruebas de tamizaje genñeticos son dependientes de la técnica, por lo que se deberia favorecer el uso de hibidración genómica comparativa.

Probably, the main cause in IVF failure is the transfer of aneuploid embryos. OBJECT: To determine if the use of preimplantational genetic screening improves the pregnancy rate in IVF cycles, compared to regular IVF. METHODS: We performed a systematic review and meta-analysis, searching in PUBMED and EMBASE databases studies published between 2006-2016, comparing the pregnancy rates in women undergoing IVF with PGS with that of women undergoing IVF only. RESULTS: Of the 115 articles found, 4 met the selection criteria, with a total of 734 women between 33 and 41 years: 221 with PGS and 592 controls. We found no association between the use of PGS and pregnancy (RR 0.88, 95% CI 0.71-1.10, p = 0.28). However, we performed a subgroup analysis by technique of PGS, and found that fluorescent in situ hybridization was associated with a diminished risk of pregnancy (3 studies;(RR 0.53; 95% CI 0.36-0.77; p = 0.0009), whereas comparative genomic hybridization was associated with an increase (1 study, RR 1.58, CI95% 1,24-2.00, p<0.001). CONCLUSION: The effectivity of PGS is determined by the technique for PGS; therefore, only comparative genomic hybridization should be offered.

Humans , Female , Pregnancy , Fertilization in Vitro , Genetic Testing , Preimplantation Diagnosis , Embryo Implantation , Genetic Testing/methods , Pregnancy Rate , Comparative Genomic Hybridization
Article in English | WPRIM | ID: wpr-633590


This is a case report of a first trimester cesarean scar pregnancy (CSP) evolving into a placenta accreta at term based on the ultrasound imaging. The gestational sac, initially implanted at the site of previous scar, grew into the uterine cavity as the pregnancy progressed and resulted into a viable birth complicated by placenta accreta.Cesarean scar pregnancy is a rare form of ectopic pregnancy and is associated with increased maternal morbidity and mortality. Thus, early recognition of the salient sonographic findings is crucial because a delay could lead to a life threatening condition. Early diagnosis also gives women the option to choose between expectant management and termination of pregnancy. The exact incidence of CSP has not been determined but its incidence is on the rise in parallel with the high rate of cesarean sections. There are two types of CSP. The first type is due to the implantation of the gestational sac on the scar with progression towards the uterine cavity. In this type expectant management is justifiable since pregnancy may progress into a viable pregnancy. The second type involves growth of gestational tissues towards the bladder and abdominal cavity and is associated with uterine rupture if immediate intervention is not undertaken. In this report, we present a case of a first trimester CSP that was managed expectantly and developed into placenta accreta at term.

Humans , Female , Adult , Placenta Accreta , Pregnancy Trimester, First , Gestational Sac , Uterine Rupture , Pregnancy, Ectopic , Cesarean Section , Embryo Implantation
Article in English | WPRIM | ID: wpr-301048


Chinese medicine (CM) has been used in clinical treatment for thousands of years in China, Japan, Korea, and other countries. CM is at present attracting many attentions around the world for reproductive health care and disease prevention, including treatment of female infertility. This review focuses on the CM treatment for female infertility patients, and supplies a summary on the efficacy, safety, and mechanism of some Chinese herbal medicines, herbal medicine-derived active compounds, and acupuncture. A large number of researches have reported that CM could alleviate or even cure female infertility by regulating hormone, improving reproductive outcome of in vivo fertilization, affecting embryonic implantation, curing polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease, relieving mental stress, and regulating immune system. Meanwhile, a few studies claimed that there was little adverse reaction of CM in randomized controlled trials. However, up to present there is a lack of adequate evidences with molecular mechanistic researches and randomized controlled trials to prove the CM as an effective and safe treatment for infertility. Thus, utility of CM as a complementary medicine will be a feasible method to improve the outcome of female infertility treatment.

Complementary Therapies , Embryo Implantation , Female , Fertilization in Vitro , Hormones , Metabolism , Humans , Infertility, Female , Allergy and Immunology , Therapeutics , Medicine, Chinese Traditional