Endometrial injury in women undergoing assisted reproductive techniques

Nastri, C.O.; Gibreel, Ahmed; Raine‐Fenning, Nick; Maheshwari, Abha; Ferriani, Rui Alberto; Bhattacharya, Siladitya; Martins, Wellington P.

doi:10.1002/14651858.cd009517.pub2

Cited by 72 publications

(45 citation statements)

References 16 publications

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“…We preferentially used live birth, but when this was not reported, we used data reported for ongoing pregnancy, providing this related to viable pregnancy to at least 12 weeks' gestation. Ongoing pregnancy is considered as a primary outcome for effectiveness, and by not including data from these studies, only a partial view of the available evidence would have been represented [10][11][12] .…”

Section: Eligibility Criteriamentioning

confidence: 99%

Blastocyst vs cleavage‐stage embryo transfer: systematic review and meta‐analysis of reproductive outcomes

Martins

Nastri²,

Rienzi

et al. 2017

Ultrasound in Obstet & Gyne

120

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Objectives (RR, 1.10 (95% CI,12 Correspondence to: Prof. W. P. Martins, SEMEAR Fertilidade, Av Aurea Apparecida Braghetto Machado, 220 Ribeirão Preto -SP, 14021-460 Brazil (e-mail: wpmartins@gmail.com) Accepted: 4 October 2016RCTs, 2418 women, I 2 = 64%), cumulative pregnancy (RR, 0.89 (95% CI,), four RCTs, 524 women, I 2 = 63%) and miscarriage (RR, 1.08 (95% CI,, 10 RCTs, 763 pregnancies, I 2 = 0%). There was moderate-quality evidence of a decrease in the number of women with surplus embryos after the blastocyst-stage embryo transfer (RR, 0.78 (95% CI,

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Section: Eligibility Criteriamentioning

confidence: 99%

Blastocyst vs cleavage‐stage embryo transfer: systematic review and meta‐analysis of reproductive outcomes

Martins

Nastri²,

Rienzi

et al. 2017

Ultrasound in Obstet & Gyne

120

View full text Add to dashboard Cite

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“…The latest Cochrane review investigating the effectiveness and safety of endometrial injury performed before embryo transfer in women undergoing ART was published in 2015 [61]. It included a total of 14 trials: thirteen studies comparing endometrial injury performed between day 7 of the previous cycle and day 7 of the embryo transfer (ET) cycle versus no injury, and one study comparing endometrial injury on the day of oocyte retrieval versus no injury.…”

Section: Endometrial Scratching (Injury/biopsy)mentioning

confidence: 99%

“…There was no evidence of an effect on miscarriage, however the evidence is of low-quality. On the contrary, results from the only RCT comparing endometrial injury on the day of oocyte retrieval versus intervention, reported that endometrial injury markedly decreased live birth (RR 0.31, 95% CI 0.14 to 0.69; P value 0.004; 156 women; low quality evidence) and clinical pregnancy (RR 0.36, 95% CI 0.18 to 0.71; P value 0.003; one RCT; 156 women; low-quality evidence), [61].…”

Section: Endometrial Scratching (Injury/biopsy)mentioning

confidence: 99%

“…on days 8,12,21 and 26 through the proceeding cycle before IVF [58] or only on days 21 and 26 of the proceeding cycle [59]. However, Hayashi et al [60] showed that a single sampling in the proliferative phase was found adequate to improve reproductive outcomes because a single, site-specific hysteroscopic biopsy-induced injury applied on the posterior endometrium at the midline, 10 to 15 mm away from the fundus on days 4 to 7 of the IVF cycle, improved results in six patients [60].The latest Cochrane review investigating the effectiveness and safety of endometrial injury performed before embryo transfer in women undergoing ART was published in 2015 [61]. It included a total of 14 trials: thirteen studies comparing endometrial injury performed between day 7 of the previous cycle and day 7 of the embryo transfer (ET) cycle versus no injury, and one study comparing endometrial injury on the day of oocyte retrieval versus no injury.…”

mentioning

confidence: 99%

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Adjuvants Therapies for Women Undergoing IVF: Is There Any Evidence of their Safety and Efficacy? An Updated Mini-Review

Fabozzi¹

2017

OGIJ

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In the last two decades a series of adjuvant therapies have been proposed to improve the success of IVF and most of them are currently prescribed even though the quality of scientific evidence supporting their efficacy in improving live birth rates after IVF is weak. The aim of this paper is to describe some of the therapies mostly used by women undergoing IVF such as dehydroepiandrosterone, testosterone, low-dose aspirin, low-molecular-weight heparin (LMWH), corticosteroids and endometrial scratching, and to assess the current evidence about their safety and efficacy. (Relative Risk (RR) 2.13; 95% CI 1.12-4.08). Similar results were obtained in subgroup analyses including randomized controlled trials and case-control studies (RR 2.57; 95% CI 1.43-4.63) and self-controlled studies (RR 3.95;). However, the effects of DHEA on oocyte retrieval, implantation, and abortion were not significant. The Cochrane review conducted in 2015 showed higher ongoing pregnancy rates or live birth rates following the pre-treatment with DHEA. Nevertheless, no benefit was observed when studies with high risk of bias were excluded [14,15]. Finally, a third meta-analysis analysing the effect of DHEA in women with DOR including a total of nine studies, four RCTs, four retrospective and one prospective concluded that clinical pregnancy rates were increased significantly in DOR patients who were pre-treated with DHEA (OR = 1.47, 95% CI: 1.09-1.99), whereas no differences were observed in the number of oocytes retrieved, the cancellation rate of IVF cycles and them is carriage rate between the cases and controls (WMD= −0.69, 95% CI: −2.18-0.81; OR = 0.74,95% CI: 0.51-1.08; OR = 0.34, 95% CI: 0.10-1.24). However, restricting the analysis to only RCTs, a non-significant difference in the clinical pregnancy rate was observed(OR = 1.08, 95% CI: 0.67-1.73) [15]. Keywords: Conclusive statementAlthough the effect of DHEA on improving ovarian response seems to be promising, there is insufficient evidence to recommend DHEA supplementation at this time. Furthermore, the long-term risk of DHEA administration remain unknown. More RCTs with large sample size are needed to obtain good quality evidence on its safety and efficacy. Testosterone (TT)Testosterone is a downstream molecule in the steroidal pathway from DHEA. It can be administered either trans-dermally or orally. Different RCTs report a beneficial effect of TT pre-treatment [16,17] and the meta-analysis from Bosdou et al. [18] analyzing both trials conducted by Massin et al. [16] and Kim et al. [17] reported that pretreatment with transdermal testosterone was associated with an increase in clinical pregnancy (risk difference (RD): +15%, 95% confidence interval (CI): +3 to +26%) and live birth rates (RD: +11%, 95% CI: +0.3 to +22%) in poor responders undergoing ovarian stimulation for IVF. A second meta-analysis conducted by also reported that testosterone-treated women achieved a significantly higher live birth rate (risk ratio, RR, 1.91, 95% CI 1.01 to 3.63), clinical pregnancy ra...

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“…Interestingly, this beneficial inflammatory effect lasts at least one additional month, thus improving implantation in the subsequent cycle. The exact mechanism of such positive effect on implantation following endometrial sampling, as well as the number of such endometrial stimulations and their timing along the cycle preceding that of embryo transfer, still needs to be determined [67].…”

Section: The Endometriummentioning

confidence: 99%

Assessment and treatment of repeated implantation failure (RIF)

Simon

Laufer

2012

J Assist Reprod Genet

215

161

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Repeated implantation failure (RIF) is determined when embryos of good quality fail to implant following several in vitro fertilization (IVF) treatment cycles. Implantation failure is related to either maternal factors or embryonic causes. Maternal factors include uterine anatomic abnormalities, thrombophilia, non-receptive endometrium and immunological factors. Failure of implantation due to embryonic causes is associated with either genetic abnormalities or other factors intrinsic to the embryo that impair its ability to develop in utero, to hatch and to implant. New methods of time-lapse imaging of embryos and assessment of their metabolic functions may improve selection of embryos for transfer, and subsequent outcomes for IVF patients, as well as for those diagnosed with RIF. This review discusses the various causes associated with RIF and addresses appropriate treatments.

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Endometrial injury in women undergoing assisted reproductive techniques

Cited by 72 publications

References 16 publications

Blastocyst vs cleavage‐stage embryo transfer: systematic review and meta‐analysis of reproductive outcomes

Blastocyst vs cleavage‐stage embryo transfer: systematic review and meta‐analysis of reproductive outcomes

Adjuvants Therapies for Women Undergoing IVF: Is There Any Evidence of their Safety and Efficacy? An Updated Mini-Review

Assessment and treatment of repeated implantation failure (RIF)

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