Strategies to manage refractory endometrium: state of the art in 2016

Garcia-Velasco, Juan A.; Acevedo, Belen; Álvarez, Claudio; Alvarez, Monica; Bellver, José; Fontes, Juan Torres; Landeras, J.; Manau, Dolors; Martínez, Francisca; Muñoz, Elkin; Robles, Ana; Rodríguez-Tabernero, Luis

doi:10.1016/j.rbmo.2016.02.001

Cited by 58 publications

(40 citation statements)

References 152 publications

(175 reference statements)

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“…published in 2016 also cites the use of autologous PRP as a potential method of improving ET in women with refractory endometrium. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

“…The available evidence does not support any specific thickness, and pregnancies with similar success have been described in endometria from 5 to 15 mm. [ 1 ] In a meta-analysis by Kasius et al ., published in 2014, evaluating the optimal ET required for implantation, the probability of clinical pregnancy for an ET ≤ 7 mm was significantly lower compared with cases with ET > 7 mm [23.3 versus 48.1%]. Positive and negative predictive values for the outcome of clinical pregnancy were 77 and 48%, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles: A pilot study

et al. 2017

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Introduction:This pilot study was to evaluate the effectiveness of intrauterine infusion of autologous platelet-rich plasma (PRP) in infertile women undergoing frozen embryo transfer cycles with suboptimal endometrium.Material and Methods:Intrauterine instillation of autologous PRP was done in 68 women between 22 and 40 years, over 8 months, with suboptimal endometrial growth, and patients with repeated cycle cancellations, in addition to Estradiol valerate. Frozen embryo transfer was performed when the endometrium reached an optimal pattern in terms of thickness, appearance, and vascularity.Results:The mean pre-PRP endometrial thickness (ET) was 5 mm which significantly increased to 7.22 mm post-PRP. There was a significant increase in vascularity, seen by the number of vascular signals seen on Power Doppler, reaching the zones 3 and 4 of the endometrium. The positive beta Human Chorionic Gonadotropin (hCG) rate was 60.93% and the clinical pregnancy rate was 45.31%. A total of 13 women are in the second trimester, 13 are in the first trimester with a healthy intrauterine pregnancy, one patient had an ectopic gestation, three had blighted ova, two had missed abortions, and two biochemical pregnancies.Conclusion:This study suggests that the use of autologous PRP holds promise in the treatment of women with suboptimal ET and vascularity for embryo transfer. It would help to reduce the incidence of cycle cancellations and thus even help reduce the financial and psychological burden of repeated cancelled cycles.

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“…published in 2016 also cites the use of autologous PRP as a potential method of improving ET in women with refractory endometrium. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles: A pilot study

et al. 2017

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“…Low-dose aspirin, hypothetically, can improve endometrial growth and embryo implantation by: 1) reducing sub-endometrial contractility; 2) reducing endometrial inflammation by inhibiting cyclooxygenase and prostaglandin biosynthesis; and 3) increasing endometrial blood flow. (91,92) Aspirin-mediated resolution of inflammation has been recently described as an alternative hypothesis.…”

Section: Resultsmentioning

confidence: 99%

Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

Chaemsaithong

Cuenca-Gomez

Plana

et al. 2020

American Journal of Obstetrics and Gynecology

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Condensation: Aspirin given at <11 weeks' gestation in high risk women does not reduce the risk of preeclampsia and gestational hypertension but may reduce the risk of preterm delivery. Short title: Early aspirin administration and preeclampsia PROSPERO registration number: CRD42019125006 AJOG at a Glance: Why was this study conducted? • To perform a systematic review and meta-analysis to evaluate the effect of lowdose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy. Secondary outcomes included preterm delivery at <37 weeks' gestation and fetal growth restriction. Key findings • The administration of low-dose aspirin at <11 weeks' gestation in women with a history of recurrent pregnancy loss, women who had undergone in vitro fertilization or women with thrombophilia or antiphospholipid syndrome was associated with a non-significant decrease in the risk of preeclampsia, gestational hypertension, and any hypertensive disorder of pregnancy. • Early low-dose aspirin reduced the risk of preterm delivery but had no impact on the risk of fetal growth restriction. • Except for preterm delivery and any hypertensive disorder of pregnancy, sensitivity analysis demonstrated similar observations; confirming the robustness of our analysis. What does this add to what is known? • Administration of low-dose aspirin at <11 weeks' gestation to high risk women does not reduce the risk of preeclampsia, gestational hypertension, any hypertensive disorder of pregnancy and fetal growth restriction but might reduce the risk of preterm delivery at <37 weeks of gestation. ABSTRACT OBJECTIVE DATA: Pre-conception or early administration of low-dose aspirin might improve endometrial growth, placental vascularization and organogenesis. Most studies have evaluated the potential benefit of pre-conception or early administration of low-dose aspirin in women with a history of recurrent pregnancy loss, women who have undergone in vitro fertilization or women with thrombophilia or antiphospholipid syndrome. These women are at an increased risk of placenta-associated complications of pregnancy, including preeclampsia, preterm delivery and fetal growth restriction. STUDY: We performed a systematic review and meta-analysis to evaluate the effect of low-dose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy. Secondary outcomes included preterm delivery at <37 weeks' gestation and fetal growth restriction. STUDY APPRAISAL AND SYNTHESIS METHODS: We searched in MEDLINE via PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.Gov and the World Health Organization International Clinical Trials Registry Platform (WHO-ICTRP) from 1985 to November 2018. Entry criteria were randomized controlled trials evaluating the effect of aspirin administered at <11 weeks' gestation in preventing preeclampsia and/or hypertensive disorders in pregnancy or improvi...

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“…Endometrial receptivity, however, remained an unsolved problem. In a recent comprehensive review on refractory endometrium, Garcia-Velasco and colleagues [14] concluded that there is not available evidence to help physicians and patients on how to improve a poor endometrium.…”

Section: Prp and Human Reproductionmentioning

confidence: 99%

Platelet-rich plasma therapy and reproductive medicine

Bös-Mikich

Oliveira²,

Frantz³

2018

J Assist Reprod Genet

108

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Reports on clinical uses of platelet-rich plasma (PRP) have dramatically increased in the last decade. Indications for PRP therapy range from muscle and skeletal injuries to hair re-growth. More recently evidences have shown its positive effects in promoting endometrial and follicular growth and gestation in assisted reproduction cycles. We discuss the putative role of PRP on endometrial receptivity, with a brief history of its applications in research and clinical therapies. Despite its widespread uses in medicine, the mechanisms through which PRP exerts its regenerative effects are only postulated, not based on scientific data. There is an unmet need for advanced research to corroborate present findings in the clinical scenario.

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Strategies to manage refractory endometrium: state of the art in 2016

Cited by 58 publications

References 152 publications

Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles: A pilot study

Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles: A pilot study

Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

Platelet-rich plasma therapy and reproductive medicine

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