Therapeutic efficacy of the optimization of thyroid function, thrombophilia, immunity and uterine milieu (<scp>OPTIMUM</scp>) treatment strategy on pregnancy outcomes after single euploid blastocyst transfer in advanced age women with recurrent reproductive failure

Kuroda, Keiji; Horikawa, Takashi; Moriyama, Azusa; Ojiro, Yuko; Takamizawa, Satoru; Watanabe, Hideaki; Maruyama, Tetsuo; Nojiri, Shuko; Nakagawa, Koji; Sugiyama, Rikikazu

doi:10.1002/rmb2.12554

Cited by 7 publications

(1 citation statement)

References 44 publications

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“…RPL refers to ≥2 pregnancy losses or miscarriages (recurrent miscarriage, RM) before 20–24 weeks of gestation ( 2 ), affecting 1–2% of all couples ( 3 ), while RIF is defined as ≥3 failed embryo transfers with good-quality in in vitro fertilization (IVF) ( 4 ), affecting about 10% of couples undergoing IVF treatment ( 5 ). RRF had brought great physical and mental pressure to the suffered couples, which linked to increased risk of infertility and pregnancy loss ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Preimplantation genetic testing for aneuploidy optimizes reproductive outcomes in recurrent reproductive failure: a systematic review

Mei,

Lin,

Chen

et al. 2024

Front. Med.

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IntroductionRecurrent reproductive failure (RRF) is a common pregnancy complication, imposing great physical, emotional and financial burden for the suffered couples. The leading cause of RRF is believed to be aneuploid embryo, which could be solved by preimplantation genetic testing for aneuploidy (PGT-A) in theory. With molecular genetic development, PGT-A based on comprehensive chromosomal screening (CCS) procedures and blastocyst biopsy is widely applied in clinical practice. However, its effects in RRF were not defined yet.MethodsA systematic bibliographical search was conducted without temporal limits up to June, 2023. Studies about the effects of PGT-A based on CCS procedures and blastocyst biopsy in RRF were included.ResultsTwenty studies about the effects of PGT-A based on CCS procedures and blastocyst biopsy in RRF were included. It revealed that PGT-A could optimise the reproductive outcomes of RRF sufferers, especially in those with advanced age. However, in patients with multiple occurrences of pregnancy losses, the benefits of PGT-A were limited.DiscussionMore randomized controlled trials with large sample size are required to evaluate the benefits of PGT-A in RRF sufferers and identify which population would benefit the most.

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Section: Introductionmentioning

confidence: 99%

Preimplantation genetic testing for aneuploidy optimizes reproductive outcomes in recurrent reproductive failure: a systematic review

Mei,

Lin,

Chen

et al. 2024

Front. Med.

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A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy loss

Kuroda

2024

Reprod Medicine & Biology

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BackgroundAside from embryonic factors, various factors can intricately interfere with embryo implantation and maintenance of pregnancy, causing recurrent implantation failure (RIF) or recurrent pregnancy loss (RPL). This review focuses the optimization of thyroid function, thrombophilia, immunity, and uterine milieu (OPTIMUM) treatment strategy on RIF and RPL.MethodsThree studies employing the OPTIMUM treatment strategy for patients with RIF and/or RPL were reviewed.ResultsThe OPTIMUM improved pregnancy rates in women with RIF aged <40 years. Among advanced age women, however, no significant differences in pregnancy rates were observed between the control, OPTIMUM, and preimplantation genetic testing for aneuploidy (PGT‐A) groups, although pregnancy rates were highest after OPTIMUM + PGT‐A. The OPTIMUM reduced miscarriage rates in women with RPL aged <40 years. Among advanced age women, PGT‐A, but not the OPTIMUM, contributed to miscarriage prevention. Factors predicting pregnancy success in women with RIF who received the OPTIMUM included thrombophilia and young age. Risk factors for an unsuccessful live birth among women with RPL who received the OPTIMUM included advanced age, infertility, diminished ovarian reserve, and non‐ART treatment.ConclusionsThe OPTIMUM can improve pregnancy outcomes in women with RIF/RPL, except for advanced age women with embryonic factor‐induced reproductive failure.

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Management strategies following implantation failure of euploid embryos

Kuroda

2024

Reprod Medicine & Biology

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BackgroundEuploid blastocyst implantation failure may result from embryonic factors undetectable by preimplantation genetic testing for aneuploidy (PGT‐A); however, various nonembryonic factors can also intricately interfere with implantation. This review seeks to clarify evidence‐based testing and treatments for implantation failure after euploid embryo transfer.MethodsWe conducted a review of the literature on implantation failure after euploid embryo transfer or multiple embryo transfer cycles, which mainly included systematic reviews and meta‐analyses.ResultsThe recommended tests for implantation failure include (1) hysteroscopy, (2) endometrial CD138 immunohistochemistry and bacterial culture, (3) serum 25‐hydroxyvitamin D3, and (4) thrombophilia screening. Based on diagnostic findings, the following treatments have been recommended: (1) antibiotics for chronic endometritis, (2) vitamin D replacement, (3) lifestyle modification, and (4) low‐dose aspirin starting from the postimplantation period for thrombophilia. Moreover, frozen–thawed single euploid blastocyst transfer using assisted hatching and hyaluronan‐enriched transfer medium may support embryo implantation.ConclusionTo ensure a successful pregnancy in subsequent embryo transfers, simple, inexpensive, and evidence‐based tests and treatments should be selected.

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Therapeutic efficacy of the optimization of thyroid function, thrombophilia, immunity and uterine milieu (OPTIMUM) treatment strategy on pregnancy outcomes after single euploid blastocyst transfer in advanced age women with recurrent reproductive failure

Cited by 7 publications

References 44 publications

Preimplantation genetic testing for aneuploidy optimizes reproductive outcomes in recurrent reproductive failure: a systematic review

Preimplantation genetic testing for aneuploidy optimizes reproductive outcomes in recurrent reproductive failure: a systematic review

A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy loss

Management strategies following implantation failure of euploid embryos

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