Thin endometrium in assisted reproductive technology

Şentürk, Levent M.; Erel, C. Tamer

doi:10.1097/gco.0b013e328302143c

Cited by 122 publications

(89 citation statements)

References 72 publications

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“…The endometrium is essential for implantation and as such the thickness of the endometrium has been always considered as an index of quality [17]), especially in assisted reproduction where the selected embryos should be transferred ideally in a receptive environment. A thin endometrium it has been reported in 5 % of women <40 years of age and in 25 % of 41-45 years old women [18] and it has also been related to poor pregnancy outcome [20].…”

Section: Introductionmentioning

confidence: 99%

“Follicular HCG endometrium priming for IVF patients experiencing resisting thin endometrium. A proof of concept study”

Papanikolaou¹,

Kyrou²,

Zervakakou³

et al. 2013

J Assist Reprod Genet

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Purpose A thin endometrium is one of the most difficult problems encountered in assisted reproduction every day practice. Whether a daily dose of 150 IU HCG for 7 days concomitant with estrogen administration in estrogen replacement cycles can increase the endometrial thickness and improve pregnancy outcome, was the objective of the current study. Methods Seventeen infertile patients with successive implantation failures and resisting thin endometrium, being recipients of fresh donor or frozen embryos were recruited. This was a prospective cohort, proof of concept study, NCT01768247. On day-8 or 9 of the estrogen administration, and continuing 8 mg estrogen per day, subcutaneous injections of 150 IU HCG were initiated daily for 7 days. After a week on HCG priming, (day-14 or 15) endometrial thickness was controlled with ultrasound, and progesterone was initiated. Results Mean endometrial thickness was increased from 5.2 mm to 6 mm (p=0.008). 35.3 % of the patients had more than 20 % improvement of their endometrial thickness after HCG priming. 17 % achieved an endometrial thickness more than 7 mm, and 29.4 % did not improve their thickness at all. Interestingly, from the later two became pregnant. Overall, 41 % of them (7/17) finally delivered. Conclusions One hundred fifty IU HCG endometrial priming for 7 days in the proliferative phase of estrogen substituted cycles for frozen embryos is highly promising, as not only the thickness of the endometrium improves but also eventually the receptivity appears normalized.

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Section: Introductionmentioning

confidence: 99%

“Follicular HCG endometrium priming for IVF patients experiencing resisting thin endometrium. A proof of concept study”

Papanikolaou¹,

Kyrou²,

Zervakakou³

et al. 2013

J Assist Reprod Genet

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“…The outcome of these 11 pregnancies (eight miscarriages, two late terminations due to malformations and one live birth) demonstrated that these patients had a poor reproductive prognosis even if some endometrial thickening or implantation did occur. The failure of the different treatment modalities to improve the poor reproductive outcome in these patients is unfortunately in accordance to published data [20]. The high pregnancy loss rate might be the consequence of an endometrial cellular or molecular defect which is presently beyond our recognition.…”

Section: Discussionmentioning

confidence: 53%

“…Endometrial receptivity is essential for successful implantation and establishment of pregnancies in both natural and ART cycles [20]. There are still no accepted criteria for evaluating endometrial receptivity in IVF patients.…”

Section: Discussionmentioning

confidence: 99%

Thin unresponsive endometrium—a possible complication of surgical curettage compromising ART outcome

Shufaro

Simon

Laufer

et al. 2008

J Assist Reprod Genet

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Purpose Endometrial thickness is important for implantation. Little data addresses the etiology of persistently thin endometrium. We present a patient cohort in order to define common features and draw conclusions. Methods Thirteen out of 1,405 IVF patients repeatedly had thin unresponsive endometrium (<7 mm). Age, history, uterine cavity status, treatment type and outcome were examined. Results Patient age was 35.9±5.7 years. Ten patients had a curettage performed previously. Nine patients had normal cavity and endometrium, and in four adhesions were diagnosed and removed. Out of 99 cycles performed afterwards, endometrial thickness increased in 22. ETs were performed in 49 cycles resulting in 11 pregnancies. Their outcome was eight miscarriages, two terminations due to malformations, and one live birth. Conclusions Thin unresponsive endometrium was associated with curettage, not necessarily with intrauterine adhesions. Even if adequate thickening eventually occurred, the reproductive outcome was still very poor. Therefore other alternatives should be sought for these patients.

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“…В ряде исследований [26,32] выявлена корреля-ция между недостаточной толщиной преовуляторно-го эндометрия (<8 мм) и нарушением его васкуляри-зации в виде высокорезистентного кровотока (воз-растание индексов RI и PI), снижения визуализации мелких артериальных сосудов (базальных и спираль-ных артерий) и уменьшения конечной диастоличе-ской скорости в маточных артериях. Однако другие исследователи [33,34] не смогли подтвердить зави-симость показателей кровотока от отставания роста эндометрия в пролиферативной фазе цикла.…”

Section: маточный кровоток и эндометриальная рецептивностьunclassified

Modern approaches to endometrial receptivity assessment (a review)

Krasnopolskaya¹,

Nazarenko²,

Ershova³

2016

Probl. reprod.

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Согласно существующим представлениям, все причины безуспешности попыток ЭКО, в которых удается выполнить перенос полученных in vitro эм-брионов, могут быть связаны либо с их неспособно-стью к внутриматочной нидации (эмбриональный фактор), либо со снижением рецептивности эндоме-трия (эндометриальный фактор) [1,2]. Необходи-мость совершенствования эндометриального факто-ра программ ЭКО определяется тем, что при исполь-зовании морфологически хороших эмбрионов, по-лученных при оплодотворении донорских ооцитов в программах ЭКО-ОД, только ненамного повышает частоту успешных имплантаций в сравнении со стандартным ЭКО (где качество переносимых эм-брионов может быть не столь хорошим). Это можно видеть из отчета РАРЧ за 2013 г. (опубликован в 2015 г.), согласно которому частота наступления бе-ременности на перенос эмбрионов (ЧНБ пэ ) в про-грамме ЭКО-ОД превысила лишь на 5,3% аналогич-ный показатель в стандартной программе ЭКО (43,8% против 38,5%) [3]. Данный факт указывает на то, что резерв для дальнейшего повышения эффек-

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Thin endometrium in assisted reproductive technology

Abstract: Various recent modalities proposed for the treatment of thin endometrium seem to be useless and inefficient from an evidence-based medicine point of view. At the moment, evaluation of endometrium using different ultrasonographic markers seems to be superior to all those therapies.

Cited by 122 publications

References 72 publications

“Follicular HCG endometrium priming for IVF patients experiencing resisting thin endometrium. A proof of concept study”

“Follicular HCG endometrium priming for IVF patients experiencing resisting thin endometrium. A proof of concept study”

Thin unresponsive endometrium—a possible complication of surgical curettage compromising ART outcome

Modern approaches to endometrial receptivity assessment (a review)

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