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

Shufaro, Yoel; Simon, Alex; Laufer, Neri; Fatum, Muhammad

doi:10.1007/s10815-008-9245-y

Cited by 58 publications

(49 citation statements)

References 22 publications

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“…The initial purpose of endometrial curettage is complete examination and removal of malignant cells, so most of clinicians perform curettage thoroughly in all directions. However, this procedure can cause irreversible mechanical damage to the normal endometrial cells and lead to unresponsive endometrium [15]. Recently, several investigators demonstrated the efficacy of hysteroscopic resection of early stage EC combined with hormonal therapy [16,17].…”

Section: Discussionmentioning

confidence: 99%

The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer

Fujimoto

Ichinose

Harada

et al. 2014

J Assist Reprod Genet

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Purpose To elucidate the problems in infertility treatment for women after conservative therapy for endometrial cancer (EC) or atypical complex endometrial hyperplasia (ACEH). Methods The clinical outcomes of 21 patients who underwent assisted reproductive technology after conservative therapy (group A) and 42 control women (group B) were retrospectively analyzed. Results There was no significant difference in the number of retrieved oocytes, fertilization rate or the number of transferred embryos between the two groups. Women in group A had a significantly thinner endometrium and a reduced implantation rate compared to those for women in group B. There was no significant difference in the cumulative clinical pregnancy and delivery rates between group A and B. The patients in group A required significantly more embryos for achieving a live-birth. Conclusions Our results indicate that a thin endometrium after repeated curettage may have a negative effect on endometrial receptivity of patients after conservative treatment for EC/ACEH. Clinicians should reconsider their present protocols and make efforts to minimize the damage to normal endometrium.

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Section: Discussionmentioning

confidence: 99%

The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer

Fujimoto

Ichinose

Harada

et al. 2014

J Assist Reprod Genet

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“…Not only does it occur after uterine cavity manipulation and infection (Shufaro et al, 2008), but it is also related to endocrine disorder, aging, and drug induction (Kumbak and Sahin et al, 2009;Le et al, 2013). The pathological and physiological characteristics of a thin endometrium were first described by Miwa et al (2009) as slow growth of the glandular epithelium, high resistance of the uterine artery blood flow, vascular dysplasia, and low expression of vascular endothelial growth factor (VEGF).…”

Section: Introductionmentioning

confidence: 99%

Effects of icariin on the expression of ER, VEGF, and KDR in the endometrial cells of thin endometrium

Le¹,

Shan²,

Wang³

et al. 2015

Genet. Mol. Res.

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ABSTRACT. We explored the effects of icariin on the expression of estrogen receptor (ER), vascular endothelial growth factor (VEGF), and kinase insert domain receptor (KDR) in the endometrial cells of the thin endometrium. Primary endometrial cells were obtained and divided into a blank control group, a high-, a middle-, and a low-dose icariin groups, as well as an estrogen treatment group to undergo cellular identification by immunocytochemistry. The expression levels of ER, VEGF, and its receptor were estimated by western blotting. The expression levels of ER, VEGF, and KDR gradually increased from the control group to the estrogen (E2) treatment and icariin treatment groups; the differences were statistically significant. However, the differences were not statistically significant among the different icariin dose groups. The endometrium may be thickened by icariin treatment by increasing the expression levels of ER, VEGF, and KDR in endometrial cells.

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“…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]. Regarding the etiology it is considered mainly idiopathic, however, a surgical complication postcurettage might be identified in some cases [19].…”

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

Cited by 58 publications

References 22 publications

The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer

The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer

Effects of icariin on the expression of ER, VEGF, and KDR in the endometrial cells of thin endometrium

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

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