جستجوی مقالات مرتبط با کلیدواژه "repeated implantation failure" در نشریات گروه "پزشکی"

The aim of the present study was to evaluate the effect of the intrauterine administration of platelet-rich plasma (PRP) before embryo transfer (ET) on pregnancy outcomes in women with repeated implantation failure (RIF).

This randomized controlled trial included 120 RIF women who were candidates for frozen-thawed ET. In the PRP group (n=60), the intrauterine infusion of 0.5 mL PRP was performed 48 hours before ET, and the control group (n=60) underwent ET without intrauterine administration.

The implantation rate (28% vs. 11.9%, P<0.001), clinical pregnancy (51.6% vs. 26.6%, P=0.005), and live birth rate (58.3% vs. 28.3%, P=0.001) in PRP group were significantly higher compared to the control group. Based on the results, there was no significant difference with regard to miscarriage (12.5% vs. 12.9%, P=0.97) and multiple pregnancy rate (0.133% vs. 0.05%, P=0.11) between the two groups. Finally, preterm delivery was significantly higher in the PRP group (P<0.001).

According to this study, the result revealed that PRP is effective in the improvement of pregnancy outcomes in RIF patients. Further studies are needed to identify the group of patients who would benefit from this intervention.

The aim of this study was to investigate the effects of vaginal sildenafil on the outcome of patients with at least two times of unsuccessful IVF / ICSI.

Method and Material(s): A total of 66 infertile women aged ≤ 38 years, with a history of normal ovarian reserve, two prior consecutive failed IVF/ICSI attempts, hCG day endometrial thickness <7 mm in all prior IVF/ICSI cycles, normal endometrial appearance in hysteroscopy or hysterosonography or hysterosalpingography were studied. The conventional GnRH protocol was used for ovarian stimulation. The patients were randomly divided into three groups: vaginal sildenafil (100 mg/daily), a combination of placebo (vaginal supp.) and vaginal Sildenafil (100 mg/daily), and placebo alone (vaginal sup.). All patients underwent color Doppler ultrasound (day 14 previous cycle) to investigate any abnormality in uterus and adnexa, and endometrial parameters including thickness, echo pattern, uterine artery resistance and pulsatility indices were recorded pre- and post-treatment. The primary outcome measures were implantation, chemical and clinical pregnancy rates. For data analysis, SPSS version 20 software was used. In all tests, the significance level was considered less than 0.05.

There was no significant difference between three groups in endometrial thickness on hCG injection day. The chemical and clinical pregnancy in women who received sildenafil (alone or in combination with placebo) showed a two-fold increase in comparison to those who just used placebo. This increase was clinically meaningful, but according to sample size, it was statistically non-significant. The results of our study showed that the implantation is also higher in women who received placebo + sildenafil compared than those in two other groups. Abortion rate was not statistically significant among the groups.

It seems that vaginal sildenafil may, conceivably, improve chemical and clinical pregnancy rates in repeated IVF failure patients. Further randomized clinical trials using oral or vaginal sildenafil with higher sample size are recommended.

Repeated implantation failure (RIF) is a major challenge in reproductive medicine and despite several methods that have been described for management, there is little consensus on the most effective one.

This study was conducted to evaluate the effectiveness of platelet-rich plasma in improvement of pregnancy rate in RIF patients.

Twenty women with a history of RIF who were candidates for frozen-thawed embryo transfer were recruited in this study. Intrauterine infusion of 0.5 ml of platelet-rich plasma that contained platelet 4-5 times more than peripheral blood sample was performed 48 hrs before blastocyst transfer.

Eighteen participants were pregnant with one early miscarriage and one molar pregnancy. Sixteen clinical pregnancies were recorded and their pregnancies are ongoing.

According to this study, it seems that platelet-rich plasma is effective in improvement of pregnancy outcome in RIF patients.

Repeated implantation failure (RIF) is defined as pregnancy failure after two to six times with at least ten high grade embryo transfer to uterus. A variety of causes have been anticipated for RIF, including anatomical, autoimmune, genetics, endocrine and thrombotic anomalies. Factors responsible for RIF have important implication regarding treatment however in many couples a perfect cause cannot be found.

Cases:

 In these case series, we reported nine couples with RIF that after investigation no definitive etiology was found for RIF and empirical therapy by heparin, aspirin and or immunotherapy was not effective. In these cases we recommended transfer of embryos to surrogate uterus. Nine patients were studied and six of them developed a normal pregnancy (pregnancy rate=66.66%).

This study showed that surrogacy is a good option for treatment of RIF.