جستجوی مقالات مرتبط با کلیدواژه « Implantation » در نشریات گروه « پزشکی »

A competent embryo, receptive endometrium and a series of highly coordinated molecular events between them are all essential for successful implantation. Evaluation of certain molecules which may be used as biomarkers may help to predict pregnancy outcome and detect subtle implantation defect. The present study was conducted with aim to assess the relationship between serum concentrations of adrenomedullin (ADM) and pentraxin3 (PTX3) measured at the day of embryo transfer and successful implantation in assisted reproductive technique cycles.

This prospective cohort study included 88 frozen embryo transfer (FET) cycles. All patients received sequential oestrogen & progesterone medications. Embryo transfer (with a minimum of one top quality embryo) was scheduled after 4 days (D3 embryo), 6 days (D5 embryo) of progesterone administration. The serum ADM and PTX3 levels were analyzed 1 hour before the embryo transfer (ET) using ELISA kits. A possible association between these two markers levels and embryo implantation was evaluated.

Overall, biochemical pregnancy rate was 25% (22/88). Data were then categorized into pregnant (22/88) & non pregnant (66/88). No significant difference were found between the two groups regarding female age, endometrial thickness, number of oocyte collected, oestradiol level (E2), FSH level, grade and number of embryo transferred (p>0.05). The ADM levels were higher on the day of ET, although was not significant in pregnant group (254.60 pg/ml vs 248.18pg/ml). PXT3 levels (pg/ml) were lower in pregnant compared to non-pregnant group (25.396±11.78 vs 28.431±16.51, p=0.428).

Higher ADM and lower PTX3 levels at the day of embro transfer may be associated with successful implantation.

This study investigated the effect of fludrocortisone treatment on the expression of genes and proteins involved in the implantation process in mice.

The study involved four groups of mice, and mRNA and protein expression were measured using real-time PCR and western blotting.

The results showed that fludrocortisone treatment slightly downregulated the expression of SGK1, ENaC-α, miR-145, and miR-200a, while slightly upregulating the expression of HAND2, miR-451, mTOR, and 4E-BP1 in the endometrial epithelium. mTOR kinase inhibitor PP242 treatment resulted in the upregulation of miR-145 and miR-200a, while partially downregulating the expression of p-4E-BP1, mTOR, SGK1, ENaC-α, HAND2, and miR-451 expression. Combination therapy of fludrocortisone and PP242 resulted in slightly decreased expression of ENaC, SGK1, miR-200a, miR-145, and 4E-BP1, while slightly upregulating the expression of miR-451 and HAND2 in the epithelial endometrium.

The findings indicated that fludrocortisone did not disrupt endometrial receptivity and may even enhance it by modulating gene expression through the activation of the mTOR signaling pathway. Overall, the study suggests that fludrocortisone treatment can modulate the expression of genes and proteins involved in the implantation process in mice. The activation of the mTOR signaling pathway was also increased during the treatment. The findings indicate that fludrocortisone may increase endometrial receptivity without disrupting it, which could have implications for fertility treatment.

Based on the laboratory assays, there is no definitive decision about embryo selection with the proper embryogenic stage for successful transfer in the in-vitro fertilization (IVF) technique leading to live birth.

This experimental study critically aimed to evaluate the efficacy of embryo transfer in cleavage and blastocyst stages based on the Identical Population (IP) concept.

The IP concept was explained based on several critical points, including the strain (Balb/c), weight (30 g), age (six and eight weeks for females and males, respectively), number of previous sexual cycles, and the same generation. All embryos in each group were divided into grades A, B, and C. Finally, the produced embryos were transferred by trans-cervical procedure, and the mortality rate was recorded.

The number of implantation sites and live births increased in all grades of the blastocyst stage compared to the cleavage stage. The number and percentage of implantation sites in blastocysts and cleavage stages were 11 (45.83%) vs. 3 (8.57%) for grade A, 8 (29.62%) vs. 1 (5.26%) for grade B, 2 (10%) vs. 0 (0%) for grade C (P > 0.05), and number and percentage of live births in blastocysts and cleavage stages were 5 (20.83%) vs. 1 (2.85%) grade A, 3 (11.11%) vs. 0 (0%) grade B, and 1 (5%) vs. 0 (0%) grade C (P > 0.05).

Based on the results, the frequency of implantation sites and the live birth was higher in blastocyst transfer than in the cleavage stage in IVF.

Induced endometrial injury is a technique described that have positive impact on implantation. The aim ofthis study was to investigate whether hysteroscopic endometrial fundal incision (EFI) in oocyte recipients before embryotransfer increases pregnancy and live birth rates or not. A prospective study was conducted between 2014 and 2019 at an in vitro fertilization (IVF) unitin Greece. As part of the protocol, hysteroscopy and EFI were offered to all the egg recipients and the outcomes comparedwith those from an older cohort from the same Unit not undergoing hysteroscopy. In total, 332 egg recipients participated in the study; 114 of them underwent EFI prior to embryo transfer. Bothgroups were similar in terms of age, years of infertility, duration of hormone replacement treatment (HRT) and numberof blastocysts transferred. In the EFI group, minor anomalies were detected and treated in 6.1% (n=7) of the participants.Moreover, pregnancy test was positive in 73.7% of the women in the hysteroscopy group compared to 57.8% in the nonhysteroscopygroup (P=0.004). Live birth rate was also higher (56.1 vs. 42.2%, P=0.016) in the EFI group compared tothe non-hysteroscopy one. Apart from the obvious benefit of recognizing obscured anomalies, requiring surgical correction, it appearsthat in oocyte recipients prior to embryo transfer, EFI might improve uterine receptivity and reproductive outcomes.

The follicular fluid (FF) of mature oocytes contains a high concentration of growth factors and cytokinesthat have the potential to influence implantation in either a paracrine or autocrine manner. During the physiologicalprocesses of ovulation, FF enters the fallopian tubes in conjunction with the oocyte. The purpose of this studyis to evaluate implantation and clinical pregnancy rates following uterine flushing with FF and granulosa cells ininfertile women with moderate male factor infertility after ovum retrieval for intracytoplasmic sperm injection (ICSI). This phase III randomised clinical trial enrolled 140 women with moderate male factorinfertility who intended to undergo ICSI at Royan Infertility Clinic (Tehran, Iran). A computer-generated program andopaque sealed envelopes were used to randomly allocate patients to either an intervention group (n=70) or a controlgroup (n=70). Participants in the intervention group received 2 ml of clear FF (without blood contamination) from 2to 3 dominant follicles after oocyte retrieval. The control group only underwent uterine cavity catheterisation. The intervention group had a clinical pregnancy rate of 38.5% (25/65) compared to the control group [42.9%(27/63); P=0.719] and an implantation rate of 24.1% compared to the control group (27%; P=0.408). These rates did notdiffer between the groups. There were no statistically significant differences between the intervention and control groupsin terms of pregnancy-related complications-ectopic pregnancy, blighted ovum or anembryonic pregnancy, and abortion. Uterine cavity flushing with FF from mature follicles following oocyte retrieval had no effect, eitherpositively or negatively, on clinical pregnancy or implantation rates in women with moderate male factor infertility(registration number: NCT04077970).

Recurrent pregnancy loss (RPL) or recurrent miscarriage is the failure of pregnancy before 20-24 weeks that influencesaround 2-5% of couples. Several genetic, immunological, environmental and physical factors may influenceRPL. Although various traditional methods have been used to treat post-implantation failures, identifying the mechanismsunderlying RPL may improve an effective treatment. Recent evidence suggested that gene expression alterationspresented essential roles in the occurrence of RPL. It has been found that long non-coding RNAs (lncRNAs) playfunctional roles in pregnancy pathologies, such as recurrent miscarriage. lncRNAs can function as dynamic scaffolds,modulate chromatin function, guide and bind to microRNAs (miRNAs) or transcription factors. lncRNAs, by targetingvarious miRNAs and mRNAs, play essential roles in the progression or suppression of RPL. Therefore, targetinglncRNAs and their downstream targets might be a suitable strategy for diagnosis and treatment of RPL. In this review,we summarized emerging roles of several lncRNAs in stimulation or suppression of RPL.

Preimplantation genetic diagnosis (PGD) is a diagnostic approach in assisted reproductive technology (ART) to detect and select unaffected embryos to be transferred. Obtaining biopsy samples from embryos (polar body, blastomere, or blastocyst) is a key step in preimplantation genetic testing (PGT), which has many technical issues.

This study aimed to evaluate the effect of biopsies from 3-day embryos (blastomere) on the quality of embryos and implantation success in couples who requested sex selection before embryo transfer.

On the third day after fertilization, 352 high-quality embryos (> six cells on day third with < 10% fragmentation) were collected from 77womenand were tested for sex selection using FISH testing. Alaserbeamwas used to obtain blastomere biopsies by removing a significantly small portion of the zona pellucida. One blastomere was gently biopsied by an aspiration pipette through its hole. After biopsy sampling, the embryo was immediately returned to the embryo scope until transfer. Embryos’ integrity and blastocyst formation were assessed on day 5.

A total of 595 embryos were studied, including 352 embryos that were biopsied on day 3 for gender selection (i.e., the intervention group) and 243 intracytoplasmic sperm injection (ICSI) embryos that did not undergo biopsy (i.e., the control group). Overall, 17.1% of the embryos were abnormal for X or Y chromosomes. Biopsy for PGD was performed 67 - 73 hours after ICSI. Blastomere biopsy taking was significantly associated with blastocyst quality and implantation success.

In this study, after obtaining blastomere biopsies, we investigated the growth process of the embryos according to morphokinetic parameters. Ourresultsshowedthat blastomere biopsy taking could affect the blastulation of embryosanddecrease the success rate of implantation.

Growth hormone (GH) is a potential treatment in the assisted reproductive technology (ART) to improve endometrial receptivity and thickness. In the current study, we investigated the effect of the intrauterine administration of GH on the endometrial thickness (EMT) and ART outcomes in the patients with refractory thin endometrium.

In this clinical trial study, women with a refractory thin endometrium and a history of one or more frozen embryo transfer (FET) cancellation who were referred to the infertility center of the Tabriz Al-Zahra hospital (Tabriz, Iran) and Milad Infertility Clinic (Tabriz, Iran) received intrauterine injections of GH every other day from day 14 of the menstrual cycle until the EMT reached ≥7 mm in addition to the routine endometrium preparation protocol. EMT was evaluated during the treatment and in the cases with EMT ≥7 mm, biochemical/clinical pregnancy was evaluated after embryo transfer.

Thirty-one women aged 35.29 ± 6.21 years were included in this study. The mean amount of EMT was significantly increased following the GH treatment (7.03 ± 1.23 mm) vs. before treatment (5.14 ± 1.1 mm, P<0.001). The EMT reached ≥7 mm in the 65% patients (20/31). Also, the embryo transfer resulted in pregnancy in the patients, biochemical pregnancy: 9/20 (45%) and clinical pregnancy: 7/20 (35%). There was a positive correlation between EMT on the day 13 of cycle (before the treatment) and the maximum EMT (r=0.577 and P=0.001). The EMT was statistically different on the embryo transfer day between clinically pregnant and non-pregnant women (7.18 ± 0.56 vs. 6.21 ± 0.72 mm, P=0.007).

The intrauterine administration of GH could be an appropriate therapeutic strategy for patients with refractory thin endometrium. This treatment could significantly increase the EMT as well as implantation and pregnancy rates in these patients (registration number: IRCT20210220050429N1).

Metal artifacts are the major weak points of cone-beam computed tomography (CBCT) scans. This study aimed to quantify the amount of metal artifacts generated by dental implants placed in different anatomical locations in the mandible on CBCT scans.

In this study, 98 CBCT scans of mandibular dental implants with prosthetic crowns were randomly selected irrespective of the age and gender of the patients. Of all 98 implants, 42 were placed in the anterior mandible and 56 were placed in the posterior mandible. The samples were divided into two groups of single and multiple implants. The CBCT scans of each implant were evaluated in apical and cervical cross-sections. The amount of metal artifacts generated around the implants was calculated. Data were analyzed using the Mann-Whitney U test at 0.05 level of significance.

Higher amounts of artifacts were noted in the anterior mandible compared to the posterior mandible. Additionally, the amount of artifacts was higher in the cervical cross-section than in the apical cross-section. The difference in the amount of artifacts generated in the cervical cross-section was significant between single and multiple implants (P<0.05). However, this difference was not significant in the apical cross-section (P>0.05).

Dental implants always generate metal artifacts on CBCT scans, and the amount of generated artifacts is influenced by the anatomical location of implants in the mandibular arch.

Given the prevalence of fertility problems in couples and the defect in embryo implantation as well as the low success rate of assisted reproductive techniques, it is necessary to investigate the causes of this phenomenon. Type 2 diabetes mellitus (T2DM) is a metabolic disease with multiple effects on various organs as well as the endometrium. In this study, the effects of endometrial cell culture on the expression of α3 and β1 integrin genes and protein in type 2 diabetic rats were investigated.

In this experimental study, 35 female rats were divided into five groups: control, sham, diabetic, Pioglitazone-treated and Metformin-treated groups. First, rats were maintained in diabetic condition for 4 weeks. Then, treatment was performed for the next four weeks. Four weeks after induction of diabetes, rats were sacrificed at the time of embryo implantation. The uterus was removed. Endometrial cells were isolated and cultured for 7 days. Immunocytochemistry staining was used to confirm endometrial cells. Expression of α3 and β1 integrin genes was determined by real-time polymerase chain reaction (PCR) technique and the α3β1 protein content measured using Western blot both before and after endometrial cell culture.

The expression level of α3 integrin gene in the Pioglitazone-treated group compared with metformin-treated group was significantly decreased (P<0.001). The same result was observed in β1 integrin gene expression (P=0.004). Also, the α3β1 protein level increased in all diabetic groups, but its reduction was significantly greater in pioglitazonetreated group (P=0.004)

T2DM altered the expression of α3 and β1 integrin genes and related proteins, which endometrial cell culture regulated this disorder. According to these results, may be the endometrial cell culture can reduce the adverse effects of diabetes on α3 and β1 integrin expression at the level of gene and protein, in endometrial cells.

It seems that 50% of the possible causes of recurrent miscarriage do not have any explainable etiology and they require in-depth etiopathogenesis analysis. The purpose of this research was to study polymorphisms relationship of the immune response genes including Val249Ile CX3CR1 (rs3732379), CT60 G/A CTLA4 (rs3087243), and HLA DQA1, DQB1, DRB1 (major histocompatibility complex, class II) with development of idiopathic form of recurrent miscarriage (iRM) in Kazakh population.

TagMan genotyping for 302 patients with iRM and 300 women with normal reproduction was performed. Molecular genetic studies were carried out by the TaqMan method of unified site-specific amplification and real-time genotyping using test systems. Statistical tests and Chi Square were carried out using PLINK, STATA13 software and p˂0.05 was considered statistically significant.

It has been shown that carriage of unfavorable genotypes (Val/Ile, Val/Val) by the Val249Ile polymorphism of CX3CR1 gene increases the risk of developing iRM by 1.43 times. Search for associations of genes allelic variants of HLA class 2 complex with iRM revealed 501 allele in DQA1 locus, 0301 in DQB1 locus, 10, 12, 15, 16 alleles in DRB1 locus, which increase the risk of developing iRM in Kazakh population.

The highly significant associations of immune response genes with development of iRM in Kazakh population indicate the possible involvement of the immune system interaction of mother cells with syncytiotrophoblast, which is realized by vascular defects and defective embryo implantation, causing termination of pregnancy.

The Coronavirus is a major health problem nowadays, which affects people's lifestyle. This pandemic virus shared a variety of phenomena in case of symptoms and side effects. One of the major issues regarding novel coronavirus is the effect of infection on pregnancy which accounts for an essential process of human life. Considering the pathogenesis of Coronavirus, overexpression of inflammatory cells and cytokines accounts a pivotal step in the development of symptoms. The over-expressed cytokines in response to covid-19 infection would render the inflammation and disruption of the immune system and tissue damage. Like coronavirus infection, implantation the main step of a successful pregnancy, activates the inflammatory cells and cytokines. The association of infection with pregnancy raises the concern about the effect of covid-19 on embryos and giving normal birth, especially in women who decide to get pregnant or are in the pregnancy period. The current review focused on immune system responses to the Coronavirus and comparison with immune system activation during implantation. It concluded that further laboratory research and studies are needed to better understand and draw general conclusions about the role of the virus in embryo implantation.

Significant post-prostatectomy incontinence (PPI) is a crippling condition and managed best through sling or artificial urinary sphincter (AUS) implantation. These procedures are often associated with complications requiring surgical intervention. The aim of our retrospective study was to evaluate the occurrence of major compli-cations and identify risk factors.

Between 2010 and 2018 ninety-one patients have been implanted with sling (22; 24.2%) or AUS (69; 75.8%) in our department. The cases where surgical revision was needed were examined regarding the etiology (mechanical failure (MF), urethral erosion (UE), urethral atrophy (UA), surgical site infection (SSI), combined reasons (COMB) and analyzed, using 16 possible perioperative risk factors.

Surgical intervention was carried out by 19 / 91 (20.9%) patients. (In 16 / 69 cases after AUS (23.1%), 3 / 13 after slings (23%)). The indication was in 6 (31.6%) cases MF, in 3 (15.8 %) COMB, in 4 (21.1%) UE, in 5 (26.3 %) SSI, in 1 (5.2%) UA. The type of reoperation was either explantation (12 / 19), system replacement (6 / 19), or cuff replacement (1 /19). Regarding the surgical intervention requiring complications only preoperative bacteriuria (P = .006) and postoperative surgical site oedema (P = .002) proved to be independent predictive factors.

Preoperative bacteriuria and surgical site oedema seemed to be good predictors for obligate surgical revision. Patients with AUS were more prone to have major complications. In most cases it was mechanical failure, infection or erosion. By reducing the frequency of these risk factors we might be able to decrease the amount of complications.

Vascular endothelial growth factor (VEGF) and the corresponding receptors play key role in vasculogenesisand angiogenesis processes. VEGF is one of the prime candidates in regulating embryo implantation byincreasing vascular permeability. VEGF receptor-2, also called Flk-1/KDR, is one of the prime receptor which isactively involved in the execution of various functions of VEGF. However, precise role of this receptor during earlygestation period is yet to be addressed. In the present study, expression of Flk-1/KDR during peri-implantation miceuterus as well as fetal-maternal tissues from day 4-day 7 (D4-D7) of gestation was investigated. In this experimental study, localization of Flk-1/KDR was investigated by immunohistochemistryand immunofluorescence techniques, in paraffin embedded tissue sections. Flk-1/KDR protein and mRNAexpressions were investigated by western blotting and quantitative reverse transcription polymerase chain reaction(qRT-PCR), respectively. Effects of ovarian steroids on expression of Flk-1/KDR were also assessed by estrogen andprogesterone antagonist treatment. Uterine tissue on D4 showed strong expression of Flk-1/KDR in luminal and uterine glandular epithelium.On D5 and D6, differential expression of Flk-1/KDR was evidenced in certain cell types of the embryo, maternaltissues and fetal-maternal interface with varied intensity. Flk-1/KDR was specifically expressed in the ectoplacentalcone (EPC) and various cells of the embryo on D7. Flk-1/KDR expression was not evidenced in the estradiol-17β (E2)and progesterone (P4) antagonist treated uterus. Western blotting result revealed presence of Flk-1/KDR protein inthe all gestation days, except antagonist treated uterus. qRT-PCR analysis showed significant increase of Flk-1/KDRmRNA transcript on D6 and D7. Spatial-temporal expression of Flk-1/KDR during peri-implntation period in mice uterus especially in thefeto-maternal interface was observed. This spatio-temporal specificity as well as increased expression of Flk-1/KDRcould be one of the determinants for establishment of fetal-maternal cross talk during the critical period of development.

Reports appear to give reassurance that vertical transmission near term is unlikely, but risks of incidental SARS-CoV-2 infection during fertility treatments, at embryo implantation, or in the first trimester remain unknown. If early pregnancy sequela in the current COVID-19 pandemic are modeled from the 2004 Coronavirus outbreak data, then SARS-CoV-2 infection proximate to blastocyst nidation is likely to cause implantation failure or spontaneous abortion. Our model explains why this outcome is less attributable to virus-associated maternal pulmonary distress and instead derives from systemic inflammation and interference with trophectoderm-endometrium molecular signaling required for implantation. COVID-19 is often accompanied by high levels of IL-6, IL-8, TNF-alpha and other cytokines, a process implicated in pulmonary collapse and systemic organ failure. Yet when regarded in an early reproductive context, this “cytokine storm” of COVID-19 triggers a pro-coagulative state hostile to normal in utero blastocyst/fetal development. Evidence from obstetrics is accumulating to show that mothers with SARS-CoV-2 deliver placentas with abnormal interstitial villi fibrin deposits, diffuse infarcts, and hemangiomatous changes. This model classifies such lesions as permissive at term but catastrophic near embryo implantation or early first trimester pregnancy, thus explaining the paucity of COVID-19 cases in early pregnancy where gestation remains viable. Clinical experience with recurrent pregnancy loss offers workable interventions to address this challenge, but success will depend on prompt and accurate SARS-CoV-2 diagnosis. Although no professional guidelines currently exist for SARS-CoV-2 in early pregnancy, this model would warrant a high-risk designation for such cases; these patients should receive priority access to screening and treatment resources.