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Uterine factor infertility

John A Robertson
The birth of a child after uterus transplant from a living donor in Sweden in October, 2013 has spurred reproductive and transplant physicians in Europe and North America to investigate whether uterus transplants, from living or cadaveric donors, will be a safe and effective therapy for women with uterine insufficiency. While progress with uterus transplant depends on medical factors, there are also important ethical and legal concerns. Uterus transplant is essential for women without access to surrogacy. It may also be sought by infertile women who dislike surrogacy...
April 2016: Journal of Law and the Biosciences
T Sheveleva, V Bejenar, E Komlichenko, A Dedul, A Malushko
Endometriosis is a chronic, progressive, relapsing estrogen-dependent disorder characterized by the growth of tissue structure and function similar to the endometrium outside the normal mucosa of the uterine cavity localization. Endometriosis is found in 10-15% of women in reproductive age and it is one of the main causes of pelvic pain syndrome and infertility. Mechanisms of the development of endometriosis and related pathological pain impulses are still poorly understood and therapeutic approaches do not always have a sufficient effect; in this connection, the study of the pathogenesis of endometriosis and endometriosis-associated pain currently is perspective...
October 2016: Gynecological Endocrinology
E A Devyatova, K A Tsaturova, E V Vartanyan
Many of the uterine infertility factors are associated with chronic endometritis. Its prevalence reaches 92.6%. Quality of endometrial transformation during the "implantation window" is the basis of successful fertility. In our retrospective comparative study of 101 in vitro fertilization (IVF) cycles, the efficacy of transvaginal Doppler ultrasound (TVDUS) in predicting successful implantation was evaluated. Inclusion criteria were as follows: age younger than 41 years and good quality of embryos. Exclusion criteria were as follows: 41 and older age, poor quality of embryos and uterine cavity lesions...
October 2016: Gynecological Endocrinology
Jacques Balayla
The uterine transplant is an innovative surgical procedure whereby a healthy uterus is transplanted into a woman with uterine factor infertility (UFI) for the purpose of procreation. Twelve uterine transplants have been attempted in the world in the last two decades, and five have led to viable births. While uterine transplantation is still in its experimental stages, it remains unclear whether Canadian centres plan to attempt the procedure in the near future. Herein, I raise several observations that are specific to the Canadian setting and apply the Montreal Criteria for the Ethical Feasibility of Uterine Transplantation to determine whether there is fertile ground for a uterine transplantation program to be adopted in Canada...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Natalie K Binder, Jemma Evans, Lois A Salamonsen, David K Gardner, Tu'uhevaha J Kaitu'u-Lino, Natalie J Hannan
Embryo implantation requires synchronized dialogue between the receptive endometrium and activated blastocyst via locally produced soluble mediators. During the mid-secretory (MS) phase of the menstrual cycle, increased glandular secretion into the uterine lumen provides important mediators that modulate the endometrium and support the conceptus during implantation. Previously we demonstrated the importance of vascular endothelial growth factor (VEGF) in the human uterus, particularly with respect to embryo implantation...
2016: PloS One
Chia-Chun Li, Tsui-Hsia Feng
Endometrial cancer is the most common gynecological cancer and the sixth most common cancer among women in Taiwan. Risk factors for endometrial cancer include obesity, long-term estrogen replacement therapy, diabetes mellitus, hypertension, nulliparty, early age at menarche, late age at menopause, and tamoxifen therapy. Most women with endometrial cancer exhibit abnormal uterine bleeding. Endometrial cancer is often diagnosed at stage I. Surgery alone is the primary treatment for stage I endometrial cancer...
October 2016: Hu Li za Zhi the Journal of Nursing
Nageswara Rao Boggavarapu, Sujata Lalitkumar, Vijay Joshua, Sergo Kasvandik, Andres Salumets, Parameswaran Grace Lalitkumar, Kristina Gemzell-Danielsson
The complexity of endometrial receptivity at the molecular level needs to be explored in detail to improve the management of infertility. Here, differential expression of transcriptomes in receptive endometrial glands and stroma revealed Ectonucleotide Pyrophosphatase/Phosphodiesterase 3 (ENPP3) as a progesterone regulated factor and confirmed by various methods, both at mRNA and protein level. The involvement of ENPP3 in embryo attachment was tested in an in vitro model for human embryo implantation. Interestingly, there was high expression of ENPP3 mRNA in stroma but not protein...
September 26, 2016: Scientific Reports
J Froněk, L Janousek, R Chmel
INTRODUCTION: Uterus transplantation is the youngest solid organ transplantation described in the literature. This procedure is the only treatment method for congenital or acquired Absolute Uterine Factor Infertility. METHOD: The method is not recognised as standard clinical care yet, there were only some 13 cases performed worldwide so far. There is only one clinical trial worldwide, which has proven both feasibility and also healthy child delivery. RESULTS: Czech Republic Ministry of Health permitted the uterus transplant clinical trial in 2015...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Omer Ozkan, Nasuh Utku Dogan, Ozlenen Ozkan, Inanc Mendilcioglu, Selen Dogan, Batu Aydinuraz, Mehmet Simsek
Absolute uterine factor infertility affects 3-5% of the general population, and unfortunately this condition is untreatable. There are some available options, including surrogacy or adoption, but neither of these suits each and every woman who desires to have her own genetic child. With recent advances in surgery and transplant immunology, uterus transplantation may be a source of hope for these women with uterine infertility. In the last decade, a number of animal species including rats, mice, rabbits, pigs, sheep, and primates have been used as experimental models, and pregnancies were achieved in some of these...
July 2016: Women's Health
Rebecca L Flyckt, Ruth M Farrell, Uma C Perni, Andreas G Tzakis, Tommaso Falcone
This commentary endeavors to share our practical experience in developing and implementing the first uterine transplant clinical trial in the United States. Uterine transplant is a promising novel treatment for uterine factor infertility. After reported successful live births after uterine transplant in Sweden, research teams around the world are either embarking on or are considering the development of uterine transplant protocols. Our observations on the applied rather than theoretical aspects of uterine transplantation research in human subjects are detailed in this article...
October 2016: Obstetrics and Gynecology
Vincent Lavoué, Cécile Vigneau, Solène Duros, Karim Boudjema, Jean Levêque, Pascal Piver, Yves Aubard, Tristan Gauthier
BACKGROUND: The aim of this systematic review was to evaluate and compare the pros and cons of using living donors or brain-dead donors in uterus transplantation programs, 2 years after the first worldwide live birth after uterus transplantation. METHODS: The Medline database and the Central Cochrane Library were used to locate uterine transplantation studies carried out in human or non-human primates. All types of articles (case reports, original studies, meta-analyses, reviews) in English or French were considered for inclusion...
September 8, 2016: Transplantation
S Huet, A Tardieu, M Filloux, M Essig, N Pichon, J F Therme, P Piver, Y Aubard, J M Ayoubi, O Garbin, P Collinet, A Agostini, V Lavoue, A Piccardo, T Gauthier
OBJECTIVE: Uterine infertility (UI), which can be caused by a variety of congenital or acquired factors, affects several thousand women in Europe. Uterus transplantation (UTx), at the current stage of research, offers hope for these women to be both the biological mother and the carrier of their child. However, the indications of UTx still need to be defined. The main aim of the study was to describe the different etiologies of UI and other data as marital and parental status from women requesting UTx who contacted us in the framework of a UTx clinical trial...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Harriet C Fitzgerald, Lois A Salamonsen, Luk J R Rombauts, Beverley J Vollenhoven, Tracey A Edgell
Endometrial gland development occurs during the proliferative phase of a woman's menstrual cycle, laying the foundation for the subsequent receptive, secretory phase when pregnancy is established. Idiopathic infertility has been rarely investigated with respect to the proliferative phase endometrium. We investigated whether gland development and/or altered secretion of cytokines during the proliferative phase is associated with infertility. Area of the glandular epithelium (GE) was measured in proliferative phase endometrial tissue collected from fertile (n=18) and infertile (n=14) women...
December 2016: Cytokine
Abbas Aflatoonian, Ramesh Baradaran Bagheri, Robabe Hosseinisadat
BACKGROUND: Implantation failure is one of the most important factors limiting success in IVF treatment. The majority of trials have demonstrated favorable effect of endometrial injury on implantation success rate especially in women with recurrent implantation failure, while some studies failed to detect any benefit. OBJECTIVE: The purpose of our trial was to explore whether endometrial injury in luteal phase prior to frozen-thawed embryo transfer cycles would improve pregnancy outcomes? MATERIALS AND METHODS: We conducted a prospective controlled trial of 93 consecutive subjects at a research and clinical center for infertility...
July 2016: International Journal of Reproductive Biomedicine (Yazd, Iran)
Yue Jiang, Ruiwei Jiang, Xi Cheng, Qun Zhang, Yali Hu, Hui Zhang, Yun Cao, Mei Zhang, Junxia Wang, Lijun Ding, Zhenyu Diao, Haixiang Sun, Guijun Yan
STUDY QUESTION: How do NR4A receptors drive decidualization of human endometrial stromal cells (hESCs)? SUMMARY ANSWER: NR4A receptors modulate endometrial decidualization by transcriptional activation of FOXO1A, and in adenomyosis patients, the reduced expression of NR4A receptors in the eutopic endometrium may represent a novel mechanism to explain impaired decidualization and subfertility. WHAT IS KNOWN ALREADY: A close relationship between impaired decidualization and subfertility has been established...
September 2016: Molecular Human Reproduction
Jorge E Chavarro, Janet W Rich-Edwards, Audrey J Gaskins, Leslie V Farland, Kathryn L Terry, Cuilin Zhang, Stacey A Missmer
OBJECTIVES: To review the Nurses' Health Study's (NHS's) contribution to identifying risk factors and long-term health consequences of reproductive events. METHODS: We performed a narrative review of the NHS I, NHS II, NHS3, and Growing Up Today Study (GUTS) publications between 1976 and 2016. RESULTS: Collection of detailed reproductive history to identify breast cancer risk factors allowed the NHS to document an association between menstrual irregularities, a proxy for polycystic ovary syndrome (PCOS), and increased risk of diabetes and cardiovascular disease...
September 2016: American Journal of Public Health
Patrizia Carrarelli, Chih-Feng Yen, Lucia Funghi, Felice Arcuri, Claudia Tosti, Giuseppe Bifulco, Alice Luddi, Chyi-Long Lee, Felice Petraglia
OBJECTIVE: Adenomyosis is a uterine disorder characterized by dysmenorrhea, dyspareunia, abnormal uterine bleeding, and infertility. Pathogenesis indicates that endometrial cells invade and proliferate within myometrium, and inflammatory mediators participate to the intense painful symptoms. The aim of the present study was to investigate the messenger RNA (mRNA) and protein expression of inflammatory (interleukin 1β [IL-1β], corticotropin-releasing hormone [CRH], urocortin [Ucn]) and neurogenic (nerve growth factors [NGFs], synaptophysin [SYN], microtubule-associated protein 2 [MAP2]) factors in adenomyotic nodules...
July 20, 2016: Reproductive Sciences
Vasanthi Soumya, Renjini A Padmanabhan, Shiny Titus, Malini Laloraya
PROBLEM: Autoimmune polyendocrinopathy, candidiasis, and ectodermal dystrophy (APECED, APS-1) patients characterized by Aire (autoimmune regulator) mutations and Aire homozygous knockouts (Aire(-/-) ) exhibit infertility. It is not clear as to what contributes to infertility in the above. METHOD OF STUDY: This study investigates the expression of "AIRE in the uterus" and its contribution to early pregnancy of mice by using quantitative real-time PCR analysis, immunohistochemistry, Western blotting, and in vivo Aire silencing experiments...
September 2016: American Journal of Reproductive Immunology: AJRI
A Nigam, P Saxena, A Mishra
Background Hysterosalpingography (HSG) is a useful screening test for the evaluation of female infertility. Laparoscopy has proven role in routine infertility work up but role of hysteroscopy in an infertile patient with normal HSG for additional information is a subject of debate. Hysteroscopy permits direct visualization of the cervical canal and the uterine cavity and thereby helping in the evaluation of shape, and cavitary lesion. Objective To detect uterine abnormalities in infertile women by various approaches i...
October 2015: Kathmandu University Medical Journal (KUMJ)
Shilpa Bhandari, Ishita Ganguly, Pallavi Agarwal, Aparna Singh, Nitika Gupta
CONTEXT: Fibroids are the most common tumors of the uterine cavity. Most of them are diagnosed during the reproductive age when the fertility is an important concern for the female. However, complications can occur after removal of fibroid (myomectomy) too for future pregnancy. Though myomectomy has been sighted as a cause of intrauterine adhesions data regarding the effect of myomectomy on endometrial cavity is lacking. AIMS: Evaluate the incidence of intrauterine adhesion formation after myomectomy and to identify the associated factors...
April 2016: Journal of Human Reproductive Sciences
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