Histopathological profile of women who had previously failed in-vitro fertilization and the association to the outcome in the subsequent in-vitro fertilization cycle (original) (raw)
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Chronic endometritis in in vitro fertilization failure patients
Clinical Journal of Obstetrics and Gynecology
Introduction: Chronic endometritis (CE) is a common cause of infertility in asymptomatic patients and its diagnosis and treatments improved assisted reproduction technique outcome in most of the specialized centers. Diagnosis of CE in endometrial biopsy by Hematoxylin and Eosin (H&E) stain is hard to identify chronic inflammatory cells from the stroma and the use of plasma cells-specific stains is helpful. Aim of the work: Evaluation of the use of CD138 in the identification of plasma cells in endometrial biopsy of patients with previous IVF trial failure. Material and methods: Hysteroscopic and curettage endometrial biopsies from fifty-five females with previous IVF trial failure were stained with H&E and CD138 immunostaining for detection of plasma cells. Results: Plasma cells were identified in 52.7% of cases by H&E and in 6/55 by CD138 immunostaining. CD138 is more sensitive in detecting plasma cells in endometrial biopsy than H&E stain. There was a significant statistical corre...
Endometriosis and in vitro fertilisation (review)
Experimental and Therapeutic Medicine, Spandidos Publications, 2018
The aim of the present review was to discuss a matter of concern in the clinical field of obstetrics/gyne cology, namely the potency of in vitro fertilization (IVF) in the management of endometriosis-associated infertility. Endometriosis is a medical condition affecting one tenth of women in their fertile years, and accounts for up to 50% of infertile women. Thus, such high prevalence has established the necessity for investigating the effectiveness of avail able techniques in eradicating the disease and constraining infertility as well as the accompanying pain symptoms of endometriosis. The underlying mechanisms connecting endometriosis with low fecundity have been extensively studied, both in terms of genetic alterations and epigenetic events that contribute to the manifestation of an infertility phenotype in women with the disease. Several studies have dealt with the impact of IVF in pregnancy rates (PRs) on patients with endometriosis, particularly regarding women who wish to conceive. Results retrieved from studies and meta-analyses depict a diverse pattern of IVF success, underlining the involvement of individual parameters in the configuration of the final outcome. The ultimate decision on undergoing IVF treatment should be based on objective criteria and clinicians' experience, customized according to patients' individual needs.
Journal of Minimally Invasive Gynecology, 2009
We sought to compare the outcomes of in vitro fertilization (IVF) treatments in women with infertility-associated deep infiltrative endometriosis (DIE) who underwent extensive laparoscopic excision of endometriosis before IVF with those who underwent IVF only. Design: Prospective cohort study. Setting: Infertility clinic and private hospital in São Paulo, Brazil. Patients: A total of 179 infertile patients younger than 38 years had symptoms and/or signs of endometriosis and sonographic images suggestive of DIE. Interventions: After thorough counseling, 179 women were invited to participate in a prospective cohort study with 2 treatment options: IVF without undergoing laparoscopic surgery (group A, n 5 105) and extensive laparoscopic excision of DIE before IVF (group B, n 5 64). Ten women were lost to follow-up. The IVF outcomes were compared between the 2 groups. Measurements and Main Results: In group B, patients had 5 6 2 (mean 6 SD) DIE lesions excised during laparoscopy. Patient characteristics in groups A and B, respectively, were: age (32 6 3 vs 32 6 3 years, p 5 .94), infertility duration (29 6 20 vs 27 6 17 months, p 5 .45), day-3 serum follicle-stimulating hormone levels (5.6 6 2.5 vs 5.9 6 2.5 IU/L, p 5 .50), and previous IVF attempts (1 6 1 vs 2 6 1, p 5 .01). The IVF outcomes differed between groups A and B, respectively, with regard to total dose of recombinant follicle-stimulating hormone required to accomplish ovulation induction (2380 6 911 vs 2542 6 1012 IU, p 5 .01), number of oocytes retrieved (10 6 5 vs 9 6 5, p 5 .04), and pregnancy rates (24% vs 41%, p 5 .004), but not number of embryos transferred (3 6 1 vs 3 6 1, p 5 1). The odds ratio of achieving a pregnancy were 2.45 times greater in group B than in group A. Conclusion: Extensive laparoscopic excision of DIE significantly improved IVF pregnancy rates of women with infertilityassociated DIE.
Histopathological Study of Endometrium in Infertility: Experience in A Tertiary Level Hospital
BIRDEM Medical Journal, 2018
Background: Infertility refers to inability to achieve conception even after one year of unprotected coitus by a couple. It is a global health problem and affects 8-10% couple worldwide. Infertility can be primary or secondary and there are many causes of infertility involving both male and female partner. A wide range of investigations can be done to find out the causes of infertility. Endometrial biopsy or curettage or aspiration followed by histopathological study is a safe procedure. It not only shows the hormonal response of endometrium but also diagnose other endometrial pathology causing infertility. The study was performed to find out the morphological pattern of endometrium in infertile women in a tertiary care hospital to find out the causes of infertility and subsequent treatment of the patients.Methods: It was a cross sectional prospective study, conducted in the Department of Histopathology and Cytopathology in a tertiary care hospital in Dhaka for a period of two years...
“Chromohysteroscopy” for evaluation of endometrium in recurrent in vitro fertilization failure
Journal of Assisted Reproduction and Genetics, 2008
Purpose To assess the efficacy of chromohysteroscopy in detecting endometrial pathologies in recurrent in vitro fertilization (IVF) failure. Materials and methods Sixty-four patients in whom conventional hysteroscopy did not show any apparent endometrial pathology were included. Five milliliter of 1% methylene blue dye was introduced through the hysteroscopic inlet. Biopsies were obtained both from dark stained and light stained areas. Results The study group was grouped according to the staining characteristics. Group I included 22 patients in whom focal dark staining was observed. Group II included 41 patients in whom diffuse light blue staining without dark areas was observed. There was no significant difference between two groups in age, smoking, body mass index, number of IVF failure and time to hysteroscopy after the last failure. But, there was a statistically significant difference in the incidence of endometritis between two groups (p=0.007). The power of dark staining for detection of endometritis was calculated as follows: sensitivity 69.2%, specificity 74%, positive predictive value 40.9% and negative predictive value 90.2%. Conclusion Chromohysteroscopy improves the efficacy of hysteroscopy in recurrent IVF failure. Observation of diffuse light blue staining without dark areas strongly suggests a normal endometrium free of endometritis.
In vitro fertilization pregnancy in a patient with proven chronic endometritis
Fertility and Sterility, 2009
Objective: To report an in vitro fertilization (IVF) pregnancy in a patient with histologically confirmed chronic endometritis before the IVF treatment without prior antibiotherapy. Design: Case report. Setting: Academic reproductive medicine unit. Patient(s): A 30-year-old woman with primary infertility due to mild oligoasthenoteratospermia of the male partner. Intervention(s): Diagnostic hysteroscopy and endometrial biopsy. Main Outcome Measure(s): Delivery after the first IVF. Result(s): Histologic examination of the endometrium revealed chronic endometritis. The patient delivered a healthy boy at 40 weeks' gestation after the first IVF treatment. Conclusion(s): Our findings suggest that the impact of chronic endometritis on infertility and IVF outcome should be further investigated in prospective randomized studies. (Fertil Steril Ò 2009;91:1293.e9-e11. Ó2009 by American Society for Reproductive Medicine.)
2007
Purpose To assess the efficacy of chromohysteroscopy in detecting endometrial pathologies in recurrent in vitro fertilization (IVF) failure. Materials and methods Sixty-four patients in whom con-ventional hysteroscopy did not show any apparent endo-metrial pathology were included. Five milliliter of 1% methylene blue dye was introduced through the hystero-scopic inlet. Biopsies were obtained both from dark stained and light stained areas. Results The study group was grouped according to the staining characteristics. Group I included 22 patients in whom focal dark staining was observed. Group II included 41 patients in whom diffuse light blue staining without dark areas was observed. There was no significant difference between two groups in age, smoking, body mass index, number of IVF failure and time to hysteroscopy after the last failure. But, there was a statistically significant difference in the incidence of endometritis between two groups (p=0.007). The power of dark staining f...