Effect of endometrial injury during menstruation on clinical outcomes in frozen-thawed embryo transfer cycles: A randomized control trial.

AIM: To explore the clinical effect of endometrial injury (EI) on the third day of the menstrual cycle before frozen-thawed embryo transfer (frozen-thawed ET) on patients experienced two or more implantation failures. METHODS: A total of 200 patients who suffered at least two failed hormone-replacement therapies and frozen-thawed ET were randomly divided into two groups: EI group and control group (n = 100 in each group). Patients in the EI group received local EI with a Pipelle catheter on the third day of the menstrual cycle before frozen-thawed ET. Primary outcomes were live birth, clinical pregnancy and implantation rates. Secondary outcomes were biochemical, multiple and ectopic pregnancy rates and abortion rates. RESULTS: The rate of live birth in EI group (51.00%) was significantly higher than that of control group (36.00%) (P = 0.032). Clinical pregnancy and implantation rates in EI group were significantly higher comparing to control group (64.00% vs 48.00%, P = 0.023 and 46.74% vs 30.11%, P = 0.001). The rate of multiple pregnancy in EI group (37.50%) was significantly higher than that of control group (18.75%) (P = 0.031). No significant difference in ectopic pregnancy rate and abortion rate was observed between EI group and control group. CONCLUSION: Applying EI to patients experienced two or more implantation failures on the third day of the menstrual cycle before frozen-thawed ET can improve clinical outcomes.

Long-term transplantation human menstrual blood mesenchymal stem cell loaded collagen scaffolds repair endometrium histological injury.

Menstrual blood mesenchymal stem cell (MBMSC) is a potential cell source for effective therapy for intrauterine adhesion (IUA). Collagen scaffold (CS) loaded with mesenchymal stem cells promotes endometrial regeneration in IUA model animals. However, role of combination of MBMSCs and CS in IUA therapy remains elusive. In particular, transplantation of MBMSCs over a long period of time requires more in-depth research. Here in this study, transplantation of human MBMSCs loaded on CS was applied for therapy for a long term rat IUA model. A rat IUA model characterized by lower number of endometrial glands and increased fibrosis was established. At 90 days after transplantation of the human MBMSC-loaded CS, expression of HuNu, a human protein, was identified in the uteri of the transplanted IUA model rats. The transplantation increased the number of endometrial glands and decreased the fibrotic areas significantly. Moreover, transplantation of the human MBMSC-loaded CS decreased the Collagen I and increased the CK 18 significantly. Immunoblotting assay results further proved the downregulation of Collagen I and the upregulation of CK 18. Together, endometrium regeneration promoted by human MBMSC-loaded CS was demonstrated in a long term rat model of IUA, shedding a new light on the role of human MBMSCs in the therapy for IUA.

The association between previous induced abortion and in vitro fertilization outcomes: A retrospective cohort study in Hefei, China.

OBJECTIVES: To assess the association between previous induced abortion and in vitro fertilization (IVF) outcomes among Chinese women. STUDY DESIGN: In this retrospective cohort study, a total of 1436 infertility patients treated with IVF for the first time in the reproductive centre of Anhui Province Maternity and Child Health Hospital from February 2014 to April 2018 were selected as the study population, and 95 (6.6 %) had a history of induced abortion. Data were assessed from the hospital electronic database and medical records in the reproductive centre. RESULTS: In total, 818 women (57.0 %) achieved clinical pregnancy, and 501 (34.9 %) achieved live birth. After adjustments for a series of potential confounding factors, women with a history of induced abortion had a significantly decreased probability of clinical pregnancy per transfer (OR: 0.71, 95 % CI: 0.53, 0.95, p = 0.037) and live birth per pregnancy (OR: 0.52, 95 % CI: 0.30, 0.90, p = 0.021) and a higher risk of miscarriage per pregnancy (OR: 1.89, 95 % CI: 1.24, 2.88, p = 0.009) than those without. Because relevant information was unavailable, the impacts of different types of previous induced abortion were not assessed. CONCLUSIONS: Previous induced abortion may have an adverse effect on IVF outcomes among infertility patients.