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Diagnosis of Endometrial-Factor Infertility: Current Approaches and New Avenues for Research.

ABSTRACT: Over the last decade, research to improve success rates in reproductive medicine has focused predominantly on the understanding and optimization of embryo quality. However, the emergence of personalized medicine in ovulation induction and embryology has shifted the focus to assessing the individual status of the endometrium. The endometrium is considered receptive during an individually defined period, the window of implantation (WOI), when the mother permits a blastocyst to attach and implant. This individual receptivity status can now be objectively diagnosed using the endometrial receptivity array (ERA) developed in 2011. The ERA, together with a computational algorithm, detects the unique transcriptomic signature of endometrial receptivity by analyzing 238 differentially expressed genes and reliably predicting the WOI. We and others have illustrated the utility of this personalized diagnostic approach to discriminate between individual physiological variation in endometrial receptivity and unknown endometrial pathology, deemed as causal in recurrent implantation failure (RIF). An international randomized controlled trial ("The ERA as a diagnostic guide for personalized embryo transfer." ClinicalTrials.gov Identifier: NCT01954758) is underway to determine the clinical value of this endometrial diagnostic intervention in the work-up for reproductive care. In this review, we analyse the current clinical practice in the diagnosis of the endometrial factor together with new avenues of research.

SUBMITTER: Katzorke N

PROVIDER: S-EPMC4922892 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Diagnosis of Endometrial-Factor Infertility: Current Approaches and New Avenues for Research.

Katzorke N N Vilella F F Ruiz M M Krüssel J-S JS Simón C C

Geburtshilfe und Frauenheilkunde 20160601 6

Over the last decade, research to improve success rates in reproductive medicine has focused predominantly on the understanding and optimization of embryo quality. However, the emergence of personalized medicine in ovulation induction and embryology has shifted the focus to assessing the individual status of the endometrium. The endometrium is considered receptive during an individually defined period, the window of implantation (WOI), when the mother permits a blastocyst to attach and implant. ...[more]

PMID: 27365540

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Project description:Endometrial-factor induced infertility remains one of the most significant pathology among all fertility disorders. Stem cell-based therapy is considered to be the next-generation approach. However, there are still issues about successfully retrieving human endometrium-derived mesenchymal stem/stromal cells (hEnMSCs). Moreover, we need to establish a better understanding of the effect of hEnMSCs on the endometrial recovery and the clinical outcome. According to these challenges we created a multi-step study. Endometrium samples were collected from females undergoing assisted reproductive technology (ART) procedure due to couple infertility. These samples were obtained using an endometrium scratching. The hEnMSCs were isolated from endometrium samples and characterized with flow cytometry analysis. Groups of endometrium injured female mice were established by the mechanical injury to uterine horns and the intraperitoneal chemotherapy. The hEnMSCs suspension was injected to some of the studied female mice at approved time intervals. Histological changes of mice uterine horns were evaluated after Masson's trichrome original staining, hematoxylin and eosin (H&E) staining. The fertility assessment of mice was performed by counting formed embryo implantation sites (ISs). The expression of fibrosis related genes (Col1a1, Col3a1, Acta2, and CD44) was evaluated by the reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Results showed that endometrium scratching is an effective procedure for mesenchymal stem/stromal cells (MSCs) collection from human endometrium. Isolated hEnMSCs met the criteria for defining MSCs. Moreover, hEnMSCs-based therapy had a demonstrably positive effect on the repair of damaged uterine horns, including a reduction of fibrosis, intensity of inflammatory cells such as lymphocytes and polymorphonuclear cells (PMNs) and the number of apoptotic bodies. The injured mice which recieved hEnMSCs had higher fertility in comparison to the untreated mice. Gene expression was reflected in histology changes and outcomes of conception. In conclusion, hEnMSCs demonstrated a positive impact on endometrium restoration and outcomes of endometrial-factor induced infertility. Further exploration is required in order to continue exploring the multifactorial associations between stem cell therapy, gene expression, endometrial changes and reproductive health, so we can identify individually effective and safe treatment strategies for endometrial-factor induced infertility, which is caused by mechanical effect or chemotherapy, in daily clinical practise.

Project description:In this article, I discuss Indigenous radio's ongoing importance for tribal communities in the US from my perspective as a settler scholar, drawing on multifaceted research into Indigenous radio's programme content and production practices before and during the pandemic. For this research, 'Indigenous radio' refers to radio produced, managed, presented and/ or owned by tribal communities. Other terms in use to describe Indigenous radio include Native American, Indian, or tribal radio, demonstrating that there is not a single universalising term and reflecting a diversity in tribal cultures, languages and practices more generally. Building on this understanding of the inherent diversity of Indigenous radio, I describe the ways in which my overarching research project investigates Indigenous radio holistically, via critical outputs combining a literature review of Indigenous theoretical approaches, an online interactive map of tribal stations and in-depth case studies of tribal stations. Through these, I explore community-building practices of Indigenous radio as produced through what Indigenous theorists Glen Coulthard and Leanne Betasamosake Simpson (2016) term grounded normativity. Building on this avenue of exploration, I suggest the place-based values embedded in Indigenous radio production practices and content can function as everyday acts of resurgence, following Jeff Corntassel's (2012) conceptualisation of ways in which Indigenous resurgence can reinforce a project of decolonisation. To exemplify and situate these arguments, I draw on examples of radio production and practitioner insights from selected tribal stations embodying diverse tribal production practices and content, before turning to focus on pandemic practices in Indigenous radio. When the pandemic emerged, my research focus necessarily widened to include and examine COVID-related practices and programming in tribal radio, enabling reflection on these in the context of a paradigm shift in which the value of tribal radio's community-building work has become acute.

Dataset Information

Diagnosis of Endometrial-Factor Infertility: Current Approaches and New Avenues for Research.

Publications

Diagnosis of Endometrial-Factor Infertility: Current Approaches and New Avenues for Research.

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