multiplexed-fluorescent-immunohistochemical-staining-four-endometrial

Multiplexed Fluorescent Immunohistochemical Staining of Four Endometrial Immune Cell Types in Recurrent Miscarriage

Immunohistochemistry is the most commonly used method for the identification and visualization of tissue antigens in biological research and clinical ...

The Chinese University of Hong Kong, Prince of Wales Hospital

The recent ESHRE-ESGE classification for female genital anomalies attempts to promote objectivity in diagnosis of normal and septate uteri. The aim of this study was to ascertain whether the uterine cavity indentation - the characteristic feature of septate uteri - varies significantly throughout the cycle. Seventy consecutive women underwent three-dimensional ultrasound twice: 35 during the proliferative and luteal phase of a natural cycle, and 35 during the first and final day of a stimulated cycle. Endometrial thickness, interostial distance, cavity indentation and percentage of cavity indentation were all assessed in accordance with the ESHRE-ESGE consensus on diagnosis of female genital anomalies. Overall, throughout both cycles, there was a significant increase in endometrial thickness (from 4.6 mm to 10.2 mm; P < 0.001) and interostial distance (from 30.1 mm to 35.1 mm; P < 0.001), which was associated with a significant reduction in the percentage of cavity indentation (from 30.3% to 15.0%; P < 0.001). Between the first and second assessment, 3/70 (4.3%) patients had a change in diagnosis from septate to normal uterus, although this did not reach statistical significance. This observation of a significant intra-cycle variation of the uterine cavity indentation has important implications for both clinical practice and research.

Intra-cycle variation of the uterine cavity indentation assessed with three-dimensional ultrasound in natural and stimulated cycles.

This retrospective study assessed the predictive value of endometrial thickness (EMT) on HCG administration day for the clinical outcome of fresh IVF and intracytoplasmic sperm injection (ICSI) cycles. A total of 8690 consecutive women undergoing 10,787 cycles over a 5-year period were included. The 5th, 50th and 95th centiles for EMT were determined as 8, 11 and 15 mm, respectively. Group analysis according to these centiles (Group 1: < 8 mm; Group 2: ≥ 8 and ≤11 mm; Group 3: > 11 and ≤15 mm; Group 4: > 15 mm) demonstrated significant differences (P < 0.001) in clinical pregnancy rates (23.0%, 37.2%, 46.2% and 53.3%, respectively), live birth rates per clinical pregnancy (63.3%, 72.0%, 78.1% and 80.3%, respectively), spontaneous abortion rates (26.7%, 23.8%, 19.9% and 17.5%, respectively), and ectopic pregnancy rates (10.0%, 4.3%, 2.1% and 2.2%, respectively). Logistic regression analyses showed EMT as one of the independent variables predictive of clinical pregnancy (OR = 1.097; P < 0.001), live birth (OR = 1.078; P < 0.001), spontaneous abortion (OR = 0.948; P < 0.001), and ectopic pregnancy (OR = 0.851; P < 0.001). Future research should aim to understand the underlying mechanisms relating EMT to conception, ectopic implantation and spontaneous abortion. 

Endometrial thickness as a predictor of pregnancy outcomes in 10787 fresh IVF-ICSI cycles.

Does three-dimensional (3D) versus two-dimensional (2D) ultrasound (US) guidance during embryo transfer (ET) increase the ongoing pregnancy rate in women undergoing ART treatment.

A prospective randomized controlled trial of 3D versus 2D ultrasound-guided embryo transfer in women undergoing ART treatment.

The endometrium becomes receptive to the embryo only in the mid-luteal phase, but not in the other stages of the menstrual cycle. Endometrial factors play an important role in implantation. Women with recurrent miscarriage and recurrent implantation failure have both been reported to have altered expression of receptivity markers during the window of implantation. We aimed to compare the gene expression profiles of the endometrium in the window of implantation among women with unexplained recurrent implantation failures (RIF) and unexplained recurrent miscarriages (RM) by RNA sequencing (RNA-Seq). In total 20 patients (9 RIF and 11 RM) were recruited. In addition 4 fertile subjects were included as reference. Endometrium samples were precisely timed on the 7th day after luteal hormone surge (LH + 7). All the 24 endometrium samples were extracted for total RNA. The transcriptome was determined by RNA-Seq in the first 14 RNA samples (5 RIF, 6 RM and 3 fertile). Differentially expressed genes between RM and RIF were validated by quantitative real-time PCR (qPCR) in all 24 RNA samples (9 RIF, 11 RM and 4 fertile). Transcriptomic profiles of RM and RIF, but not control samples, were separated from each other by principle component analysis (PCA) and support vector machine (SVM). Complementary and coagulation cascades pathway was significantly up-regulated in RIF while down-regulated in RM. Differentially expressed genes  and  in complement and coagulation cascade pathway between RM and RIF were further validated by qPCR. This study compared endometrial transcriptome among patients with RIF and RM in the window of implantation; it identified differential molecular pathways in endometrium between RIF and RM, which potentially affect the implantation process.

A comparison of transcriptomic profiles in endometrium during window of implantation between women with unexplained recurrent implantation failure and recurrent miscarriage.

To compare the expression pattern of angiogenic cytokines in CD56+ uNK cells from peri-implantation endometrium in women with a history of recurrent miscarriage and fertile controls.

Increased expression of angiogenic cytokines in CD56+ uterine natural killer cells from women with recurrent miscarriage.

To compare the prevalence of chronic endometritis (CE) when different diagnostic methods are used.

Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure.

Embryo transfer is the final and rate-limiting step of the assisted reproductive technique. Few advances have occurred in the last few decades with regard to this procedure. Studies conducted thus far have focused on factors and interventions taking place before, during and after this procedure. These factors are highly varied and range from methods to improve the psychological state of the patients to methods aimed at reducing uterine contractility and methods aimed at optimising the precise transfer of the embryo. The key question is which factors and interventions have thus far been proven to increase pregnancy rates and live birth rates. This paper aims to review the evidence relating to embryo transfer techniques in a systematic manner with a view to provide practical recommendations to practitioners involved in the procedure.

Embryo transfer techniques.

Preface: Volume 59.

To compare the changing peripheral levels of immune checkpoint proteins T-cell immunoglobulin mucin-3 (Tim-3)/galectin-9 (Gal-9), and programmed cell death-1 (PD-1)/programmed death-ligand 1 (PD-L1) over a 9-day period after blastocyst transfer between women who did and did not conceive.

Early transient suppression of immune checkpoint proteins T-cell immunoglobulin mucin-3 and programmed cell death-1 in peripheral blood lymphocytes after blastocyst transfer is associated with successful implantation.

The association between metal/metalloid exposure on human sperm quality is still inconclusive. There is a lack of data on the effect of metal/metalloid on sperm function.

Tin Chiu Li

Department of Obstetrics and Gynaecology

The Chinese University of Hong Kong, Prince of Wales Hospital

Multiplexed Fluorescent Immunohistochemical Staining of Four Endometrial Immune Cell Types in Recurrent Miscarriage

Tin Chiu Li

.css-o250i3{font-size:18px;font-family:Open Sans,sans-serif;line-height:21.6px;}Department of Obstetrics and Gynaecology

The Chinese University of Hong Kong, Prince of Wales Hospital

Multiplexed Fluorescent Immunohistochemical Staining of Four Endometrial Immune Cell Types in Recurrent Miscarriage

Department of Obstetrics and Gynaecology