Current Trends in Reproductive Endocrinology

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (20 December 2023) | Viewed by 3226

Special Issue Editors

1. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
2. Division of Gynecology and Reproductive Medicine, Department of Gynecology, IRCCS Humanitas Research Hospital, Fertility Center, Rozzano, Italy
Interests: assisted reproductive technology; endometriosis; reproductive medicine; laparoscopy
Department of Gynecology and Obstetrics, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
Interests: Dienogest; ovarian reserve; Elagolix; infertility; in vitro fertilization; childlessness; endometriosis; hemoperitoneum; pregnancy

Special Issue Information

Dear Colleagues,

The recent progress made in reproductive endocrinology is remarkable. On the other hand, the transition from the bench to the bedside in reproductive medicine is often too fast, and does not wait for all of the necessary evidence regarding efficacy and safety. Clinicians as well as their patients are often overwhelmed by the large amount of information, and struggle to orient themselves. In order to fill this gap, at least partially, the purpose of this Special Issue is to provide information on the state of the art regarding some of the most debated aspects in the field of reproductive endocrinology. In this Special Issue, we invite authors to submit papers focused on the following issues: i) endometriosis: diagnosis and management of affected patients; ii) idiopathic recurrent pregnancy loss: advancements in diagnosis and treatment; iii) controlled ovarian stimulation for in vitro fertilization: a focus on non-conventional stimulation protocols; iv) add-ons for repeated embryo implantation failure: evidence beyond a biological rationale; and v) pre-implantation genetic testing (PGT).

Dr. Andrea Busnelli
Dr. Laura Benaglia
Guest Editors

Manuscript Submission Information

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Keywords

  • reproductive endocrinology
  • endometriosis
  • recurrent pregnancy loss
  • controlled ovarian stimulation
  • repeated embryo implantation failure
  • pre-implantation genetic testing

Published Papers (3 papers)

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Research

11 pages, 1258 KiB  
Article
Impact of Endometrial Preparation on the Maternal and Fetal Cardiovascular Variables of the First Trimester Combined Screening Test
J. Clin. Med. 2023, 12(21), 6854; https://doi.org/10.3390/jcm12216854 - 30 Oct 2023
Viewed by 747
Abstract
The modality of endometrial preparation for the transfer of frozen-thawed embryos may influence maternal and fetal adaptation to pregnancy and could thus impact the results of the first trimester combined screening test. We conducted a retrospective cross-sectional study on singleton pregnancies achieved by [...] Read more.
The modality of endometrial preparation for the transfer of frozen-thawed embryos may influence maternal and fetal adaptation to pregnancy and could thus impact the results of the first trimester combined screening test. We conducted a retrospective cross-sectional study on singleton pregnancies achieved by embryo transfer of a single frozen-thawed blastocyst, comparing two different endometrial preparation protocols: natural cycle (n = 174) and hormone replacement therapy (HRT) (n = 122). The primary outcome was the risk of preeclampsia at the first trimester combined screening test. Secondary endpoints included variable reflecting fetal cardiac function (nuchal translucency and fetal heart rate), maternal adaptation (median arterial blood pressure—MAP and uterine arteries pulsatility index—UtA-PI), and placentation (pregnancy associated plasma protein A and placental growth factor). The risk of early preeclampsia was comparable in the two groups (38% vs. a 28%, p = 0.12). However, women in the natural cycle group showed lower fetal heart rate (159 [155–164] vs. 164 [158–168], p = 0.002) and higher UtA-PI (0.96 [0.74–1.18] vs. 0.72 [0.58–0.90], p < 0.001). The frequency of a screening test at high risk for aneuploidies was similar. The modality of transfer of frozen-thawed embryos is associated with changes in the variables reflecting maternal and fetal cardiovascular function. Full article
(This article belongs to the Special Issue Current Trends in Reproductive Endocrinology)
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11 pages, 270 KiB  
Article
Reproductive and Obstetric Outcomes Following a Natural Cycle vs. Artificial Endometrial Preparation for Frozen–Thawed Embryo Transfer: A Retrospective Cohort Study
J. Clin. Med. 2023, 12(12), 4032; https://doi.org/10.3390/jcm12124032 - 13 Jun 2023
Viewed by 1033
Abstract
Background: The proportion of frozen embryo transfer cycles has consistently grown in recent decades. Some adverse obstetric outcomes after frozen embryo transfer could possibly be explained by different approaches in endometrial preparation. The aim of the present study was to investigate reproductive and [...] Read more.
Background: The proportion of frozen embryo transfer cycles has consistently grown in recent decades. Some adverse obstetric outcomes after frozen embryo transfer could possibly be explained by different approaches in endometrial preparation. The aim of the present study was to investigate reproductive and obstetric outcomes after frozen embryo transfer, comparing different endometrial preparation strategies. Methods: This retrospective study included 317 frozen embryo transfer cycles, of which 239 had a natural or modified natural cycle and 78 underwent artificial endometrial preparation. After excluding late abortion and twin pregnancies, the outcomes of 103 pregnancies were analyzed, 75 of which were achieved after a natural cycle/modified natural cycle, and 28 were achieved after an artificial cycle. Results: The overall clinical pregnancy rate/embryo transfer was 39.7%, the miscarriage rate was 10.1%, and the live birth rate/embryo transfer was 32.8%, without significant differences in reproductive outcomes between natural/modified cycle and artificial cycle groups. The risks of pregnancy-induced hypertension and abnormal placental insertion were significantly increased in pregnancies achieved after the artificial preparation of the endometrium (p = 0.0327 and =0.0191, respectively). Conclusions: Our study encourages the use of a natural cycle or modified natural cycle for endometrial preparation for frozen embryo transfer in order to ensure the presence of a corpus luteum able to orchestrate maternal adaptation to pregnancy. Full article
(This article belongs to the Special Issue Current Trends in Reproductive Endocrinology)
13 pages, 774 KiB  
Article
Concomitant Autoimmunity in Endometriosis Impairs Endometrium–Embryo Crosstalk at the Implantation Site: A Multicenter Case-Control Study
J. Clin. Med. 2023, 12(10), 3557; https://doi.org/10.3390/jcm12103557 - 19 May 2023
Cited by 5 | Viewed by 1111
Abstract
Endometriosis and autoimmune diseases share a hyper-inflammatory state that might negatively impact the embryo–endometrium crosstalk. Inflammatory and immune deregulatory mechanisms have been shown to impair both endometrial receptivity and embryo competence at the implantation site. The aim of this study was to investigate [...] Read more.
Endometriosis and autoimmune diseases share a hyper-inflammatory state that might negatively impact the embryo–endometrium crosstalk. Inflammatory and immune deregulatory mechanisms have been shown to impair both endometrial receptivity and embryo competence at the implantation site. The aim of this study was to investigate the potential additional impact of co-existing autoimmunity in women affected by endometriosis on the early stages of reproduction. This was a retrospective, multicenter case-control study enrolling N = 600 women with endometriosis who underwent in vitro fertilization–embryo transfer cycles between 2007 and 2021. Cases were women with endometriosis and concomitant autoimmunity matched based on age and body mass index to controls with endometriosis only in a 1:3 ratio. The primary outcome was the cumulative clinical pregnancy rate (cCPR). The study found significantly lower cleavage (p = 0.042) and implantation (p = 0.029) rates among cases. Autoimmunity (p = 0.018), age (p = 0.007), and expected poor response (p = 0.014) were significant negative predictors of cCPR, with an adjusted odds ratio of 0.54 (95% CI, 0.33–0.90) for autoimmunity. These results suggest that the presence of concomitant autoimmunity in endometriosis has a significant additive negative impact on embryo implantation. This effect might be due to several immunological and inflammatory mechanisms that interfere with both endometrial receptivity and embryo development and deserves further consideration. Full article
(This article belongs to the Special Issue Current Trends in Reproductive Endocrinology)
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