Couples with mild male factor infertility and at least 3 failed previous IVF attempts may benefit from laparoscopic investigation regarding assisted reproduction outcome

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Abstract

The aim of this study is to assess the value of laparoscopy for couples diagnosed with mild male factor infertility and at least three previous failed In-Vitro Fertilization (IVF) attempts. A total of 169 couples were included in this prospective cohort study. Patients were presented with the option of being subjected to laparoscopic investigation for correction of previously unidentified endometriosis or pelvic adhesions. The outcome measures were Live Birth/Ongoing Pregnancy, clinical pregnancy and positive hCG rate. One-hundred and one of them opted for, whereas 68 opted against laparoscopic investigation. All patients proceeded with a single ICSI cycle. Following laparoscopic investigation, 43 patients were diagnosed with endometriosis, 22 with adhesions, while for 36 patients laparoscopic investigation provided no further diagnosis. No statistically significant differences were observed regarding baseline hormonal levels and other characteristics between the two groups and the three subgroups. When compared to the no-laparoscopy group, women subjected to laparoscopy presented with a higher clinical pregnancy and ongoing pregnancy/live birth rate. Following endometriosis correction, a marginally non-statistically significant trend was observed regarding a decrease in poor-quality blastocysts (p = 0.056). A statistically significant higher clinical pregnancy (p = 0.03) and ongoing pregnancy/live birth rate was observed in the endometriosis group when compared to male factor infertility only (p = 0.04). Laparoscopic identification and correction of undiagnosed endometriosis in couples initially diagnosed with male infertility and at least 3 failed previous IVF attempts, appears to be a promising approach efficiently addressing infertility for these patients while avoiding IVF overuse.

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Most cited references 39

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The transfer of the human embryo at the blastocyst stage during an in-vitro fertilization procedure is a way of increasing implantation rates. This, in turn, means that significantly fewer embryos are required to be transferred in order to establish a successful pregnancy. The result of this is that high order multiple gestations are eliminated, while maintaining high pregnancy rates, in in-vitro fertilization.

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What exactly do we mean by 'recurrent implantation failure'? A systematic review and opinion.

Lukasz Polanski, Miriam Baumgarten, Siobhan Quenby … (2014)

Recurrent implantation failure (RIF) is an iatrogenic condition, being the result of repetitive unsuccessful cycles of IVF or intracytoplasmic sperm injection (ICSI) treatment. The aim of this review was to assess the definitions of RIF used in literature as well as suggest a uniform definition of this condition. A systematic search of MEDLINE, Embase and Cochrane Library was conducted. The most commonly stated definitions described RIF as 'three or more failed treatment cycles' or 'two or more failed cycles'. Other identified definitions were based solely on the number of embryos transferred in previous cycles or combined the number of previously failed cycles with the number of transferred embryos. Several other definitions were also identified. This review highlights the lack of uniformity of the definition of RIF. Based on the available literature and the expert opinion of the authors, RIF should be defined as the absence of implantation after two consecutive cycles of IVF, ICSI or frozen embryo replacement cycles where the cumulative number of transferred embryos was no less than four for cleavage-stage embryos and no less than two for blastocysts, with all embryos being of good quality and of appropriate developmental stage. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

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Chronic endometritis is a frequent finding in women with recurrent implantation failure after in vitro fertilization.

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To determine the role of endometrial sampling for identification and treatment of chronic endometritis (CE) in patients undergoing IVF-ET who repeatedly failed to conceive despite the transfer of good-quality embryos. Retrospective chart review. University-based tertiary fertility center. Thirty-three patients with recurrent implantation failure (RIF) who underwent endometrial sampling and subsequent ET were analyzed based on immunohistochemically confirmed CE: CE present on biopsy (group 1; n = 10) and CE absent on biopsy (group 2; n = 23). Patients with RIF undergoing IVF cycles during the same time period who did not have endometrial sampling were used as controls (group 3; n = 485). Endometrial sampling for CE and subsequent antibiotic treatment in affected patients followed by another IVF-ET cycle. Chronic endometritis was identified in 30.3% of patients with RIF. Group 1 had lower implantation rates (11.5%) in the IVF cycle following treatment than did group 2 and group 3 (32.7% and 20.3%, respectively). Clinical pregnancy and ongoing pregnancy rates were similar across groups. Recurrent implantation failure warrants investigation of CE as a contributing factor. Women demonstrating CE on endometrial sampling have lower implantation rates in a subsequent IVF-ET cycle; however, there were no differences in subsequent clinical pregnancy or ongoing pregnancy rates after successful antibiotic treatment. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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Author and article information

Contributors

Mara Simopoulou:

ORCID: http://orcid.org/0000-0002-1000-9100

marasimopoulou@hotmail.com

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 11 February 2020

Publication date PMC-release: 11 February 2020

Publication date Collection: 2020

Volume: 10

Electronic Location Identifier: 2350

Affiliations

[1 ]Centre for Human Reproduction, Genesis Athens Clinic, Athens, Greece

[2 ]ISNI 0000 0001 2155 0800, GRID grid.5216.0, Department of Physiology, , Medical School, National and Kapodistrian University of Athens, ; Athens, Greece

[3 ]ISNI 0000 0001 2155 0800, GRID grid.5216.0, Assisted Conception Unit, 2nd Department of Obstetrics and Gynaecology, Aretaieion Hospital, , Medical School, National and Kapodistrian University of Athens, ; Athens, Greece

Author information

Sokratis Grigoriadis http://orcid.org/0000-0002-1861-8701

Mara Simopoulou http://orcid.org/0000-0002-1000-9100

Article

Publisher ID: 59170

DOI: 10.1038/s41598-020-59170-5

PMC ID: 7012822

PubMed ID: 32047198

SO-VID: efabe797-4009-43f4-9c3e-ad1c8f736b66

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 13 November 2019

Date accepted : 20 January 2020

Custom metadata

ScienceOpen disciplines: Uncategorized

Keywords: reproductive techniques,infertility

Data availability:

ScienceOpen disciplines: Uncategorized

Keywords: reproductive techniques, infertility

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