Inflammatory Changes after Medical Suppression of Suspected Endometriosis for Implantation Failure: Preliminary Results

Bruce A. Lessey, Allan Dong, Allan C. Dong, Jeffrey L Deaton, Daniel Angress, Ricardo Francalacci Savaris, Stephen J. Walker
International journal of molecular sciences · 2024 · vol. 25(13) , pp. 6852 · doi:10.3390/ijms25136852 · PMID:38999962 · W4399972515
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This study investigated inflammation and miRNA expression in women with unexplained euploid embryo transfer failure treated with GnRH antagonist, finding potential improvement in success rates and resolution of inflammatory changes.

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Abstract

Unexplained euploid embryo transfer failure (UEETF) is a frustrating and unanswered conundrum accounting for 30 to 50% of failures in in vitro fertilization using preimplantation genetic testing for aneuploidy (PGT-A). Endometriosis is thought by many to account for most of such losses and menstrual suppression or surgery prior to the next transfer has been reported to be beneficial. In this study, we performed endometrial biopsy in a subset of women with UEETF, testing for the oncogene BCL6 and the histone deacetylase SIRT1. We compared 205 PGT-A cycles outcomes and provide those results following treatment with GnRH agonist versus controls (no treatment). Based on these and previous promising results, we next performed a pilot randomized controlled trial comparing the orally active GnRH antagonist, elagolix, to oral contraceptive pill (OCP) suppression for 2 months before the next euploid embryo transfer, and monitored inflammation and miRNA expression in blood, before and after treatment. These studies support a role for endometriosis in UEETF and suggest that medical suppression of suspected disease with GnRH antagonist prior to the next transfer could improve success rates and address underlying inflammatory and epigenetic changes associated with UEETF.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Implantation Embryo Transfer Embryo Transfer Embryo Transfer Embryo Transfer

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References (86)

Cited by (1)

SciLite annotations

chemicals 40
elagolix estrogen progesterone steroid progesterone estrogen estrogen estrogen estradiol prostaglandin e2 estrogen progesterone elagolix ketoconazole elagolix elagolix estradiol progesterone estradiol progesterone progesterone progesterone elagolix elagolix elagolix elagolix elagolix elagolix elagolix polyunsaturated fatty acid elagolix progesterone progesterone elagolix progesterone estrogen elagolix progesterone estrogen elagolix
organisms 11
human human human human human human human noordeloos 2009062 transgenic mice human human

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