Antiangiogenic agents for endometriosis
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This review discusses the controversies and evidence regarding hydrosalpinges and uterine leiomyoma impact on IVF outcomes, noting hydrosalpinges may negatively affect results and hysteroscopy is recommended for cavity evaluation.
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The paper/chapter examines medical treatment strategies for endometriosis by focusing on the angiogenic activity of the peritoneal environment and the rationale for antiangiogenic interventions. It describes how angiogenesis depends on new blood-vessel formation driven by existing vessels, and notes that multiple antiangiogenic agents have shown success in experimental endometriosis models by inhibiting new vessel formation, often acting directly on endothelial cells without deep tissue penetration. The chapter also highlights a caveat that some anticancer drugs with antiangiogenic potential can impair reproductive function in both animal models and patients. Relevance to endometriosis: this paper is centrally about endometriosis—its chapter 10 specifically addresses antiangiogenic agents for endometriosis and discusses dopamine agonists’ antiangiogenic mechanisms in the context of VEGF-VEGFR signaling.
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Abstract
This chapter addresses the controversies surrounding the impact and surgical management of hydrosalpinges and uterine leiomyoma on in vitro fertilization (IVF) cycle outcome. Evidence accumulated over the last 15 years suggests that either unilateral or bilateral hydrosalpinges may exert deleterious effects on IVF cycle outcome. Hydrosalpinx fluid may have a direct embryotoxic effect and may also inhibit fertilization. This deleterious effect may be mediated by the presence of inflammatory cytokines present within hydrosalpinx fluid. Several groups have reported that only large hydrosalpinges, visible on ultrasound, resulted in reduced implantation and pregnancy rates. The impact of uterine leiomyomata specifically on the outcome of assisted reproductive technologies has been evaluated with conflicting results. Evaluation of the uterine cavity by hysteroscopy or sonohysterography should be a routine part of the pre-cycle evaluation. The accuracy of routine ultrasound evaluation and hysterosalpingography is more limited.
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Human Assisted Reproductive Technology
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[Opens in a new window] Future Trends in Laboratory and Clinical Practice
- Human Assisted Reproductive Technology
- Human Assisted Reproductive Technology
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Acknowledgments
- Chapter 1 Use of robotics in reproductive surgery
- Chapter 2 Removal of hydrosalpinges and uterine leiomyoma to improve IVF outcome
- Chapter 3 Ovarian endometriomas:
- Chapter 4 Impact of uterine cavity abnormalities on IVF and pretreatment cavity evaluation
- Chapter 5 Sperm retrieval techniques
- Chapter 6 New concepts in ovarian stimulation
- Chapter 7 GnRH antagonists in ART
- Chapter 8 Pharmacogenetics of ovarian stimulation in the twenty-first century
- Chapter 9 Non-invasive diagnosis of endometriosis with proteomic technologies
- Chapter 10 Antiangiogenic agents for endometriosis
- Chapter 11 New concepts in the management of polycystic ovary syndrome
- Chapter 12 Adjuvant therapy to increase implantation rates
- Chapter 13 Ovarian hyperstimulation syndrome
- Chapter 14 The evidence-based practice of assisted reproduction
- Chapter 15 Three-dimensional in vitro ovarian follicle culture
- Chapter 16 Artificial gametes
- Chapter 17 Current status and future trends of the clinical practice of human oocyte in vitro maturation
- Chapter 18 Oocyte and zona imaging
- Chapter 19 Granulosa cells and their impact on human ART
- Chapter 20 Sperm diagnosis:
- Chapter 21 Embryo culture in the twenty-first century
- Chapter 22 Morphometric analyses of embryos
- Chapter 23 Embryo biopsy:
- Chapter 24 Analysis of the embryonic transcriptome
- Chapter 25 Analysis of embryo-derived factors as markers of developmental potential and viability
- Chapter 26 Proteomics analysis of the endometrium and embryo. Can we improve IVF outcome?
- Chapter 27 Analysis of embryo metabolism and the metabolome to identify the most viable embryo within a cohort
- Chapter 28 Oocyte and embryo cryopreservation
- Index
Published online by Cambridge University Press: 16 May 2011
Book contents
- Human Assisted Reproductive Technology
- Human Assisted Reproductive Technology
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Acknowledgments
- Chapter 1 Use of robotics in reproductive surgery
- Chapter 2 Removal of hydrosalpinges and uterine leiomyoma to improve IVF outcome
- Chapter 3 Ovarian endometriomas:
- Chapter 4 Impact of uterine cavity abnormalities on IVF and pretreatment cavity evaluation
- Chapter 5 Sperm retrieval techniques
- Chapter 6 New concepts in ovarian stimulation
- Chapter 7 GnRH antagonists in ART
- Chapter 8 Pharmacogenetics of ovarian stimulation in the twenty-first century
- Chapter 9 Non-invasive diagnosis of endometriosis with proteomic technologies
- Chapter 10 Antiangiogenic agents for endometriosis
- Chapter 11 New concepts in the management of polycystic ovary syndrome
- Chapter 12 Adjuvant therapy to increase implantation rates
- Chapter 13 Ovarian hyperstimulation syndrome
- Chapter 14 The evidence-based practice of assisted reproduction
- Chapter 15 Three-dimensional in vitro ovarian follicle culture
- Chapter 16 Artificial gametes
- Chapter 17 Current status and future trends of the clinical practice of human oocyte in vitro maturation
- Chapter 18 Oocyte and zona imaging
- Chapter 19 Granulosa cells and their impact on human ART
- Chapter 20 Sperm diagnosis:
- Chapter 21 Embryo culture in the twenty-first century
- Chapter 22 Morphometric analyses of embryos
- Chapter 23 Embryo biopsy:
- Chapter 24 Analysis of the embryonic transcriptome
- Chapter 25 Analysis of embryo-derived factors as markers of developmental potential and viability
- Chapter 26 Proteomics analysis of the endometrium and embryo. Can we improve IVF outcome?
- Chapter 27 Analysis of embryo metabolism and the metabolome to identify the most viable embryo within a cohort
- Chapter 28 Oocyte and embryo cryopreservation
- Index
Medical treatment of endometriosis is a necessary step in the management of the disease due to its high rate of recurrence and different clinical situations. Women with endometriosis present a peritoneal environment with increased angiogenic activity. Angiogenesis involves the formation of new blood vessels released by pre-existing vessels. Several antiangiogenic agents have been successfully tested in experimental models of endometriosis inhibiting new vessel formation. These compounds target specifically the endothelial cells without penetration in the tissues. Several anticancer drugs with antiangiogenic potential have been found to have a detrimental effect on reproductive function in both animal models and patients. The studies in experimental oncological models demonstrated that dopamine agonists (DA) have an antiangiogenic effect promoting the vascular endothelial growth factor receptors (VEGFR)-2 endocytosis in endothelial cells, preventing the VEGF-VEGFR-2 union and avoiding receptor phosphorylation and signal cascade.
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- Chapter
- Information
- Human Assisted Reproductive TechnologyFuture Trends in Laboratory and Clinical Practice, pp. 101 - 109Publisher: Cambridge University PressPrint publication year: 2011
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- Book: Human Assisted Reproductive Technology
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- Antiangiogenic agents for endometriosis
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- Book: Human Assisted Reproductive Technology
- Online publication: 16 May 2011
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- Antiangiogenic agents for endometriosis
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- Book: Human Assisted Reproductive Technology
- Online publication: 16 May 2011
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