Endometrial scratching in unexplained repeated implantation failure causes two competing forces, angiogenesis and anti-angiogenesis: An RCT study

  • سال انتشار: 1403
  • محل انتشار: International Journal of Reproductive BioMedicine، دوره: 22، شماره: 4
  • کد COI اختصاصی: JR_IJRM-22-4_001
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 47
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نویسندگان

Samaneh Aghajanpour

Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Fereshteh Mehraein

Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.

Fatemehsadat Amjadi

Reproductive Sciences and Technology Research Center, Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Zahra Zandieh

Reproductive Sciences and Technology Research Center, Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Firouzeh Ghaffari

Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

Khashayar Aflatoonian

School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Elham Hosseini

Department of Obstetrics and Gynecology, Mousavi Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.

Mehrdad Bakhtiyari

Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Reza Aflatoonian

Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

چکیده

Background: A significant association between endometrial vascularity and pregnancy has been shown in previous research, while poor vascularization was attributed to repeated implantation failure (RIF). One possible approach to enhance angiogenesis for successful implantation is endometrial scratching (ES). Objective: The purpose was to investigate endometrial responses to scratching by profiling angiogenesis-related gene expression in unexplained RIF participants. Materials and Methods: In this randomized controlled trial study, ۲۰ infertile women with unexplained RIF were assigned to ۲ groups by the balanced block randomization method (n = ۱۰/each group): the intervention group (group A) (who received ES in the follicular phase) and the control group (group B). Endometrial biopsy was performed in the secretory phase. Gene expression profiling was performed using a polymerase chain reaction-array kit for human-angiogenic growth factors. The implantation and clinical pregnancy rates were also assessed. Results: Among the angiogenesis-promoting genes, FGF۱, FGF۱۳, FGF۲, TGFA, ANG, ANGPT۱, and VEGFA were significantly upregulated (p < ۰.۰۵). IL۱۲A (an angiogenesis-inhibiting cytokine) was significantly upregulated (p < ۰.۰۱). In contrast, ۱۵ genes with angiogenesis-related functions, including CXCL۱۱, CXCL۱۳, CXCL۳, CXCL۵, CXCL۶, EREG, FIGF, FST, IL۱۰, LEP, PPBP, PROK۱, RHOB, TNF, and TYMP, were downregulated after ES. No significant differences were observed between the intervention (group A) and control (group B) groups in terms of implantation (۴۳.۷۵% vs. ۲۸.۵۷%) or clinical pregnancy rates (۷۵% vs. ۵۷.۱%). Conclusion: ES induced significant alterations in the expression of angiogenesis-related genes, with notable up/downregulation of key angiogenic/antiangiogenic factors. These findings enhance our understanding of the molecular responses triggered by ES, underscoring the potential influence of ES on the complex processes of angiogenesis crucial for implantation.

کلیدواژه ها

Endometrium, Angiogenesis, Embryo implantation, Polymerase chain reaction., آندومتر, رگ زایی, لانه گزینی جنین, واکنش زنجیره ای پلیمراز.

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