The Experts below are selected from a list of 459 Experts worldwide ranked by ideXlab platform
Deborah M Hodgson - One of the best experts on this subject based on the ideXlab platform.
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abstract 1761 neonatal immune activation with lipopolysaccharide and a second hit of adulthood stress alters ovarian inflammatory mediators implications for Female Subfertility
Brain Behavior and Immunity, 2016Co-Authors: E A Fuller, M C Carey, Kate A Redgrove, Eileen A Mclaughlin, Deborah M HodgsonAbstract:Agnogentic Subfertility is a clinical concern for many women of a healthy reproductive age. Accumulating evidence suggests developmental factors, such as immune status, are involved in the aetiology of Female Subfertility. Normal immune function is crucial for the initial quality and quantity of the ovarian follicular pool, and continued reproductive success. Our laboratory, in parallel with others, has established that early-life immune stress leads to sustained alterations in immune and neuroendocrine function, and perinatally programs vulnerability to subsequent stressors. However, investigation into the effects of early-life immune stress on Female reproductive development is limited. This study investigates the immediate and long-term effects of immune activation during early-life on ovarian development and continued Female reproductive health. Using a rat model, our findings suggest that neonatal immune activation (NIA) with lipopolysaccharide on post-natal days 3 and 5 leads to significant depletion of the ovarian follicular pool, acute upregulation of ovarian proinflammatory mediators, and precocious onset of puberty ( p p
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Abstract # 1761 Neonatal immune activation with lipopolysaccharide and a ‘second hit’ of adulthood stress alters ovarian inflammatory mediators: Implications for Female Subfertility
Brain Behavior and Immunity, 2016Co-Authors: E A Fuller, M C Carey, Kate A Redgrove, Eileen A Mclaughlin, Deborah M HodgsonAbstract:Agnogentic Subfertility is a clinical concern for many women of a healthy reproductive age. Accumulating evidence suggests developmental factors, such as immune status, are involved in the aetiology of Female Subfertility. Normal immune function is crucial for the initial quality and quantity of the ovarian follicular pool, and continued reproductive success. Our laboratory, in parallel with others, has established that early-life immune stress leads to sustained alterations in immune and neuroendocrine function, and perinatally programs vulnerability to subsequent stressors. However, investigation into the effects of early-life immune stress on Female reproductive development is limited. This study investigates the immediate and long-term effects of immune activation during early-life on ovarian development and continued Female reproductive health. Using a rat model, our findings suggest that neonatal immune activation (NIA) with lipopolysaccharide on post-natal days 3 and 5 leads to significant depletion of the ovarian follicular pool, acute upregulation of ovarian proinflammatory mediators, and precocious onset of puberty ( p p
Eileen A Mclaughlin - One of the best experts on this subject based on the ideXlab platform.
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abstract 1761 neonatal immune activation with lipopolysaccharide and a second hit of adulthood stress alters ovarian inflammatory mediators implications for Female Subfertility
Brain Behavior and Immunity, 2016Co-Authors: E A Fuller, M C Carey, Kate A Redgrove, Eileen A Mclaughlin, Deborah M HodgsonAbstract:Agnogentic Subfertility is a clinical concern for many women of a healthy reproductive age. Accumulating evidence suggests developmental factors, such as immune status, are involved in the aetiology of Female Subfertility. Normal immune function is crucial for the initial quality and quantity of the ovarian follicular pool, and continued reproductive success. Our laboratory, in parallel with others, has established that early-life immune stress leads to sustained alterations in immune and neuroendocrine function, and perinatally programs vulnerability to subsequent stressors. However, investigation into the effects of early-life immune stress on Female reproductive development is limited. This study investigates the immediate and long-term effects of immune activation during early-life on ovarian development and continued Female reproductive health. Using a rat model, our findings suggest that neonatal immune activation (NIA) with lipopolysaccharide on post-natal days 3 and 5 leads to significant depletion of the ovarian follicular pool, acute upregulation of ovarian proinflammatory mediators, and precocious onset of puberty ( p p
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Abstract # 1761 Neonatal immune activation with lipopolysaccharide and a ‘second hit’ of adulthood stress alters ovarian inflammatory mediators: Implications for Female Subfertility
Brain Behavior and Immunity, 2016Co-Authors: E A Fuller, M C Carey, Kate A Redgrove, Eileen A Mclaughlin, Deborah M HodgsonAbstract:Agnogentic Subfertility is a clinical concern for many women of a healthy reproductive age. Accumulating evidence suggests developmental factors, such as immune status, are involved in the aetiology of Female Subfertility. Normal immune function is crucial for the initial quality and quantity of the ovarian follicular pool, and continued reproductive success. Our laboratory, in parallel with others, has established that early-life immune stress leads to sustained alterations in immune and neuroendocrine function, and perinatally programs vulnerability to subsequent stressors. However, investigation into the effects of early-life immune stress on Female reproductive development is limited. This study investigates the immediate and long-term effects of immune activation during early-life on ovarian development and continued Female reproductive health. Using a rat model, our findings suggest that neonatal immune activation (NIA) with lipopolysaccharide on post-natal days 3 and 5 leads to significant depletion of the ovarian follicular pool, acute upregulation of ovarian proinflammatory mediators, and precocious onset of puberty ( p p
Jan Bosteels - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Anti-adhesion therapy following operative hysteroscopy for treatment of Female Subfertility.
Cochrane Database of Systematic Reviews, 2017Co-Authors: Jan Bosteels, Steven Weyers, Jenneke C Kasius, Frank J M Broekmans, Thomas D'hoogheAbstract:Background Observational evidence suggests a potential benefit with several anti-adhesion therapies in women undergoing operative hysteroscopy (e.g. insertion of an intrauterine device or balloon, hormonal treatment, barrier gels or human amniotic membrane grafting) for decreasing intrauterine adhesions (IUAs). Objectives To assess the effectiveness of anti-adhesion therapies versus placebo, no treatment or any other anti-adhesion therapy, following operative hysteroscopy for treatment of Female Subfertility. Search methods We searched the following databases from inception to June 2017: the Cochrane Gynaecology and Fertility Group Specialised Register; the Cochrane Central Register of Studies (CRSO); MEDLINE; Embase; CINAHL and other electronic sources of trials, including trial registers, sources of unpublished literature and reference lists. We handsearched the Journal of Minimally Invasive Gynecology, and we contacted experts in the field. We also searched reference lists of appropriate papers. Selection criteria Randomised controlled trials (RCTs) of anti-adhesion therapies versus placebo, no treatment or any other anti-adhesion therapy following operative hysteroscopy in subfertile women. The primary outcome was live birth. Secondary outcomes were clinical pregnancy, miscarriage and IUAs present at second-look hysteroscopy, along with mean adhesion scores and severity of IUAs. Data collection and analysis Two review authors independently selected studies, assessed risk of bias, extracted data and evaluated quality of evidence using the GRADE method. Main results The overall quality of the evidence was low to very low. The main limitations were serious risk of bias related to blinding of participants and personnel, indirectness and imprecision. We identified 16 RCTs comparing a device versus no treatment (two studies; 90 women), hormonal treatment versus no treatment or placebo (two studies; 136 women), device combined with hormonal treatment versus no treatment (one study; 20 women), barrier gel versus no treatment (five studies; 464 women), device with graft versus device without graft (three studies; 190 women), one type of device versus another device (one study; 201 women), gel combined with hormonal treatment and antibiotics versus hormonal treatment with antibiotics (one study; 52 women) and device combined with gel versus device (one study; 120 women). The total number of participants was 1273, but data on 1133 women were available for analysis. Only two of 16 studies included 100% infertile women; in all other studies, the proportion was variable or unknown. No study reported live birth, but some (five studies) reported outcomes that were used as surrogate outcomes for live birth (term delivery or ongoing pregnancy). Anti-adhesion therapy versus placebo or no treatment following operative hysteroscopy. There was insufficient evidence to determine whether there was a difference between the use of a device or hormonal treatment compared to no treatment or placebo with respect to term delivery or ongoing pregnancy rates (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.42 to 2.12; 107 women; 2 studies; I² = 0%; very-low-quality evidence). There were fewer IUAs at second-look hysteroscopy using a device with or without hormonal treatment or hormonal treatment or barrier gels compared with no treatment or placebo (OR 0.35, 95% CI 0.21 to 0.60; 560 women; 8 studies; I² = 0%; low-quality evidence). The number needed to treat for an additional beneficial outcome (NNTB) was 9 (95% CI 5 to 17). Comparisons of different anti-adhesion therapies following operative hysteroscopy It was unclear whether there was a difference between the use of a device combined with graft versus device only for the outcome of ongoing pregnancy (OR 1.48, 95% CI 0.57 to 3.83; 180 women; 3 studies; I² = 0%; low-quality evidence). There were fewer IUAs at second-look hysteroscopy using a device with or without graft/gel or gel combined with hormonal treatment and antibiotics compared with using a device only or hormonal treatment combined with antibiotics, but the findings of this meta-analysis were affected by evidence quality (OR 0.55, 95% CI 0.36 to 0.83; 451 women; 5 studies; I² = 0%; low-quality evidence). Authors' conclusions Implications for clinical practice The quality of the evidence ranged from very low to low. The effectiveness of anti-adhesion treatment for improving key reproductive outcomes or for decreasing IUAs following operative hysteroscopy in subfertile women remains uncertain. Implications for research More research is needed to assess the comparative safety and (cost-)effectiveness of different anti-adhesion treatments compared to no treatment or other interventions for improving key reproductive outcomes in subfertile women.
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anti adhesion therapy following operative hysteroscopy for treatment of Female Subfertility
Cochrane Database of Systematic Reviews, 2015Co-Authors: Jan Bosteels, Steven Weyers, Jenneke C Kasius, Frank J M Broekmans, Thomas DhoogheAbstract:Background Observational evidence suggests a potential benefit with several anti-adhesion therapies in women undergoing operative hysteroscopy (e.g. insertion of an intrauterine device or balloon, hormonal treatment, barrier gels or human amniotic membrane grafting) for decreasing intrauterine adhesions (IUAs). Objectives To assess the effectiveness of anti-adhesion therapies versus placebo, no treatment or any other anti-adhesion therapy, following operative hysteroscopy for treatment of Female Subfertility. Search methods We searched the following databases from inception to June 2017: the Cochrane Gynaecology and Fertility Group Specialised Register; the Cochrane Central Register of Studies (CRSO); MEDLINE; Embase; CINAHL and other electronic sources of trials, including trial registers, sources of unpublished literature and reference lists. We handsearched the Journal of Minimally Invasive Gynecology, and we contacted experts in the field. We also searched reference lists of appropriate papers. Selection criteria Randomised controlled trials (RCTs) of anti-adhesion therapies versus placebo, no treatment or any other anti-adhesion therapy following operative hysteroscopy in subfertile women. The primary outcome was live birth. Secondary outcomes were clinical pregnancy, miscarriage and IUAs present at second-look hysteroscopy, along with mean adhesion scores and severity of IUAs. Data collection and analysis Two review authors independently selected studies, assessed risk of bias, extracted data and evaluated quality of evidence using the GRADE method. Main results The overall quality of the evidence was low to very low. The main limitations were serious risk of bias related to blinding of participants and personnel, indirectness and imprecision. We identified 16 RCTs comparing a device versus no treatment (two studies; 90 women), hormonal treatment versus no treatment or placebo (two studies; 136 women), device combined with hormonal treatment versus no treatment (one study; 20 women), barrier gel versus no treatment (five studies; 464 women), device with graft versus device without graft (three studies; 190 women), one type of device versus another device (one study; 201 women), gel combined with hormonal treatment and antibiotics versus hormonal treatment with antibiotics (one study; 52 women) and device combined with gel versus device (one study; 120 women). The total number of participants was 1273, but data on 1133 women were available for analysis. Only two of 16 studies included 100% infertile women; in all other studies, the proportion was variable or unknown. No study reported live birth, but some (five studies) reported outcomes that were used as surrogate outcomes for live birth (term delivery or ongoing pregnancy). Anti-adhesion therapy versus placebo or no treatment following operative hysteroscopy. There was insufficient evidence to determine whether there was a difference between the use of a device or hormonal treatment compared to no treatment or placebo with respect to term delivery or ongoing pregnancy rates (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.42 to 2.12; 107 women; 2 studies; I² = 0%; very-low-quality evidence). There were fewer IUAs at second-look hysteroscopy using a device with or without hormonal treatment or hormonal treatment or barrier gels compared with no treatment or placebo (OR 0.35, 95% CI 0.21 to 0.60; 560 women; 8 studies; I² = 0%; low-quality evidence). The number needed to treat for an additional beneficial outcome (NNTB) was 9 (95% CI 5 to 17). Comparisons of different anti-adhesion therapies following operative hysteroscopy It was unclear whether there was a difference between the use of a device combined with graft versus device only for the outcome of ongoing pregnancy (OR 1.48, 95% CI 0.57 to 3.83; 180 women; 3 studies; I² = 0%; low-quality evidence). There were fewer IUAs at second-look hysteroscopy using a device with or without graft/gel or gel combined with hormonal treatment and antibiotics compared with using a device only or hormonal treatment combined with antibiotics, but the findings of this meta-analysis were affected by evidence quality (OR 0.55, 95% CI 0.36 to 0.83; 451 women; 5 studies; I² = 0%; low-quality evidence). Authors' conclusions Implications for clinical practice The quality of the evidence ranged from very low to low. The effectiveness of anti-adhesion treatment for improving key reproductive outcomes or for decreasing IUAs following operative hysteroscopy in subfertile women remains uncertain. Implications for research More research is needed to assess the comparative safety and (cost-)effectiveness of different anti-adhesion treatments compared to no treatment or other interventions for improving key reproductive outcomes in subfertile women.
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The Cochrane Library - Anti‐adhesion therapy following operative hysteroscopy for treating Female Subfertility
Cochrane Database of Systematic Reviews, 2014Co-Authors: Jan Bosteels, Steven Weyers, Jenneke C Kasius, Frank J M Broekmans, Thomas D'hoogheAbstract:Background Limited observational evidence suggests potential benefit for subfertile women undergoing operative hysteroscopy with several anti- adhesion therapies (e.g. insertion of an intrauterine device (IUD) or balloon, hormonal treatment, barrier gels or human amniotic membrane grafting) to decrease intrauterine adhesions (IUAs). Objectives To assess the effectiveness of anti-adhesion therapies versus placebo, no treatment or any other anti-adhesion therapy following operative hysteroscopy for treatment of Female Subfertility. Search methods We searched the following databases from inception to March 2015: the Cochrane Menstrual Disorders and Subfertility Specialised Register, the Cochrane Central Register of Controlled Trials (2015, Issue 2), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and other electronic sources of trials, including trial registers, sources of unpublished literature and reference lists. We handsearched The Journal of Minimally Invasive Gynecology, and we contacted experts in the field. Selection criteria Randomised comparisons of anti-adhesion therapies versus placebo, no treatment or any other anti-adhesion therapy following operative hysteroscopy in subfertile women. The primary outcome was live birth or ongoing pregnancy. Secondary outcomes were clinical pregnancy, miscarriage and IUAs present at second look, along with their mean adhesion scores or severity. Data collection and analysis Two review authors independently selected studies, assessed risk of bias, extracted data and evaluated quality of the evidence using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) method. Main results We included 11 randomised studies on use of an inserted device versus no treatment (two studies; 84 women) or another inserted device (one study; 162 women), hormonal treatment versus no treatment or placebo (two studies; 131 women), gel versus no treatment (five studies; 383 women) and graft versus no graft (one study; 43 women). The total number of women randomly assigned was 924,but data on only 803 participants were available for analysis. The proportion of subfertile women varied from 0% (one study; 41 women), to less than 50% (six studies; 487 women), to 100% (one study; 43 women); the proportion was unknown in three studies (232 women). Most studies (9/11) were at high risk of bias with respect to one or more methodological criteria. We found no evidence of differences between anti-adhesion therapy and no treatment or placebo with respect to live birth rates (odds ratio (OR) 0.99, 95% confidence interval (CI) 0.46 to 2.13, P value = 0.98, three studies, 150 women; low-quality evidence) and no statistical heterogeneity (Chi2 = 0.14, df = 2 (P value = 0.93), I2 = 0%). Anti-adhesion therapy was associated with fewer IUAs at any second-look hysteroscopy when compared with no treatment or placebo (OR 0.36, 95% CI 0.20 to 0.64, P value = 0.0005, seven studies, 528 women; very low-quality evidence). We found no statistical heterogeneity (Chi2 = 2.65, df = 5 (P value = 0.75), I2 = 0%). The number needed to treat for an additional beneficial outcome (NNTB)was 9 (95% CI 6 to 20). No evidence suggested differences between an IUD and an intrauterine balloon with respect to IUAs at second-look hysteroscopy (OR 1.23, 95% CI 0.64 to 2.37, P value = 0.54, one study, 162 women; very low-quality evidence). Authors’ conclusions Implications for clinical practice The quality of the evidence retrievedwas lowor very lowfor all outcomes.Clinical effectiveness of anti-adhesion treatment for improving key reproductive outcomes or for decreasing IUAs following operative hysteroscopy in subfertile women remains uncertain. Implications for research Additional studies are needed to assess the effectiveness of different anti-adhesion therapies for improving reproductive outcomes in subfertile women treated by operative hysteroscopystatus: publishe
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is reproductive surgery effective in the treatment of Female Subfertility an evidence based approach
Human Reproduction, 2011Co-Authors: Jan Bosteels, S Weyers, Thomas DhoogheAbstract:ing can be predictive for hESC derivation efficiency from PQEs. In this study, we investigate the influence of patient parameters and embryo cohort on blastocyst development, ICM quality and successful hESC derivation from PQEs. Material and Methods: Donated PQEs on day 3 of development that did not meet the IVF laboratory’s criteria for transfer or cryopreservation were included in this study if they had ≥ 4 blastomeres and ≤ 50% fragmentation. Embryos were cultured individually in Cook Blastocyst Media from day 3 until day 6 at 37°C, 6% CO2, and 5% O2. On day 6, blastocysts were graded for expansion status and the quality of the ICM and trophectoderm. Only blastocysts with good quality ICMs were used for hESC derivation. Embryo history, cohort parameters, and anonymous patient data were then retrospectively compiled and analyzed. Results: Overall, 3690 PQEs from 777 patient cycles did not meet clinical criteria for transfer or cryopreservation. Of these, 2785 (75.6%) met the criteria for inclusion into this study, resulting in 895 blastocysts. 385 blastocysts originating from 250 cycles contained good quality ICMs on day 6 of development. The cycles that resulted in blastocysts with good quality ICMs had significantly more oocytes retrieved, mature oocytes, fertilized oocytes and embryos cryopreserved than those that did not develop to blastocysts or had only poor quality ICMs (all P < 0.005). Blastocyst development in this group was also signifi cantly higher than the overall mean (49.5% vs. 32.1% P < 0.001). Blastocysts with good quality ICMs came from significantly younger patients than those
E A Fuller - One of the best experts on this subject based on the ideXlab platform.
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abstract 1761 neonatal immune activation with lipopolysaccharide and a second hit of adulthood stress alters ovarian inflammatory mediators implications for Female Subfertility
Brain Behavior and Immunity, 2016Co-Authors: E A Fuller, M C Carey, Kate A Redgrove, Eileen A Mclaughlin, Deborah M HodgsonAbstract:Agnogentic Subfertility is a clinical concern for many women of a healthy reproductive age. Accumulating evidence suggests developmental factors, such as immune status, are involved in the aetiology of Female Subfertility. Normal immune function is crucial for the initial quality and quantity of the ovarian follicular pool, and continued reproductive success. Our laboratory, in parallel with others, has established that early-life immune stress leads to sustained alterations in immune and neuroendocrine function, and perinatally programs vulnerability to subsequent stressors. However, investigation into the effects of early-life immune stress on Female reproductive development is limited. This study investigates the immediate and long-term effects of immune activation during early-life on ovarian development and continued Female reproductive health. Using a rat model, our findings suggest that neonatal immune activation (NIA) with lipopolysaccharide on post-natal days 3 and 5 leads to significant depletion of the ovarian follicular pool, acute upregulation of ovarian proinflammatory mediators, and precocious onset of puberty ( p p
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Abstract # 1761 Neonatal immune activation with lipopolysaccharide and a ‘second hit’ of adulthood stress alters ovarian inflammatory mediators: Implications for Female Subfertility
Brain Behavior and Immunity, 2016Co-Authors: E A Fuller, M C Carey, Kate A Redgrove, Eileen A Mclaughlin, Deborah M HodgsonAbstract:Agnogentic Subfertility is a clinical concern for many women of a healthy reproductive age. Accumulating evidence suggests developmental factors, such as immune status, are involved in the aetiology of Female Subfertility. Normal immune function is crucial for the initial quality and quantity of the ovarian follicular pool, and continued reproductive success. Our laboratory, in parallel with others, has established that early-life immune stress leads to sustained alterations in immune and neuroendocrine function, and perinatally programs vulnerability to subsequent stressors. However, investigation into the effects of early-life immune stress on Female reproductive development is limited. This study investigates the immediate and long-term effects of immune activation during early-life on ovarian development and continued Female reproductive health. Using a rat model, our findings suggest that neonatal immune activation (NIA) with lipopolysaccharide on post-natal days 3 and 5 leads to significant depletion of the ovarian follicular pool, acute upregulation of ovarian proinflammatory mediators, and precocious onset of puberty ( p p
Thomas Dhooghe - One of the best experts on this subject based on the ideXlab platform.
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anti adhesion therapy following operative hysteroscopy for treatment of Female Subfertility
Cochrane Database of Systematic Reviews, 2015Co-Authors: Jan Bosteels, Steven Weyers, Jenneke C Kasius, Frank J M Broekmans, Thomas DhoogheAbstract:Background Observational evidence suggests a potential benefit with several anti-adhesion therapies in women undergoing operative hysteroscopy (e.g. insertion of an intrauterine device or balloon, hormonal treatment, barrier gels or human amniotic membrane grafting) for decreasing intrauterine adhesions (IUAs). Objectives To assess the effectiveness of anti-adhesion therapies versus placebo, no treatment or any other anti-adhesion therapy, following operative hysteroscopy for treatment of Female Subfertility. Search methods We searched the following databases from inception to June 2017: the Cochrane Gynaecology and Fertility Group Specialised Register; the Cochrane Central Register of Studies (CRSO); MEDLINE; Embase; CINAHL and other electronic sources of trials, including trial registers, sources of unpublished literature and reference lists. We handsearched the Journal of Minimally Invasive Gynecology, and we contacted experts in the field. We also searched reference lists of appropriate papers. Selection criteria Randomised controlled trials (RCTs) of anti-adhesion therapies versus placebo, no treatment or any other anti-adhesion therapy following operative hysteroscopy in subfertile women. The primary outcome was live birth. Secondary outcomes were clinical pregnancy, miscarriage and IUAs present at second-look hysteroscopy, along with mean adhesion scores and severity of IUAs. Data collection and analysis Two review authors independently selected studies, assessed risk of bias, extracted data and evaluated quality of evidence using the GRADE method. Main results The overall quality of the evidence was low to very low. The main limitations were serious risk of bias related to blinding of participants and personnel, indirectness and imprecision. We identified 16 RCTs comparing a device versus no treatment (two studies; 90 women), hormonal treatment versus no treatment or placebo (two studies; 136 women), device combined with hormonal treatment versus no treatment (one study; 20 women), barrier gel versus no treatment (five studies; 464 women), device with graft versus device without graft (three studies; 190 women), one type of device versus another device (one study; 201 women), gel combined with hormonal treatment and antibiotics versus hormonal treatment with antibiotics (one study; 52 women) and device combined with gel versus device (one study; 120 women). The total number of participants was 1273, but data on 1133 women were available for analysis. Only two of 16 studies included 100% infertile women; in all other studies, the proportion was variable or unknown. No study reported live birth, but some (five studies) reported outcomes that were used as surrogate outcomes for live birth (term delivery or ongoing pregnancy). Anti-adhesion therapy versus placebo or no treatment following operative hysteroscopy. There was insufficient evidence to determine whether there was a difference between the use of a device or hormonal treatment compared to no treatment or placebo with respect to term delivery or ongoing pregnancy rates (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.42 to 2.12; 107 women; 2 studies; I² = 0%; very-low-quality evidence). There were fewer IUAs at second-look hysteroscopy using a device with or without hormonal treatment or hormonal treatment or barrier gels compared with no treatment or placebo (OR 0.35, 95% CI 0.21 to 0.60; 560 women; 8 studies; I² = 0%; low-quality evidence). The number needed to treat for an additional beneficial outcome (NNTB) was 9 (95% CI 5 to 17). Comparisons of different anti-adhesion therapies following operative hysteroscopy It was unclear whether there was a difference between the use of a device combined with graft versus device only for the outcome of ongoing pregnancy (OR 1.48, 95% CI 0.57 to 3.83; 180 women; 3 studies; I² = 0%; low-quality evidence). There were fewer IUAs at second-look hysteroscopy using a device with or without graft/gel or gel combined with hormonal treatment and antibiotics compared with using a device only or hormonal treatment combined with antibiotics, but the findings of this meta-analysis were affected by evidence quality (OR 0.55, 95% CI 0.36 to 0.83; 451 women; 5 studies; I² = 0%; low-quality evidence). Authors' conclusions Implications for clinical practice The quality of the evidence ranged from very low to low. The effectiveness of anti-adhesion treatment for improving key reproductive outcomes or for decreasing IUAs following operative hysteroscopy in subfertile women remains uncertain. Implications for research More research is needed to assess the comparative safety and (cost-)effectiveness of different anti-adhesion treatments compared to no treatment or other interventions for improving key reproductive outcomes in subfertile women.
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is reproductive surgery effective in the treatment of Female Subfertility an evidence based approach
Human Reproduction, 2011Co-Authors: Jan Bosteels, S Weyers, Thomas DhoogheAbstract:ing can be predictive for hESC derivation efficiency from PQEs. In this study, we investigate the influence of patient parameters and embryo cohort on blastocyst development, ICM quality and successful hESC derivation from PQEs. Material and Methods: Donated PQEs on day 3 of development that did not meet the IVF laboratory’s criteria for transfer or cryopreservation were included in this study if they had ≥ 4 blastomeres and ≤ 50% fragmentation. Embryos were cultured individually in Cook Blastocyst Media from day 3 until day 6 at 37°C, 6% CO2, and 5% O2. On day 6, blastocysts were graded for expansion status and the quality of the ICM and trophectoderm. Only blastocysts with good quality ICMs were used for hESC derivation. Embryo history, cohort parameters, and anonymous patient data were then retrospectively compiled and analyzed. Results: Overall, 3690 PQEs from 777 patient cycles did not meet clinical criteria for transfer or cryopreservation. Of these, 2785 (75.6%) met the criteria for inclusion into this study, resulting in 895 blastocysts. 385 blastocysts originating from 250 cycles contained good quality ICMs on day 6 of development. The cycles that resulted in blastocysts with good quality ICMs had significantly more oocytes retrieved, mature oocytes, fertilized oocytes and embryos cryopreserved than those that did not develop to blastocysts or had only poor quality ICMs (all P < 0.005). Blastocyst development in this group was also signifi cantly higher than the overall mean (49.5% vs. 32.1% P < 0.001). Blastocysts with good quality ICMs came from significantly younger patients than those
