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Cervical Ectopic Pregnancy
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
After a cervical ectopic pregnancy is diagnosed, one of the main questions is what etiologic factors led to the occurrence of this type of pregnancy. Prior instrumentation is a key factor. Prior instrumentations causes injury to the uterine endometrium and, as a result, adversely impacts implantation of the pregnancy, thereby resulting in ectopic pregnancies, such as cervical ectopic pregnancies [11–13]. Other associated factors include other previous injuries to the endometrium, such as dilatation and curettage; in vitro fertilization with embryo transfer; fertilized ovum not released in the endometrial cavity; and prior ectopic pregnancies. In addition, cervical procedures can be associated with cervical ectopic pregnancies, specifically loop electrosurgical excision procedures (LEEPs), conization, and cryosurgery [12, 13]. Other factors that play a role in this diagnosis include previous cesarean deliveries, previous uterine myomectomies, and Asherman syndrome [12, 13].
Implantation and In Utero Growth
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
Kugajeevan Vigneswaran, Ippokratis Sarris
Asherman syndrome has significant reproductive implications for patients. In most case series, the rate of fertility and full-term birth directly correlates to extent of disease. However, there does not seem to be a connection between number of prior curettages or the etiology of adhesions in predicting outcome. Fertility following hysteroscopic treatment of adhesions is possible provided there is adequate residual normal endometrial tissue, although gonadotropins, intrauterine insemination, or IVF is sometimes necessary.
Different kinds of infertility, possible reasons for infertility
Published in Elisabeth Hildt, Dietmar Mieth, In Vitro Fertilisation in the 1990s, 2018
Hans-Rudolf Tinneberg, Ulrich Göhring
Changes of the endometrium due to infections or hormonal dysbalance are uterine factors which can impair implantation. Also, intrauterine polyps and submucous fibroids can be relevant inhibitors for implantation. The Asherman syndrome with massive intrauterine adhesions can inhibit sperm migration as well as implantation of the embryo. In severe cases no significant endometrium can be detected.
Impact of biomimetic electrical stimulation combined with Femoston on pregnancy rate and endometrium characteristics in infertility patients with thin endometrium: a prospective observational study
Published in Gynecological Endocrinology, 2023
Yilinuer Shabiti, Shaadaiti Wufuer, Remila Tuohuti, Tan Yun, Jing Lu
Nevertheless, the selection of the hormonal treatment for a thin endometrium is mostly unknown. Shao [25] pointed out, regarding a thin endometrium, that ‘Comprehensive treatment can be attempted from the aspects of increasing estrogen, improving endometrial circulation, promoting endometrial proliferation, etc. Estrogen administration needs to stimulate the endometrial and inhibit the growth of dominant follicles at the same time’. In addition, it is pointed out that ‘Pelvic floor muscle contraction and relaxation caused by electrical stimulation of pelvic floor nerve muscle may promote pelvic floor blood circulation, increase intima and subintima blood perfusion, and promote intima growth’. [26]. A recent paper by Di Guardo & Palumbo [27] discusses the approaches to restoring a functional endometrium in women with Asherman syndrome. Insights could be gleaned from those approaches but will have to be examined in future studies.
Pipelle endometrial sampling success rates in Kazakhstani settings: results from a prospective cohort analysis
Published in Journal of Obstetrics and Gynaecology, 2022
Milan Terzic, Gulzhanat Aimagambetova, Gauri Bapayeva, Talshyn Ukybassova, Kamila Kenbayeva, Aiym Kaiyrlykyzy, Bakytkali Ibrayimov, Alla Lyasova, Sanja Terzic, Ibrahim Alkatout, Georgios Gitas, İsmet Hortu, Simone Garzon, Antonio Simone Laganà
Patients were approached if they were signed up to undergo endometrial sampling through D and C within 3 months of recruitment. A consecutive sample of 87 participants was recruited. Inclusion criteria were female gender; age 18 years or older; intact uterus and cervix; endometrial biopsy recommendation due to (but not limited to) abnormal uterine bleeding and irregular cycles (for pre-menopausal women) or post-menopausal vaginal bleeding. Exclusion criteria were cervical cancer, pregnancy, acute pelvic inflammatory disease, coagulation disorders, acute cervical or vaginal infection, uterine anomalies/malformations, hysterectomy, previous endometrial ablation, or any intervention/procedure done for Asherman syndrome. For each patient, we recorded age, BMI, ethnic group, as well as healthcare provider experience and biopsy indications.
Sustained delivery of 17β-estradiol by human amniotic extracellular matrix (HAECM) scaffold integrated with PLGA microspheres for endometrium regeneration
Published in Drug Delivery, 2020
Yue Chen, Weidong Fei, Yunchun Zhao, Fengmei Wang, Xiaoling Zheng, Xiaofei Luan, Caihong Zheng
Intrauterine adhesions (IUAs), known as Asherman syndrome, are characterized by damage to the endometrium due to curettage or endometritis (Dreisler & Kjer, 2019). IUAs cause endometrial functional repair disorder leading to endometrial fibrosis. Approximately 25–30% of infertile women suffer from IUAs, which represents the most common cause of uterine infertility (Hanstede et al., 2015). It is also associated with the following gynecological diseases: hypomenorrhea, amenorrhea, recurrent abdominal pain, and recurrent spontaneous abortion. The traditional treatments for IUAs mainly focus on hysteroscopic transcervical resection of adhesion (TCRA) combined with postoperative management, including prevention of adhesion reformation (by the placement of an intrauterine device, foley catheter balloon, biomaterials, or other methods), and estrogen therapy for stimulation of endometrial regeneration (Khan & Goldberg, 2018). However, the recurrence of IUAs is still prevalent after various treatments, in severe cases, the incidence of adhesion reformation was reported to be as high as 62.5% (Rein et al., 2011). In addition, there are some disadvantages in available IUA treatments, including high recurrence rate, low pregnancy rate, and increased risk of thrombosis and breast tumors due to the high therapeutic dose of estrogen (Brown & Hankinson, 2015). Thus, it is highly desired to develop alternative approaches that lead to endometrial functional repair.