Projects / Programmes
Experimental and Laboratory Aspects in Premature Ovarian Insufficiecy
| Code |
Science |
Field |
Subfield |
| 3.05.00 |
Medical sciences |
Human reproduction |
|
| Code |
Science |
Field |
| B570 |
Biomedical sciences |
Obstetrics, gynaecology, andrology, reproduction, sexuality |
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
poor respond on gonadotrophines, ART, endometrium receptivity, reproductive biology, blastocysts, vitrification
Researchers (14)
Organisations (2)
Abstract
1.1.
Our research will show the impact of testosterone supplementation on the ovarian response to controlled ovarian stimulation in poor responding patients. We expect to see an increase in ovarian response with the use of transdermal testosterone, exhibited in a greater number of retrieved oocytes and a higher proportion of mature oocytes. We expect this to lead to a higher number of embryos, higher pregnancy rates and more live births in comparison to the control group. The results of our research could significantly improve our understanding and treatment of infertility in poor responders, which is one of the greatest challenges in reproductive medicine today.
1.2.
Adenomyosis is a common benign change of the uterus. Due to the development of imaging diagnostics, today it is possible to diagnose this condition with non-invasive methods. However, there is not enough evidence to show the influence of adenomyosis on the reproductive capacity. Our research will compare the ultrasonic indicators of endometrial receptivity in patients with adenomyosis and in the control group. The ultrasonic findings of factors that could indicate a change in endometrial receptivity in the process of medically assisted reproduction could affect further treatment of female patients and give an answer to the question whether the screening of adenomyosis is necessary prior to fertility treatment. If the affect of specific ultrasonic indicators on the process of embryo implantation would be proven, we could introduce targeted therapy to these patients in the next stage, which could, consequently, have a positive impact on the success of medically assisted reproduction. Thus, a lot of agents as for example selective antagonists of oxytocin that may have an impact on the decreased miometric contractility after embryo transfer are already being investigated today.
1.3.
We will investigate whether artificial collapsing of blastocysts before vitrification improves the efficacy of the redundant blastocysts freezing programme in MAR. The artificial collapsing of blastocysts is routinely performed in most of the IVF centres, yet there are no real comparative studies about the advantages of such procedure. First, an animal model and then clinically useful human blastocysts will be used to perform morphometric measurements and observed after thawing and prior to transfer to the uterus with time-lapse microcameras. The clinical results will be compared in a randomised multicentre trial.
We will try to identify proteins in the liquid from blastocoel that may predict the developmental potential of the embryo.
We will try to mark proteins of sperm centrosome in oocytes and irregularly dividing zygotes, which we will observe with confocal microscope and determine their role in the improper fertilisation and division.
We will try to show the presence of free oxygen radicals in the semen of patients with astheno-, oligo- and cryptozoospermia and test their role in the deterioration of semen quality. We will modify the classic technique of cryopreservation for semen samples with extremely low number of sperm cells and freeze these samples in microdroplets in order to improve the effectiveness of semen cryopreservation.
1.4.
Coeliac disease is an autoimmune disorder of the small intestine associated with numerous health problems due to malabsorption as well as problems with reproductive health. Although the connection between coeliac disease and fertility is established, the results of the published studies are still poorly documented and validated.
Significance for science
The project deals with solving topical problems of modern reproductive medicine. This involves the appropriate treatment of female patients undergoing medically assisted reproduction treatment procedures. Due to the inadequate response to therapy, patients cannot have high expectations for the success of MAR treatment. We expect to confirm the clinical effectiveness of the process of sensitization of FSH receptors in granulosa cells and in this way improve the clinical success of the treatment.
The problem of embryo implantation in the process of MAR often depends on the readiness of the lining of the uterus for implantation. Echographic parameters of the endometrium, its vascularisation and subendometrial contractility as well as changes in the appearance of the myometrium due to the presence of adenomyosis, which can be identified by an echographic examination, can clarify the incidence of recurrent absence of implantation (RIF) after the transfer of embryos into the uterus.
Determining the characteristics of gametes and embryos in the early stage development in vitro is a prerequisite for successful clinical application of treatments with ART. The analyses of the first hours of embryonic development after the modification techniques of vitrification or freezing of blastocysts on an animal model can significantly improve the clinical usefulness of the method. The analysis of fluid from blastocoel is not clinically defined but certainly opens up opportunities to learn about the genetic diversity of blastocysts according to their implantation ability.
Considering the actuality of the problem of coeliac disease in modern society, the results of the research on reproductive health of this group of patients would enrich the knowledge on this autoimmune disease in relation to reproductive health. A similar research has not yet been performed in Slovenia and the results would be relevant for the patients.
There are still no diagnostic criteria to identify the right parameters of the endometrial receptivity. A non-invasive method of ultrasound monitoring can contribute to a better definition and assessment of the endometrial receptivity in patients undergoing MAR treatment. Despite the long-standing clinical use of the ultrasound to diagnose the conditions investigated in our research, there is not much data published on the subject.
The impact of coeliac disease on the development of female and male infertility and reproductive health is not yet fully explored. Similarly, the possibility of positive effects of the treatment with gluten-free diet in order to eliminate these impacts has not yet been investigated.
Significance for the country
Poor ovarian response in patients undergoing MAR treatment is noticed in 20% - 25% of patients. The stimulation of ovulation in this group of patients is often unsuccessful or achieved by a high consumption of expensive drugs (gonadotropins). The costs of such treatment are therefore extremely high and the use of clinical protocols that would improve ovarian responsiveness to gonadotropins would thus significantly lower the cost of the treatment.
The vast majority (60%) of MAR cycles do not end with pregnancy despite the transferring of good embryos. Therefore, the technique of identifying endometrial receptiveness and conditions that do not promise a good clinical outcome of embryo transfer can significantly improve the performance of embryo transfer. For instance, if the endometrium does not promise a good clinical outcome, we can postpone the embryo transfer and vitrification of embryos until the next, more appropriate cycle.
The clinical usefulness of blastocyst cryopreservation after the blastocoel collapse before vitrification calls for clinical validation. Successful technique of freezing blastocysts can increase the effectiveness of MAR treatment in almost 40-50% of all MAR cycles.
The awareness of the impact of coeliac disease on reproductive function is also important for the organised associations of patients, like the Slovenian Society for Coeliac Disease.
Most important scientific results
Interim report,
final report
Most important socioeconomically and culturally relevant results
Interim report,
final report
