Recurrent Implantation Failure Clinical Trial
Official title:
Anticoagulation Therapies Effect on the Endometrial Blood Flow and Pregnancy Outcomes in Unexplained Recurrent Implantation Failure Women
The aim of the study is to investigate whether Low Dose Aspirin and Low Molecular Weight Heparin could increase the uterine perfusion, and finally improve the implantation and pregnancy rates in patients with unexplained recurrent implantation failure.
Infertility is a growing issue for many couples all over the world. Nowadays, Assisted
reproductive technology is widely used to treat couples affected by infertility, but, the
success rate is still very low. Recurrent implantation failure is an important cause of
repeated IVF failure. In addition to the embryo quality, a functioning and receptive
endometrium is crucial for embryo implantation. There is a growing amount of evidence shows
that uterine perfusion playing an important part in regulating endometrial receptivity and in
successful pregnancy.
Recently, transvaginal ultrasonography is often used to examine endometrial thickness,
pattern and blood flow status to predict uterine receptivity. Some studies have demonstrated
that uterine artery blood flow resistance in RM (Recurrent miscarriage) patients is
significantly higher than in normal fertile patients. It has been postulated that abnormal
uterine perfusion could be related to the reproductive failure, enhancing the uterine
perfusion may improve the successful pregnancy. In accordance with this hypothesis, some
therapeutic approaches including low dose aspirin (LDA), nitric oxide donor, low molecular
weight heparin, sildenafil are applying in clinic. Low molecular weight heparin (LMWH) is
derived from unfractionated heparin. It also has anticoagulation or the antithrombin effect.
Aspirin has analgesic, antipyretic, and anti-inflammatory properties. Initially, aspirin and
low molecular weight heparin have been used either as single agents or in combination to
treat patients with recurrent miscarriage, diagnosed with antiphospholipid syndrome. The
treatment confers a significant benefit in live births rate. Furthermore, various studies
have shown that thrombophilia are more common in women with RIF compared with healthy fertile
controls. In these women, heparin treatment could potentially enhance the implantation
process, and may finally improve the live birth rate. The aim of the study is to investigate
whether Low Dose Aspirin and Low Molecular Weight Heparin could increase the uterine
perfusion, and finally improve the implantation and pregnancy rates in patients with
unexplained recurrent implantation failure.
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