Uterine Diseases Clinical Trial
Official title:
Do müllerian Anomalies Affect Embryo Implantation?
Müllerian anomalies (MA) are associated with infertility and affect approximately 6.3% of the infertile population. The estimation of the frequency of MAs is not without controversy because it depends on the diagnostic method used and sometimes on the established diagnostic criteria. This pathology is associated with abortion during the second trimester in addition to other complications that include preterm labor, fetal malpositions and an increased rate of caesarean section, although some patients may remain asymptomatic. An association between MA and endometriosis has been described and in particular the case of the septum uterus, therefore it is difficult to establish whether the reproductive results of women with MA tdepend only on the uterine factor or also on the quality of the oocytes.
The main reproductive problems associated with these malformations include, abortion ,
recurrent abortion ectopic pregnancy and preterm delivery . The experience gained from oocyte
donation shows that these women are pregnant less, even with the transfer of good quality
embryos. The hypothesis of this poor uterine receptivity is in the poor endometrial
vascularization that can decrease embryo implantation. The reason for infertility in women
with AM includes decreased muscle mass, decreased endometrial vascularization, decreased
capacity of the endometrial cavity, less receptive areas (septum). The lower fertility
observed in some women with Müllerian malformations has been partially explained by its tubal
factor and its association with endometriosis, with a higher prevalence in them, compared to
patients without malformations.
Studies have confirmed an irregular differentiation and estrogenic maturation of the
endometrium lining the uterine septum or its internal structure, which has less presence of
connective tissue and more muscle mass. Given the confusion generated if the unfavorable
reproductive result is due to oocyte quality or endometrial receptivity, it is necessary to
use a model that guarantees oocyte / embryo quality and this is offered by oocyte donation.
The aim is to evaluate the implantation rate in women with MA who receive donated oocytes
compared to women without MA.
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