A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy loss

Abstract Background Aside from embryonic factors, various factors can intricately interfere with embryo implantation and maintenance of pregnancy, causing recurrent implantation failure (RIF) or recurrent pregnancy loss (RPL). This review focuses the optimization of thyroid function, thrombophilia,...

Full description

Saved in:
Bibliographic Details
Main Author: Keiji Kuroda
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Reproductive Medicine and Biology
Subjects:
Online Access:https://doi.org/10.1002/rmb2.12561
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850053149143859200
author Keiji Kuroda
author_facet Keiji Kuroda
author_sort Keiji Kuroda
collection DOAJ
description Abstract Background Aside from embryonic factors, various factors can intricately interfere with embryo implantation and maintenance of pregnancy, causing recurrent implantation failure (RIF) or recurrent pregnancy loss (RPL). This review focuses the optimization of thyroid function, thrombophilia, immunity, and uterine milieu (OPTIMUM) treatment strategy on RIF and RPL. Methods Three studies employing the OPTIMUM treatment strategy for patients with RIF and/or RPL were reviewed. Results The OPTIMUM improved pregnancy rates in women with RIF aged <40 years. Among advanced age women, however, no significant differences in pregnancy rates were observed between the control, OPTIMUM, and preimplantation genetic testing for aneuploidy (PGT‐A) groups, although pregnancy rates were highest after OPTIMUM + PGT‐A. The OPTIMUM reduced miscarriage rates in women with RPL aged <40 years. Among advanced age women, PGT‐A, but not the OPTIMUM, contributed to miscarriage prevention. Factors predicting pregnancy success in women with RIF who received the OPTIMUM included thrombophilia and young age. Risk factors for an unsuccessful live birth among women with RPL who received the OPTIMUM included advanced age, infertility, diminished ovarian reserve, and non‐ART treatment. Conclusions The OPTIMUM can improve pregnancy outcomes in women with RIF/RPL, except for advanced age women with embryonic factor‐induced reproductive failure.
format Article
id doaj-art-55e1b371ab484aad8b627d8efa6d6e62
institution DOAJ
issn 1445-5781
1447-0578
language English
publishDate 2024-01-01
publisher Wiley
record_format Article
series Reproductive Medicine and Biology
spelling doaj-art-55e1b371ab484aad8b627d8efa6d6e622025-08-20T02:52:37ZengWileyReproductive Medicine and Biology1445-57811447-05782024-01-01231n/an/a10.1002/rmb2.12561A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy lossKeiji Kuroda0Center for Reproductive Medicine and Endoscopy Sugiyama Clinic Marunouchi Tokyo JapanAbstract Background Aside from embryonic factors, various factors can intricately interfere with embryo implantation and maintenance of pregnancy, causing recurrent implantation failure (RIF) or recurrent pregnancy loss (RPL). This review focuses the optimization of thyroid function, thrombophilia, immunity, and uterine milieu (OPTIMUM) treatment strategy on RIF and RPL. Methods Three studies employing the OPTIMUM treatment strategy for patients with RIF and/or RPL were reviewed. Results The OPTIMUM improved pregnancy rates in women with RIF aged <40 years. Among advanced age women, however, no significant differences in pregnancy rates were observed between the control, OPTIMUM, and preimplantation genetic testing for aneuploidy (PGT‐A) groups, although pregnancy rates were highest after OPTIMUM + PGT‐A. The OPTIMUM reduced miscarriage rates in women with RPL aged <40 years. Among advanced age women, PGT‐A, but not the OPTIMUM, contributed to miscarriage prevention. Factors predicting pregnancy success in women with RIF who received the OPTIMUM included thrombophilia and young age. Risk factors for an unsuccessful live birth among women with RPL who received the OPTIMUM included advanced age, infertility, diminished ovarian reserve, and non‐ART treatment. Conclusions The OPTIMUM can improve pregnancy outcomes in women with RIF/RPL, except for advanced age women with embryonic factor‐induced reproductive failure.https://doi.org/10.1002/rmb2.12561infertilityIVFmiscarriagerecurrent implantation failurerecurrent pregnancy loss
spellingShingle Keiji Kuroda
A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy loss
Reproductive Medicine and Biology
infertility
IVF
miscarriage
recurrent implantation failure
recurrent pregnancy loss
title A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy loss
title_full A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy loss
title_fullStr A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy loss
title_full_unstemmed A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy loss
title_short A review of the optimization of thyroid function, thrombophilia, immunity and uterine milieu: OPTIMUM treatment strategy for recurrent implantation failure and recurrent pregnancy loss
title_sort review of the optimization of thyroid function thrombophilia immunity and uterine milieu optimum treatment strategy for recurrent implantation failure and recurrent pregnancy loss
topic infertility
IVF
miscarriage
recurrent implantation failure
recurrent pregnancy loss
url https://doi.org/10.1002/rmb2.12561
work_keys_str_mv AT keijikuroda areviewoftheoptimizationofthyroidfunctionthrombophiliaimmunityanduterinemilieuoptimumtreatmentstrategyforrecurrentimplantationfailureandrecurrentpregnancyloss
AT keijikuroda reviewoftheoptimizationofthyroidfunctionthrombophiliaimmunityanduterinemilieuoptimumtreatmentstrategyforrecurrentimplantationfailureandrecurrentpregnancyloss