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Concomitant Autoimmunity in Endometriosis Impairs Endometrium–Embryo Crosstalk at the Implantation Site: A Multicenter Case-Control Study

Endometriosis and autoimmune diseases share a hyper-inflammatory state that might negatively impact the embryo–endometrium crosstalk. Inflammatory and immune deregulatory mechanisms have been shown to impair both endometrial receptivity and embryo competence at the implantation site. The aim of this...

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Autores principales: Salmeri, Noemi, Gennarelli, Gianluca, Vanni, Valeria Stella, Ferrari, Stefano, Ruffa, Alessandro, Rovere-Querini, Patrizia, Pagliardini, Luca, Candiani, Massimo, Papaleo, Enrico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219087/
https://www.ncbi.nlm.nih.gov/pubmed/37240662
http://dx.doi.org/10.3390/jcm12103557
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author Salmeri, Noemi
Gennarelli, Gianluca
Vanni, Valeria Stella
Ferrari, Stefano
Ruffa, Alessandro
Rovere-Querini, Patrizia
Pagliardini, Luca
Candiani, Massimo
Papaleo, Enrico
author_facet Salmeri, Noemi
Gennarelli, Gianluca
Vanni, Valeria Stella
Ferrari, Stefano
Ruffa, Alessandro
Rovere-Querini, Patrizia
Pagliardini, Luca
Candiani, Massimo
Papaleo, Enrico
author_sort Salmeri, Noemi
collection PubMed
description Endometriosis and autoimmune diseases share a hyper-inflammatory state that might negatively impact the embryo–endometrium crosstalk. Inflammatory and immune deregulatory mechanisms have been shown to impair both endometrial receptivity and embryo competence at the implantation site. The aim of this study was to investigate the potential additional impact of co-existing autoimmunity in women affected by endometriosis on the early stages of reproduction. This was a retrospective, multicenter case-control study enrolling N = 600 women with endometriosis who underwent in vitro fertilization–embryo transfer cycles between 2007 and 2021. Cases were women with endometriosis and concomitant autoimmunity matched based on age and body mass index to controls with endometriosis only in a 1:3 ratio. The primary outcome was the cumulative clinical pregnancy rate (cCPR). The study found significantly lower cleavage (p = 0.042) and implantation (p = 0.029) rates among cases. Autoimmunity (p = 0.018), age (p = 0.007), and expected poor response (p = 0.014) were significant negative predictors of cCPR, with an adjusted odds ratio of 0.54 (95% CI, 0.33–0.90) for autoimmunity. These results suggest that the presence of concomitant autoimmunity in endometriosis has a significant additive negative impact on embryo implantation. This effect might be due to several immunological and inflammatory mechanisms that interfere with both endometrial receptivity and embryo development and deserves further consideration.
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spelling pubmed-102190872023-05-27 Concomitant Autoimmunity in Endometriosis Impairs Endometrium–Embryo Crosstalk at the Implantation Site: A Multicenter Case-Control Study Salmeri, Noemi Gennarelli, Gianluca Vanni, Valeria Stella Ferrari, Stefano Ruffa, Alessandro Rovere-Querini, Patrizia Pagliardini, Luca Candiani, Massimo Papaleo, Enrico J Clin Med Article Endometriosis and autoimmune diseases share a hyper-inflammatory state that might negatively impact the embryo–endometrium crosstalk. Inflammatory and immune deregulatory mechanisms have been shown to impair both endometrial receptivity and embryo competence at the implantation site. The aim of this study was to investigate the potential additional impact of co-existing autoimmunity in women affected by endometriosis on the early stages of reproduction. This was a retrospective, multicenter case-control study enrolling N = 600 women with endometriosis who underwent in vitro fertilization–embryo transfer cycles between 2007 and 2021. Cases were women with endometriosis and concomitant autoimmunity matched based on age and body mass index to controls with endometriosis only in a 1:3 ratio. The primary outcome was the cumulative clinical pregnancy rate (cCPR). The study found significantly lower cleavage (p = 0.042) and implantation (p = 0.029) rates among cases. Autoimmunity (p = 0.018), age (p = 0.007), and expected poor response (p = 0.014) were significant negative predictors of cCPR, with an adjusted odds ratio of 0.54 (95% CI, 0.33–0.90) for autoimmunity. These results suggest that the presence of concomitant autoimmunity in endometriosis has a significant additive negative impact on embryo implantation. This effect might be due to several immunological and inflammatory mechanisms that interfere with both endometrial receptivity and embryo development and deserves further consideration. MDPI 2023-05-19 /pmc/articles/PMC10219087/ /pubmed/37240662 http://dx.doi.org/10.3390/jcm12103557 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Salmeri, Noemi
Gennarelli, Gianluca
Vanni, Valeria Stella
Ferrari, Stefano
Ruffa, Alessandro
Rovere-Querini, Patrizia
Pagliardini, Luca
Candiani, Massimo
Papaleo, Enrico
Concomitant Autoimmunity in Endometriosis Impairs Endometrium–Embryo Crosstalk at the Implantation Site: A Multicenter Case-Control Study
title Concomitant Autoimmunity in Endometriosis Impairs Endometrium–Embryo Crosstalk at the Implantation Site: A Multicenter Case-Control Study
title_full Concomitant Autoimmunity in Endometriosis Impairs Endometrium–Embryo Crosstalk at the Implantation Site: A Multicenter Case-Control Study
title_fullStr Concomitant Autoimmunity in Endometriosis Impairs Endometrium–Embryo Crosstalk at the Implantation Site: A Multicenter Case-Control Study
title_full_unstemmed Concomitant Autoimmunity in Endometriosis Impairs Endometrium–Embryo Crosstalk at the Implantation Site: A Multicenter Case-Control Study
title_short Concomitant Autoimmunity in Endometriosis Impairs Endometrium–Embryo Crosstalk at the Implantation Site: A Multicenter Case-Control Study
title_sort concomitant autoimmunity in endometriosis impairs endometrium–embryo crosstalk at the implantation site: a multicenter case-control study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219087/
https://www.ncbi.nlm.nih.gov/pubmed/37240662
http://dx.doi.org/10.3390/jcm12103557
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