Laurentiu Craciunas

• Doctor - Medic, MRCOG, PhD
• SST at Newcastle Fertility Centre

Background: Early reproductive failure is the most common complication of pregnancy with only 30% of conceptions reaching live birth. Establishing a successful pregnancy depends upon implantation, a complex process involving interactions between the endometrium and the blastocyst. It is estimated that embryos account for one-third of implantation...

Background: Most women undergoing assisted reproduction treatment will reach the stage of embryo transfer (ET), but the proportion of embryos that can be successfully implanted after ET has remained small since the mid-1990s. Human chorionic gonadotropin (hCG) is a hormone that is synthesised and released by the syncytiotrophoblast and has a fundam...

Background: Thyroid disease is the second most common endocrine disorder affecting women of reproductive age. Subclinical hypothyroidism is diagnosed by an elevated thyroid-stimulating hormone concentration with a normal concentration of free thyroxine hormone. Autoimmune thyroid disease (ATD) is diagnosed by the presence of thyroid autoantibodies...

To determine whether the modified Beckman-Coulter 2nd-generation (Gen II) antimüllerian hormone (AMH) assay (Gen IIm) provides more consistent results following storage at room temperature and on dilution than the original Gen II assay, to compare AMH results from the modified assay with those obtained from the original assay, and to assess the rel...

Objective To characterise the endometrial transcriptomic profiles of women who suffered recurrent miscarriage and to set the foundation for the development of an endometrial receptivity test that could predict the fate of subsequent pregnancies. Study design This was a prospective multicentre cohort study performed at the Tommy's National Centre f...

This British Fertility Society (BFS) Policy and Practice guideline aims to support clinicians in preventing ovarian hyperstimulation syndrome (OHSS) in patients undergoing gonadotropin ovarian stimulation. A systematic literature search of the medical databases was performed. The Guideline Development Group (GDG) identified the risk factors of OHSS...

More than four decades have passed since the birth of the first infant conceived through the use of assisted reproductive technology (ART). During this time, ART has increased the chance for millions of people who have trouble conceiving to achieve a healthy pregnancy and birth. In the early years of IVF/ICSI, clinicians may have transferred all av...

Vaginal vault dehiscence with evisceration is a rare but a potentially life-threatening complication of total hysterectomy that requires prompt recognition, diagnosis, and management. The overall incidence of vaginal vault dehiscence is 0.53%. The mortality rate increases to 5.6% when bowel evisceration is present. We report a case of vaginal vault...

STUDY QUESTION Which clinical and embryological factors should be considered to apply double embryo transfer (DET) instead of elective single embryo transfer (eSET)? SUMMARY ANSWER No clinical or embryological factor per se justifies a recommendation of DET instead of eSET in IVF/ICSI. WHAT IS KNOWN ALREADY DET is correlated with a higher rate of...

The ESHRE guideline on the number of embryos to transfer during IVF/ICSI has been developed to provide infertility care practitioners with the best available evidence and recommendations on how many embryos to transfer during IVF/ICSI. This guideline provides 35 recommendations and good practice points to help clinicians reach the ultimate objecti...

Objective: To study the safety and feasibility of virtual consultations in reproductive medicine. Design: This was a descriptive cross-sectional study involving subfertile patients attending a video consultation between September 2021 and August 2022. Clinicians conducting virtual consultations during the same period responded to a parallel surv...

Objective: To study the safety and feasibility of virtual consultations in reproductive medicine. Design: This was a descriptive cross-sectional study involving subfertile patients attending a video consultation between September 2021 and August 2022 at St. Mary’s Hospital in Manchester, UK. Clinicians conducting virtual consultations during the sa...

Video Consultations in Reproductive Medicine: safety, feasibility and patient satisfaction Oral Presentation in the Fertility conference, Belfast 13/1/2023

Background: Premature ovarian insufficiency (POI) is a clinical syndrome resulting from loss of ovarian function before the age of 40. It is a state of hypergonadotropic hypogonadism, characterised by amenorrhoea or oligomenorrhoea, with low ovarian sex hormones (oestrogen deficiency) and elevated pituitary gonadotrophins. POI with primary amenorr...

Background: Endometrial receptivity has been the focus of continuous research for over eight decades; however, current clinical practice lacks an accurate test of endometrial receptivity to allow the prediction of successful pregnancy. We aimed to characterise the endometrial metabolomic profiles of women who suffered recurrent miscarriage using d...

Background: Ovarian tissue cryopreservation involves freezing and storing of surgically retrieved ovarian tissue in liquid or vapour nitrogen below -190°C. The tissue can be thawed and transplanted back with the aim of restoring fertility or ovarian endocrine function. The techniques for human ovarian tissue freezing and transplantation have evolv...

Background: Embryo transfer (ET) is a crucial step of in vitro fertilisation (IVF) treatment, and involves placing the embryo(s) in the woman's uterus. There is a negative association between endometrial wave-like activity (contractile activities) at the time of ET and clinical pregnancy, but no specific treatment is currently used in clinical pra...

Study question Do reproductive and endocrine outcomes from fresh and frozen-thawed ovarian transplants differ based on age and anti-cancer therapy before cryopreservation? Summary answer There was a significant difference in reproductive outcomes of women who have their tissue cryopreserved before or at the age of 35 years. What is known already...

This chapter includes clinical cases, background, evidence‐based practical management options, preventive measures, key‐point summaries of endometrial receptivity and answers to questions patients ask. In everyday IVF practice patients repeatedly ask questions about endometrial receptivity. They demand explanations, tests and treatments. The chapte...

This chapter includes clinical cases, background, evidence‐based practical management options, preventive measures and key‐point summaries of endometrial polyp. An endometrial polyp may play an important role in subfertility, implantation failure and miscarriage. Multiple polyps were found in 35% of women with polyps; notably, when benign endometri...

BACKGROUND Miscarriage describes the spontaneous loss of pregnancy before the threshold of viability; the vast majority occur before 12 weeks of gestation. Miscarriage affects one in four couples and is the most common complication of pregnancy. Chromosomal abnormalities of the embryo are identified in ∼50% of first trimester miscarriages; aneuploi...

Abstract: The removal of cumulus cells in a process called oocyte denudation is required in order to visualise, grade and manipulate the oocytes before injection. The objective of this study was to appraise critically the published randomised controlled trials (RCTs) comparing recombinant hyaluronidase with bovine hyaluronidase for oocyte denudatio...

Objectives More than 60,000 hysteroscopies are performed every year in the UK for common reasons such as heavy menstrual bleeding (HMB) or postmenopausal bleeding. A significant number of women requiring hysteroscopy receive oral anticoagulants and there is often a reluctance to perform these procedures due to bleeding concerns. Study Design We ar...

STUDY QUESTION What is the global variability in recurrent implantation failure (RIF) definition, investigation and therapy, currently offered to patients undergoing IVF? SUMAMRY ANSWER Definitions, diagnostic investigations and treatments offered to RIF patients differ widely amongst assisted reproduction healthcare professionals and clinical gui...

Objective To assess the women’s views in relation to the characteristics of an endometrial receptivity test in the context of recurrent miscarriage with an overarching aim to guide the development of a Target Product Profile (TPP) based on minimum acceptable (“worst-case”) and ideal (“best-case”) features. Study design This was a descriptive cross...

More than £4 are being avoidably wasted for every £1 invested in useful medical research according to Chalmers et al. (Lancet 2009; 374: 86-9). This is particularly important for a broad specialty such as Obstetrics and Gynaecology that only benefits from just over 5% of the total medical research funding according to the National Institute for Hea...

This is the protocol for a review and there is no abstract. The objectives are as follows: To investigate whether the use of oxytocin antagonists around the time of embryo transfer improves reproductive outcomes in subfertile women undergoing assisted reproduction. © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Background: Subfertility affects 15% of couples and represents the inability to conceive naturally following 12 months of regular unprotected sexual intercourse. Assisted reproduction refers to procedures involving the in vitro handling of both human gametes and represents a key option for many subfertile couples. Most women undergoing assisted rep...

Fragestellung: Identifikation, Bewertung und Zusammenfassung von Interventionen zur Verbesserung des Outcomes der assistierten Reproduktion bei Frauen mit einem Polyzystischem Ovar Syndrom (PCOS). Methodik: Medizinische Datenbanken wurden durchsucht und die Daten der eingeschlossenen Studien von 2 Autoren unabhängig voneinander extrahiert. Die stat...

Objectives: To identify, appraise and summarize the current evidence regarding the efficacy of strategies aimed at improving assisted reproductive techniques in women with polycystic ovary syndrome (PCOS). Methods: A comprehensive literature search of the standard medical databases was performed. The last electronic search was run in July 2015....

The removal of cumulus cells in a process called oocyte denudation is required in order to visualise, grade and manipulate the oocytes before injection. The objective of this study was to appraise critically the published randomised controlled trials (RCTs) comparing recombinant hyaluronidase with bovine hyaluronidase for oocyte denudation before i...

Background: Most women undergoing assisted reproduction treatment will reach the stage of embryo transfer (ET), but the proportion of embryos that can be successfully implanted after ET has remained small since the mid-1990s. Human chorionic gonadotropin (hCG) is a hormone that is synthesised and released by the syncytiotrophoblast and has a funda...

The majority of patients undergoing in vitro fertilization (IVF) and intracytoplasmatic sperm injection (ICSI) treatment will reach the stage of embryo transfer (ET), but only a small proportion of transferred embryos implant. Bed rest following ET has been recommended as a way to prevent embryo expulsion by gravity. We performed a systematic revie...

AIM: To appraise critically the published randomised controlled trials (RCTs) reporting on the effectiveness of using hyaluronic acid (HA) for sperm immobilisation and selection before intracytoplasmic sperm injection (ICSI). METHODS: Two authors used the PICO Method in order to perform a comprehensive literature search of the standard medical dat...

Does the prevalence of adverse maternal and neonatal outcomes vary in women diagnosed with polycystic ovary syndrome (PCOS) according to different definitions? A comparison of different criteria revealed that there is a substantial risk for perinatal complications in PCOS women, regardless of the used definition. Pregnant women with PCOS are suscep...

This is the protocol for a review and there is no abstract. The objectives are as follows: To investigate whether the intrauterine administration of hCG around the time of ET improves the clinical outcomes in subfertile women undergoing assisted reproduction.

Consistent data are available on supporting the routine use of prophylactic antibiotics for several obstetrical and gynaecological procedures. According to the Surgical Wounds Classification scheme, operations involving the vagina are included in the clean-contaminated category of procedures, and guidelines recommend the routine use of prophylactic...

Objective To appraise critically the published randomized controlled trials (RCTs) reporting on the effectiveness of cervical mucus removal before embryo transfer. Design Systematic review and meta-analysis of RCTs. Setting Assisted reproduction technology (ART) units. Patient(s) Women undergoing embryo transfer after in vitro fertilization/intr...

The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15% Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of hospitalisation periods. There is currently no guideline that supports the use of chewing gum after caesarean sections. To systematically analyse the...

Objective: To appraise critically the published randomized controlled trials (RCTs) comparing carbon dioxide (CO2) with normal saline (NS) as distension medium for diagnostic hysteroscopy. Design: Systematic review and meta-analysis of RCTs. Setting: Outpatient and inpatient hysteroscopy clinics. Participants: Women undergoing diagnostic hys...

The objective of this article is to systematically analyse the randomized, controlled trials comparing transinguinal preperitoneal (TIPP) and Lichtenstein repair (LR) for inguinal hernia. Randomized, controlled trials comparing TIPP vs LR were analysed systematically using RevMan® and combined outcomes were expressed as risk ratio (RR) and standard...

Presented at the International Surgical Congress of the Association of Surgeons of Great Britain and Ireland (ASGBI), May 2013, Glasgow, UK.

Presented at the International Surgical Congress of the Association of Surgeons of Great Britain and Ireland (ASGBI), May 2013, Glasgow, UK.

Presented at the International Surgical Congress of the Association of Surgeons of Great Britain and Ireland (ASGBI), May 2013, Glasgow, UK.

Presented at the International Surgical Congress of the Association of Surgeons of Great Britain and Ireland (ASGBI), May 2013, Glasgow, UK.

Presented at the International Surgical Congress of the Association of Surgeons of Great Britain and Ireland (ASGBI), May 2013, Glasgow, UK.

Presented at the International Surgical Congress of the Association of Surgeons of Great Britain and Ireland (ASGBI), May 2013, Glasgow, UK.

The objective of this article is to systematically analyse the randomized, controlled trials that compare the use of antibacterial sutures (ABS) for skin closure in controlling surgical site infections. Randomized, controlled trials on surgical patients comparing the use of ABS for skin closure in controlling the surgical site infections were analy...

Presented at the Royal College of Obstetricians and Gynaecologists (RCOG) World Congress, June 2013, Liverpool, UK.

The objective of this article is to systematically analyze the randomized, controlled trials comparing the effectiveness of suture anastomosis (SUA) versus stapled anastomosis (STA) in patients undergoing ileostomy closure. Randomized, controlled trials comparing the effectiveness of SUA versus STA in patients undergoing ileostomy closure were anal...