Search

To explore whether intracytoplasmic sperm injection (ICSI) would increase the malformation risk in fetuses and live births compared with conventional in vitro fertilization (IVF). Retrospective cohort study. Data were collected from couples who underwent conventional IVF or ICSI from January 2009 to December 2019 at the Center for Reproductive Medicine of Peking University Third Hospital in the People's Republic of China. A total of 46,167 conventional IVF fresh transfer cycles and 33,247 ICSI fresh transfer cycles were included. Intracytoplasmic sperm injection and conventional IVF. The primary outcomes were congenital abnormalities in live births. The secondary outcomes included the pregnancy outcomes, the malformations among the miscarriages, specific types of malformations in live births, birth weight, and sex. The rates of congenital malformations in conventional IVF and ICSI were 5.44‰ and 5.78‰, respectively. There was no statistically significant difference between the two groups, as indicated by the adjusted odds ratio of 1.098 (95% confidence interval 0.787, 1.532). The rates of specific malformations were comparable between ICSI and IVF. Additionally, no discernible disparities were noted in pregnancy outcomes, the malformations among the miscarriages,birth weight between the two groups. Our study suggested the safety of ICSI and provided novel evidence by comparing pregnancy outcomes and congenital malformations in offspring between patients undergoing conventional IVF and ICSI. [ABSTRACT FROM AUTHOR]

Objective To explore the correlation between seminal plasma oxidative stress and reproductive hormone levels with teratospermia and ICSI outcome. Methods A total of 206 male infertility patients from the reproductive medicine center of our hospital from August 2021 to December 2022 were selected as the research objects. They were grouped according to the fifth edition of the World Health Organization’s Handbook on Human Semen Testing and Processing Laboratories, of which 120 patients with percentage of normal sperm morphology ＜ 4% were included in the teratospermia group. 86 cases with percentage of normal sperm morphology ≥4% were included in the normal group. The levels of seminal plasma oxidative stress (reactive oxygen species (ROS), superoxide dismutase (SOD)) and reproductive hormones (follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T)) were detected in both groups. The influencing factors of teratospermia were analyzed. The ICSI rates of patients with different spermatozoa oxidative stress and reproductive hormone levels were compared in the teratospermia group. The correlation between the severity of teratozoospermia and seminal oxidative stress and reproductive hormone levels was analyzed. Results The proportions of advanced age, higher body mass index, smoking, drinking, varicocele and diabetes in the teratospermia group were higher than those in the control group, while sperm activity rate and forward movement sperm rate were lower than those in the control group (P＜0.05). Levels of ROS, FSH and LH in spermatozoa group were higher than those in the control group, while the levels of SOD and T in the spermatozoa group were lower than those in the control group (P＜0.05). Smoking, varicocele and ROS were independent risk factors for teratospermia, while SOD and T were independent protective factors for teratospermia (P＜ 0.05). In the teratospermia group, the fertilization rate was decreased with the increase of ROS level, and it was increased with the increase of seminal plasma SOD and T level (P＜0.05); Spearman’s correlation analysis showed a positive correlation between the severity of teratospermia and the level of seminal plasma ROS (r=0.832, P＜0.001). Furthermore, a negative correlation was observed between the severity of teratospermia and the level of SOD (r=-0.825, P＜0.001). However, there was little correlation between the severity of teratospermia and the level of T (r=0.206, P=0.024). Conclusion Oxidative stress and abnormal expression of reproductive hormones are closely related to the occurrence of teratospermia and affect the outcome of ICSI. [ABSTRACT FROM AUTHOR]

Objective: To explore the impact of poly-pronucleus (PN) incidence on the embryonic development and pregnancy outcome after intracytoplasmic sperm injection (ICSI). Methods: This is a retrospective cohort study, analyzing the clinical data of patients after ICSI between January 2016 and December 2021. The objects of study were divided into three groups according to the proportion of poly-PN: the control group (the proportion of poly-PN=0%, n=333), the low-frequency poly-PN group (0%＜the proportion of poly-PN＜20%, n=80) and the high -frequency poly -PN group (the proportion of poly -PN ≥20%, n =31). The embryonic development and pregnancy outcomes were compared among the groups, respectively. Results: The numbers of oocytes retrieved and available embryos on day 3 (D3) were higher in the low-frequency poly-PN group than those in the control group, but the rates of normal fertilization and high -scoring blastocyst formation were lower than those in the control group (all P＜0.017). Compared with the control group and the low-frequency poly-PN group, the high-frequency poly-PN group had lower rate of normal fertilization rate, lower number of available embryos on D3 (all P＜0.017), and low rate of biochemical pregnancy and high miscarriage rate (but P＞0.017). Multifactorial Logistic analysis showed that patients in the high-frequency poly-PN group had significantly lower biochemical pregnancy rate and live birth rate when compared with the control group (aOR=0.402, 95%CI: 0.186-0.870, aP=0.021; aOR=0.247, 95%CI: 0.068-0.901, aP=0.034). Conclusions: In the ICSI cycles, the incidence of poly-PN may reflect oocyte quality, and the incidence of poly -PN ≥20% may predict the poor embryo development, lower biochemical pregnancy rate and lower live birth rate. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the efficacy of physiological intracytoplasmic sperm injection (PICSI) and intracytoplasmic sperm injection (ICSI) in terms of the fertilization rate and embryo quality using sibling oocyte cycles. Methods: This prospective, cross-sectional study collected data from 76 couples who underwent their first cycle at the Hue Center for Reproductive Endocrinology and Infertility, Vietnam, between May 2019 and November 2021. The inclusion criteria were cycles with at least eight oocytes and a sperm concentration of 5×106/mL. Sperm parameters, sperm DNA fragmentation (SDF), fertilization, and the quality of cleavage-stage embryos on day 2 and blastocysts on day 5 were examined. Results: From 76 ICSI cycles, 1,196 metaphase II (MII) oocytes were retrieved, half of which were randomly allocated to either the PICSI (n=592) or ICSI (n=604) treatment group. The results showed no significant difference between the two groups in terms of fertilization (72.80% vs. 75.33%, p=0.32), day 2 cleavage rate (95.13% vs. 96.04%, p=0.51), blastulation rate (52.68% vs. 57.89%), and high-quality blastocyst rate (26.10% vs. 31.13%, p=0.13). However, in cases where SDF was low, 59 cycles consisting of 913 MII oocytes produced a considerably higher blastulation rate with PICSI than with ICSI (50.49% vs. 35.65%, p=0.00). There were no significant differences between the pregnancy outcomes of the PICSI and ICSI embryo groups following embryo transfer. Conclusion: Using variable sperm quality provided no benefit for PICSI versus ICSI in terms of embryo outcomes. When SDF is low, PICSI appears to be able to produce more blastocysts. [ABSTRACT FROM AUTHOR]

Aim: Recurrent implantation failure is an important issue in Assisted reproduction and despite various treatments that have been described before, there is no agreement on which is the best option. This study was directed to assess the efficacy of autologous platelet-rich plasma (PRP) on pregnancy rate in recurrent implantation failure. Between 2016 and 2019, a total of 98 women who unsuccessful to be pregnant after three or more high-quality embryo transfers undergoing frozen-thawed embryo transfer with or without an intrauterine infusion of platelet-rich plasma. Thus, 0.5 ml of platelet-rich plasma at 4–6 times higher concentration than peripheral blood infused intrauterine 48 h before embryo transfer. A control group underwent standard protocol. There were no significant differences between the two groups in terms of age, body mass index and duration and cause of infertility and total transferred embryos and kind of treatment protocol, but secondary infertility and endometrial thickness 96 h before embryo transfer, was more in the intervention group. The clinical pregnancy (48.3% versus 23.26; p =.001) and ongoing pregnancy (46.7% versus 11.7%; p =.001) and implantation rate (58.3% versus 25%; p =.001) was more significant in the intervention group rather than controls. In conclusion, intrauterine infusion of platelet-rich plasma 48 h before freeze-thawed embryo transfer may have more effectiveness in in vitro fertilization (IVF) outcomes in recurrent implantation failure. [ABSTRACT FROM AUTHOR]

Introduction: In different studies worldwide, gender ratios derived from ICSI (Assisted reproductive techniques) have been reported differently. Objective: Evaluation of neonatal gender in ICSI women referred to Mehr Infertility Research Center of Rasht. Materials and Methods: In this descriptive-analytical study, the cases of infertile women referred to Mehr Infertility Research Center in Rasht for ICSI were examined to determine the sex ratio of the neonates. Data were analyzed using SPSS 21 and descriptive and an alytical (Chi-square and independent t) tests. Results:The results showed that 52% of single-born neonates, 60% of multiple pregnancies (single sex) and 52.5% of multiple pregnancy (two sexes) were male. Conclusion:The ratio of male in single and multiple pregnancies in ICSI was higher than female. [ABSTRACT FROM AUTHOR]

Purpose: The relationship between male systemic inflammation and fertility seems intriguing, but no data about its impact on the assisted reproductive technology outcomes has been reported. Here, we aimed to evaluate the prognostic role of male systemic inflammatory parameters in intracytoplasmic sperm injection (ICSI) outcomes prediction, in couples undergoing an ovum donation program. Materials and Methods: From January 2016 to December 2017, one hundred-ten couples were considered for this crosssectional study. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-eosinophil ratio (MER), platelet-to-lymphocyte ratio (PLR), seminal parameters, fertilization rate (FR), cleavage rate (CR), pregnancy rate (PR) were evaluated. Male patients were divided into Group A with FR ≤70%, Group B with FR >70%. Results: Overall, FR was 74.5%, CR 90.9%, PR 41.8%. Group A included 43 patients, Group B 67 men. Group A showed a median NLR of 1.55, PLR of 106.09, MER of 2.33. Group B reported a median NLR of 1.64, PLR 109.0, MER 2.76. We found no statistically differences between two groups with respect to NLR, PLR, MER (p=0.90, p=0.70, p=0.96, respectively). The age-adjusted linear regression analysis demonstrated only a relationship between NLR and sperm motility count (r=-0.02; p<0.05). Using the univariate logistic regression analysis, we found no significant associations. Conclusions: We did not find any relationship between ICSI outcomes and male inflammation parameters. [ABSTRACT FROM AUTHOR]

Study Question: Is the presence or absence of certain vaginal bacteria associated with failure or success to become pregnant after an in vitro fertilization (IVF) or IVF with intracytoplasmic sperm injection (IVF-ICSI) treatment?Summary Answer: Microbiome profiling with the use of interspace profiling (IS-pro) technique enables stratification of the chance of becoming pregnant prior to the start of an IVF or IVF-ICSI treatment.What Is Known Already: Live-birth rates for an IVF or IVF-ICSI treatment vary between 25 and 35% per cycle and it is difficult to predict who will or will not get pregnant after embryo transfer (ET). Recently, it was suggested that the composition of the vaginal microbiota prior to treatment might predict pregnancy outcome. Analysis of the vaginal microbiome prior to treatment might, therefore, offer an opportunity to improve the success rate of IVF or IVF-ICSI.Study Design, Size, Duration: In a prospective cohort study, 303 women (age, 20-42 years) undergoing IVF or IVF-ICSI treatment in the Netherlands were included between June 2015 and March 2016.Participants/materials, Setting, Methods: Study subjects provided a vaginal sample before the start of the IVF or IVF-ICSI procedure. The vaginal microbiota composition was determined using the IS-pro technique. IS-pro is a eubacterial technique based on the detection and categorization of the length of the 16S-23S rRNA gene interspace region. Microbiome profiles were assigned to community state types based on the dominant bacterial species. The predictive accuracy of the microbiome profiles for IVF and IVF-ICSI outcome of fresh ET was evaluated by a combined prediction model based on a small number of bacterial species. From this cohort, a model was built to predict outcome of fertility treatment. This model was externally validated in a cohort of 50 women who were undergoing IVF or IVF-ICSI treatment between March 2018 and May 2018 in the Dutch division of the MVZ VivaNeo Kinderwunschzentrum Düsseldorf, Germany.Main Results and the Role Of Chance: In total, the vaginal microbiota of 192 women who underwent a fresh ET could be analysed. Women with a low percentage of Lactobacillus in their vaginal sample were less likely to have a successful embryo implantation. The prediction model identified a subgroup of women (17.7%, n = 34) who had a low chance to become pregnant following fresh ET. This failure was correctly predicted in 32 out of 34 women based on the vaginal microbiota composition, resulting in a predictive accuracy of 94% (sensitivity, 26%; specificity, 97%). Additionally, the degree of dominance of Lactobacillus crispatus was an important factor in predicting pregnancy. Women who had a favourable profile as well as <60% L. crispatus had a high chance of pregnancy: more than half of these women (50 out of 95) became pregnant. In the external validation cohort, none of the women who had a negative prediction (low chance of pregnancy) became pregnant.Limitations, Reasons For Caution: Because our study uses a well-defined study population, the results will be limited to the IVF or IVF-ICSI population. Whether these results can be extrapolated to the general population trying to achieve pregnancy without ART cannot be determined from these data.Wider Implications Of the Findings: Our results indicate that vaginal microbiome profiling using the IS-pro technique enables stratification of the chance of becoming pregnant prior to the start of an IVF or IVF-ICSI treatment. Knowledge of their vaginal microbiota may enable couples to make a more balanced decision regarding timing and continuation of their IVF or IVF-ICSI treatment cycles.Study Funding/competing Interest(s): This study was financed by NGI Pre-Seed 2014-2016, RedMedTech Discovery Fund 2014-2017, STW Valorisation grant 1 2014-2015, STW Take-off early phase trajectory 2015-2016 and Eurostars VALBIOME grant (reference number: 8884). The employer of W.J.S.S.C. has in collaboration with ARTPred acquired a MIND subsidy to cover part of the costs of this collaboration project. The following grants are received but not used to finance this study: grants from Innovatie Prestatie Contract, MIT Haalbaarheid, other from Dutch R&D tax credit WBSO, RedMedTech Discovery Fund, (J.D.d.J.). Grants from Ferring (J.S.E.L., K.F., C.B.L. and J.M.J.S.S.), Merck Serono (K.F. and C.B.L.), Dutch Heart Foundation (J.S.E.L.), Metagenics Inc. (J.S.E.L.), GoodLife (K.F.), Guerbet (C.B.L.). R.K. is employed by ARTPred B.V. during her PhD at Erasmus Medical Centre (MC). S.A.M. has a 100% University appointment. I.S.P.H.M.S., S.A.M. and A.E.B. are co-owners of IS-Diagnostics Ltd. J.D.d.J. is co-owner of ARTPred B.V., from which he reports personal fees. P.H.M.S. reports non-financial support from ARTPred B.V. P.H.M.S., J.D.d.J. and A.E.B. have obtained patents `Microbial population analysis' (9506109) and `Microbial population analysis' (20170159108), both licenced to ARTPred B.V. J.D.d.J. and A.E.B. report patent applications `Method and kit for predicting the outcome of an assisted reproductive technology procedure' (392EPP0) and patent `Method and kit for altering the outcome of an assisted reproductive technology procedure' by ARTPred. W.J.S.S.C. received personal consultancy and educational fees from Goodlife Fertility B.V. J.S.E.L. reports personal consultancy fees from ARTPred B.V., Titus Health B.V., Danone, Euroscreen and Roche during the conduct of the study. J.S.E.L. and N.G.M.B. are co-applicants on an Erasmus MC patent (New method and kit for prediction success of in vitro fertilization) licenced to ARTPred B.V. F.J.M.B. reports personal fees from Advisory Board Ferring, Advisory Board Merck Serono, Advisory Board Gedeon Richter and personal fees from Educational activities for Ferring, outside the submitted work. K.F. reports personal fees from Ferring (commercial sponsor) and personal fees from GoodLife (commercial sponsor). C.B.L. received speakers' fee from Ferring. J.M.J.S.S. reports personal fees and other from Merck Serono and personal fees from Ferring, unrelated to the submitted paper. The other authors declare that they have no competing interests.Trial Registration Number: ISRCTN83157250. Registered 17 August 2018. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between the embryodynamic parameters using time-lapse system and the pregnancy outcomes, so as to establish a model of the optimal embryo selection. Methods: A total of 137 cycles with the time-lapse system (IVF/ICSI-ET cycle) were retrospectively analyzed from December 2016 to December 2017. The clinical data including basic information and pregnancy outcomes were collected. The morphokinetic parameters using the time -lapse system (t2、t3、t4、t5、t6、t7、t8、cc2、s2、cc3、s3) were compared between the implanted embryos and the unimplanted embryos. Based on those parameters related with embryo implantation, a multivariate classification model was developed. This model was then primarily verified. Results: ① Totally 171 embryos had one or more early abnormal division event, in which 16 were considered to be implantable, and then transplanted. There were 4 embryos implantated succesfully. ② There were no significant differences in all of 11 morphokinetic parameters between the implanted embryos and the unimplanted embryos (P>0.05).③Thet6(OR=1.462,95%CI:1.093-1.954, P=0.010)and t7 (OR=0.803,95%a:0.653-0.989, P=0.039) could be the best predictors of implantation. A classification model was developed with these two parameters combined with the exclusion standard of abnormal division event. The implantation rate was declined as the embryonic grade dropped. The area under the receiver operating characteristic curve (AUC) was 0.649 (95% CI: 0.528-0.770). Conclusions: Two of morphokinetic parameters (t6, t7) could be closely related to the implantation potential. We tried to develop an embryo selecting model with these two parameters combined with exclusion standard of abnormal division events. It is true that this model should be furtherly validated in our centers. [ABSTRACT FROM AUTHOR]

Objective: To investigate the application of intracytoplasmic sperm injection (ICSI) combined with immature oocyte in vitro maturation (IVM) in those ageing women with poor ovarian response(POR) who underwent different ovarian stimulation. Methods: A total of 81 cycles of ICSI were evaluated retrospectively from January 2016 to September 2018 at the First Affiliated Hospital of Zhengzhou University. The inclusion criteria were age 多 35 years, the number of oocytes 矣3, and the oocytes immature. These cycles were grouped according to the protocols of ovulation stimulation: the micro-stimulation group (n=37) and the antagonist group (n=44). The basal levels of reproductive hormones and the pregnancy outcome were compared between the two gruops. Results: There were no significant differences in age, infertility years, basal levels of hormones (including AMH) and basal antral follicles between the two groups (P>0.05). The amount of Gn in the antagonist group was significantly higher than that in the micro-stimulation group (P<0.05). There were no significant differences in the in vitro culture maturation rate, 2PN rate, cleavage rate, embryonic rate and excellent embryo rate between the two groups (P<0.05). Meanwhile, there were no significant differences in the implantation rate and the clinical pregnancy rate (P> 0.05). Conclusions: The ICSI combined with IVM in ageing women with POR is beneficial to improve the oocyte maturation rate and embryo utilization, and to increase the pregnancy chance. The micro-stimulation protocol is a cost-effective option for those women with POR. [ABSTRACT FROM AUTHOR]

Objective：To evaluate the effect of GnRHa ultra long protocol on clinical outcomes of IVF/ ICSI-ET in patients with different stages of endometriosis. Methods：PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wanfang Data, VIP database, CBM and Google Scholar were searched to identify those studies involving human subjects published before August 1st, 2018. Those clinical trials that compared the effects of the GnRHa ultra long protocol and the GnRHa long protocol on clinical outcomes of IVF/ICSI-ET in patients with endometriosis were included. The meta-analysis was performed by two investigators. Results：Nine studies were included in the meta-analysis. Comparing with the GnRHa long protocol, the GnRHa ultral long protocol in those endometriosis patients at stage Ⅰ-Ⅱ had significantly higher Gn doses (SMD=0.36, 95%CI：0.01-0.70) and higher implantation rate (RR=1.19, 95%CI: 1.04-1.37), and lower number of oocytes retrieved (SMD=-0.26, 95%CI: -0.48- -0.04), although there were no significant differences in basal FSH, Gn days and clinical pregnancy rate (all P＞0.05). In those endometriosis patients at stage Ⅲ-Ⅳ, the GnRHa ultra long protocol had significantly higher clinical pregnancy rate (RR=1.38, 95%CI: 1.06 -1.80) when compared with the GnRHa long protocol, although there were no significantly differences in basal FSH, Gn doses, Gn days, the number of oocytes retrieved and implantation rate (all P＞0.05). Conclusions：For those endometriosis patients at stage Ⅰ-Ⅱ, the GnRHa ultra long protocol could not improve the pregnancy rate, but cost more Gn and retrieve fewer oocytes. For those endometriosis patients at stage Ⅲ-Ⅳ, the GnRHa ultra long protocol could significantly improve the pregnancy rate. [ABSTRACT FROM AUTHOR]

Objective：To investigate the correlation between serum vitamin D and the pregnancy outcome of in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in women with polycystic ovary syndrome (PCOS). Methods: A total of 286 infertility women with PCOS underwent IVF/ICSI from November 2016 to June 2018 were included，including 114 women received fresh embryo transfer (ET). According to the level of 25-hydroxyvitamin D(25OHD), those patients were divided into three groups: vitamin D deficiency group (≤10 ng/mL), insufficiency group (10-30 ng/mL) and sufficiency group (≥30 ng/mL).The pregnancy rate of IVF/ICSI was analyzed. Furthermore, the patients with fresh ET were further divided into two groups: clinical pregnancy group and non -pregnancy group. After adjusting for baselines of luteinizing hormone (LH), testosterone and endometrial thickness on the ET day, logistic regression analysis on the vitamin D level and clinical pregnancy outcome of IVF/ICSI -ET was performed. Results: (1)There were significant differences in BMI, baseline testosterone, the ratio of baseline LH/ FSH among three groups (P＜0.05). There were no significant differences in the indicators of ovulation induction (P＞0.05). (2)In those fresh ET patients, there were significant differences in BMI, the rate of fertilization and the rate of embryo implantation among three subgroups (P＜0.05). (3) The baselines of LH and testosterone in the pregnancy group were lower than those in the non-pregnancy group (P＜0.05), while the endometrial thickness on the ET day and the rate of fertilization in the pregnancy group were significantly higher than those in the nonpregnancy group (P＜0.05). After adjusting for age, baseline LH, baseline testosterone, the endometrial thickness on the ET day and the ratio of baseline LH/FSH, the logistic regression analysis showed that the pregnancy rates in the vitamin D insufficiency group and the sufficiency group were significantly higher than this rate in the vitamin D deficiency group （aOR=5.559，95%CI：1.463-21.124，P=0.012；aOR=11.192，95%CI：1.674 -74.822，P =0.013）. Conclusions: The level of serum vitamin D≥10 ng/mL is a protective factor of IVF/ICSI-ET in women with PCOS. [ABSTRACT FROM AUTHOR]

Objective：To investigate the high-accuracy predictive factors of ovarian response to ovulation induction. Methods：The basic information, medication and outcome of 5 859 IVF/ICSI cycles were respectively analyzed in our center from June 2014 to December 2016. The Logistic regression model was developed to predict the ovarian response. There were a total of 517 cycles in the low-response group, 1 281 cycles in the high - response group and 4 061 cycles in the normal-response group. The clinical data of 1 143 cycles in 2017 were used to test the diagnostic value of those factors. Results：The differences in the age, AFC, basal hormone levels, medication and clinical outcomes were significant among the three groups (P＜0.001). The level of serum AMH was the important predictor of ovarian response, with the cut-off values of 2.76 ng/mL for high ovarian response and 1.50 ng/mL for low ovarian response. AMH if combining with age could predict high ovarian response, while AMH combining with AFC also predict low ovarian response. Conclusions：The level of serum AMH was a good predictor of ovarian response before Gn initiation. AMH if combining with AFC and age was of great significance in obtaining an appropriate number of oocytes, ensuring a good pregnancy outcome and preventing ovarian hyperstimulation syndrome. [ABSTRACT FROM AUTHOR]

Objective：To evaluate whether the index of sperm DNA fragmentation index (DFI) can be used as a parameter of male fertility. Methods：A total of 460 infertile men were enrolled in the observation group, and 107 fertile men in the control group. Semen parameters were calculated by the computer assisted semen analysis system (CASA). Sperm DNA fragmentation index (DFI) was detected by the sperm chromatin structure assay (SCSA). The results of routine semen analysis were divided into the normal, oligospermia, asthenospermia and oligoasthenospermia subgroups. Objects were also grouped into 3 subgroups according to the age, ＜30 years, 30-39 years, and over 40 years. Specially, those objects were further divided into three subgroups according to DFI, ≤15, 15 -30 and ≥30. DFI was compared between the control group and the observation group. The correlations between sperm DFI and age, IVF/ICSI embryonic development and reproductive outcome were successively analyzed. Results：There were significant differences in the proportions of normal, oligospermia, asthenospermia and oligoasthenospermia between the observation group and the control group (22.17% vs. 60.96%, 13.26% vs. 34.59%, 52.62% vs. 1.75% and 11.95% vs. 2.70%, all P＜0.05). In the observation group, the proportion of sperm DFI ≤15% was decreased while the proportion of DFI ≥30% increased (both P＜0.05). The level of sperm DFI was increased with age (P＜0.05). The early abortion rates of those IVF or ICSI embryos derived from sperms with DFI≥30 were significantly increased (31% and 25%, P＜0.05). However, there were no significant differences in the fertilization rate, cleavage rate, biochemical pregnancy rate, clinical pregnancy rate, implantation rate among those subgroups (all P＞0.05). Conclusions： The sperm DFI in infertile men is at a higher level, and increased with age. The early abortion rate of IVF or ICSI embryos will be increased when sperm DFI≥30, suggesting that sperm DFI is a practical reference for the evaluation of the potential fertility in those infertile men. [ABSTRACT FROM AUTHOR]

Abstract: A wide variety of assisted reproductive techniques (ARTs) are available to aid in managing aspects of equine reproduction. Embryo recovery and transfer can be used to obtain more than one foal per mare per year, and to obtain foals from mares that cannot carry a foal to term. Oocyte recovery and either transfer to the oviduct of an inseminated recipient mare (oocyte transfer), or intracytoplasmic sperm injection (ICSI) and embryo culture can be used to obtain foals from mares with some types of subfertility, such as problems of the tubular tract. ICSI can be used to obtain foals when sperm number or quality is low. Because of its ease of use for the mare owner and efficiency, oocyte recovery and ICSI is being used in some cases for management of normally fertile mares and stallions. Oocytes can be recovered from live mares by the referring veterinarian, and shipped overnight to a laboratory for ICSI, without any decrease in oocyte or embryo viability. In case of unexpected death of a mare, ovaries or oocytes can be transported to the ICSI laboratory for production of embryos. Embryos produced both in vitro and in vivo can be biopsied to determine their genetic makeup before they are transferred. Equine embryos can be vitrified successfully; collapse of the blastocoele cavity allows efficient vitrification of expanded blastocysts. In contrast, cryopreservation of unfertilized equine oocytes still has low success. Genetics of valuable animals can be preserved via nuclear transfer (cloning) and several commercial companies offer this service clinically. [ABSTRACT FROM AUTHOR]

Objective：To explore the relationship between chromosomal polymorphism of the infertile couples and the outcomes of IVF/ICSI -ET. Methods: The chromosome karyotype analysis of 1 318 infertile couples received IVF/ICSI-ET was performed in our center from September 2015 to November 2016. The couples with either male or female chromosome polymorphism were enrolled as the study group，while the couples with normal chromosome karyotypes were served as the control group. The outcomes of IVF/ICSI-ET of two groups were compared. Results: The occurrence of miscarriage history in the study group was significantly higher than that in the control group (24.64% vs. 15.65%, P=0.007). The rate of high-grade blastocysts in the male polymorphic couple was significantly lower than that in the woman′s chromosomal polymorphism (18.11% vs. 29.03%, P=0.016) or the control group (18.11% vs. 23.81% , P =0.017). Conclusions: The infertile couples with chromosomal polymorphism have higher rate of previous miscarriage history, and the embryos from male chromosomal polymorphism might have relatively low development potential. However, their outcomes of IVF/ICSI -ET are similar to those with normal chromosome karyotypes. [ABSTRACT FROM AUTHOR]

Oocyte activation deficiency (OAD) refers to the failure of the evoking calcium oscillations which orchestrates a series of key events, such as the resumption of meiosis, extrusion of polar body, exocytosis of cortical granules and the formation of pronuclei after the spermatozoon is engulfed by the oocyte cytoplasm. These events are essential for the following embryogenesis. Both the defect of sperm and oocyte may cause OAD. Assisted oocyte activation (AOA) and the recombinant protein recombinant human phospholipases C zeta (rhPLCζ) injected into oocyte can significantly improve the fertilization outcome of OAD oocyte undergoing intracytoplasmic sperm injection (ICSI). In this paper, the causes and countermeasures of OAD were discussed. [ABSTRACT FROM AUTHOR]

Background: Multiple pregnancies occur more frequently in assisted reproductive technology (ART) compared to normal conception (NC). It is known that the risk of congenital malformations in a multiple pregnancy are higher than single pregnancy. The aim of this study is to compare congenital malformations in singleton infants conceived by ART to singleton infants conceived naturally. Materials and Methods: In this historical cohort study, we performed a historical cohort study of major congenital malformations (MCM) in 820 singleton births from January 2012 to December 2014. The data for this analysis were derived from Tehran's ART linked data file. The risk of congenital malformations was compared in 164 ART infants and 656 NC infants. We performed multiple logistic regression analyses for the independent association of ART on each outcome. Results: We found 40 infants with MCM 29 (4.4%) NC infants and 14 (8.3%) ART infants. In comparison with NC infants, ART infants had a significant 2-fold increased risk of MCM (P=0.046). After adjusting individually for maternal age, infant gender, prior stillbirth, mother's history of spontaneous abortion, and type of delivery, we did not find any difference in risk. In this study the majority (95.1%) of all infants were normal but 4.9% of infants had at least one MCM. We found a difference in risk of MCMs between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). We excluded the possible role of genotype and other unknown factors in causing more malformations in ART infants. Conclusion: This study reported a higher risk of MCMs in ART singleton infants than in NC singleton infants. Congenital heart disease, developmental dysplasia of the hip (DDH), and urogenital malformations were the most reported major malformations in singleton ART infants according to organ and system classification. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this retrospective cohort study was to establish a ratio of the progesterone level to the number of follicles (having diameter larger than 12 mm) on ovulation trigger day [human chorionic gonadotropin (hCG)-day] and to demonstrate if this ratio is associated with pregnancy outcome in gonadotropin releasing hormone (GnRH) antagonist/intracytoplasmic sperm injection cycles with high hCG-day serum progesterone value (≥1.5 ng/mL). Material and Methods: Among 2.111 GnRH antagonist cycles which were conducted at İzmir Tepecik Education and Research Hospital, Gynecology and Obstetrics Clinic, In Vitro Fertilization Center between March 2010-July 2015, 203 cycles matching inclusion criteria and with serum progesterone levels ≥1.5 ng/mL on hCG day were included in the analysis. Following controlled ovarian stimulation, serum progesterone levels and the follicle diameters were measured on hCG-day. In addition, the basal demographic and hormonal data, the embryo development data after oocyte pick-up process, and the pregnancy results were included in the analysis. Results: In this study, the receiver operating characteristics area under curve value, cut-off value, sensitivity and specificity were found to be 0.617, 0.307, 0.97 and 0.24 for progesterone/follicle ratio (P/F ratio), respectively (p=0.023). In addition, it was also found in our study that while the total follicle stimulating hormone amount used and hCG day progesterone level in patients, who have P/F ratio value ≤0.307 was significantly lower (p<0.01, p<0.001); whereas hCG-day ≥12 mm and ≥17 mm follicle number, hCG-day endometrial thickness, hCGday estradiol level, total and metaphase II oocyte number were significantly higher in patients with P/F ratio ≤0.307. Moreover, chemical, clinical, ongoing pregnancy and live birth rates were significantly higher in patients with P/F ratio ≤0.307. Conclusions: As a conclusion, in patients with hCG-day serum progesterone levels ≥1.5 ng/mL, progesterone/follicle ratio is a useful parameter in predicting live birth rate in patients undergoing fresh embryo transfer and antagonist IVF cycle. [ABSTRACT FROM AUTHOR]

Study Question: Can an externally validated model, based on biological variables, be developed to predict successful sperm retrieval with testicular sperm extraction (TESE) in men with non-obstructive azoospermia (NOA) using a large nationwide cohort?Summary Answer: Our prediction model including six variables was able to make a good distinction between men with a good chance and men with a poor chance of obtaining spermatozoa with TESE.What Is Known Already: Using ICSI in combination with TESE even men suffering from NOA are able to father their own biological child. Only in approximately half of the patients with NOA can testicular sperm be retrieved successfully. The few models that have been developed to predict the chance of obtaining spermatozoa with TESE were based on small datasets and none of them have been validated externally.Study Design, Size, Duration: We performed a retrospective nationwide cohort study. Data from 1371 TESE procedures were collected between June 2007 and June 2015 in the two fertility centres.Participants/materials, Setting, Methods: All men with NOA undergoing their first TESE procedure as part of a fertility treatment were included. The primary end-point was the presence of one or more spermatozoa (regardless of their motility) in the testicular biopsies.We constructed a model for the prediction of successful sperm retrieval, using univariable and multivariable binary logistic regression analysis and the dataset from one centre. This model was then validated using the dataset from the other centre. The area under the receiver-operating characteristic curve (AUC) was calculated and model calibration was assessed.Main Results and the Role Of Chance: There were 599 (43.7%) successful sperm retrievals after a first TESE procedure. The prediction model, built after multivariable logistic regression analysis, demonstrated that higher male age, higher levels of serum testosterone and lower levels of FSH and LH were predictive for successful sperm retrieval. Diagnosis of idiopathic NOA and the presence of an azoospermia factor c gene deletion were predictive for unsuccessful sperm retrieval. The AUC was 0.69 (95% confidence interval (CI): 0.66-0.72). The difference between the mean observed chance and the mean predicted chance was <2.0% in all groups, indicating good calibration. In validation, the model had moderate discriminative capacity (AUC 0.65, 95% CI: 0.62-0.72) and moderate calibration: the predicted probability never differed by more than 9.2% of the mean observed probability.Limitations, Reasons For Caution: The percentage of men with Klinefelter syndrome among men diagnosed with NOA is expected to be higher than in our study population, which is a potential selection bias. The ability of the sperm retrieved to fertilize an oocyte and produce a live birth was not tested.Wider Implications Of the Findings: This model can help in clinical decision-making in men with NOA by reliably predicting the chance of obtaining spermatozoa with TESE.Study Funding/competing Interest: This study was partly supported by an unconditional grant from Merck Serono (to D.D.M.B. and K.F.) and by the Department of Obstetrics and Gynaecology of Radboud University Medical Center, Nijmegen, The Netherlands, the Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, Den Bosch, The Netherlands, and the Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, The Netherlands. Merck Serono had no influence in concept, design nor elaboration of this study.Trial Registration Number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: To compare the pregnancy outcomes after two embryos versus three embryos transfers (ETs) in women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Materials and Methods: This retrospective study was performed on three hundred eighty seven women with primary infertility and with at least one fresh embryo in good quality in order to transfer at each IVF/ICSI cycle, from September 2006 to June 2010. Patients were categorized into two groups according to the number of ET as follows: ET2 and ET3 groups, indicating two and three embryos were respectively transferred. Pregnancy outcomes were compared between ET2 and ET3 groups. Chi square and student t tests were used for data analysis. Results: Clinical pregnancy and live birth rates were similar between two groups. The rates of multiple pregnancies were 27 and 45.2% in ET2 and ET3 groups, respectively. The rate of multiple pregnancies in young women was significantly increased when triple instead of double embryos were transferred. Logistic regression analysis indicated two significant prognostic variables for live birth that included number and quality of transferred embryos; it means that the chance of live birth following ICSI treatment increased 3.2-fold when the embryo with top quality (grade A) was transferred, but the number of ET had an inverse relationship with live birth rate; it means that probability of live birth in women with transfer of two embryos was three times greater than those who had three ET. Conclusion: Due to the difficulty of implementation of the elective single-ET technique in some infertility centers in the world, we suggest transfer of double instead of triple embryos when at least one good quality embryo is available for transfer in women aged 39 years or younger. However, to reduce the rate of multiple pregnancies, it is recommended to consider the elective single ET strategy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the pregnancy outcomes of those patients with balanced reciprocal translocations after conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), and to provide valuable reference for genetic counseling and assisted reproductive technology (ART) treatment. Methods: Forty- one patients with balanced reciprocal translocation (the study group) and 751 couples with normal karyotypes (the control group) were included. Clinical pregnancy outcomes were compared between the two groups. Results: In the study group, 24 patients were treated with IVF, while other patients treated with ICSI. Additionally, 28 patients were diagnosed as primary infertility, and 11 patients had a history of adverse pregnancy or childbearing. There were not significant differences in the maternal age, number of retrieved oocytes, number of M II oocytes, number of transferred embryo, clinical pregnancy rate, late abortion rate, ectopic pregnancy rate, fetal malformation rate, stillbirth rate, live birth rate, live birth rate per ovum pick-up (OPU) cycle between the two groups (P>0.05). However, there was significant differences in the embryo implantation rate and early miscarriage rate (P<0.05). Nineteen patients in the study group delivered a total of 22 babies in 27 pregnancy cycles. Conclusions: Those balanced reciprocal translocation carrier could achieve an ideal pregnancy outcome when treated with conventional IVF/ICSI and prenatal diagnosis which is an economical and effective treatment for those patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of the collected oocytes by controlled ovarian stimulation (COS, long GnRHa protocol) on the clinical outcomes of intracytoplasmic sperm injection (ICSI). Methods: All couples (1 042 cycles) who underwent ICSI because of male factor were involved in this retrospective study, from January 2007 to June 2013 in our center. Those cycles were divided into 4 groups according to the number of collected oocytes: G1 as ≤4 oocytes(90 cycles), G2 as 5-10(368 cycles), G3 as 11-20 oocytes(449 cycles) and G4 as ≥21 oocytes (135 cycles). Results: In the ICSI treatment cycle, the mean age in G1 was highest among 4 groups (P<0.01), while 57.8% women were aged <35. The total fertilization failure(TFF) rate in G1, the ovarian hyperstimulation syndrome (OHSS) rate in G4 and the rates of cancelled transfer cycles in G1 and G4 were significantly higher than those in G2 and G3 (P<0.01). The rate of clinical pregnancy in G1 was the lowest in 4 groups (31.3%, P<0.05). The rate of clinical pregnancy, the implant rate and the live birth rate in G3 were the highest in 4 groups (P<0.05). Conclusions: In the ICSI treatment cycle, the number of collected oocytes lower than 4 has negative effect on fertilization; the collected oocytes between 11 to 20 have good clinical outcomes. [ABSTRACT FROM AUTHOR]

The motile sperm organelle morphology examination (MSOME), a morphological analysis of isolated motile spermatozoa in real-time at more than 6 000 times magnification, can help embryologist to select those sperms with normal morphology for intracytoplasmic sperm injection (ICSI). MOSME is a very special method to identify sperm head vacuoles. What are sperm vacuoles? Whether may sperm vacuoles influence the outcome of ART? This article reviewed those characteristics of sperm vacuoles as follows: (1)Vacuoles were commonly found in sperm head; (2)Vacuoles were distributed more frequently in the anteromedian region of sperm head; (3)There were different types of vacuoles; (4)The origin of sperm vacuoles was still unsure; (4)There were correlation in a certain extent between sperm vacuoles and routine semen parameters. It was found, although unasserted, that sperm vacuoles were positively correlated with abnormal chromatin condensation, DNA fragmentation rate, and aneuploid rate; (6)Spern vacuoles could lead to the lowed fertilization rate, the lowed rate of high-qualified embryo, and the lowed rate of clinical pregnancy specially. [ABSTRACT FROM AUTHOR]

Background: Clinical reproductive centers produce large amounts of surplus poor-quality embryos annually, how to maximize the use of these embryos, and which of them have the potential to develop into blastocyst stage and influencing factors were lack of systematic research. Objective: To investigate the fate of surplus poor-quality embryos which were cultured to obtain blastocyst, determine the factors which may influence the blastulation, and discuss their application in predicting of the pregnancy outcomes. Materials and Methods: Day 3 (D3) after embryo transfer and freezing, surplus poor-quality embryos from IVF/ICSI cycles were cultured to blastocyst by the sequential method, then the blastulation outcomes were observed. Focusing on the blastulation rate of those embryos with different number cells and different embryonic grade; and last the relationship between the pregnancy outcomes of remained poor-quality embryos with successful blastulation or failed blastulation groups were studied. Results: Of 127 patients with 569 poor-quality in vitro cultured embryos, there were formation of 248 blastocysts from 91 patients (43.59%), which lead to development of 138 high-quality blastocysts (24.25%). With the increase in cells number of D 3 blastomeres, the blastulation rate gradually increased, that, 7-cell blastomeres blastulation rate was the highest (70.59%), and 8-cell blastomeres is a little below (70.37%); while the embryonic levels and blastulation rate did not show this positive relationship. The clinical pregnancy rate and implantation rate of those who had successful blastulation (67.03% and 42.39%) were higher than of those who failed to develop to blastocyst (p=0.039). Conclusion: Day 3 poor-quality embryos with successful blastulation or with failed blastulation had predictive value on pregnancy outcomes. For embryo transfer 7-8 cells grade III-IV embryo is better than 4-5 cells grade I-II embryo, in case of lack good-quality embryos. [ABSTRACT FROM AUTHOR]

Background: With introduction of intracytoplasmic sperm injection with testicular sperm extraction or precutaneouse epididymal sperm aspiration, effective treatment was provided for azoospermic men. The aim of present study was to compare clinical outcome following intracytoplasmic sperm injection using extracted testicular/epididymal sperm or ejaculated severe oligoasthenoteratozoospermic sperm. Methods: After retrospective evaluation of more than four hundred medical records of patients undergoing intracytoplasmic sperm injection Mehr medical institute (between 2011-2012), 45 cycles with severe eligoasthenoteratozoospermia and 34 cycles with azoospermia were included. Patients were treated with gonadotropin releasing hormone agonist. The clinical characteristics and intracytoplasmic sperm injection outcome such as the rate of fertilization, implantation and clinical pregnancy were compared between the two groups. Results were presented as mean±standard deviation and number (percent). Differences between variables were analyzed using student's t test and the chi-square test was used to examine differences between categorical variables. P value less than 0.05 were considered as statistically significant. Results: Mean of female age (29±4.9 vs. 30.2±5.8), body mass index (26.9±5.3 vs. 26.9±3.8), estradiol level on human chorionic gonadotropin administration day (1375.6±843.9 vs. 1181.8±673.1), total number of retrieved oocytes (9.7±5.3 vs. 9.2±5.9) and metaphase II oocytes (7.7±5.1 vs. 7.5±5.4) were similar between the two groups. Of 436 and 313 retrieved oocytes, respectively 232 and 163 oocytes were fertilized in oligoasthenoteratozoospermic and azoospermic groups (53.2% vs. 52.1%, P=0.214). There were not statistical differences between groups in number of transferred top quality embryos (1.5±1.2 vs. 1±1.2, P=0.09), implantation rate (22.7% vs. 16.9%, P=0.238) and clinical pregnancy rate (21 (47.7%) vs. 11 (35.4%), P=0.199). Conclusion: Intracytoplasmic sperm injection with precutaneouse epididymal sperm aspiration and testicular sperm extraction are effective methods to treat azoospermic men and its clinical outcome were comparable to ejaculated sever oligoasthenoteratozoospermic cycles. It can be concluded that the influence of sperm quality and origin on intracytoplasmic sperm injection outcome are the same. [ABSTRACT FROM AUTHOR]

Objective:To explore the effects of two criteria of hCG administration on the clinical outcomes of IVF/ICSI -ET. These criteria were individually based on the follicle diameter and the follicle symmetry. Methods: It's a prospective randomized study in our hospital reproductive center. IVF/ICSI-ET patients were randomly divided into two groups from Jan 2013 to Mar 2013. The criterion of hCG administration in Group A was based on the follicle diameter, while Group B on the follicle symmetry. Clinical and laboratory outcomes were then compared. Results: The average days of Gn, serum levels of progesterone and estradiol on the hCG day, the average number of matured eggs, and the rate of matured oocytes of group B were significantly higher than those of group A(P<0.05). There was not significant difference in the numbers of frozen embryos and good quality embryos between the two groups. However, the clinical pregnancy rate of group B was significantly lower than that of group A (42.19% vs. 54.22%, χ²=4.18, P=0.04), and the incidence of OHSS in group B significantly higher than that of group A(10.77% vs. 5.86%, χ²=4.07,P=0.04). Conclusions: The criterion based on the uniform size of follicular is not superior to the traditional criterion focused on the dominant follicle size in the efficacy and safety of IVF/ICSI-ET treatment. [ABSTRACT FROM AUTHOR]

Introduction Infertility affects 15-17% of reproductive age couples in our country, and 10-15% of couples worldwide. The aim of this paper was to present results and experience gained after the first 1000 cycles of the national In Vitro Fertilization (IVF) program, to offer professional standard of work in our country and to compare it with results obtained in Europe and worldwide. Material and methods The study prospectively included 1000 women who had undergone national In Vitro Fertilization program from October 2006 until November 2009 at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina, Novi Sad. Results The analysis included 1000 in vitro fertilization cycles. Male factor infertility was the leading cause (56.9%) followed by tubal factor (45.9%). The classic method of in vitro fertilization constituted 72.3% of all cycles, while intracytoplasmic sperm injection (ICSI) method was used in 27.7% of all cycles. The average number of embryos transferred was 2.67. The cycle cancellation rate was 14.10% and the aspiration rate was 94.40%. The clinical pregnancy and live birth rate were 33.41% and 26.78% per embryo transfer, respectively. Discussion and conclusion The results in our study showed that in our setting there are far less intracytoplasmic sperm injection cycles compared with the European average of 66.5% of all fresh cycles, and that we transferred more embryos on average. Our success rates are comparable with those in other European countries where the clinical pregnancy rates per aspiration and per transfer for in vitro fertilization were 29 and 32.4%, respectively in the period of observation. For intracytoplasmic sperm injection, the corresponding rates were 29.9 and 33%. [ABSTRACT FROM AUTHOR]

This article focuses on the in vitro fertilization technique that uses intracytoplasmatic sperm injection and addresses both the technical and ethical and legal aspects of this. This technique differs from others as it involves the injection of a single live sperm into the cytoplasm of the oocyte and is one of the principal alternative treatments for male infertility, mainly for couples where the man has a significantly reduced sperm-count or sperm-mobility. It is worth pointing out that rapid advances are being made in assisted reproduction and this has given rise to controversial issues relating to the beginning of embryonic life and genetic manipulation. It is thus important to reflect on this subject and consider where ethical boundaries lie. There is therefore urgent need for regulation in this area, despite the advances already achieved by the new Civil Code and Biosafety Law. [ABSTRACT FROM AUTHOR]

This article focuses on the in vitro fertilization technique that uses intracytoplasmatic sperm injection and addresses both the technical and ethical and legal aspects of this. This technique differs from others as it involves the injection of a single live sperm into the cytoplasm of the oocyte and is one of the principal alternative treatments for male infertility, mainly for couples where the man has a sign ificandy reduced sperm-count or sperm-mobility. It is worth pointing Out that rapid advances are being made in assisted reproduction and this has given rise to controversial issues relating to the beginning of embryonic life and genetic manipulation. It is thus important to reflect on this subject and consider where ethical boundaries lie. There is therefore urgent need for regulation in this area, despite the advances already achieved by the new Civil Code and Biosafety Law. [ABSTRACT FROM AUTHOR]

Sperm morphology is closely related to male fertility. Abnormal sperm morphology is one of main causes of male infertility. Since the intracytoplasmic sperm injection (ICSI) was successfully developed in 1992, it has helped so many infertile couples with abnormal sperm parameters to obtain their children. Under a magnification of x400, the only major defects in sperm morphology could be found. Those sperms with many abnormities in subcellular organelles might not be identified, which could affect the success rate of ICSI. The motile sperm organelle morphology examination (MSOME) established by Bartoov in 2001 allowed to assess the subcellular organelles of sperm under high magnification, which is helpful to pick out sperm with normal morphology. The intracytoplasmic morphologically selected sperm injection (IMSI), combined MS0ME with ICSI, provided a new technique for the clinical ICSI practice. [ABSTRACT FROM AUTHOR]

The aim of our study was to describe labour characteristics after intracytoplasmic sperm injection programe. This is the first study of those deliveries at the Department of Gynecology and Obstetrics in Novi Sad. Patients and methods Subjects were 73 parturients and their babies from the intracytoplasmic sperm injection programe (48 singletons, 22 twins and 3 triplets), delivered from January 1st, 2001 to December 31st, 2006. Results At the Department of Gynecology and Obstetrics in Novi Sad. 0.65% of all deliveries are those from assisted reproductive programes. 30.67% of all labours after assisted reproductive programes ore after intracytoplasmic sperm injection. One half of all labours after intracytoplasmic sperm injection are twins. The mean age of women is 33-34. More than 95%of all babies were delivered by Cesarean section. Discussion The most frequent pathologies in labours after intracytoplosmic sperm injection are hypertensive disorders and premature rupture of membranes. There is still a matter of debate what is a real cause for those pathologies, especially far hypertension (age of woman, laboratory factors and/or induction of ovulation). Conclusion At the Department of Gynecology and Obstetrics in Novi Sad, one third of all deliveries after assisted reproductive programe are after intracytoplasmic sperm injection. The most frequent pathologies after intracytoplasmic sperm injection are hypertensive disorders, which is similar to findings of other authors. The mean age of women is also similar to the mean European age of women after intracytoplasmic sperm injection. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of conventional in vitro fertilization (IVF)and intracytoplasmic sperm injection (ICSI)in older patients with poor ovarian response. Methods:The data of 381 in vitro fertilization-embryo transfer (IVF-ET) cycles of older patients (≥ 40 years old)with poor ovarian response were analyzed retrospectively. Those cycles were divided into two groups, IVF group (conventional IVF, 200 cycles) and ICSI group (181 cycles). Fertilization rate and clinical pregnancy rate were compared between two groups. Results: The fertilization rate and clinical pregnancy rate in the IVF group were insignificantly higher than those in the ICSI group, while the rate of effective cycles and high quality embryos in the ICSI group were very limitedly higher than those in the IVF group. However, there were not statistically differences in those rats between two groups (P>0.05). Conclusions: ICSI treatment did not increase fertilization rate and clinical pregnancy rate in IVF-ET cycles in those patients at ≥ 40 years with poor ovaian response. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of days of the elevated serum progesterone before hCG administration on the outcomes of IVF/ICSI-ET treatment. Methods: 2 905 cases of IVF/ICSI -ET treatment, from June 2012 to June 2013, were divided into two groups according to whether finding the follicle (s) of diameter ≥ 20 mm (Group A 2 725 cases, and Group B 180 cases) on the hCG day. Two groups were respectively divided into 3 subgroups according to days of the elevated level of progesterone (>1 ng/mL). Group A1 (1 788 cases) and B1 (83 cases) had 0 day of the elevated level of progesterone. Group A2 (717 cases) and B2 (67 cases) had 1-2 days of the elevated level of progesterone. Groups A3 (220 cases) and B3 (30 cases) had ≥3 days of the elevated level of progesterone. The clinical pregnancy rates of groups were meticulously compared. Results: There was significant difference in the clinical pregnancy rates among the Group A1 (55.42%), A2 (44.21%) and A3 (41.81%, P<0.01). Interestingly, there was no significant difference in those rates among the Group B1 (48.19%), B2 (47.76%) and B3 (46.66%, P>0.05). Conclusions: The clinical pregnancy rate could decrease following days of the elevated level of serum progesterone (>1 ng/mL) in those IVF/ICSI-ET patients with the follicle(s) of diameter ≥20 mm on the hCG day. [ABSTRACT FROM AUTHOR]

Following the development of intracytoplasmic sperm and haploid spermatid injection techniques, the cryopreservation technology of male germ cell, as important part of assisted reproductive technology (ART), has played a key role in the ART treatment for the couples with male infertility. Freezing methods of male germ cells include the programmed cryopreservation and vitrification freezing. Cryoprotectant, usually classified as permeable and impermeable cryoprotective agents,could minimize the cell injuries during the freeze-thaw. Various frozen carriers such as cryoloop and cryoleaf are widely used in cell cryopreservation. In this paper, the freezing method,carrier,cryoprotectants and frozen effect of male germ cell were reviewed. [ABSTRACT FROM AUTHOR]

• Embryo implantation dysfunction, is considered as one of the most important causes of recurrent implantation failure. • RIF remains a significant challenge in patients undergoing in vitro fertilization (IVF) procedures. • Intra-uterine administration of PBMC, increases the clinical pregnancy rate in patients experienced RIF. Prior studies have provided conflicting results regarding the use of platelet-rich plasma (PRP) in women undergoing in-vitro fertilization (IVF) or intracytoplasmic injection (ICSI). The objective of this study was to evaluate the effect of the intrauterine infusion of PRP on the outcome of embryo transfer (ET) in women undergoing IVF/ICSI. We searched databases, including PubMed, Embase, Scopus, Web of Science, and the Cochrane Database of Clinical Trials (CENTRAL). Meta-analysis using a random-effects model was performed to calculate the pooled estimates. Seven studies involving 625 patients (311 cases and 314 controls) were included. The probability of chemical pregnancy (n = 3, risk ratio (RR): 1.79, 95 % confidence intervals (CI): 1.29, 2.50; P < 0.001, I2 = 0 %), clinical pregnancy (n = 7, RR: 1.79, 95 % CI: 1.37, 2.32; P < 0.001, I2 = 16 %), and implantation rate (n = 3, RR: 1.97, 95 % CI: 1.40, 2.79; P < 0.001, I2 = 0 %) was significantly higher in women who received PRP compared with control. There was no difference between women who received PRP compared with control group regarding miscarriage (RR: 0.72, 95 % CI: 0.27, 1.93; P = 0.51, I2 = 0 %). Following the intervention, endometrial thickness increased in women who received PRP compared to control group (SMD: 1.79, 95 % CI: 1.13, 2.44; P < 0.001, I2 = 64 %). The findings of this systematic review suggest that PRP is an alternative treatment strategy in patients with thin endometrium and recurrent implantation failure (RIF). Further prospective, large, and high quality randomized controlled trials (RCTs) are needed to identify the subpopulation that would most benefit from PRP. [ABSTRACT FROM AUTHOR]

Objective: To evaluate at the age of 5 years the behavioral, cognitive, and motor performance and physical development of children born after testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI).Design: A prospective longitudinal cohort study.Setting: Two university medical centers.Patient(s): A total of 103 5-year-olds who were born after TESE-ICSI.Intervention(s): The follow-up of the children was performed by questionnaires at birth and again at 1 year and at 4 years of age. Five-year-old children were invited for individual assessment. Behavioral performance was assessed with the use of the Child Behavior Checklist for parents and teachers. Cognitive performance was assessed with the use of the Dutch Wechsler Preschool and Primary Scale of Intelligence test, 3rd version. Motor performance was assessed with the use of the Dutch Movement Assessment Battery for Children, 2nd version. Physical development was assessed by means of physical examination and medical history.Main Outcome Measure(s): Behavioral, cognitive, and motor performance and physical development.Result(s): Eighty-nine children were completely assessed, and 14 were partially assessed at the age of 5 years. The 5-year-old cohort assessed significantly better on behavioral and cognitive performance and significantly worse on motor performance-but still in the normal range-compared with the theoretic distribution in the general population. Four children (3.8%) of the 5-year-old cohort had developmental problems/delays. Two of them were previously diagnosed with a form of autism (pervasive developmental disorder-not otherwise specified). Two children had developmental problems based on our behavioral, cognitive, and/or motor assessments.Conclusion(s): The long-term effects on development and health in children born after TESE-ICSI procedures seem to be reassuring. [ABSTRACT FROM AUTHOR]