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The leading indicator for successful outcomes in in-vitro fertilization (IVF) is the quality of gametes in oocytes and sperm. Thus, advanced research aims to highlight the parameter in assessing these qualities – DNA fragmentation in sperm and oocyte development capacity (ODC) via evaluation of microenvironments involving its maturation process. Regarding oocytes, most evidence reveals the role of cumulus cells as non-invasive methods in assessing their development competency, mainly via gene expression evaluation. Our review aims to consolidate the evidence of GDF-9 derivatives, the HAS2, GREM1, and PTGS2 gene expression in cumulus cells used as ODC markers in relevant publications and tailored to current IVF outcomes. In addition to that, we also added the bioinformatic analysis in our review to strengthen the evidence aiming for a better understanding of the pathways and cluster of the genes of interest - HAS2, GREM1, and PTGS2 in cumulus cell level. Otherwise, the current non-invasive method can be used in exploring various causes of infertility that may affect these gene expressions at the cumulus cell level. Nevertheless, this method can also be used in assessing the ODC in various cohorts of women or as an improvement of markers following targeted tools or procedures by evaluating the advancement of these gene expressions following the targeted intervention.

IntroductionStress and infertility form a complex relationship. In line with this, various stress-related biological markers have been investigated in infertility.MethodsThis systematic review was performed using PRISMA guidelines (i) to report whether cortisol is highly present in infertile patients compared to fertile control; (ii) to report whether there is any significant difference in the cortisol level in infertile subjects that conceive and those that didn’t at the end of assisted reproduction treatments. Original articles involving human (male and female) as subjects were extracted from four electronic databases, including the list of references from the published papers. Sixteen original full-length articles involving male (4), female (11), and both genders (1) were included.ResultsFindings from studies that compared the cortisol level between infertile and fertile subjects indicate that (i) Male: three studies reported elevated cortisol level in infertile patients and one found no significant difference; (ii) Female: four studies reported increased cortisol level in infertile subjects and three studies found no significant difference. Findings from studies that measured the cortisol level from infertile patients that conceived and those that didn’t indicate that (i) Male: one study reported no significant difference; (ii) Female: one study reported elevated cortisol in infertile patients that conceived, whereas two studies reported increased cortisol in infertile patients that was unable to conceive. Five studies found no significant difference between the groups.DiscussionIn the present review we only included the cortisol value that was measured prior to stimulation or IVF treatment or during natural or spontaneous cycles, despite this, there are still variations in the sampling period, assessment techniques and patients’ characteristics. Hence, at present, we are still unable to conclude that cortisol is significantly elevated in infertile patients. We warrant future studies to standardize the time of biological sample collection and other limitations that were addressed in the review to negate the unwanted influencing factors.

Simple Summary: Oocyte quality is essential in reflecting the overall IVF outcome. Thus, evaluating its quality is vital as a precursor to improving the overall cycle performance in IVF centers. To date, various methods are used for oocyte quality measures, but they need to be standardized depending on the tool and advancement of each center. The optimal reproducibility and standard measures of the oocyte quality method still need to be more conclusive. Hence, we elaborated via systematic review on the current technique of oocyte quality assessment that has been implemented worldwide. Our outcome revealed that morphological assessment via oocyte quality scoring provided an excellent, cost-effective prediction and was easily implemented even in low-resource centers. However, the learning curve is considered challenging in reducing bias; thus, a proper training protocol should be advocated. Our results added value as a current insight into oocyte quality assessment for optimizing the IVF outcome worldwide. An overall in vitro fertilization (IVF) outcome is dynamic. Good oocyte quality is important for achieving a better IVF pregnancy. Various methods have been used for OQ assessment (OQA). However, due to inconclusive evidence, one method's superiority has not been proposed over others. Thus, OQA should be consolidated based on the current evidence for this matter. Our study aims to summarize the current OQA used and compare their recommended methods. Our results revealed that the optimal OQA for cost-effectiveness and clinical implementation is still via morphological assessment. The current method most opted for is total oocyte scoring. Although other methods—follicular fluid evaluation, mitochondria spindle assessment, or live zona imaging—can be applied with better precision, due to cost, additional tools, and expertise, and they should cater to research purposes and selected centers. Our results added value as a current strategy for optimizing OQA in IVF practice, aiming at cost-effectiveness and reproducibility for better clinical implementation. [ABSTRACT FROM AUTHOR]

Overactivation of the angiotensin-converting enzyme (ACE)/angiotensin II type 1 receptor (AT1R) pathway leads to vasoconstriction and elevated blood pressure. Persicaria minor (Huds.) Opiz is an herbal plant known for its antioxidant, anti-hyperlipidemic, and anti-atherosclerotic properties, with bioactive compounds that exhibit antihypertensive effects. Therefore, this study aimed to evaluate the antihypertensive effects of the standardized aqueous extract of P. minor leaf (AEPM) through the ACE/AT1R pathway in human umbilical vein endothelial cells (HUVECs) induced with phorbol 12-myristate 13-acetate (PMA). HUVECs were stimulated with PMA to induce ACE, with or without AEPM or captopril treatment, for 24 h. Subsequently, ACE mRNA expression, ACE protein levels, ACE activity, angiotensin II levels, and AT1R expression were measured. The results demonstrated that AEPM treatment significantly reduced ACE mRNA expression, ACE protein levels, ACE activity, angiotensin II levels, and AT1R expression in PMA-induced HUVECs. The modulatory effects of AEPM on the ACE/AT1R pathway were comparable to those of captopril. Ex vivo experiments further confirmed that AEPM reduced the contraction responses of rat aortic rings to PMA. In conclusion, P. minor effectively inhibits the ACE/AT1R pathway in PMA-induced HUVECs, suggesting its potential as a natural antihypertensive agent. [ABSTRACT FROM AUTHOR]

A major breakthrough in developmental biology is the ex vivo generation of synthetic human embryos from stem cells. A comprehensive, in-depth bioethical analysis from a Sunni Islamic perspective reveals that the reproductive applications of synthetic human embryos contravene Islamic precepts of preserving lineage integrity (Hifz al-Nasl) due to disruption and confusion of kinship and familial relationships, similar to human cloning with somatic cell nuclear transfer. However, their non-reproductive applications in generating replacement tissues/organs, serving as in vitro experimental models of human development and disease, and testing platforms for evaluating pharmaceuticals and biomedical devices appear to align with Islamic principles. [ABSTRACT FROM AUTHOR]

ObjectiveTo verify understanding and awareness of fertility preservation (FP) in pediatric patients undergoing FP treatments.MethodsA questionnaire survey was conducted before and after explanation of fertility issues and FP treatments for patients 6–17 years old who visited or were hospitalized for the purpose of ovarian tissue cryopreservation (OTC) or oocyte cryopreservation (OC), or sperm cryopreservation between October 2018 and April 2022. This study was approved by the institutional review board at St. Marianna University School of Medicine (No. 4123, UMIN000046125).ResultParticipants in the study comprised 36 children (34 girls, 2 boys). Overall mean age was 13.3 ± 3.0 years. The underlying diseases were diverse, with leukemia in 14 patients (38.9%), brain tumor in 4 patients (11.1%). The questionnaire survey before the explanation showed that 19 patients (52.8%) wanted to have children in the future, but 15 (41.7%) were unsure of future wishes to raise children. And most children expressed some degree of understanding of the treatment being planned for the underlying disease (34, 94.4%). Similarly, most children understood that the treatment would affect their fertility (33, 91.7%). When asked if they would like to hear a story about how to become a mother or father after FP which including information of FP, half answered “Don’t mind” (18, 50.0%). After being provided with information about FP treatment, all participants answered that they understood the adverse effects on fertility of treatments for the underlying disease. Regarding FP treatment, 32 children (88.9%) expressed understanding for FP and 26 (72.2%) wished to receive FP. “Fear” and “Pain” and “Costs” were frequently cited as concerns about FP. Following explanations, 33 children (91.7%) answered “Happy I heard the story” and no children answered, “Wish I hadn’t heard the story”. Finally, 28 of the 34 girls (82.4%) underwent OTC and one girl underwent OC.DiscussionThe fact that all patients responded positively to the explanations of FP treatment is very informative. This is considered largely attributable to the patients themselves being involved in the decision-making process for FP.ConclusionsExplanations of FP for children appear valid if age-appropriate explanations are provided.

Objectives: Our review aimed to consolidate the latest update on the application of in vitro maturation among immature oocyte harvest in combination with ovarian tissue cryopreservation known as ovarian tissue oocyte–in vitro maturation. Methods: A thorough search for relevant studies was conducted via PubMed, Google Scholar, EMBASE, and clinical.gov databases up to December 2020. The primary outcome was the oocyte maturation rate, which measured the number of immature oocytes (geminal vesicle stage) that progressed to mature oocytes (meiosis II stage) following in vitro maturation. The secondary outcomes were the fertilization rate following intracytoplasmic sperm injection/in vitro fertilization of these oocytes for the embryo cryopreservation cohort. Our review included pre-pubertal girls and women with cancer who underwent ovarian tissue oocyte–in vitro maturation as fertility preservation. Results: The primary search identified 207 studies. Twelve manuscripts were selected for inclusion in our review following duplication assessment, title and abstract screening, and full-text evaluation tailored to our inclusion criteria. All the population belonged to a cancer group and underwent concurrent ovarian tissue oocyte–in vitro maturation. A total of 5724 immature oocytes were obtained following ovarian tissue cryopreservation. Approximately 33.84% of the immature oocytes successfully matured via in vitro maturation, which were cryopreserved as oocytes or fertilized as embryos and subsequently stored for future use. Conclusion: Our review proposed the potential application of ovarian tissue oocyte–in vitro maturation in increasing the number of mature oocytes. The acceptable improvement in oocyte maturation rate following in vitro maturation indicates that improving oocyte outcomes is an excellent cost-effective strategy for fertility preservation among women with cancer.

The COVID-19 infection is an infectious disease characterized by severe respiratory symptoms and was discovered as a terminal infection starting in December 2019 in Wuhan China. In Malaysia, our first Covid-19 positive cases found on 25 January 2020. Subsequently, there was an increasing trend of confirmed cases leading to the implementation of Movement Restriction Order (MCO) Act starting on 18 March 2020 aiming to flatten the infection curve. During this pandemic, UKM Medical Centre services were modified as hybrid-COVID-19 cluster hospital and treating both confirmed COVID-19 cases and standard cases. This modification is significantly affected overall our health management, including our oncofertility services. We were sharing the experience of the impact of Covid-19 toward our oncofertility services and modification to overcome it. We experience the reduction of oncofertility services uptake during this period due to both clinician and patient attitude while combating the pandemic Covid-19 battle in Malaysia.