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Copyright of Deutsche Zeitschrift für Akupunktur is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

No increased risk of postpartum major depression (PPMD) was reported in women conceiving through assisted reproductive technologies (ART). However, ART may be associated with a higher risk of parenting difficulties in women with PPMD. In 359 women with a PPMD admitted to a Mother-Baby Unit (MBU), ART-women (4.2%) showed a 5-fold higher rate of parenting difficulties than those with spontaneous pregnancy (73.33% vs. 35.17%, multivariate ORa = 5.09 [1.48–17.48] p = 0.01). Specific support for mother-child relationship should be implemented in ART-women with PPMD. [ABSTRACT FROM AUTHOR]

Objective: Although several studies have investigated the clinical outcomes of assisted reproductive techniques (ARTs) and male reproductive performance during the coronavirus disease 2019 (COVID-19) pandemic, few well-designed studies have focused on female reproductive performance after a recent mild to moderate COVID-19 infection. Methods: This cohort study of 75 participants was performed at Arash Women's Hospital, Tehran, Iran. The 35 participants in the exposed group were women with infertility who visited the hospital from October 2021 to February 2022 and were prospectively followed. The 40 participants in the non-exposed matched group were selected retrospectively from hospital patients who underwent ART before the COVID-19 pandemic. Study variables were compared between the non-exposed and exposed groups. Results: The exposed group had a non-significantly smaller total of retrieved oocytes and fewer mature oocytes than the non-exposed group (p=0.26, p=0.10). The numbers of total and transferred embryos were also lower in the exposed group, but these results were not statistically significant (p=0.27, p=0.77). The rate of spontaneous abortion was higher in the exposed group (43% vs, 11%), and the ongoing pregnancy rate was lower (57% vs, 89%); however, these differences were not statistically significant. Conclusion: Recent mild to moderate COVID-19 infection seems to have no detrimental effects on female reproductive performance and embryo transfer outcomes; however, considering the small sample size of the present study, the statistically insignificant differences in the exposed group—namely, fewer embryos, fewer retrieved oocytes, a lower ongoing pregnancy rate, and a higher spontaneous abortion rate—might be important from a clinical standpoint. [ABSTRACT FROM AUTHOR]

With the advancement of vitrification freezing technology, frozen-thawed embryo transfer (FET) plays a crucial role in assisted reproductive technology by preventing ovarian hyperstimulation syndrome, reducing ectopic pregnancy rates, and enhancing cumulative pregnancy rates. The proportion of FET cycles in assisted reproduction has been increasing annually, establishing FET as a key component of reproductive technologies. The outcome of FET pregnancies is influenced by various factors, including age, embryo quality, endometrial thickness, endometrial preparation protocols, DNA fragmentation, and Y chromosome microdeletions. Age, embryo quality, and endometrial receptivity are pivotal factors determining the success of FET treatments, directly impacting embryo development, implantation, and pregnancy success rates. Therefore, identifying the influencing factors of FET pregnancy outcome, so as to implement more precise, personalized and targeted prevention to improve pregnancy rates, has become a research hotspot. This review aims to summarize the relevant factors affecting the outcome of FET pregnancies, providing a reference for clinical decision. [ABSTRACT FROM AUTHOR]

With the development of assisted reproductive technology (ART), ovarian hyperstimulation syndrome (OHSS) as a main iatrogenic complication is also inevitable, which further increases the risk of ovarian torsion. The clinical symptoms and imaging characteristics of the patient with OHSS combined with ovarian torsion are relatively atypical, which means that the early identification and diagnosis of this acute abdomen is difficult. We report a case of OHSS combined with ovarian torsion before egg retrieval during ART treatment. The conservative treatment after egg retrieval was ineffective, and ultimately surgical treatment was still inevitable. This case suggests that the understanding of OHSS complicated with ovarian torsion should be strengthened during ART treatment, so as to achieve the early identification, early diagnosis and early treatment of this acute abdomen. [ABSTRACT FROM AUTHOR]

ABSTRACT Varicocele can reduce male fertility potential through various oxidative stress mechanisms. Excessive production of reactive oxygen species may overwhelm the sperm's defenses against oxidative stress, damaging the sperm chromatin. Sperm DNA fragmentation, in the form of DNA strand breaks, is recognized as a consequence of the oxidative stress cascade and is commonly found in the ejaculates of men with varicocele and fertility issues. This paper reviews the current knowledge regarding the association between varicocele, oxidative stress, sperm DNA fragmentation, and male infertility, and examines the role of varicocele repair in alleviating oxidative-sperm DNA fragmentation in these patients. Additionally, we highlight areas for further research to address knowledge gaps relevant to clinical practice.

The incidence of ectopic pregnancy (EP) has increased in recent years, owing to causes such as pelvic inflammatory diseases and assisted reproductive technologies (ART). The present study reported a case of a 33-year-old nulliparous woman with a history of previous ectopic pregnancies, who underwent pelvic ultrasound in August 2022, which revealed a double EP including a cervical pregnancy and a tubal stump pregnancy. Despite known risk factors and elevated beta-human chorionic gonadotropin (β-hCG) levels, a conservative approach, utilizing multiple doses of systemic methotrexate (MTX) injections, was employed to preserve fertility at the Regional Perinatal Center in Aktobe, Kazakhstan. Treatment efficacy was monitored through β-hCG levels and ultrasound imaging, with successful resolution of both EPs and preservation of reproductive function. The present case highlighted the safety and efficacy of MTX therapy in managing complex EP presentations, emphasizing the necessity of individualized treatment approaches in reproductive medicine, particularly in terms of preserving fertility in patients undergoing ART. Multiple high doses of MTX injections were beneficial for pregnancy with two distinct regions, fetal cardiac activity, and elevated serum β-hCG level. Further research is required to explore optimal treatment strategies for EP, considering patient-specific factors and treatment goals.

Human papilloma virus (HPV) infection is one of the most common sexually transmitted diseases, which is associated with the development of tumors in multiple organs. In recent years, the impact of HPV infection on fertility has garnered significant attention, particularly its vertical transmission through germ cells and potential effects on early embryonic development. Studies have shown that HPV infection may affect sperm quality, leading to infertility, and may also interfere with embryonic development, increasing the risk of spontaneous abortion and adversely affecting pregnancy outcomes in assisted reproductive technology. This review summarizes the research progress on the vertical transmission of HPV through sperm cells and its impact on early embryonic development, to deeply understand the potential threat of HPV to reproductive health and to provide references for clinical practice and further research. [ABSTRACT FROM AUTHOR]

Abstract Objective To compare outcomes in patients with repeated implantation failure undergoing Intracytoplasmic Sperm Injection/In vitro fertilization (IVF/ICSI) plus immunosuppressants such as prednisolone, prednisone, or cyclosporine A versus the use of IVF/ICSI alone. Data source Databases were systematically searched in PubMed, Cochrane, and Embase databases in September 2023. Study Selection Randomized clinical trials and observational studies with the outcomes of interest were included. Data collect We computed odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics. Data were analyzed using Review Manager 5.4.The main outcomes were live birth, miscarriage, implantation rate, clinical pregnancy, and biochemical pregnancy. Data synthesis Seven studies with 2,829 patients were included. Immunosuppressive treatments were used in 1,312 (46.37%). Cyclosporine A improved implantation rate (OR 1.48; 95% CI 1.01-2.18) and clinical pregnancy (1.89, 95% CI 1.14-3.14). Compared to non-immunosuppressive treatment, prednisolone and prednisone did not improve live birth (OR 1.13, 95% CI 0.88-1.46) and miscarriage (OR 1.49, 95% CI 1.07-2.09). Prednisolone showed no significant effect in patients undergoing IVF/ICSI, clinical pregnancy (OR 1.34; 95% CI 0.76-2.36), or implantation rate (OR 1.36; 95% CI 0.76-2.42). Conclusion Cyclosporine A may promote implantation and clinical pregnancy rates. However, given the limited sample size, it is important to approach these findings with caution. Our results indicate that prednisolone and prednisone do not have any beneficial effects on clinical outcomes of IVF/ICSI patients with repeated implantation failure. PROSPERO CRD42023449655

The patients undergoing the treatment of assisted reproductive technology, as a special group that is different from other groups of diseases, are prone to sleep disorders due to the impact of physiological and psychosocial factors. In this review, the current status, assessment tools, and non-pharmacological intervention of sleep disorders in patients undergoing assisted reproductive technology were introduced. The appropriate tools were used to evaluate the degree of sleep disorders effectively. The appropriate intervention measures can improve the sleep quality of patients, including digital cognitive behavioral therapy, mindfulness-based stress reduction, music therapy, aerobic and resistance exercises and progressive muscle relaxation. This review will provide a reference for the evaluation of sleep disorders and non-pharmacological intervention for those patients undergoing assisted reproductive technology for pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To explore the influencing factors of hypertensive disorders of pregnancy (HDP) after frozen embryo transfer (FET) by a predictive model of HDP. Methods: The clinical data of FET cycles in the Reproductive Medicine Center of the First Hospital of Lanzhou University from January 2019 to May 2023 were included. The cycles that meet the exclusion criteria were excluded. The general clinical data, FET-related data and HDP incidence of the included patients were statistically analyzed. The least absolute shrinkage and selection operator (LASSO) regression technique was used to select the predictors. According to the ratio of 7∶3, the final 4 079 cycles were randomly assigned to the training set (n=2 855) and the validation set (n=1 224). The nomogram prediction model of HDP incidence was established by multiple Logistic regression analysis and use a nomogram to represent it. The area under the curve (AUC), Hosmer-Lemeshow goodness-of-fit test and decision curve analysis (DCA) were used to evaluate this model. Results: Seven non -zero coefficient variables were selected according to LASSO regression analysis. After multivariate Logistic regression analysis, seven factors including endometrial preparation, polycystic ovary syndrome (PCOS), endometriosis, diminished ovarian reserve, family history of hypertension, body mass index, and number of intrauterine gestational sacs were used as the predictors to establish a model and displayed in a nomogram. The AUC of the training set was 0.728, and the AUC of the validation set was 0.734. The Hosmer-Lemeshow test showed that the model fitted well (P=0.867, mean absolute error=0.004). DCA suggested that when the threshold probability of clinical pregnancy was between 7% and 64%, the application of this nomogram could increase the net benefit. Conclusions: The prediction model of HDP after FET has a certain ability to distinguish, which can provide reference for clinical practice, but further development of more effective predictive factors is still necessary. [ABSTRACT FROM AUTHOR]

Premature ovarian insufficiency (POI) is a clinical syndrome in women who develops ovarian insufficiency before the age of 40 years, which manifests itself as a weakening of reproductive and endocrine functions, and is one of the most important factors leading to female infertility, but the pathogenesis is unknown and the treatment is limited. Melatonin is a neuroendocrine hormone mainly synthesized and secreted by the pineal gland, which exerts effects in regulating circadian rhythms, antioxidant activity, and scavenging free radicals. Studies have shown that melatonin is involved in regulating ovarian steroid hormone synthesis, follicular development, ovulation and oocyte quality. Animal models for studies of POI have found that melatonin can alleviate oxidative stress, reduce apoptosis, regulate ovarian function and delay POI through the regulation of multiple signaling pathways. Clinical studies have shown that melatonin can improve ovarian function and pregnancy rate in POI patients. Its potential value in assisted reproduction provides a new direction to improve the fertility of POI patients. [ABSTRACT FROM AUTHOR]

Nowadays, sirolimus as a popular immunosuppressant has been frequently used to shield the organ transplant recipients from immunological rejection. The immunomodulatory effects of sirolimus in the female reproductive process have been demonstrated by ongoing medical study. By blocking the immune-regulating action of mammalian target of rapamycin, sirolimus may help those patients with recurrent implantation failure, recurrent spontaneous abortion, endometriosis, chronic endometritis, polycystic ovary syndrome, and other illnesses of the reproductive system. Additionally, sirolimus can enhance the rates of embryo implantation and clinical pregnancy in individuals with aberrant immunological statuses at the mother-fetal interface, reduce ovarian hyperstimulation syndrome during assisted reproductive treatment, and improve the pregnancy outcomes. A review was conducted on the mode of action, research status and safety of sirolimus in female reproductive disorders. [ABSTRACT FROM AUTHOR]

Copyright of Die Gynäkologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In assisted reproductive technology, it is very important to prevent the premature endogenous luteinizing hormone (LH) peak in process of controlled ovarian stimulation. Traditional controlled ovarian stimulation protocols with gonadotropin-releasing hormone (GnRH) analogues (GnRH agonists or antagonists) to inhibit the level of endogenous LH have many disadvantages such as high cost and inconvenient use. Progestin-primed ovarian stimulation (PPOS) protocol has been proved to achieve good clinical outcomes in various populations by the negative feedback effect of exogenous progesterone on pituitary gland to inhibit LH level, and its offspring safety has also been preliminarily confirmed. In this paper, the mechanism of PPOS, application of different exogenous progesterone drugs, application effects of different populations and offspring safety of PPOS were reviewed. [ABSTRACT FROM AUTHOR]

Twin reversed arterial perfusion sequence (TRAPS) is a rare and severe complication of monochorionic twin pregnancies, due to abnormal placental-fetal vascular anastomosis, which is characterized by absence of heart or loss of normal cardiac structure in one twin. We reported a case of triplet pregnancy complicated by TRAPS after assisted reproductive technology. Two cleavage-stage frozen embryos were transferred, one of which developed into monochorionic twin pregnology. The TRAPS was diagnosed by ultrasound at 8 +5 weeks. However, due to personal factors, the patient did not intervene in a timely manner and the pump twin died. Another single fetus developed normally until full term delivery. If the treatment is needed, as for the technique of choice to interrupt the vascular supply to the acardiac twin, the radiofrequency ablation of the intrafetal vessel is usually the preferred approach. However, the best timing of intervention is still debated. [ABSTRACT FROM AUTHOR]

Objective To explore the safety of fertility-sparing surgery and the selection of ovulation induction protocols in patients with early-stage borderline ovarian tumors (BOTs). Methods Clinical data were collected from four patients with early-stage BOTs who underwent fertility-sparing surgery and later sought treatment for infertility with assisted reproduction and successfully delivered in Xinhua Hospital Affiliated to School of Medicine in Shanghai Jiao Tong University from January 2015 to December 2021. The postoperative follow-up and assisted reproduction of the patients were reviewed in combination with the literature. The estrogen levels of patients on HCG day were compared between antagonist protocol, agonist protocol, and letrozole mild stimulation protocol. Results Two of the four patients with early-stage BOTs relapsed after fertility-sparing surgery. The pa-thological type of relapse was BOTs without malignant transformation. No recurrence was observed during follow-up after the se-cond operation. All four patients underwent assisted reproduction and achieved delivery. One of the patients who experienced relapse underwent oocyte retrieval before the second surgery and achieved pregnancy through frozen embryo transplantation after the surgery. Three out of four patients used letrozole mild stimulation protocol (two of them achieved pregnancy, while the other patient switched to agonist protocol after failing to retrieve oocytes and subsequently became pregnant). The remaining patient used anta-gonist protocol and achieved pregnancy. Compared with the antagonist and agonist protocols, letrozole mild stimulation protocol had the lowest serum estrogen level on the HCG day. Conclusion Fertility-sparing surgery for patients with early-stage BOTs is safe and feasible. Oocyte retrieval can be considered in case of recurrence before reoperation. Letrozole mild stimulation protocol provides a relatively safe option with minimal adverse effects on the ovaries.

Since the first successful use of oocyte cryopreservation and resuscitation, to obtain twin pregnancies, in 1986, oocyte cryopreservation has gradually become an intervention measure for iatrogenic ovarian dysfunction. In recent years, the number of patients with diminished ovarian reserve (DOR) has shown an increasing trend, and the preservation of their fertility is receiving increasing attention. The iatrogenic influencing factors of DOR mainly include reproductive system surgery, tumor radiotherapy and chemotherapy, etc. Oocyte cryopreservation is a first-line treatment option for fertility preservation, and its safety, applicability, utilization rate, and egg donation treatment in the clinical application of iatrogenic DOR patients have been confirmed by clinical data and relevant literature. However, the issues related to the timing of oocyte cryopreservation, limitations of clinical application and ethical policies cannot be ignored. Oocyte cryopreservation is of great significance for improving the pregnancy outcomes of unmarried patients with iatrogenic DOR and the reproductive autonomy of married patients. After clarifying the iatrogenic influencing factors of DOR, it is recommended to seek consultation from multiple disciplines such as oncology, gynecology and reproductive health as soon as possible to develop the personalized oocyte cryopreservation plans. [ABSTRACT FROM AUTHOR]

Epidemiologists indicate that about half of the couple’s infertility cases are due to a male factor. Despite this, the role of andrologists or endocrinologists in assisted reproductive technique (ART) centers is still underestimated. According to our literature review, this reduces the chance of a thorough clinical evaluation of the male partners, which, sometimes consists only in a mere semen analysis, usually performed by laboratory technicians. A more complete diagnostic process could lead to the identification of potentially treatable causes of infertility, the recognition of diseases that require immediate treatment, and to the discovery of genetic diseases and, therefore, transmissible to the offspring. It can also increase the success rate of ART resulting in less psychological and financial burden for both public health resources and infertile couples. The presence of medical personnel with andrological and endocrinological skills in the ART centers represents the first step in creating ‘precision medicine’. We hope that the guidelines of the various scientific societies will clearly contemplate this possibility. [ABSTRACT FROM AUTHOR]

Endocrine disrupting chemicals (EDC) are exogenous compounds, which can interfere with the hormones action and endocrine pathways, affect the development of female reproductive system and ovarian function, and therefore EDCs are associated with female infertility. Current research mainly focus on EDC exposure and its correlation with the different diseases of the endocrine axes. Studies have shown that EDCs affect female fertility by causing ovarian dysfunction, follicular development abnormality, endometrial receptivity reduction, and embryo quality decline, as well as the lowed clinical outcome of assisted reproduction in infertile women. Accumulating evidence in animal studies has provided important insights into the mechanism of EDC effects. This review summarizes some of the most common EDCs including pesticides, bisphenol A and phthalates, and the effects of EDCs on female fertility and clinical outcomes of assisted reproductive technology. [ABSTRACT FROM AUTHOR]

The platelet-rich plasma (PRP) is a concentrate extracted from whole blood centrifugation at a platelet concentration of up to 7 times that of circulating serum, being rich in growth factors and cytokines. Some of factors promote tissue healing and regeneration by inducing chemotaxis, cell migration and differentiation. Ovarian reserve refers to the quality and quantity of eggs retained in ovaries, which is an important indicator of female fertility potential. Based on the current basic research and clinical trials at home and abroad, it is proposed that PRP can promote ovarian vascular production, reduce apoptosis of granule cells and atresia of follicles, promote cumulus dilation, increase mitochondrial activity pathway and promote oocyte development. This review may provide a theoretical basis for the clinical practice of PRP in the assisted reproduction of those women with the reduced ovarian reserve. [ABSTRACT FROM AUTHOR]

Cesarean scar defect (CSD) is one of the common complications after cesarean section. The clinical manifestations include abnormal uterine bleeding, pelvic pain and secondary infertility. With the evolution of fertility policy and the increase of cesarean section rate, the infertility associated with it is gradually gaining attention. There is no consensus on the treatment options of infertility secondary to CSD currently. In patients combined with small amounts of uterine cavity effusion, the prolonged GnRHa down-regulation protocol can be used to assist reproduction. While in patients with abnormal uterine bleeding or obvious endometrial cavity fluid, surgery should be considered as first-line treatment. However, there is still a lack of uniformity in the choice of surgical approach and surgical plans are usually determined based on the residual myometrial thickness on the scar. In addition, treatment options such as intrauterine ozone infusion, traditional Chinese medicine conditioning and physiotherapy, and stem cell transplantation may also have potential benefits in the treatment of secondary infertility in CSD. [ABSTRACT FROM AUTHOR]

Copyright of Die Gynäkologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Embryo anomaly is the most common cause of implantation failure and abortion in women of reproductive age. However, there is controversy about the cause of implantation failure or miscarriage that occurs after the transfer of a normal embryo screened by preimplantation genetic testing (PGT) . Objective To analyze the influencing factors affecting implantation failure and miscarriage after PGT assisted reproduction. Methods Three hundred and twenty-nine women who received PGT assisted reproduction in Reproductive Center, the First Affiliated Hospital of Anhui Medical University from December 2018 to February 2021 were enrolled, including 218 with clinical pregnancy〔175 of whom had a live birth (live birth subgroup) , and 43 had an abortion (abortion subgroup) 〕, and 111 with implantation failure. Clinical data, results of accessory examinations, ovulation induction and in vitro embryonic development were compared between women with clinical pregnancy and implantation failure, and between live birth and abortion subgroups. The influencing factors of implantation failure and abortion after PGT assisted reproduction were screened by multivariate logistic regression analysis, and predictive values of the determined factors for implantation failure and abortion were estimated using the receiver operating characteristic (ROC) analysis. Results Multivariate logistic regression analysis showed that, two or more previous abortions〔OR=4.032 0, 95%CI (2.423 0, 6.710 0) 〕 and low level of high-density lipoprotein cholesterol (HDL-C) 〔OR=3.890 0, 95%CI (1.455 0, 10.403 0) 〕were risk factors for implantation failure after PGT assisted reproduction (P

Whether the artificial intervention of assisted reproductive technology (ART) in the early life will bring potential risks to the long-term health and safety of the offspring has always been a key issue of human health. This article reviews the key points of ART, such as artificial insemination, in vitro fertilization -embryo transfer and its derivative technology, and summarizes and analyzes the safety of offspring from the aspects of adverse pregnancy outcomes, birth defects, long-term health problems, and genetic imprinting abnormalities. Most studies support the safety of ART and believe that children born by ART do not increase the incidence of adverse events. However, since most research data focus on infants and young children, it is still necessary to conduct the long-term health follow-up of children born by ART to obtain health data in adolescents and adulthood, and to further demonstrate the safety of children born by ART. [ABSTRACT FROM AUTHOR]

The ovarian hyperstimulation syndrome (OHSS) complicated with superior mesenteric venous thrombosis (SMVT) and portal vein thrombosis (PVT) is a rare thrombotic disease, with the continuous increase of human chorionic gonadotropin in pregnant women and the further aggravated condition. In severe cases, intestinal ischemic hemorrhage, septic shock, abortion, premature delivery and death may occur. Therefore, it is one of the serious complications in the process of in vitro fertilization -embryo transfer (IVF -ET). The early clinical manifestations and auxiliary examinations of the disease are lack of specificity, and it is easy to be misdiagnosed or missed, and to delay treatment. A case of OHSS found 10 days after IVF-ET and diagnosed with SMVT and PVT complicated with intestinal obstruction 61 days after transplantation was reported. After multidisciplinary consultation, the comprehensive treatment of oxygen inhalation, expansion of blood volume, anticoagulation, infection prevention, correction of electrolyte disorders and others was given. The effect was poor and the condition deteriorated sharply. After transferred to our hospital, the emergency resection of necrotic small intestine plus end-to-end anastomosis of residual small intestine plus thrombectomy of superior mesenteric vein and portal vein was performed. At more than 5 months of pregnancy, induction of labor was performed due to fetal death. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare pregnancy rates in domestic cats using fresh semen for the bilateral intrauterine insemination (BIUI) method and the novel uterine body insemination (UBI) method. Queens received a single injection of equine chorionic gonadotropin (eCG) (200 IU; IM) to induce ovarian follicular development and, after 83 h, an injection of human chorionic gonadotropin (hCG) (100 IU; IM) for final oocyte maturation and ovulation induction. Thirty-four hours after hCG administration, 3 × 106 fresh spermatozoa were used for insemination by the BIUI (n = 8 queens) or by the UBI (n = 7 queens) techniques respectively. Pregnancy rates were 75.00% (6/8) by BIUI and 42.85% (3/7) by the UBI method. The mean litter size was 3.0 ± 0.86 for the BIUI, and 2.0 ± 1.0 for the UBI method. Spontaneous abortion occurred on day 35 of pregnancy in one queen following the UBI method. Our findings showed that the BIUI of queens with fresh semen resulted in higher pregnancy rates than the novel UBI method; also, acceptable pregnancy rates were achieved following BIUI with fresh semen in the domestic cat.

The provision of care that is responsive to the preferences, needs and values of gamete donors is key to improving their recruitment and ensuring the functioning of gamete banks. This qualitative study aimed to explore gamete donors' experiences about the facilitating and constraining human and system factors to donor-centred healthcare delivery in gamete banks. It is based on 20 semi-structured interviews with oocyte and sperm donors, recruited at the Portuguese Public Bank of Gametes, conducted from November 2017 to February 2019. Deductive content analysis was performed using the software NVivo12, following the patient-centred infertility care model. Interviewees identified facilitating factors mostly related with the human dimension of care (i.e. careful and available attitude and behaviours of health professionals, as well as their good communication skills and emotional support). Constraining factors were predominantly identified at the system level (i.e. insufficient information provision, poor coordination, and integration). Lack of privacy emerged simultaneously as a human and a system constraining factor (i.e. physical discomfort during medical-technical acts or gamete collection). There is room for improving clinical practice and the organisation of healthcare services within a context where the competence and attitude of, and relationship with, the staff are highly valued. [ABSTRACT FROM AUTHOR]

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundPregnancy outcome in patients with poor ovarian response (POR) has always been one of the difficult problems in reproductive medicine, but there is few threshold effect analysis of influence of age on live birth rate in POR patients treated by assisted reproductive technology (ART) .ObjectiveTo analyze the threshold effect of influence of age on live birth rate in POR patients treated by ART.MethodsAmong 19 185 women who received routine in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and embryo transplantation in Department of Gynaecology and Obstetrics, the First People's Hospital of Shangqiu and Fertility Support Center, the First Affiliated Hospital of Xinjiang Medical University from August 2014 to December 2018, 3 337 patients with POR were selected, and received controlled ovarian stimulation, embryo transplantation by IVF/ICSI and luteal support therapy. The incidence of live birth was analyzed. Univariate and multivariate Logistic analyses were used to analyze the influence of age on live birth in POR patients treated by ART. Moreover, smooth curve fitting and threshold effect analysis were conducted.ResultsOf the 3 337 cases, 1 134 obtained a live birth, the other 2 203 did not, achieving a rate of live birth of 33.98% (1 134/3 337) . Multivariate Logistic analysis result showed that, age was independently associated with live birth in POR patients treated by ART〔OR=0.920, 95%CI (0.902, 0.939) , P

ABSTRACT Purpose: Sperm DNA fragmentation (SDF) and seminal oxidative stress are emerging measurable factors in male factor infertility, which interventions could potentially reduce. We evaluated (i) the impact of lifestyle changes combined with oral antioxidant intake on sperm DNA fragmentation index (DFI) and static oxidation-reduction potential (sORP), and (ii) the correlation between DFI and sORP. Materials and Methods: We conducted a prospective study involving 93 infertile males with a history of failed IVF/ICSI. Ten healthy male volunteers served as controls. Semen analysis was carried out according to 2010 WHO manual, whereas seminal sORP was measured using the MiOXSYS platform. SDF was assessed by sperm chromatin structure assay. Participants with DFI >15% underwent a three-month lifestyle intervention program, primarily based on diet and exercise, combined with oral antioxidant therapy using multivitamins, coenzyme Q10, omega-3, and oligo-elements. We assessed changes in semen parameters, DFI, and sORP, and compared DFI results to those of volunteers obtained two weeks apart. Spearman rank correlation tests were computed for sORP and DFI results. Results: Thirty-eight (40.8%) patients had DFI >15%, of whom 31 participated in the intervention program. A significant decrease in median DFI from 25.8% to 18.0% was seen after the intervention (P

Objectives: To compare age‐adjusted all‐cause and CVD mortality, relative to the general female population, for women registered for fertility treatment who received it and those who did not. Design: Prospective cohort study; analysis of Monash IVF clinical registries data, 1975–2018, linked with National Death Index mortality data. Participants: All women who registered for fertility treatment at Monash IVF (Melbourne, Victoria), 1 January 1975 – 1 January 2014, followed until 31 December 2018. Main outcome measures: Standardised mortality ratios (SMRs) for all‐cause and CVD mortality, for women who did or did not undergo fertility treatment; SMRs stratified by area‐level socio‐economic disadvantage (SEIFA Index of Relative Socioeconomic Disadvantage [IRSD]) and (for women who underwent treatment), by stimulated cycle number and mean oocytes/cycle categories. Results: Of 44 149 women registered for fertility treatment, 33 520 underwent treatment (66.4%), 10 629 did not. After adjustment for age, both all‐cause (SMR, 0.58; 95% CI, 0.54–0.62) and CVD mortality (SMR, 0.41; 95% CI, 0.32–0.53) were lower than for the general female population. All‐cause mortality was similar for women registered with Monash IVF who did (SMR, 0.55; 95% CI, 0.50–0.60) or did not undergo fertility treatment (SMR, 0.63; 95% CI, 0.56–0.70). The SMR was lowest for both treated and untreated women in the fifth IRSD quintile (least disadvantage), but the difference was statistically significant only for untreated women. CVD mortality was lower for registered women who underwent fertility treatment (SMR, 0.29; 95% CI, 0.19–0.43) than for those who did not (SMR, 0.58; 95% CI, 0.42–0.81). Conclusion: Fertility treatment does not increase long term all‐cause or CVD mortality risk. Lower mortality among women registered for fertility treatment probably reflected their lower socio‐economic disadvantage. [ABSTRACT FROM AUTHOR]

The research related to the detrimental effect of COVID -19 has not been limited in the respiratory system, but it gradually expanded to other important systems. Several studies demonstrated that SARSCoV-2 recognized the angiotensin converting enzyme 2 (ACE2) receptors in human tissues and organs, thereby causing damages to the structure and function of human systems including reproduction. For male reproductive system, SARS-CoV-2 affects the function of hypothalamic-pituitary-gonad (HPG) axis, damages the spermatogenic process and decreases sperm quality. For female reproductive system, SARS-CoV-2 also disturbes the function of HPG axis. Considering the pregnant women infected with the virus, the rate of severe diseases was low and the rehabilitation was good, but adverse pregnancy outcomes may also occur. The impact of SARS-CoV-2 on assisted-reproduction is mild, but it could be a risk factor of pulmonary and renal complications when the patient suffered from ovarian hyperstimulation syndrome during ovulation induction. In addition, there is no evidence to show the obvious negative effect of various SARS -CoV-2 vaccines on the reproductive system. However, mental health problems such as the decreased fertility intention caused by the COVID-19 pandemic still need to be further investigated. [ABSTRACT FROM AUTHOR]

Cellular proteins and the mRNAs that encode them are key factors in oocyte and sperm development, and the mechanisms that regulate their translation and degradation play an important role during early embryogenesis. There is abundant evidence that expression of microRNAs (miRNAs) is crucial for embryo development and are highly involved in regulating translation during oocyte and early embryo development. MiRNAs are a group of short (18-24 nucleotides) non-coding RNA molecules that regulate post-transcriptional gene silencing. The miRNAs are secreted outside the cell by embryos during preimplantation embryo development. Understanding regulatory mechanisms involving miRNAs during gametogenesis and embryogenesis will provide insights into molecular pathways active during gamete formation and early embryo development. This review summarizes recent findings regarding multiple roles of miRNAs in molecular signaling, plus their transport during gametogenesis and embryo preimplantation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

In vitro embryo culture often falls short of mimicking the physiological dynamism occurring in the reproductive tract, prompting developmental plasticity in mammalian embryos with consequential genotypic and phenotypic deviations. Recent research highlights the potential of biological derivatives in in vitro culture to mitigate these effects, being the extracellular matrix (ECM) one of the most important components in retaining structural and biological signals derived from the native source tissue. Current bioengineering techniques could provide ECM-based biomaterials mimicking the native environment and offering optimal embryonic development. Rabbit oviducts (n = 24) were decellularized and solubilized to create tissue-specific ECM (OviECM) hydrogels. Following physicochemical characterization, these hydrogels were applied as coatings for the in vitro culture of two-cell embryos over 48 h, along with embryos cultured under In vitro control conditions (n = 218/group), which were subsequently transferred to recipient females. A subset of embryos was recovered on day 6 for transcriptomic analysis (n = 75-80/group), while the remaining embryos were used to assess implantation and birth rates. Rabbit weights were monitored over 20 weeks post-delivery, with blood tests conducted at weeks 8 and 20. Bayesian inference methods were used for statistical analysis. Differences were considered relevant if P ≥ 0.8 (80%). No differences in embryo development and morphology were detected between the OviECM coating and In vitro control conditions. However, embryos cultured on these coatings exhibited upregulation of pathways involved in antigen presentation and immune system activation, as well as, increased cellular response to external stimulus and intracellular protein transport. The implantation and live birth rates were significantly higher in the coating group than in the In vitro control group (30.8% vs. 26.1% and 21.2% vs. 18.1%, respectively). During the first 20 weeks of life, the animals from the coating group showed higher weights than the In vitro control group P0 > 0.8. The animals of both experimental groups showed normal blood parameters. Implementation of OviECM coatings allows for improving in vitro conditions and decreases postnatal phenotypic deviations after assisted reproductive technology (ART). This study could initiate a new embryo culture techniques era to guarantee that ART is utilized in the most efficient and safest possible practice., Competing Interests: Declarations Ethics approval and consent to participate This study was approved by the Ethical Committee for Experimentation with Animals of the Polytechnic University of Valencia, Spain. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Purpose of Review: Infertility impacts one in six couples worldwide, with male infertility contributing to approximately half of these cases. However, the causes of infertility remain incompletely understood, and current methods of clinical management are cost-restrictive, time-intensive, and have limited success. Artificial intelligence (AI) may help address some of these challenges. In this review, we synthesize recent literature in AI with implications for the clinical management of male infertility., Recent Findings: Artificial intelligence may offer opportunities for proactive, cost-effective, and efficient management of male infertility, specifically in the areas of hypogonadism, semen analysis, and interventions such as assisted reproductive technology. Patients may benefit from the integration of AI into a male infertility specialist's clinical workflow. The ability of AI to integrate large volumes of data into predictive models could help clinicians guide conversations with patients on the value of various treatment options in infertility, but caution must be taken to ensure the quality of care being delivered remains high., (© 2024. The Author(s).)

Problem: Investigating the impact of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection on female fertility and laboratory outcomes in patients undergoing assisted reproductive technology (ART) treatment who were initially uninfected but later became infected., Methods of the Study: This self-controlled study included 197 patients who underwent repeated oocyte retrieval before and after SARS-CoV-2 infection between March 2021 and April 2023, of which 117 used the same ovarian stimulation protocol within a consistent age range. We evaluated the ovarian reserve, ovarian response, and laboratory outcomes in patients before and after SARS-CoV-2 infection., Results: The ovarian reserve (follicle-stimulating hormone [FSH], luteinizing hormone [LH], estrogen [E 2 ], anti-Müllerian hormone [AMH], antral follicle count [AFC]), ovarian response (total Gn dosage, duration of Gn administration, number of follicles ≥14 mm on trigger day, number of retrieved oocytes), and laboratory outcomes (cleavage stage good-quality embryo rate, blastocyst formation rate, and cycle freezing rate) showed no significant differences before and after SARS-CoV-2 infection in 117 patients (p > 0.05). When stratified by age, the ≤ 35 years group showed a higher two pronuclei (2PN) fertilization rate post-infection, while the >35 years group had increased mature metaphase II (MII) oocyte and blastocyst stage good-quality embryo rates. Additionally, upon stratified by the time interval between SARS-CoV-2 infection and ART treatment, in the ≤ 3 months group, there was an increased post-infection MII oocyte rate, 2PN fertilization rate, and blastocyst stage good-quality embryo rate. Meanwhile, no significant differences were found in any indicators when the interval exceeded three months., Conclusion: Our study suggested that undergoing IVF/ICSI treatment after recovering from COVID-19 may not adversely affect female fertility and laboratory outcomes., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

With an aging population seeking infertility treatment, diminished ovarian reserve (DOR) is a prevalent indication for assisted reproductive technology (ART). This study aims to investigate the relationship between sleep parameters and DOR among women attending an infertility clinic. Methods We consecutively enrolled women attending an infertility clinic from July 2020 to June 2021. Participants completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale(ESS), and STOP-Bang Questionnaire to assess self-reported sleep quality. DOR-related indices including antral follicle count, anti-Müllerian hormone(AMH), follicle-stimulating hormone (FSH) were evaluated. A total of 979 women were enrolled, with 148 classified into the DOR group and 831 in the non-DOR group. The DOR group was notably older compared to the non-DOR group. Analysis showed that the DOR group exhibited significantly shorter sleep onset latency (p = 0.001) and shorter total sleep duration (p = 0.014) compared to the non-DOR group. Logistic regression analysis identified age, PSQI-sleep latency, and PSQI score as independent factors associated with an increased risk of DOR(all p < 0.05). Furthermore, stratified analysis by age group revealed that snoring and PSQI-sleep latency were particularly notable risk factors for DOR among women aged 35 years and older (OR = 2.489, p = 0.040; OR = 2.007, p = 0.008, respectively). Our study highlights that shorter sleep onset latency and shorter total sleep duration may be associated with DOR among women undergoing ART treatments. Particularly noteworthy, snoring and sleep latency were identified as additional risk factors for DOR among women aged 35 years and older., (© 2024. The Author(s).)

The vasectomy is a safe and effective method of contraception for men. Up to 6% of men who underwent vasectomy have a renewed child wish. Microsurgical vasectomy reversal (VR) in men, microsurgical epididymal sperm aspiration (MESA), or testicular sperm extraction (TESE) in men plus assisted reproductive technology (ART) in the female partner as well as the combination of VR and MESA/TESE plus ART represent established therapeutic strategies. Various factors may impact the success of VR, as defined by patency and pregnancy rate following VR, including the female partner's age, the obstructive interval, and the surgical VR technique. There is no difference in the pregnancy and live birth rate following VR or MESA/TESE plus ART. However, following MESA/TESE plus ART, time to pregnancy is shorter compared with VR. Overall, VR is more cost-effective than MESA/TESE plus ART and allows for a lower therapeutic burden, especially in the female partner. In addition, VR combined with TESE plus-if necessary-ART is more cost-effective than MESA/TESE plus ART alone, even in female partners with advanced age. For successful counseling regarding the different therapy options for a renewed child wish after vasectomy, it is important to evaluate the underlying individual situation of the couple., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Study Question: Which decision-making factors influence family building among permanently infertile couples?, Summary Answer: Ethical, legal, and financial considerations outweigh genetic relatedness in decision-making, favouring domestic gestational surrogacy, if this were possible, over international options., What Is Known Already: Permanent infertility affects 4-5% of people in the fertile age. Their family-building options include adoption, surrogacy, uterus transplantation, foster care, and intentional multiple parenthood. However, in most countries, including Denmark, legal barriers constrain these methods due to surrogacy restrictions, suspended international adoptions, and the experimental status of uterus transplantation. Despite existing research on surrogacy, adoption, and specific causes of permanent infertility, a significant gap remains in our understanding of how couples with permanent infertility make family-building decisions within these limited frameworks., Study Design, Size, Duration: This cross-sectional study with 150 permanently infertile Danish participants was conducted from June to November 2023 using an online questionnaire. Multiple strategies, such as online forums, fertility clinics, hospital departments, and snowballing, were used to recruit a diverse sample., Participants/materials, Setting, Methods: The study included couples aged 26-50 years facing permanent infertility due to the following primary causes: women without a uterus (15%), women with a non-functional uterus (47%) or women for whom pregnancy would be life-threatening (9%), male couples (16%), transgender partner couples (2%), and other causes (11%). The survey collected data on demographics, reproductive history, family-building choices, and communication strategies. Closed questions were analysed using descriptive statistics., Main Results and the Role of Chance: Among 150 respondents, 41% had used transnational surrogacy, 27% adoption, 14% chose to remain childless, and 19% were undecided. Critical factors on family-building decisions were ethical, legal, and financial concerns which ranked higher than genetic relatedness. Despite the complexity of family building, most participants were open about their child's origin and received social support. If all family-building methods were legal and available in Denmark, domestic gestational surrogacy would be the preferred method, with uterus transplantation and remaining childless being least popular., Limitations, Reasons for Caution: The sample size is relatively small, despite the use of a variety of recruitment strategies. Nevertheless, this has ensured a diverse cohort representing the different reasons for infertility and family-building choices. It is important to note that the strategies may have favoured individuals achieving parenthood., Wider Implications of the Findings: The finding of our study reveals a notable gap between available family-building options in Denmark and the preferences of couples facing permanent infertility. These insights could be instrumental for organizations reviewing and developing family-building frameworks. Furthermore, for healthcare professionals guiding couples experiencing infertility issues in their attempts to build a family, an understanding of these preferences is essential to facilitate informed decisions about their future family plans., Study Funding/competing Interest(s): The project was financed by the Independent Research Fund Denmark. The authors have no conflict of interest to declare., Trial Registration Number: N/A., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

Reciprocal in vitro fertilization (IVF) and intravaginal culture (IVC) are two technologies that allow same-sex female couples to jointly contribute biologically to a pregnancy. This systematic review aimed to synthesize the clinical outcomes of each method including live birth rate, clinical pregnancy rate, embryo quality, and perinatal complications. A dual-reviewer protocol identified eight studies on reciprocal IVF and ten studies on IVC. In retrospective studies reporting on a total of 1,405 reciprocal IVF cycles, reciprocal IVF has demonstrated similar cycle and pregnancy outcomes to autologous IVF. One study that reported on pregnancy complications found a comparable rate of hypertensive disease in pregnancy between patients undergoing reciprocal IVF and intrauterine insemination. However, a lack of prospective studies on reciprocal IVF limits the generalizability of these results. Overall, small prospective and retrospective studies reporting on a total of 776 IVC cycles show that IVC offers good cycle and pregnancy outcomes, comparable to IVF. However, randomized prospective studies reported that the rate of quality embryo creation in IVC may be lower than in IVF. Although both reciprocal IVF and IVC show promise for same-sex female couples and the larger lesbian, gay, bisexual, transgender, intersex, asexual, and other sexual or gender minorities community, this review has highlighted the need for larger, prospective, more diverse studies on methods of shared biological contribution for family building., Competing Interests: Declaration of Interests B.D. has nothing to disclose. H.N. has nothing to disclose. K.S.N. has nothing to disclose. I.C.B. has nothing to disclose. P.B. has nothing to disclose. S.L.E. has nothing to disclose., (Copyright © 2024 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: The present systematic review aimed to assess the fecundity of women with congenital uterine anomalies (CUAs) undergoing assisted reproductive technology (ART)., Methods: The present systematic review of the literature was reported according to the PRISMA guidelines. We systematically searched PubMed, MEDLINE, Embase and Scopus, from database inception to 17th October 2023. Studies were deemed eligible only if they included women with CUAs clearly fitting into one of the categories of the ASRM Müllerian anomalies classification 2021., Results: Data relevant to the reproductive outcomes of women with CUAs who underwent ART were extracted from 55 studies. Regarding Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, studies on gestational surrogacy reported a live birth rate (LBR) ranging from 37 to 54%. Uterus transplant, although still experimental, showed promising results. Most studies reported a negative impact of unicornuate uterus and partial or complete septate uterus on both the miscarriage rate (MR) and the live birth rate (LBR). The reproductive prognosis of women with unicornuate uterus was shown to be particularly poor in case of twin pregnancy. Uterus didelphys, bicornuate and arcuate uterus seem not to negatively impact the ART reproductive outcomes. Uterus didelphys was associated with an increased risk of preterm birth (PTB), cesarean section and low birth weight (LBW)., Conclusion: Women with CUAs should be informed regarding the impact (if any) of their congenital anomaly on both the chances of success of ART and on pregnancy-related complications. Elective single embryo transfer (eSET) should always be the first choice in patients with an increased baseline obstetric risk., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective(s): Assisted reproductive technology (ART) Centers and laboratories perform complex tasks with patients and their gametes/embryos daily. The degree of problems/non-conformances in such surroundings must be minimized at zero point. This study aimed to establish the proper risk management system with well-defined process steps to prevent and eliminate problems/non-conformances., Study Design: Failure mode and effect analysis (FMEA) was introduced in the ART Center and the IVF laboratory. ART Center working processes were grouped into the categories of Clinical procedures, Forms, Identification, Personnel, Patients, and Facility. Working processes in the IVF laboratory were grouped into the categories of Consumables, Media, Equipment, Personnel, Working space, and Procedures. The traceability and safety of the working processes were evaluated before and after corrective measures regarding risk priority number (RPN). The severity (S), occurrence (O), and detection (D) index of problems/non-conformance were scaled from 1 to 5. The RPN was calculated by multiplying the SOD index, and the cut-off value for RPN was ≥12., Results: The increased RPN was found in the following working processes of the ART Center: Embryo transfer and pregnancy (RPN = 18) in the category of Clinical procedures; Informed consents and agreements (RPN = 16) in the category Forms; Continuous education of the knowledge and skills (RPN = 12) in Personnel category; Space conditions (RPN = 24) and Equipment (RPN = 12) in the category Facility. In the IVF laboratory, increased RPN was found in the following working processes: Production of the plasticware (RPN = 12), Transport (RPN = 12) and Storage (RPN = 12) in the category Consumables; Media production (RPN = 16) in category Media; Alarm notification system for the critical equipment (RPN = 12) in category Equipment; Personnel number and qualifications (RPN = 12), Standard operative procedures (SOP) (RPN = 12) and Continuous education of the knowledge and skills (RPN = 12) in category Personnel; Working conditions (RPN = 18) and Security (RPN = 20) in Working space; Patient identification (RPN = 20), Biological samples identification (RPN = 20), Records (RPN = 12), ART procedure (RPN = 30), Embryo transfer (RPN = 30) and Cryopreservation and thawing of biological samples (RPN = 30) in category Procedures. According to the RPN score, corrective measures were implemented. Most RPN scores were reduced after the implementation of the electronic witnessing system in patient/sample tracing steps. Phases Patient identification and Biological sample identification showed a double reduction of RPN scores, from 20 to 10. Also, for critical steps in ART procedures, Embryo transfer, Cryopreservation, and thawing of biological samples, the RPN score was reduced from 30 to 10. Proper education of personnel was another corrective measure that significantly contributed to a reduction of RPN scores in most of the categories., Conclusion(s): The FMEA analysis is useful in recognizing the critical steps of an ART Center. The RPN scores for patient traceability were successfully reduced using the electronic witnessing system. Nonetheless, the study has certain limitations, as FMEA is highly dependent on the specific healthcare organization, adherence to national guidelines, and the subjective nature of SOD and RPN evaluations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The global burden of infertility is significant and the evidence suggests it is increasing in prevalence worldwide. Assisted reproductive technologies (ARTs) are fertility related treatments used to achieve pregnancy which involve the manipulation of both oocytes and sperm. The specialty is rapidly growing and anaesthesia may be required for several stages in the ART cycle. Anaesthesiologists should appreciate the processes involved and how anaesthesia care can influence safe and effective treatment outcomes. In this review article we explain the key steps of the ART cycle and the role of anaesthesiologists in this process. We also highlight key patient considerations, the implications of remote site anaesthesia and the safety concerns with provision of sedation by non-anaesthesiologists. Finally we outline a typical anaesthetic technique used in our institution for transvaginal oocyte retrieval., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

When considering the typical lesions associated with endometriosis, such as endometriomas, and pelvic adherences involving the tubes, it is very clear how this pathology may impair both natural and assisted reproductive technology (ART) fertility. It may be more difficult for clinicians to recognize that endometriosis can reduce female fertility potential through other mechanisms which may be independent of direct damage to ovarian reserve and tubal function. The most recent clinical studies have shown that endometriosis is associated with increased risk of infertility, independent of the type of endometriosis (ovarian, peritoneal and deep endometriosis). In the IVF setting, the cumulative live birth rate in women with endometriosis has been reported to be significantly lower compared with women without endometriosis. Endometriosis is a complex, multifactorial condition that encompasses not only the presence of endometriotic lesions, but also involves women's sexuality, uterine and ovarian compartment. Endometriosis should always be considered a severe risk factor for infertility and ART failure., (Copyright © 2024 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Abstract: Artificial intelligence (AI) is revolutionizing the current approach to medicine. AI uses machine learning algorithms to predict the success of therapeutic procedures or assist the clinician in the decision-making process. To date, machine learning studies in the andrological field have mainly focused on prostate cancer imaging and management. However, an increasing number of studies are documenting the use of AI to assist clinicians in decision-making and patient management in andrological diseases such as varicocele or sexual dysfunction. Additionally, machine learning applications are being employed to enhance success rates in assisted reproductive techniques (ARTs). This article offers the clinicians as well as the researchers with a brief overview of the current use of AI in andrology, highlighting the current state-of-the-art scientific evidence, the direction in which the research is going, and the strengths and limitations of this approach., (Copyright © 2024 Copyright: ©The Author(s)(2024).)

It is not controversial to state that parental age is increasing in several countries. But how to deal with this increase might be. Some Nordic countries have set an upper age limit for females seeking assisted reproduction in their national legislation, but none have done so for males. There are also recommendations in place that restrict access to publicly funded assisted reproduction for both females and males of advanced age in some Nordic countries. As recent data now show somatic and psychiatric health risks related to advanced paternal age, we ask if the time has come for countries to set an upper age limit for males seeking assisted reproduction like there already is for females, and summarize some of the risks and rewards involved in treating couples with advanced age in fertility clinics., (© 2024 The Author(s). Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)

The objective of this study is to explore the correlation of metal levels with assisted reproductive technology (ART) outcomes in polycystic ovary syndrome (PCOS) patients. The individuals were recruited who met the research criteria, only tubal factor or male infertility served as the control group (n = 40) and patient group was PCOS patients (n = 35). Individuals (n = 75) were divided into PCOS group (n = 35) and control group (n = 40). The normal body mass index (BMI) group (control) includes women with BMI < 25 kg/m 2 in PCOS group (n = 24) and control group (n = 33), and BMI ≥ 25 kg/m 2 in PCOS group (n = 11) and control group (n = 7). We performed an analysis of insulin resistance (IR) (n = 15) group and without insulin resistance (NIR) group (n = 20) in PCOS patient and control patients. Comparing difference demographic data, ART outcomes and the metal levels in every group respectively, the correlation of metal levels and ART outcomes in control participants and PCOS patients were analyzed by the Spearman correlation analysis, and multiple linear regression model was used to examine the association between the concentration of 19 metals and ART outcomes in PCOS group and control group. Plasma manganese (Mn), titanium (Ti), sodium (Na), magnesium (Mg), copper (Cu), calcium (Ca)/Mg ratio, and Cu/zinc (Zn) ratio levels in PCOS patients were higher than that in control, while Zn and Ca levels were lower in PCOS patients than that in control. The Mg levels had a positive connection with the number of eggs recovered, and the iron (Fe) levels were positively associated with the number of transplanted embryos in PCOS-IR. In PCOS-NIR, Mn levels positively correlated with the number of follicles and the number of good embryos. Silver (Ag) levels were negatively correlated with the number of follicles, and aluminum (Al) levels were negatively related with the normal fertilization and the number of good embryos. The Spearman analysis in PCOS-BMI ≥ 25 group exhibited that nickel (Ni) levels were negatively associated with the number of follicles. The plasma metal levels seem to affect the clinical manifestations and in vitro fertilization outcomes in assisted reproduction., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)