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As interest in deep space travel grows exponentially, understanding human adaptation in becoming an interplanetary species is crucial. This includes the prospect of reproduction. This review summarizes recent updates and innovations in assisted reproductive technologies (ART) on Earth, while also discussing current challenges and areas for improvement in adapting ART studies to the space environment. We discuss the critical components of ART - gamete handling and preparation, fertilization, embryo culture, and cryopreservation - from the daily practice perspective of clinical embryologists and reproductive endocrinologists and lay out the complicated path ahead. In vitro embryo development in low Earth orbit and beyond remains questionable due to synergetic effects of microgravity and radiation-induced damage observed in simulated and actual in-space mammalian studies. Cryopreservation and long-term storage of frozen samples face substantial obstacles - temperature limitations, lack of trained personnel, and absence of adapted cosmic engineering options. We touch on recent innovations, which may offer potential solutions, such as microfluidic devices and automated systems. Lastly, we stress the necessity for intensive studies and the importance of an interdisciplinary approach to address numerous practical challenges in advancing reproductive medicine in space, with possible implications for both space exploration and terrestrial fertility treatments. [ABSTRACT FROM AUTHOR]

Introduction: This study compared, in high responders undergoing IVF treatment, GnRH agonist-only trigger and dual trigger on oocyte retrieval rate and cumulative live birth rate (LBR). The aim was to determine if the GnRH agonist-only triggers had provided outcomes comparable to dual trigger, while minimizing the risk of ovarian hyperstimulation syndrome (OHSS). Materials and methods: A retrospective, matched case-control study was conducted at Taichung Veterans General Hospital, Taiwan, including women who underwent IVF/ICSI between January 1, 2014, and December 31, 2022. Inclusion criteria were: GnRH antagonist protocol and estrogen level >3,000 pg/ml on trigger day. Exclusion criteria were: immune/metabolic diseases, donated oocytes, and mixed stimulation cycles. Propensity score matching was applied to balance age, AMH level, and oocyte number between the GnRH agonist-only and dual trigger groups. Outcomes were analyzed for patients who had complete treatment cycles, focusing on oocyte retrieval rate and cumulative LBR. Results: We analyzed 116 cycles in the agonist-only group, and 232 cycles in the dual trigger group. No inter-group difference was found in their age, BMI, and AMH levels. The dual trigger group had a higher oocyte retrieval rate (93% vs. 80%; p <0.05), while fertilization rates, blastocyst formation rates, and cumulative LBR were comparable. Notably, no OHSS cases had been reported in the GnRH agonist-only group, compared with 7 cases in the dual trigger group. Conclusion: GnRH agonist-only triggers resulted in a lower oocyte retrieval rate compared to dual triggers but did not significantly affect cumulative LBR in high responders. This approach effectively reduces OHSS risk without compromising pregnancy outcomes, making it a preferable option in freeze-all strategies, despite a longer oocyte pick-up duration and a medium cost. GnRH agonistonly trigger, however, may not be suitable for fresh embryo transfers or patients with low serum LH levels on trigger day. [ABSTRACT FROM AUTHOR]

The utilization of electroporation for delivering CRISPR/Cas9 system components has enabled efficient gene editing in mammalian zygotes, facilitating the development of genome-edited animals. In this study, our research focused on targeting the ACTG1 and MSTN genes in sheep, revealing a threshold phenomenon in electroporation with a voltage tolerance in sheep in vitro fertilization (IVF) zygotes. Various poring voltages near 40 V and pulse durations were examined for electroporating sheep zygotes. The study concluded that stronger electric fields required shorter pulse durations to achieve the optimal conditions for high gene mutation rates and reasonable blastocyst development. This investigation also assessed the quality of Cas9/sgRNA ribonucleoprotein complexes (Cas9 RNPs) and their influence on genome editing efficiency in sheep early embryos. It was highlighted that pre-complexation of Cas9 proteins with single-guide RNA (sgRNA) before electroporation was essential for achieving a high mutation rate. The use of suitable electroporation parameters for sheep IVF zygotes led to significantly high mutation rates and heterozygote ratios. By delivering Cas9 RNPs and single-stranded oligodeoxynucleotides (ssODNs) to zygotes through electroporation, targeting the MSTN (Myostatin) gene, a knock-in efficiency of 26% was achieved. The successful generation of MSTN-modified lambs was demonstrated by delivering Cas9 RNPs into IVF zygotes via electroporation. [ABSTRACT FROM AUTHOR]

Can a set of metabolites present in embryo culture media correlate with embryo implantation? Case-control study in two phases: discovery phase (101 samples) and validation phase (169 samples), collected between 2018 and 2022, with a total of 218 participants. Culture media samples with known implantation outcomes were collected after blastocyst embryo transfer (including both PGT and non-PGT cycles) and were analyzed using chromatography followed by mass spectrometry. The spectra were processed and analyzed using statistical and machine learning techniques to identify biomarkers associated with embryo implantation, and to develop a predictive model. In the discovery phase, 148 embryo implantation biomarkers were identified using high resolution equipment, and 47 of them were characterized. Our results indicate a significant enrichment of tryptophan metabolism, arginine and proline metabolism, and lysine degradation biochemical pathways. After transferring the method to a lower resolution equipment, a model able to assign a Metabolite Pregnancy Index (MPI) to each embryo culture media was developed, taking the concentration of 36 biomarkers as input. Applying this model to 20% of the validation samples (N=34) used as the test set, an accuracy of 85.29% was achieved, with a PPV (Positive Predictive Value) of 88% and a NPV (Negative Predictive Value) of 77.78%. Additionally, informative results were obtained for all the analyzed samples. Metabolite concentration in the media after in vitro culture shows correlation with embryo implantation potential. Furthermore, the mathematical combination of biomarker concentrations using Artificial Intelligence techniques can be used to predict embryo implantation outcome with an accuracy of around 85%. [ABSTRACT FROM AUTHOR]

After in vitro fertilization with a single embryo, the parents learned about being pregnant with twins in the 10th week with various indications that an embryonic mix-up could have taken place. The affected couple thus expressed the urgent desire for a clarification of parenthood considering an abortion. However, the prenatal test results would not have been available until the 14/15th week of pregnancy. Legally, then, severe physical or mental distress of the pregnant woman must be claimed by physicians to justify an abortion after the twelfth week. However, a lack of genetic relatedness could lead to serious psychological distress for the parents, making a pregnancy termination possible even after the twelfth week, which is discussed in this case study alongside the interdisciplinary team's ethical, legal, and medical considerations. For the invasive relationship testing, cultivated chorionic villi samples (CVS) from both unborn and saliva samples from the putative parents were genetically analyzed using classical short tandem repeats (STR) analysis. The perfect match of both CVS profiles suggested the occurrence of an unusual late twin shaft, for which, fortunately, parenthood could be confirmed. To our knowledge, this is the first report on a prenatal investigation of a suspected embryo mix-up after assisted reproductive technology (ART), in which parenthood should be fixed. We want to draw attention to this unthinkable scenario, which may increase in the future with ART-induced rising multiple pregnancies. [ABSTRACT FROM AUTHOR]

Abstract As interest in deep space travel grows exponentially, understanding human adaptation in becoming an interplanetary species is crucial. This includes the prospect of reproduction. This review summarizes recent updates and innovations in assisted reproductive technologies (ART) on Earth, while also discussing current challenges and areas for improvement in adapting ART studies to the space environment. We discuss the critical components of ART - gamete handling and preparation, fertilization, embryo culture, and cryopreservation - from the daily practice perspective of clinical embryologists and reproductive endocrinologists and lay out the complicated path ahead. In vitro embryo development in low Earth orbit and beyond remains questionable due to synergetic effects of microgravity and radiation-induced damage observed in simulated and actual in-space mammalian studies. Cryopreservation and long-term storage of frozen samples face substantial obstacles - temperature limitations, lack of trained personnel, and absence of adapted cosmic engineering options. We touch on recent innovations, which may offer potential solutions, such as microfluidic devices and automated systems. Lastly, we stress the necessity for intensive studies and the importance of an interdisciplinary approach to address numerous practical challenges in advancing reproductive medicine in space, with possible implications for both space exploration and terrestrial fertility treatments.

Abstract This study aimed to explore the relationship between female age and pregnancy outcomes in patients undergoing their first elective single embryo transfer (eSET) of in vitro fertilization (IVF) cycles. The retrospective cohort study encompassed 7089 IVF/intracytoplasmic sperm injection (ICSI) patients of the Reproductive Medicine Center, Henan Provincial Peoples’ Hospital of China, from September 1, 2016, to May 31, 2022. Patients all received the first eSET in their IVF/ICSI cycles. A generalized additive model (GAM) was employed to examine the the dose–response correlation between age and pregnancy outcomes, namely the clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR). Logistic regression model was employed to ascertain the correlation between the CPR/OPR and age. The study cohort has an average age of 30.74; 3843 patients got clinical pregnancy rate of 61.40% and ongoing pregnancy rate of 54.21%. The multiple pregnancy rate of is 1.24%. For patients aged 34 and above, the CPR decreased by 10% for every 1-year increase in age (adjusted OR 0.90, 95% CI 0.84–0.96, p

The methylenetetrahydrofolate reductase (MTHFR) regulates the metabolism of homocysteine in the human body, and MTHFR C677T polymorphism is correlated with male infertility among Asian populations. The relationship between paternal MTHFR C677T polymorphism and clinical outcomes is unclear due to conflicting study findings. In the current retrospective study, we enrolled 849 infertile couples from the First Affiliated Hospital of USTC, categorizing them into three subgroups based on their paternal MTHFR 677 genotype: CC, CT and TT. The clinical pregnancy (CC: 60.8%, CT: 62.5%, TT: 63.7%; p = 0.83), implantation (CC: 36.6%, CT: 42.2%, TT: 40.5%; p = 0.15), blastocyst formation (CC: 49%, CT: 48.4%, TT: 50.6%; p = 0.49), good-quality embryo (CC: 48.3%, CT: 49.8%, TT: 51.3%; p = 0.19), and normal fertilization (embryo development) (CC: 67.1%, CT: 66.2%, TT: 67.5%; p = 0.51) rates were comparable among all groups. Similarly, the live birth (CC: 54.2%, CT: 53.2%, TT: 53.7%; p = 0.97) and miscarriage (CC: 10.9%, CT: 14.9%, TT: 15.7%; p = 0.45) rates were comparable among the three cohorts. Regarding neonatal outcomes, the Apgar score, gestational age at delivery, neonatal sex, birth weight, birth height and preterm birth rates were non-significant among all groups. Finally, the rates of birth defects were also comparable among individuals of all groups (CC: 0%, CT: 0.3%, TT: 1.9%; p = 0.18). These findings suggest that paternal MTHFR C677T polymorphism does not exert any discernible effect on embryo quality, neonatal outcomes or birth defects in vitro fertilization (IVF) treatment. Therefore, in our population, paternal MTHFR C677T polymorphism is not informative in explaining IVF failure. Further studies, however examining the other enzymes in the folic acid pathway are warranted.

Background Objectives Materials and methods Results Conclusion With the development of socio‐economic conditions and a shift in attitudes towards fertility, there has been a gradual increase in delayed childbearing since the 2000s. Age plays a significant role in the decline of fertility. However, we know very little about the association of paternal age with reproductive outcomes.To investigate the correlation between advanced paternal age and semen quality, embryo quality, pregnancy, and neonatal outcomes in IVF cycles.In this study, after excluding female partners aged ≥35 years, we analyzed data from 761 infertile couples who underwent in vitro fertilization cycles at the First Affiliated Hospital of USTC between June 2020 and March 2023. Cases were classified into three groups according to the age of the male: <35 years (530 infertile couples), 35 years ≤ paternal age <40 years (125 infertile couples), and ≥40 years (106 infertile couples). Then, we compared the general clinical data arising from in vitro fertilization cycles between the three groups, including semen parameters, embryonic parameters, and pregnancy and neonatal birth outcomes.Data analysis showed that the duration of infertility and the incidence of secondary infertility were significantly higher in paternal age ≥35 years groups than those aged <35 years (all p < 0.05). We also observed a significant difference between ≥40 years and <35 years groups in terms of the normal fertilization rate, high‐quality embryo rate, clinical pregnancy rate, miscarriage rate, live birth rate, Apgar scores, and the low birth weight neonatal rate (all p < 0.05). The group with paternal age ≥40 years showed statistically significant differences in terms of clinical pregnancy rate, miscarriage rate, live birth rate, and low birth weight on multivariable logistic regression (all p < 0.05).The results of our study indicate that advanced paternal age (≥40 years) has a significant impact on the embryo quality, pregnancy outcome, and neonatal outcome. Paternal age over 40 years is a risk for in vitro fertilization success rate. [ABSTRACT FROM AUTHOR]

This study aimed to explore the relationship between female age and pregnancy outcomes in patients undergoing their first elective single embryo transfer (eSET) of in vitro fertilization (IVF) cycles. The retrospective cohort study encompassed 7089 IVF/intracytoplasmic sperm injection (ICSI) patients of the Reproductive Medicine Center, Henan Provincial Peoples' Hospital of China, from September 1, 2016, to May 31, 2022. Patients all received the first eSET in their IVF/ICSI cycles. A generalized additive model (GAM) was employed to examine the the dose–response correlation between age and pregnancy outcomes, namely the clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR). Logistic regression model was employed to ascertain the correlation between the CPR/OPR and age. The study cohort has an average age of 30.74; 3843 patients got clinical pregnancy rate of 61.40% and ongoing pregnancy rate of 54.21%. The multiple pregnancy rate of is 1.24%. For patients aged 34 and above, the CPR decreased by 10% for every 1-year increase in age (adjusted OR 0.90, 95% CI 0.84–0.96, p < 0.0001). Similarly, the OPR decreased by 16% for every 1-year increase in age (adjusted OR 0.84, 95% CI 0.81–0.88, p < 0.0001). Patients aged 35–37 years had an acceptable OPR of 52.4% after eSET, with a low multiple pregnancy rate (1.1%). Pregnancy outcomes were significantly better in blastocyst cycles compared to cleavage embryo cycles, and this trend was more pronounced in older patients. There was a non-linear relationship between female age and pregnancy outcomes in patients undergoing their first eSET cycles. The clinical pregnancy rate and ongoing pregnancy rate decreased significantly with age, especially in women older than 34 years. For patients under 37 years old, single embryo transfer should be prioritized. For patients over 38 years old with available blastocysts, eSET is also recommended. [ABSTRACT FROM AUTHOR]

In assisted reproductive technology, in vitro fertilization involves cultivating embryos in an artificial environment, often yielding lower-quality embryos compared to in vivo conditions. This study investigated core body temperature (CBT) fluctuations in mice during early pregnancy. Their CBT was measured with a high temporal resolution to identify the optimal thermal conditions during the first five days post-fertilization, aiming to improve in vitro culture conditions. Data were collected from 12 female mice, with 8 becoming pregnant, using temperature loggers every minute for 11 days. Data analysis focused on trends, circadian rhythms, frequency components, and complexity using multiscale entropy (MSE). The results for the pregnant mice showed a mean CBT increase from 37.23 °C to 37.56 °C post-mating, primarily during the light phase, with a significant average rise of 0.58 °C. A Fourier analysis identified dominant 24, 12, 8, and 6 h components, with the 24 h component decreasing by 57%. Irregular fluctuations decreased, and MSE indicated increased complexity in the CBT time series post-mating. These results suggest that reducing diurnal temperature variations and maintaining a slightly elevated mean CBT of approximately 37.5 °C, with controlled minor fluctuations, may enhance embryo quality in pregnant mice. This study provides a reference for temperature regulation in embryo culture, improving embryo quality by aligning in vitro conditions with the natural thermal environment of the fallopian tubes. [ABSTRACT FROM AUTHOR]

Introduction: In vitro fertilization (IVF) is a technology that assists couples experiencing infertility to conceive children. However, unsuccessful attempts can lead to significant physical and financial strain. Some individuals opt for electro-acupuncture (EA) during IVF, even though there is limited evidence regarding the efficacy of this practice. Thus, this pilot study aims to explore the effectiveness and safety of EA during IVF on pregnancy outcomes. Methods and analysis: This clinical trial is a parallel, randomized, shamcontrolled study. It aims to include a total of 118 infertile women who intend to undergo IVF. The participants will be randomly divided into three groups in a 1:1:1 ratio: the EA + IVF group, the placebo electro-acupuncture (pEA) +IVF group, and the IVF control group. All of the patients will be required to use ovarian stimulation drugs, while those in the EA + IVF and pEA + IVF groups will receive acupuncture treatment at three sessions per week (every other day) until trigger day with a minimum five session. The primary outcome of this trial will focus on the clinical pregnancy rate (CPR). CPR is defined as the rate of achieving clinical pregnancy from the first fresh/frozen embryo transfer cycle with an ultrasound-confirmed gestational sac in the uterine cavity. The secondary outcomes will assess embryology data, biochemical pregnancy rate, early miscarriage rate, Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Fertile Quality of Life (FertiQoL), patient retention rate, treatment adherence, and safety outcomes. Ethics and dissemination: Ethics approval was obtained from the Ethics Committee of Sichuan Jinxin Xi'nan Women and Children Hospital (number 2021-007). The results will be disseminated through peer-reviewed publications. The participants gave informed consent to participate in the study before taking part in it. [ABSTRACT FROM AUTHOR]

About 18% of reproductive-age adults worldwide are affected by infertility. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are widely used assisted reproductive technologies (ARTs) aimed at improving clinical outcomes. Efficient and noninvasive selection and isolation of highly motile sperm with intact DNA are essential for the success of IVF and ICSI and can potentially impact the therapeutic efficacy and the health of the offspring. Compared to traditional methods, microfluidic technology offers significant advantages such as low sample consumption, high efficiency, minimal damage, high integration, similar microenvironment, and high automation, providing a new platform for ARTs. Here, we review the current situation of microfluidic technology in the field of sperm motility screening and evaluation and IVF research. First, we focus on the working principle, structural design, and screening results of sperm selection microfluidic platforms. We then highlight how the multiple steps of the IVF process can be facilitated and integrated into a microfluidic chip, including oocyte capture, sperm collection and isolation, sperm sorting, fertilization, and embryo culture. Ultimately, we summarize how microfluidics can complement and optimize current sperm sorting and IVF protocols, and challenges and possible solutions are discussed. [ABSTRACT FROM AUTHOR]

Background: Amphiregulin (AR) is a growth factor that resembles the epidermal growth factor (EGF) and serves various functions in different cells. However, no systematic studies or reports on the role of AR in human oocytes have currently been performed or reported. This study aimed to explore the role of AR in human immature oocytes during in vitro maturation (IVM) and in vitro fertilization (IVF) in achieving better embryonic development and to provide a basis for the development of a pre-insemination culture medium specific for cumulus oocyte complexes (COCs). Methods: First, we examined the concentration of AR in the follicular fluid (FF) of patients who underwent routine IVF and explored the correlation between AR levels and oocyte maturation and subsequent embryonic development. Second, AR was added to the IVM medium to culture immature oocytes and investigate whether AR could improve the effects of IVM. Finally, we pioneered the use of a fertilization medium supplemented with AR for the pre-insemination culture of COCs to explore whether the involvement of AR can promote the maturation and fertilization of IVF oocytes, as well as subsequent embryonic development. Results: A total of 609 FF samples were examined, and a positive correlation between AR levels and blastocyst formation was observed. In our IVM study, the development potential and IVM rate of immature oocytes, as well as the fertilization rate of IVM oocytes in the AR-added groups, were ameliorated significantly compared to the control group (All P < 0.05). Only the IVM-50 group had a significantly higher blastocyst formation rate than the control group (P < 0.05). In the final IVF study, the maturation, fertilization, high-quality embryo, blastocyst formation, and high-quality blastocyst rates of the AR-added group were significantly higher than those of the control group (All P < 0.05). Conclusion: AR levels in the FF positively correlated with blastocyst formation, and AR involvement in pre-insemination cultures of COCs can effectivelyimprove laboratory outcomes in IVF. Furthermore, AR can directly promote the in vitro maturation and developmental potential of human immature oocytes at an optimal concentration of 50 ng/ml. [ABSTRACT FROM AUTHOR]

Background/Objectives: This paper undertakes an investigation into the implications of premature progesterone rise (PPR) on pregnancy outcomes in freeze-all strategy cycles. Methods: A retrospective cohort study encompassing 675 IVF/ICSI cycles using a freeze-all strategy was enrolled. The cycles were categorized into two groups based on serum progesterone levels at the time of hCG administration: 526 cycles had levels below 1.5 ng/mL, while 149 cycles had levels equal to or above 1.5 ng/mL. Results: The findings revealed a significantly higher number of mature follicles and retrieved oocytes in patients with PPR across all AMH categories. Multiple analyses revealed factors influencing PPR, including the duration of induction and the number of retrieved oocytes. Within the same oocyte retrieval number group, patients with PPR demonstrated non-inferior pregnancy outcomes compared to non-PPR patients. Upon adjustment for age, AMH, and total follicle-stimulating hormone (FSH) dosage, PPR maintained a positive correlation with the cumulative live birth rate (LBR). Conclusions: The study showed that PPR correlates with an increase in retrieved oocytes while maintaining similar embryo quality and oocyte retrieval rates and results in a higher cumulative LBR. [ABSTRACT FROM AUTHOR]

The objectives of this study were to analyze the (1) effects of donor age and multiparity on development of in vitro fertilization (IVF) embryos after ovum pickup (OPU), (2) effects of repeated and consecutive OPU-IVF procedures on embryo development, and (3) embryo production from OPU-IVF in donors with differing embryo yields after multiple ovulation and embryo transfer technology (MOET) in Japanese Black cattle (Wagyu). Donors were pre-treated with low-dosage follicle-stimulating hormone (FSH; 200 IU total), and oocytes were collected via OPU and fertilized by IVF to generate blastocysts. The number of oocytes collected per OPU session per donor was lower in heifers (2–4 years old, 5.3 oocytes) than in primiparous and pluriparous cows (2–10 years old, 13.6–19.1 oocytes; P < 0.05). Rates of blastocyst development for oocytes from heifers (33.1%) were lower than for those from cows (2–10 years old, 44.1–54.3%; P < 0.05), and average blastocyst yield/OPU/animal was lower in heifers (3.7) than in 5–6 years old cows (10.1; P < 0.05). Donors undergoing five consecutive OPU-IVF sessions after low-dosage FSH showed similar oocyte retrieval (12.2–15.1 oocytes per OPU/animal), blastocyst development rates (35.6–45.0%), and embryo yield/OPU/animal (4.8–5.8; P > 0.05) across sessions. Additionally, embryo yield from OPU-IVF was significantly improved in animals with previous low embryo yield from MOET (5.9 vs. 2.6, respectively, P < 0.05). These results indicate that Wagyu cows with previous births can be more productive as OPU-IVF donors than heifers, and oocytes from donors undergoing to five consecutive OPU-IVF cycles are competent for embryo development without loss of embryo yield/OPU/animal. Moreover, OPU-IVF can be used for embryo production and breeding from all elite Japanese Black cattle, regardless of previous low embryo yield in routine MOET. • Wagyu heifers (2–4 years old) had lower blastocyst rates and embryo yields via OPU-IVF than cows (2–10 years old). • After 5 consecutive OPU sessions , number of oocytes collected per OPU per animal, and blastocyst rates were not different. • Low-embryo-yield donors in a MOET program can be allocated to OPU-IVF to produce more embryos. [ABSTRACT FROM AUTHOR]

Background: Infertility affects married adults, and In Vitro Fertilization (IVF) is an Assisted Reproductive Technology (ART) that can treat it. Women undergoing IVF are more likely to experience depression. There is a need to reduce depression by supporting and advising sufferers. The aim of this study is to evaluate the effect of depression on pregnancy rates among infertile females underwent IVF treatment. Materials and Methods: This observational study analyzed 149 patients attending the infertility center at Kamal Al-Samaraie hospital seeking a chance of a conception. The participants received a traditional hospital protocol. The study assessed depression status using the CES-D (Center for Epidemiologic Studies Depression) scale at the beginning of the IVF cycle. Results: Conclusion: Our findings show that the pregnancy rate was not related to baseline depression of women underwent the first IVF procedure. .

Introduction: Polycystic ovary syndrome (PCOS) is a common multifactorial and polygenic disorder of the endocrine system, affecting up to 20% of women in reproductive age with a still unknown etiology. Follicular fluid (FF) represents an environment for the normal development of follicles rich in metabolites, hormones and neurotransmitters, but in some instances of PCOS the composition can be different. Vasoactive intestinal peptide (VIP) is an endogenous autonomic neuropeptide involved in follicular atresia, granulosa cell physiology and steroidogenesis. Methods: ELISA assays were performed to measure VIP and estradiol levels in human follicular fluids, while AMH, FSH, LH, estradiol and progesterone in the plasma were quantified by chemiluminescence. UHPLC/QTOF was used to perform the untargeted metabolomic analysis. Results: Our ELISA and metabolomic results show: i) an increased concentration of VIP in follicular fluid of PCOS patients (n=9) of about 30% with respect to control group (n=10) (132 ± 28 pg/ml versus 103 ± 26 pg/ml, p=0,03) in women undergoing in vitro fertilization (IVF), ii) a linear positive correlation (p=0.05, r=0.45) between VIP concentration and serum Anti-Müllerian Hormone (AMH) concentration and iii) a linear negative correlation between VIP and noradrenaline metabolism. No correlation between VIP and estradiol (E2) concentration in follicular fluid was found. A negative correlation was found between VIP and noradrenaline metabolite 3,4-dihydroxyphenylglycolaldehyde (DOPGAL) in follicular fluids. Conclusion: VIP concentration in follicular fluids was increased in PCOS patients and a correlation was found with noradrenaline metabolism indicating a possible dysregulation of the sympathetic reflex in the ovarian follicles. The functional role of VIP as noradrenergic modulator in ovarian physiology and PCOS pathophysiology was discussed. [ABSTRACT FROM AUTHOR]

The last few decades have witnessed a rise in the global uptake of in vitro fertilization (IVF) treatment. To ensure optimal use of this technology, it is important for patients and clinicians to have access to tools that can provide accurate estimates of treatment success and understand the contribution of key clinical and laboratory parameters that influence the chance of conception after IVF treatment. The focus of this review was to identify key predictors of IVF treatment success and assess their impact in terms of live birth rates. We have identified 11 predictors that consistently feature in currently available prediction models, including age, duration of infertility, ethnicity, body mass index, antral follicle count, previous pregnancy history, cause of infertility, sperm parameters, number of oocytes collected, morphology of transferred embryos, and day of embryo transfer. [ABSTRACT FROM AUTHOR]

With all the current misinformation on social media platforms about the COVID-19 vaccine and its potential effects on fertility, it is essential for healthcare providers to have evidenced-based research to educate their patients, especially those who are trying to conceive, of the risks to mothers and fetuses of being unvaccinated. It is well known that COVID-19 infection puts pregnant women at higher risk of complications, including ICU admission, placentitis, stillbirth, and death. In February of 2021, the American College of Obstetricians and Gynecologists (ACOG), the American Society for Reproductive Medicine (ASRM), and the Society for Maternal–Fetal Medicine (SMFM) released a statement denying any link between COVID vaccination and infertility. ASRM later confirmed and stated that "everyone, including pregnant women and those seeking to become pregnant, should get a COVID-19 vaccine". In this review, we aim to provide a compilation of data that denies any link between vaccination and infertility for healthcare providers to be able to educate their patients based on evidence-based medicine. We also reviewed the effect of COVID-19 virus and vaccination on various parameters and processes that are essential to obtaining a successful pregnancy. [ABSTRACT FROM AUTHOR]

Objective: Obesity is known to have negative impaction on reproductive health and ovarian functions. It may alter endocrine axis and quality of oocytes, and indirectly effect the success of in vitro fertilization (IVF). Methods: Medical records of patients with polycystic ovary syndrome (PCOS) who were applied for IVF between 2018 and 2024 were reviewed. Demographics, indications for reproductive treatment, IVF outcome parameters and the factors contributing to morbidity of treatment were recorded. Student's test with one-way analysis of variance (ANOVA) and Kruskal-Wallis tests were used to compare the variables. P < 0.05 was considered statistically significant. Results: 186 patients with PCOS were divided as lean (BMI<25 kg/m2, control), overweight (BMI 25-30 kg/m2) and obese (BMI>30 kg/m2). Mean ages and primary infertility rates were similar (both, P > 0.05), but duration of infertility was longer in overweight and obese patients (P < 0.05). Although patients with higher BMI required more induction dose for the cycle, number of retrieved oocytes did not change significantly, with achieved chemical and clinical pregnancy (each, P > 0.05). Moreover, fertilization rates of transferred oocytes and rates of adverse outcomes during pregnancies were similar in the groups (each, P > 0.05). Although overweight and obese patients with PCOS required more gonadotropin induction for IVF cycle (2311 vs 1920 vs 1752 IU, respectively, P < 0.05), the numbers of metaphase II and fertilized oocytes were seen to be similar with increasing BMI (each, P > 0.05). Conclusion: There is longer infertility duration and a higher requirement for gonadotropins in overweight and obese patients with no effect of BMI on most of IVF parameters such as retrieved oocyte, clinical pregnancy, obstetric complication and delivery rate. [ABSTRACT FROM AUTHOR]

Endometriosis has been shown to be associated with unfavorable development and maturation of oocytes, as well as aberrancies in embryonal development, including arrest after fertilization, following in vitro fertilization (IVF). Time-lapse monitoring (TLM) enables continuous and non-invasive monitoring of embryo morphokinetics during the IVF process and might be useful in the assessment of embryos from women with endometriosis. In this review, five eligible studies were evaluated to determine if embryo morphokinetics assessed under TLM differ in patients with endometriosis and subsequently predict blastocyst quality, implantation and success of pregnancy. The studies showed overall inferior morphokinetic parameters of embryos from endometriosis patients when compared to controls, independent of the severity of endometriosis. Embryos with optimal early morphokinetic parameters (t2, s2, t5, tSB, tEB) and late developmental events (compaction, morulation, and blastulation) had better implantation rates than those who had suboptimal ranges. However, due to few studies available with mostly retrospective data, the validity of these findings and their generalizability for clinical practice needs to be further assessed. Prospective studies with larger sample sizes are needed to determine whether using TLM for embryo selection in endometriosis improves pregnancy and live birth outcomes. [ABSTRACT FROM AUTHOR]

Infertility affects 15% of couples in reproductive age worldwide. In women in particular, infertility can be caused by various abnormalities, with polycystic ovary syndrome (PCOS) being the most common. Currently, there are many assisted reproductive techniques (ART) available to combat the burden of infertility. However, positive results are not guaranteed. The administration of inositol has been shown to increase positive reproductive outcomes in women undergoing ART. Here we present a series of clinical cases in which women with a history of infertility and previously failed ART, supplemented with a specific 3.6:1 MYO:DCI ratio, antioxidants, vitamins, and minerals for a period of 1 to 3 months before undergoing in vitro fertilization (IVF). In this series of case reports, we provide preliminary evidence that supplementation with a specific 3.6:1 MYO to DCI ratio, as well as antioxidants, vitamins, and minerals may contribute positively to female fertility in women undergoing IVF, with a history of primary or secondary infertility and previously failed ART. [ABSTRACT FROM AUTHOR]

Semaphorin 3A (SEMA3A) plays a crucial role in the development, differentiation, and plasticity of specific types of neurons that secrete Gonadotropin-Releasing Hormone (GnRH) and regulates the acquisition and maintenance of reproductive competence in humans and mice. Its insufficient expression has been linked to reproductive disorders in humans, which are characterized by reduced or failed sexual competence. Various mutations, polymorphisms, and alternatively spliced variants of SEMA3A have been associated with infertility. One of the common causes of infertility in women of reproductive age is diminished ovarian reserve (DOR), characterized by a reduced ovarian follicular pool. Despite its clinical significance, there are no universally accepted diagnostic criteria or therapeutic interventions for DOR. In this study, we analyzed the SEMA3A plasma levels in 77 women and investigated their potential role in influencing fertility in patients with DOR. The results revealed that the SEMA3A levels were significantly higher in patients with DOR than in healthy volunteers. Furthermore, the SEMA3A levels were increased in patients who underwent fertility treatment and had positive Beta-Human Chorionic Gonadotropin (βHCG) values (β+) after controlled ovarian stimulation (COS) compared to those who had negative βHCG values (β−). These findings may serve as the basis for future investigations into the diagnosis of infertility and emphasize new possibilities for the SEMA3A-related treatment of sexual hormonal dysfunction that leads to infertility. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This case report illustrates that in vitro fertilization (IVF) may be a potential risk factor for pregnancy‐associated osteoporosis (PAO), highlighting the need for awareness and monitoring of bone health in women undergoing IVF treatments. PAO is a rare disease resulting from an imbalance of calcium in the body during pregnancy and lactation and presenting with fragility fractures. PAO occurs in late pregnancy or early postpartum period. A 28‐year‐old woman who conceived through IVF experienced severe back pain 2 days after delivery. Magnetic resonance imaging of the spine showed wedge‐shaped fractures of T9‐T12 vertebrae. Bone mineral density (BMD) was low on dual‐energy x‐ray absorptiometry. The laboratory tests were within the normal range. Based on the clinical manifestations, osteoporotic spine fracture, results of BMD, and exclusion of other causes of osteoporosis, the patient was diagnosed with PAO. Considering the deleterious effect of treatment with gonadotropin‐releasing hormone and repeated superovulation on bone, we hypothesized that IVF may be an etiological factor for PAO. [ABSTRACT FROM AUTHOR]

Since the inception of in vitro fertilization (IVF), monitoring of controlled ovarian stimulation (COS) has traditionally involved numerous appointments for ultrasound and laboratory testing to guide medication use and dosing, determine trigger timing, and allow for measures to reduce the risk of ovarian hyperstimulation syndrome (OHSS). Recent advances in the field of assisted reproductive technology (ART) have called into question the timing and frequency of COS monitoring appointments, as discussed in this commentary. [ABSTRACT FROM AUTHOR]

Graphene oxide (GO) and Fe3O4 super paramagnetic material are good candidate for some applications such as drug delivery. It has been shown that combining Fe3O4 with graphene oxide increases the biological efficiency of GO. The use of novel assisted reproductive technologies such as gonadotropins injection has been able to help the fertility of infertile people, but the side effects of these methods and high costs are still problems. The aim of the present study was to investigate the effect of magnetic graphene oxide (MGO) on the in vivo maturation of mouse oocytes. Thirty 6–8-week old female Naval Medical Research Institute (NMRI) mice were treated with intra peritoneal (I.P) injection of MGO mixed with hormones. 12 h after I.P. injection of MGO mixed with PMSG and HCG, the number of metaphase II (MII) oocytes obtained from the left fallopian tubes was counted in each group. Also, immuno-cytochemical staining of glutathione and morphometric analysis of ovaries were studied. The results of this study showed that the simultaneous use of MGO, pregnant mare serum gonadotropin (PMSG), and human chorionic gonadotrophin (HCG) increases the number of MII oocytes and helps to increase maturation of oocytes. It could be concluded that MGO can increase the efficiency of super ovulating hormones due to increase in adsorption of serum hormones and growth factors.

Objective: It has been demonstrated that the composition of the follicular fluid and many internal/external factors affect success in subfertile couples undergoing intracytoplasmic sperm injection (ICSI). We examined the effect of folic acid, B12, D, and E vitamins and melatonin values in follicular fluid on pregnancy in women with low, normal, and high ovarian reserves who underwent ICSI. Methods: Our study was conducted at Samsun Medical Park Hospital between January 2021 and February 2022. Follicular fluid induction samples were taken from 96 infertile women with low, normal, and high ovarian reserve, and ICSI was applied. Folic acid, B12, D, and E vitamins and melatonin levels were measured in follicular fluid samples by ELISA method. Statistical analyzes were done with SPSS, and ROC curve analyses were used. Results: Nine people with poor reserve, 19 people with normal reserve and 14 people with high reserve became pregnant. Folic acid, Vitamin-D, B12, E and melatonin levels were lower in those with poor ovarian reserve than in those with normal and high ovarian reserve (p<0.05). According to the pregnancy test, the probability of pregnancy was 43,783 times higher with high levels of folic acid, while it was 8,096 times higher for vitamin D. While vitamin B12 levels were 31,474 times more likely to be pregnancies, vitamin E levels were 35,227 times higher. For melatonin, the values showed that the probability of pregnancy increased by 11,564 times. Conclusions: High antioxidants may increase the likelihood of conception in infertile women undergoing ICSI. Therefore, couples who will be treated should be advised to increase these markers, especially melatonin in the follicular fluid. [ABSTRACT FROM AUTHOR]

The aim: to study of the prognostic value of endometrial receptivity and preimplantation genetic diagnosis of embryos, and their influence on the effectiveness of in vitro fertilization (IVF) programs. We also evaluate the importance of this factor in comparison with other potential causes of infertility. Materials and methods: This prospective cohort study included 123 infertile women who underwent in vitro fertilization (IVF) treatment. 93 patients had repeated unsuccessful implantation attempts and were divided into three groups: group 1 - patients who were treated using genetically untested embryos according to a standard fixed stimulation protocol, group 2 - patients who were treated using euploid embryos after preimplantation genetic screening according to standard fixed protocol; group 3 - patients who underwent treatment using euploid embryos after pre-implantation genetic screening and determination of the implantation window with subsequent modification of the stimulation protocol, according to the endometrial examination result. 30 patients had a first attempt at IVF, which was carried out using genetically untested embryos, according to a standard fixed protocol, and made up the control group (CG). Determination of the window of implantation was carried out by triple aspiration biopsy of the endometrium during the luteal phase of the menstrual cycle since the endometrium is most susceptible to implantation during this period. Samples were analyzed using scanning electron microscopy. Based on the results obtained, the endometrial preparation protocol was individualized for the next attempt. preimplantation genetic testing (PGT) of embryos was carried out by the next generation (NGS) method. Statistical analysis was performed using IBM SPSS V25.0 for Windows software. Results: According to the obtained results, patient characteristics, screening rates, IVF cycle characteristics, and the number, quality, and stage of transferred embryos were compared between groups. The rate of clinical pregnancy was 46.7 % among patients of group 1.70 % among patients of group 2, 82.8 % among patients of group 3 and 50.0 % of the control group and statistically significantly different between groups (χ2=10.955, p=0.012). The rate of live birth was 43.3 % among patients of group 1, 53.3 % among patients of group 2, 72.4 % among patients of group 3 and 43.3 % - of the control group, however, it did not differ statistically significantly between groups (χ2=6.639, р=0.084). Conclusions: The unique window of implantation and the embryonic factor are among the main reasons for multiple failed implantation attempts. Personalization of the endometrial preparation protocol and preimplantation embryo diagnosis are effective methods to improve IVF outcomes. [ABSTRACT FROM AUTHOR]

Graphene oxide (GO) and Fe3O4 super paramagnetic material are good candidate for some applications such as drug delivery. It has been shown that combining Fe3O4 with graphene oxide increases the biological efficiency of GO. The use of novel assisted reproductive technologies such as gonadotropins injection has been able to help the fertility of infertile people, but the side effects of these methods and high costs are still problems. The aim of the present study was to investigate the effect of magnetic graphene oxide (MGO) on the in vivo maturation of mouse oocytes. Thirty 6-8-week old female Naval Medical Research Institute (NMRI) mice were treated with intra peritoneal (I.P) injection of MGO mixed with hormones. 12 h after I.P. injection of MGO mixed with PMSG and HCG, the number of metaphase II (MII) oocytes obtained from the left fallopian tubes was counted in each group. Also, immuno-cytochemical staining of glutathione and morphometric analysis of ovaries were studied. The results of this study showed that the simultaneous use of MGO, pregnant mare serum gonadotropin (PMSG), and human chorionic gonadotrophin (HCG) increases the number of MII oocytes and helps to increase maturation of oocytes. It could be concluded that MGO can increase the efficiency of super ovulating hormones due to increase in adsorption of serum hormones and growth factors. [ABSTRACT FROM AUTHOR]

Background The chance of achieving a successful pregnancy through in vitro fertilization and embryo transfer (IVF-ET) is limited despite recent scientific advances in this field due to several factors that are known to affect the outcome. There are studies linking the presence of bacteria in the male genital tract to poor semen parameters and IVF-ET outcomes. Results are, however, contradictory. The finding of confirmed genital tract infection warrants treatment, especially when dealing with infertile couples, but treating asymptomatic bacteriospermia is controversial. This study assessed the prevalence and effects of seminal fluid bacterial isolates on semen quality and rates of fertilization and biochemical and clinical pregnancies in IVF-ET. Methodology This is an analytical cross-sectional study conducted at the IVF Center of National Hospital Abuja, Nigeria. Due to the low turnout of clients, we enrolled all consecutive consenting eligible male partners of women undergoing the procedure during the study period to obtain a sample size of 242. Participants observed sterile techniques to prevent contamination of the seminal fluid during collection. Growth of bacteria > 10,000 colony-forming units (CFU)/ml was considered significant and tested for sensitivity to a panel of antibiotics. We determined the influence of positive bacterial isolates on fertilization, biochemical pregnancy, clinical pregnancy (primary outcome), and multiple pregnancies. Data were analyzed using SPSS version 22. Student's t-test, chi-square test, and Fisher's exact tests were employed as appropriate. p-value < 0.05 at a 95% confidence interval was regarded as statistically significant. Results Seminal fluid culture was positive in 57 patients (47.11%). Staphylococcus aureus was the predominant organism cultured (43.90%), followed by Streptococci spp. (21.05%), Escherichia coli (17.54%), Klebsiella spp. (8.77%), Pseudomonas aeruginosa (5.26%), Staphylococcus saprophyticus (1.75%), mixed Staphylococcus aureus, and Streptococcus spp. organisms (1.75%). The fertilization rate was 95.4%, the biochemical pregnancy rate was 42.2%, the clinical pregnancy rate was 38%, and the multiple pregnancy rate was 16.53%. Significant factors found to be associated with positive clinical pregnancy were primary infertility (p-value = 0.001) and negative seminal fluid culture result (p-value = 0.033). Conclusion The prevalence of bacteriospermia was relatively high, and the presence of bacterial isolates adversely affected fertilization and clinical pregnancy rates among couples undergoing the IVF-ET program. [ABSTRACT FROM AUTHOR]

The author examines two open questions for religious ethicists: whether continuing to have children is a bad idea, given the challenges of antinatalism and climate change, and how we should evaluate the future of reproductive technology. Kao responds to these questions without resolving them by drawing upon human rights, the reproductive justice framework, and principles of social justice. [ABSTRACT FROM AUTHOR]

Aims: To investigate the association between the number of oocytes and the polyspermy rate following in vitro fertilization (IVF) treatment. Materials and methods: 376 IVF cycles with gonadotropin-releasing hormone (GnRH) antagonist protocol in the reproductive center of our hospital were retrospectively included in the analysis, which were divided into five groups according to the number of oocytes retrieved. Group A (78 cases):1–5 oocytes, group B (118 cases): 6–10 oocytes, group C (94 cases): 11–15 oocytes, group D (55 cases): 16–20 oocytes, group E (31 cases): ≥21 oocytes. According to polyspermy rate, 376 IVF cycles were then divided into two groups. Normal level polyspermy group (170 cases): polyspermy rate<6%, and high level polyspermy group (206 cases): polyspermy rate ≥ 6%. The variables with p <.10 in univariate analysis were incorporated into the multiple logistic regression model to control the confounding, and the effect of the number of oocytes on the increase of polyspermy rate was analyzed. Results: Multiple logistic regression analysis showed that after adjustment for confounding factor, the increase risk of polyspermy rate in group B, C, D and E was 1.763, 3.804, 2.021 and 3.208 times of that in group A respectively (OR = 1.763, p =.085; OR = 3.804, p =.001; OR = 2.021, p =.158; OR = 3.208, p =.068, respectively). Conclusion: This result demonstrated that when the oocyte number is 15 or less, the more the oocyte number, the greater the increase risk of polyspermy rate. While, there appears to be little increase risk of polyspermy rate when the oocyte number is more than 15. [ABSTRACT FROM AUTHOR]

Background: Glutathione S-transferase (GST) M1 belongs to a family of detoxification enzymes and deficiency in enzyme activity is due to a homozygous deletion of the GSTM1 gene. Several studies reveal a possible correlation between female infertility and GSTM1 polymorphisms. The aim of this study is to investigate the effect of the GSTM1-null polymorphism in female infertility as well as in IVF parameters. Methods: In the study group 125 women were classified as infertile according to WHO and 49 women with at least one successful pregnancy and no miscarriages, as control group. Genomic DNA from blood samples was isolated and PCR amplification was applied to determine the presence of GSTM1-null genotype. Results: Data analysis demonstrated a statistically significant higher presence of GSTM1-null variant in the infertile group compared to the control group. In a subgroup analysis of the infertile group, the estradiol levels, the number of fertilized oocytes as well as the number and the quality of the cumulus-oocyte complex, were statistically significant higher in women detected with the wildtype of GSTM1 gene compared to those who had the GSTM1 null genotype (deletion). Conclusions: Our study results propose a possible involvement of GMST1 in female infertility and may help elucidate possible interactions between the microenvironment of oocytes and the oxidative stress. [ABSTRACT FROM AUTHOR]

Women with polycystic ovary syndrome (PCOS) tend to have elevated anti-Müllerian hormone (AMH) levels, which appear to correlate with disease severity and pregnancy outcomes. This was a retrospective observational study designed to assess the relationship between circulating AMH levels and in vitro fertilization (IVF) outcomes. The study involved 150 women with PCOS who underwent IVF treatments. The women's IVF cycles were allocated into three subgroups according to AMH levels: 'low' (AMH < 3.7 ng/mL; n = 49), 'middle' (AMH 3.7–7.4 ng/mL; n = 94), and 'high' (AMH > 7.4 ng/mL; n = 56). All pregnancy-related outcomes (positive beta human chorionic gonadotropin (βHCG), clinical pregnancy rate, live birth rate, and cumulative live birth rate) were greater in women's IVF cycles with 'low' AMH when compared to those with 'middle' or 'high' AMH (p < 0.05). AMH levels below 3.7 ng/mL were found to be associated with lower oocyte immaturity rate and better pregnancy outcomes, although baseline AMH was not shown to have any significant predictive power for live birth and cumulative live birth in the multivariable logistic regression analysis after adjusting for possible confounders nor in the ROC analyses. In summary, the current study lays the groundwork to validate high AMH levels as a poor prognostic factor for pregnancy outcomes after IVF in women with PCOS. [ABSTRACT FROM AUTHOR]

IntroductionPolycystic ovary syndrome (PCOS) is a common multifactorial and polygenic disorder of the endocrine system, affecting up to 20% of women in reproductive age with a still unknown etiology. Follicular fluid (FF) represents an environment for the normal development of follicles rich in metabolites, hormones and neurotransmitters, but in some instances of PCOS the composition can be different. Vasoactive intestinal peptide (VIP) is an endogenous autonomic neuropeptide involved in follicular atresia, granulosa cell physiology and steroidogenesis.MethodsELISA assays were performed to measure VIP and estradiol levels in human follicular fluids, while AMH, FSH, LH, estradiol and progesterone in the plasma were quantified by chemiluminescence. UHPLC/QTOF was used to perform the untargeted metabolomic analysis.ResultsOur ELISA and metabolomic results show: i) an increased concentration of VIP in follicular fluid of PCOS patients (n=9) of about 30% with respect to control group (n=10) (132 ± 28 pg/ml versus 103 ± 26 pg/ml, p=0,03) in women undergoing in vitro fertilization (IVF), ii) a linear positive correlation (p=0.05, r=0.45) between VIP concentration and serum Anti-Müllerian Hormone (AMH) concentration and iii) a linear negative correlation between VIP and noradrenaline metabolism. No correlation between VIP and estradiol (E2) concentration in follicular fluid was found. A negative correlation was found between VIP and noradrenaline metabolite 3,4-dihydroxyphenylglycolaldehyde (DOPGAL) in follicular fluids.ConclusionVIP concentration in follicular fluids was increased in PCOS patients and a correlation was found with noradrenaline metabolism indicating a possible dysregulation of the sympathetic reflex in the ovarian follicles. The functional role of VIP as noradrenergic modulator in ovarian physiology and PCOS pathophysiology was discussed.

Key Clinical Message This case report illustrates that in vitro fertilization (IVF) may be a potential risk factor for pregnancy‐associated osteoporosis (PAO), highlighting the need for awareness and monitoring of bone health in women undergoing IVF treatments. PAO is a rare disease resulting from an imbalance of calcium in the body during pregnancy and lactation and presenting with fragility fractures. PAO occurs in late pregnancy or early postpartum period. A 28‐year‐old woman who conceived through IVF experienced severe back pain 2 days after delivery. Magnetic resonance imaging of the spine showed wedge‐shaped fractures of T9‐T12 vertebrae. Bone mineral density (BMD) was low on dual‐energy x‐ray absorptiometry. The laboratory tests were within the normal range. Based on the clinical manifestations, osteoporotic spine fracture, results of BMD, and exclusion of other causes of osteoporosis, the patient was diagnosed with PAO. Considering the deleterious effect of treatment with gonadotropin‐releasing hormone and repeated superovulation on bone, we hypothesized that IVF may be an etiological factor for PAO.

Objective: This study’s aim is to compare pregnancy outcomes in multifetal gestations that were conceived spontaneously compared to in vitro fertilization (IVF). Few population-based studies have addressed this topic. Study design: This is a retrospective cohort study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) database. Our study cohort included 90,552 multifetal gestations conceived spontaneously and 3219 IVF conceptions, from 2008 to 2014, inclusively. Multivariate logistic regression analyses were performed comparing maternal and neonatal outcomes, whilst adjusting for confounding variables. Subject was conducted using ICD-9 codes for multifetal gestation: 651. X and 76.1 and ICD-9 code for IVF: 23.85. Each pregnancy was included once. Results and conclusion: IVF multifetal gestations had increased risk of pregnancy-induced hypertension (aOR 1.31, 95 % CI 1.20–1.43), gestational hypertension (aOR 1.21, 95 % CI 1.04–1.41), preeclampsia (aOR 1.31, 95 % CI 1.19–1.45), gestational diabetes (aOR 1.26, 95 % CI 1.13–1.41) and placenta previa (aOR 1.7, 95 % CI 1.32–2.19). IVF delivery outcomes were more likely complicated by cesarean section (aOR 1.21, 95 % CI 1.10–1.33), preterm premature rupture of membranes (aOR 1.33, 95 % CI 1.16–1.52), chorioamnionitis (aOR 1.71, 95 % CI 1.37–2.14), postpartum hemorrhage (aOR 1.44, 95 % CI 1.26–1.63) and transfusions (aOR 1.48, 95 %CI 1.26–1.74). IVF neonatal outcomes were more likely complicated by small for gestational age (aOR 1.26, 95 % CI 1.12–1.41) and congenital anomalies (aOR 1.82, 95 % CI 1.29–2.57). IVF was not found to increase risks of eclampsia, preterm delivery, operative vaginal delivery, hysterectomy, or intrauterine fetal demise.IVF increased the risk of pregnancy, delivery, and neonatal outcomes in multifetal pregnancies with risks increased from 20 % to 70 %. The role of infertility versus the need for IVF and the type of IVF protocol used should be further evaluated.

Attempts at assessing endometrial receptivity through its transcriptomic signature have unfortunately failed. On the contrary, RCTs have indicated that the period of receptivity is fairly wide, lasting 48–72 hours. Today, the ultimate challenge is to optimize hormonal preparation for frozen embryo transfers (FETs). Recent data have provided compelling evidence that vaginal progesterone provides insufficient plasma levels of progesterone in a large fraction of patients, which leads to lower live birth rates and increased risks of miscarriage. The most efficient option consists in delivering injectable progesterone, or opting for a combo approach associating vaginal and injectable progesterone.

Assisted reproductive technologies (ART) have accomplished spectacular progresses over the last few years, leading to sustained implantation rates (sIR) [Formula: see text]60% following euploid blastocyst transfers. These results raise new challenges for infertility specialists, notably the ability to care for infertile couples who fail ART, sometimes recurrently. ART failures may be due to disorders residing in the endometrium (the soil) or embryo (seed). To simplify the review of this dilemma and limit variables, we focused our research on the outcome of euploid blastocysts transfers conducted in E2 and i.m. progesterone replacement cycles. This methodological choice for our research should not be confused with a therapeutic recommendation in case of ART failures. The sum of the data collected indicates that if recurrent implantation failure (RIF) exists, it is extremely rare, affecting only [Formula: see text]5% of ART couples.

Abstract Background Many clinical studies based on spontaneous pregnancies (SPs) have demonstrated the superiority of non-invasive prenatal testing (NIPT), and the question of whether this technology is suitable for offspring conceived by assisted reproductive technology has attracted attention. This study aimed to evaluate the application value of NIPT in screening for trisomy (T)21, T18, T13 and sex chromosome aneuploidy (SCA) in pregnant women who conceived by in vitro fertilization (IVF). Results In total, there were 804 high-risk cases [0.88% (804/91280), singleton = 795, twin = 9] in the SP group. Among the 558 invasive prenatal diagnosis (IPD) cases (singleton = 556, twin = 2), 343 (singleton = 342, twin = 1) were true positive, including 213 cases of T21, 28 of T18, 5 of T13 and 97 (singleton = 96, twin = 1) of SCA. The positive predictive values (PPVs) of T21, T18, T13, SCA and T21/T18/T13 combined in singleton pregnancy were 89.12% (213/239), 51.85% (28/54), 21.74% (5/23), 40.00% (96/240), and 77.85% (246/316), respectively, and the PPV of SCA in twin pregnancy was 100.00%. In the IVF group, IPD was performed in 19 (singleton = 16, twin = 3) of the 27 high-risk cases [0.78% (27/3477), singleton = 16, twin = 3], of which 9 (singleton = 8, twin = 1) were true positive, including 5 cases (singleton = 4, twin = 1) of T21 and 4 of SCA. The PPVs of singleton T21, SCA and T21/T18/T13 combined were 66.67% (4/6), 50.00% (4/8) and 57.14% (4/7), respectively, and the PPV of twin T21 was 100.00% (1/1). There were no significant differences in PPV among T21, SCA and T21/T18/T13 combined in singletons between the groups (89.12% vs. 66.67%, p = 0.09; 40.00% vs. 50.00%, p = 0.57; 77.85% vs. 57.14%, p = 0.20). The sensitivity and specificity were higher for singleton and twin pregnancies in the two groups. Based on follow-up results, 1 case of false negative T21 was found in the singleton SP group. Additionally, the mean foetal fraction (FF) of the IVF group was lower than that of the SP group (11.23% vs. 10.51%, p

Abstract Background Because often introduced without proper validation studies, so-called “add-ons” to IVF have adversely affected in vitro fertilization (IVF) outcomes worldwide. All-freeze cycles (embryo banking, EB) with subsequently deferred thaw cycles are such an “add-on” and, because of greatly diverging reported outcomes, have become increasingly controversial. Based on “modeling” with selected patient populations, we in this study investigated whether reported outcome discrepancies may be the consequence of biased patient selection. Results In four distinct retrospective case control studies, we modeled in four cohort pairings how cryopreservation with subsequent thaw cycles affects outcomes differently in good-, average- and poor-prognosis patients: (i) 127 fresh vs. 193 frozen donor-recipient cycles to model best-prognosis patients; (ii) 741 autologous fresh non-donor IVF cycles vs. 217 autologous frozen non-donor IVF cycles to model average prognosis patients; (iii) 143 favorably selected autologous non-donor IVF cycles vs. the same 217 frozen autologous cycles non-donor to monitor good- vs. average-prognosis patients; and (iv) 598 average and poor-prognosis autologous non-donor cycles vs. the same 217 frozen autologous non-donor cycles to model poor vs. average prognosis patients. In best-prognosis patients, EB marginally improved IVF outcomes. In unselected patients, EB had no effects. In poor-prognosis patients, EB adversely affected IVF outcomes. Unexpectedly, the study also discovered independent-of-age-associated chromosomal abnormalities, a previously unreported effect of recipient age on miscarriage risk in donor-egg recipients. Conclusions In poor-prognosis patients, EB cycles should be considered contraindicated. In intermediate-prognosis patients EB does not appear to change outcomes, not warranting additional cost and time delays. Therefore, only good-prognosis patients are candidates for EB, though they will experience only marginal benefits that may not be cost-effective.

In assisted reproductive technology, in vitro fertilization involves cultivating embryos in an artificial environment, often yielding lower-quality embryos compared to in vivo conditions. This study investigated core body temperature (CBT) fluctuations in mice during early pregnancy. Their CBT was measured with a high temporal resolution to identify the optimal thermal conditions during the first five days post-fertilization, aiming to improve in vitro culture conditions. Data were collected from 12 female mice, with 8 becoming pregnant, using temperature loggers every minute for 11 days. Data analysis focused on trends, circadian rhythms, frequency components, and complexity using multiscale entropy (MSE). The results for the pregnant mice showed a mean CBT increase from 37.23 °C to 37.56 °C post-mating, primarily during the light phase, with a significant average rise of 0.58 °C. A Fourier analysis identified dominant 24, 12, 8, and 6 h components, with the 24 h component decreasing by 57%. Irregular fluctuations decreased, and MSE indicated increased complexity in the CBT time series post-mating. These results suggest that reducing diurnal temperature variations and maintaining a slightly elevated mean CBT of approximately 37.5 °C, with controlled minor fluctuations, may enhance embryo quality in pregnant mice. This study provides a reference for temperature regulation in embryo culture, improving embryo quality by aligning in vitro conditions with the natural thermal environment of the fallopian tubes.