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Objectives: The objective of the study was to evaluate the prevalence and impact of impaired thyroid-stimulating hormone (TSH) levels on the reproductive outcomes of in vitro fertilization patients diagnosed with endometriosis and compared to controls without endometriosis. Design: This is a retrospective cohort study on prospectively collected data. Setting: The study was conducted at tertiary care university hospital. Participants: Participants were infertile women with histopathological diagnosis of endometriosis. Methods: For 12 months (January 2018 to January 2019), women were deemed suitable and subsequently divided according to serum TSH levels above or below 2.5 mIU/L and compared to patients without endometriosis. Needed sample size was at least 41 patients for each cohort of women. Co-primary outcomes were the live birth rate (LBR), clinical pregnancy rate (CPR), and pregnancy loss rate (PLR). Results: Overall, 226 women (45 with endometriosis and 181 controls without endometriosis) were included. Diagnoses of Hashimoto thyroiditis were significantly more frequent in women with rather than without endometriosis (14/45 [31.1%] vs. 27/181 [14.9%]; p = 0.012). Similarly, in women with endometriosis, Hashimoto diagnosis rates were higher with TSH ≥2.5 mIU/L compared to TSH <2.5 mIU/L (9/15 [60%] vs.5/30 [16.6%]; p = 0.001) so were the Hashimoto diagnosis rates in control group (women without endometriosis) with TSH ≥2.5 mIU/L compared to TSH <2.5 mIU/L (17/48 [35.4%] vs. 10/133 [7.5%], respectively; p = 0.001). Effect size analysis confirmed an increased risk of Hashimoto thyroiditis in women with endometriosis and TSH ≥2.5 mIU/L compared to women with endometriosis and TSH <2.5 mIU/L (risk ratio [RR] 3.60 [95% CI 1.46–8.86]) and in women with endometriosis and TSH ≥2.5 mIU/L compared to non-endometriotic euthyroid patients (RR 7.98 [95% CI 3.86–16.48]). Dysmenorrhea risk was higher in endometriotic euthyroid women compared to euthyroid patients with no endometriosis (RR 1.87 [95% CI 1.21–2.87]). The risk was still increased in euthyroid women with endometriosis relative to dysthyroid women with no endometriosis (RR 1.97 [95% CI 1.11–3.50]). There were no significant differences between the four groups for CPR, LBR, PLR and retrieved oocytes, immature oocytes, degenerated and unfertilized oocytes, cultured blastocysts, embryos and transferred embryos. Limitations: Limitations of the study were retrospective design, limited sample size, and use of different ovarian stimulation protocol. Conclusions: Thyroid autoimmunity seems more common in women with endometriosis and TSH over 2.5 mIU/L. However, there was no significant impact on in vitro fertilization and reproductive outcomes related to the coexistence of endometriosis, Hashimoto disease, and higher TSH levels. Due to limitations of the study, additional evidence is required to validate the abovementioned findings. [ABSTRACT FROM AUTHOR]

Background Study design Objective Materials and methods Results Discussion and conclusion Microsurgical vasoepididymostomy is an effective surgical method for treating epididymal obstructive azoospermia but the surgical outcomes can be affected in some non‐vasectomized epididymal obstructive azoospermia patients with concurrent vas‐deferens obstruction. This study aimed to explore the clinical characteristics and surgical outcomes in non‐vasectomized epididymal obstructive azoospermia patients with versus without concurrent vas‐deferens obstruction.Retrospective study.To explore the clinical characteristics and surgical outcomes in non‐vasectomized epididymal obstructive azoospermia patients with versus without concurrent vas‐deferens obstruction, aiming to identify predictive factors for concurrent vas‐deferens obstruction and evaluate the efficacy of microsurgical vasoepididymostomy in patients with epididymal obstructive azoospermia and concurrent short‐segment vas‐deferens obstruction.A retrospective analysis of 225 epididymal obstructive azoospermia cases was conducted at the First Affiliated Hospital of Fujian Medical University from November 2016 to March 2023. All patients underwent a comprehensive preoperative evaluation. During surgery, the vas deferens were assessed to determine the presence and extent of obstruction. Depending on the obstruction length, either a standard microsurgical vasoepididymostomy was performed, or the obstructed segment was resected followed by microsurgical vasoepididymostomy. If the remaining length post‐resection was insufficient for anastomosis, the procedure was discontinued. Data on patient clinical characteristics, operative findings, and outcomes were collected and analyzed. Logistic regression was used to identify predictive factors for concurrent vas‐deferens obstruction, and comparative analysis assessed patency and pregnancy rates between patients with and without concurrent vas‐deferens obstruction.Of the 225 patients in the study, 77 (34.22%) presented with epididymal obstructive azoospermia and concurrent vas‐deferens obstruction. Logistic regression analysis revealed that “the history of epididymitis” was a significant predictive factor for epididymal obstructive azoospermia patients with concurrent vas‐deferens obstruction (odds ratio = 9.06, p < 0.001). The average length of vas deferens obstruction amenable to microsurgical vasoepididymostomy post‐resection was 1.31 ± 0.54 cm (range from 0.50 to 2.50 cm). In contrast, cases unsuitable for microsurgical vasoepididymostomy presented an average obstruction length of 15.26 ± 5.79 cm (p < 0.001). The patency rates were 82.17% in epididymal obstructive azoospermia patients without concurrent vas‐deferens obstruction and 74.14% in those with concurrent vas‐deferens obstruction. The pregnancy rates followed a similar trend, at 34.11% and 34.48%, respectively. These differences were not statistically significant (p > 0.05 for both). However, epididymal obstructive azoospermia patients with vas‐deferens obstruction exhibited a decreased likelihood of bilateral microsurgical vasoepididymostomy (p < 0.001).Our study identifies a noticeable occurrence of concurrent vas‐deferens obstruction in non‐vasectomized epididymal obstructive azoospermia patients, with approximately one‐third of the cases (34.22%) exhibiting vas‐deferens obstruction during surgical interventions. Notably, a small fraction (6.67%) of these individuals chose not to proceed with any microsurgical vasoepididymostomy, even on one side, due to the extensive length of the obstruction. Through logistic analysis, we have demonstrated that “the history of epididymitis” is a critical predictive factor for the presence of vas‐deferens obstruction, underscoring its significance in preoperative evaluations. Furthermore, our research confirms that microsurgical vasoepididymostomy is still an effective treatment for epididymal obstructive azoospermia patients with concurrent short‐segment vas‐deferens obstruction, achieving significant patency and favorable pregnancy rates compared to those patients without vas‐deferens obstruction. These insights are pivotal for enhancing surgical strategies and improving fertility outcomes in this patient cohort. [ABSTRACT FROM AUTHOR]

Simple Summary: To better inform nilgai antelope management decisions, basic life history data are needed. We collected reproductive tracts of free-ranging female nilgai from 2018 to 2021 in Southern Texas. We found high pregnancy and twinning rates. Moreover, we found nilgai as young as 1 year old to be pregnant and nilgai as old as 12 years old to be pregnant. Our findings demonstrate the high reproductive potential of free-ranging nilgai in Southern Texas. To prevent nilgai overpopulation and associated damage to the land, harvest management strategies should be used, particularly in introduced areas where there are no natural predators. Free-ranging nilgai antelope (Boselaphus tragocamelus) are an understudied species, both on their native ranges of India, Pakistan, and Nepal and on their introduced ranges in southern Texas. Basic data related to population sizes, survival, reproduction, and recruitment are needed throughout their range to inform management and conservation decisions. We collected nilgai fetuses from 3 ranches in southern Texas, including East Foundation's El Sauz and Santa Rosa ranches, and the Norias Division of the King Ranch® from 2018–2021. We calculated the percentage of individuals that were pregnant in each of the sample years and overall. We determined monthly average, maximum, and minimum fetus length. Of 488 nilgai cows, we found 386 to be pregnant (79%) and 214 to be pregnant with twins (56%). We found nilgai cows as young as 1-year old to have fetuses and therefore to have reached sexual maturity. Sex ratios of fetuses during any sampling year did not differ. We found ample evidence supporting our hypothesis that nilgai are fecund on their introduced range of southern Texas. To prevent nilgai overpopulation and associated problems, harvest management strategies should be implemented, specifically on nilgai cows. [ABSTRACT FROM AUTHOR]

Perfluoroalkyl and polyfluoroalkyl substances (PFASs), widely utilized in various industries, may pose potential reproductive well-being risks. However, the research on the impact of PFAS exposures on pregnancy and live birth rates remains scarce. To address this gap, we conducted a cross-sectional study using the data from the United States National Health and Nutrition Examination Survey (NHANES) collected between 2013 and 2018. We focused on six PFAS compounds measured in the serum of women aged 20 to 50 years, employing the Poisson regression, Quantile G-composition (Qgcomp), and Weighted Quantile Sum (WQS) regression models. Adjusting for age, racial/ethnic origin, educational level, marital status, family income, body mass index (BMI), menarche age, birth control pill use, and other female hormone consumption, the Poisson regression identified significant negative associations between the individual PFAS exposures and pregnancy and live birth numbers (p < 0.05 for all 24 null hypotheses for which the slope of the trend line is zero). The Qgcomp analysis indicated that a one-quartile increase in the mixed PFAS exposures was associated with reductions of 0.09 (95% CI: −0.15, −0.03) in the pregnancy numbers and 0.12 (95% CI: −0.19, −0.05) in the live birth numbers. Similarly, the WQS analysis revealed that a unit increase in the WQS index corresponded to decreases of 0.14 (95% CI: −0.20, −0.07) in the pregnancy numbers and 0.14 (95% CI: −0.21, −0.06) in the live birth numbers. Among the six specific PFAS compounds we studied, perfluorononanoic acid (PFNA) had the most negative association with the pregnancy and live birth numbers. In conclusion, our findings suggest that PFAS exposures are associated with lower pregnancy and live birth numbers among women of reproductive age. [ABSTRACT FROM AUTHOR]

Objective: To propose a new classification system (Urman‐Vitale Classification System) for intrauterine adhesions (IUAs) and to evaluate anatomical and fertility outcomes after hysteroscopic adhesiolysis accordingly. Methods: A retrospective analysis of consecutive patients treated over 11 years by a single operator in a tertiary care hospital. Women with sonographic suspicion of IUAs were scheduled for hysterosalpingography (HSG) and hysteroscopy for confirmation and treatment. IUAs were divided into five classes according to symptoms, ultrasound, HSG findings, and postsurgical hysteroscopic appearance. Hysteroscopic adhesiolysis was performed using a bipolar cutting electrode in an office setting. Evaluated outcomes were restoration of the uterine cavity, clinical pregnancy, pregnancy loss, and live birth rates. Results: A total of 227 patients (479 procedures) were included. Mean number of hysteroscopies increased in frequency with class of adhesions from Class 1 to Class 5 (1.0 ± 0.2 vs 2.3 ± 0.5; P = 0.001). Full restoration of the cavity was achieved in 100% of patients with Class 1 compared with 18.5% for Class 5 (43/43 vs 5/27; P = 0.001). Clinical pregnancy (Class 1 vs Class 4: P = 0.034; 1 vs 5: P = 0.006; 2 vs 5: P = 0.024) and live birth (Class 1 vs Class 4: P = 0.001; 1 vs 5: P = 0.006; 2 vs 4: P = 0.007; 2 vs 5: P = 0.0208) rates decreased with increasing severity of IUAs. Pregnancy loss rate was related to IUA severity (Class 1 vs Class 4: P = 0.012; 1 vs 5: P = 0.003: 2 vs 4: P = 0.014; 2 vs 5: P = 0.021). Conclusion: A classification based on symptoms, imaging findings, and postsurgical macroscopic appearance of the uterine cavity could be useful in predicting prognosis and fertility in women with IUAs. Synopsis: A new classification for intrauterine adhesions based on symptoms, imaging, and hysteroscopic appearance of the uterine cavity could simplify postsurgical prognosis and fertility. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the developmental potential of 0PN, 1PN, and 2PN zygotes in IVF cycles and compare their clinical outcomes. Methods: We conducted a retrospective cohort study involving IVF patients. Blastocyst formation rates were assessed with 0PN, 1PN, and 2PN zygotes. Subsequently, we collected clinical outcome data following the transfer of these zygotes. Results: The overall blastulation rate was similar between 0PN (29.6%) and 2PN (32.1%) zygotes, but 1PN zygotes exhibited a significantly lower blastulation rate (17.0%) compared to both 0PN and 2PN zygotes. Similarly, the overall rate of good-quality blastulation was comparable between 0PN (15.3%) and 2PN (17.5%) zygotes, while 1PN zygotes showed a significantly lower rate (7.0%) compared to both 0PN and 2PN. Clinical pregnancy, ectopic pregnancy, implantation, and live birth rates were similar among single blastocyst frozen embryo transfers (FET) of 0PN, 1PN, and 2PN. Additionally, no significant differences were observed between single- and double-blastocyst FET of 0PN and 2PN. Conclusions: Our findings suggest that 0PN and 2PN zygotes have comparable developmental potential, while 1PN embryos exhibit lower developmental potential. Blastocyst FET outcomes appear similar among 0PN, 1PN, and 2PN zygotes. [ABSTRACT FROM AUTHOR]

Perfluoroalkyl and polyfluoroalkyl substances (PFASs), widely utilized in various industries, may pose potential reproductive well-being risks. However, the research on the impact of PFAS exposures on pregnancy and live birth rates remains scarce. To address this gap, we conducted a cross-sectional study using the data from the United States National Health and Nutrition Examination Survey (NHANES) collected between 2013 and 2018. We focused on six PFAS compounds measured in the serum of women aged 20 to 50 years, employing the Poisson regression, Quantile G-composition (Qgcomp), and Weighted Quantile Sum (WQS) regression models. Adjusting for age, racial/ethnic origin, educational level, marital status, family income, body mass index (BMI), menarche age, birth control pill use, and other female hormone consumption, the Poisson regression identified significant negative associations between the individual PFAS exposures and pregnancy and live birth numbers (p < 0.05 for all 24 null hypotheses for which the slope of the trend line is zero). The Qgcomp analysis indicated that a one-quartile increase in the mixed PFAS exposures was associated with reductions of 0.09 (95% CI: −0.15, −0.03) in the pregnancy numbers and 0.12 (95% CI: −0.19, −0.05) in the live birth numbers. Similarly, the WQS analysis revealed that a unit increase in the WQS index corresponded to decreases of 0.14 (95% CI: −0.20, −0.07) in the pregnancy numbers and 0.14 (95% CI: −0.21, −0.06) in the live birth numbers. Among the six specific PFAS compounds we studied, perfluorononanoic acid (PFNA) had the most negative association with the pregnancy and live birth numbers. In conclusion, our findings suggest that PFAS exposures are associated with lower pregnancy and live birth numbers among women of reproductive age.

Intrauterine adhesion (IUA) is primarily caused by endometrial injury, and hysteroscopic adhesiolysis is presently the main treatment. However, postoperative recurrence and poor pregnancy outcomes remain intractable. In this study, we aim to assess the effects of different treatments on clinical symptoms and reproductive outcomes in IUA. This retrospective study was conducted in a tertiary university-affiliated women's hospital. The study included 1449 consecutive women who desired to have a baby and were diagnosed with IUA through hysteroscopy from January 2016 to December 2021. Patients with IUA underwent hysteroscopic electric resection (E) or cold scissors separation (C), as well as hormone therapy and one or both of the following secondary prevention measures: intrauterine devices (IUD) and hyaluronic acid gel (HA). The pregnancy rate (PR) was significantly higher in the E + IUD + HA (90.23% CI: 85.82, 94.64%) than in other groups (p = 0.000) groups. The rates of full-term birth (p = 0.000) and live birth (p = 0.000) were significantly higher in the E + IUD + HA (67.82% and 68.97%, respectively) and E + HA (62.41% and 63.91%, respectively) groups. Multivariate logistic regression analysis revealed a significantly higher PR in women who received second-look hysteroscopy (OR 1.571, 95% CI: 1.009–2.224, p = 0.013) and E + IUD + HA (OR 4.772, 95% CI: 2.534–8.987, p = 0.000). Combining hysteroscopic electric resection with IUDs and HA gel could prevent adhesion recurrence and improve postoperative pregnancy and live birth outcomes in IUA. Furthermore, postoperative second-look hysteroscopy may increase the PR and shorten the waiting period. [ABSTRACT FROM AUTHOR]

Introduction: Usefulness of hysteroscopy before assisted reproductive technique (ART) was considered debatable. However, over the last decade, several new trials have been added to available literature. We aimed to assess the impact of diagnostic and operative hysteroscopy on reproductive outcomes of infertile women with and without intrauterine abnormalities. Materials and Methods: MEDLINE, Scopus, SciELO, Embase, Cochrane Library at CENTRAL, PROSPERO, CINAHL, grey literature, conference proceedings, and international controlled trials registries were searched without temporal, geographical, or language restrictions. Randomized controlled trials (RCTs) of infertile women comparing hysteroscopy versus no hysteroscopy prior to the first ART or after at least one failed attempt were included. RCTs of infertile women with intrauterine pathology comparing diagnostic versus operative hysteroscopy were included in separate analysis. Random-effect meta-analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Grading of Recommendations, Assessment, Development and Evaluation and Cochrane criteria were used for quality of evidence and risk of bias assessment. Primary outcome was live birth rate (LBR). Secondary outcomes were clinical pregnancy (CPR) and pregnancy loss rate. Results: Fifteen studies (5,038 women) were included. Compared to no hysteroscopy before first or after failed ART attempts, moderate-quality evidence showed that hysteroscopy increased the LBR (relative risk [RR] 1.24, 95% confidence interval [CI] 1.09–1.43, I2 = 21%), confirmed by subgroup analysis for women with failure after one or more ART cycles (RR 1.43, 95% CI: 1.19–1.72, I2 = 0%) but not before the first ART. Moderate-quality evidence showed that it increased the CPR (RR 1.36, 95% CI: 1.18–1.57; I2 = 51%), confirmed in subgroup analysis for both implantation failure (RR 1.40, 95% CI: 1.12–1.74, I2 = 52%) and before first ART (RR 1.32, 95% CI: 1.11–1.57, I2 = 42%). Low-quality data suggest that operative hysteroscopy increases CPR when used to treat intrauterine pathologies (RR 2.13, 95% CI: 1.56–2.92, I2 = 0%). Conclusions: Although moderate-quality evidence supports performing hysteroscopy before ART in women with history of implantation failure, hysteroscopic evaluation of uterine cavity should be considered a first-line technique in all infertile women undergoing ART. Additional high-quality RCTs are still needed, particularly to assess yield during couple's initial evaluation even before ART is considered. [ABSTRACT FROM AUTHOR]

Ganirelix is a gonadotropin-releasing hormone (GnRH) antagonist with high antagonistic activity that blocks the GnRH receptor by competitive binding. A daily dose of 0.25 mg of ganirelix was sel5ected after a phase II study because it was the minimal, effective daily dose to prevent premature luteinizing hormone surges and this dose yielded the highest ongoing pregnancy rate per started cycle. After subcutaneous administration, ganirelix is rapidly absorbed, reaching peak levels within 1–2 hours (tmax), and has a high absolute bioavailability (>90%). Prospective, comparative studies have demonstrated the advantages of GnRH antagonists over long GnRH agonist treatment in assisted reproduction, including the immediate reversibility of drug effects, a requirement for less follicle-stimulating hormone, a shortened duration of stimulation, a reduced incidence of ovarian hyperstimulation syndrome, and reduced patient burden. Combined analyses concluded that in the general in vitro fertilization population, there is a trend for a slightly lower ongoing pregnancy rate and a lower risk of ovarian hyperstimulation syndrome that is largely eliminated when considering triggering with GnRH agonist instead of human chorionic gonadotropin. Regardless of all the research, it is still not fully elucidated why the long GnRH agonist protocol has a trend for higher pregnancy rates after fresh transfer of the same number of good-quality embryos.

Background: The first service conception rate (FSCR) is an important parameter for any artificial insemination (AI) programme. The present study was conducted to determine the FSCR and its influencing factors in cows inseminated with frozen semen produced by Rural Development Academy, Bogura. Methods: Data were collected from 372 cows at 39 villages under Sherpur Upazilla of Bogura district on breed, age, body condition score (BCS), parity, milk yield, suckling, AI season and the interval between oestrus to AI using a questionnaire. Results: The overall FSCR of cows was 66.4% and the service per conception was 1.53. The FSCR was higher (74.1%) in local cows compared to the Holstein-Friesian (HF) cross counterpart (64.2%). The FSCR was higher (70.4%) in 24-47 months old cows compared to 84-98 months old counterpart (61.5%). The highest FSCR (81.6%) was observed in cows with 3.0 to 3.5 BCS and the lowest (25.7%) was observed in cows with 2.5 BCS. The highest FSCR (68.3%) was observed in the 0 (zero) parity (heifers) group of cows and the lowest (62.5%) was observed in the 4-7 parity counterpart. The highest FSCR (72.4%) was observed in cows yielded daily >15-22 L milk and the lowest (62.1%) was observed in cows yielded =5 L milk. The highest FSCR (72.7%) was observed in suckling restricted cows and the lowest (60.9%) was observed in cows that had several times suckling daily. The highest FSCR (72.1%) was observed in cows received inseminations in Rainy (July-October) season and the lowest (58.4%) was observed in cows received inseminations in Winter (November-February). The highest FSCR (67.1%) was observed in cows received inseminations between 12-18 hrs of detection of oestrus and the lowest (59.1%) was observed in cows received insemination between 8-11 hrs of detection of oestrus. However, the difference in FSCR in cows with different BCS groups was significant (p<0.01). Conclusion: The current FSCR in cows can be considered to be satisfactory. The BCS of cows significantly influences the FSCR in cows. [ABSTRACT FROM AUTHOR]

Background: Uterine blood flow determines endometrial thickness. This study examined how vaginal sildenafil citrate and estradiol valerate altered endometrial thickness, blood flow, and fertility in infertile women. Methods: This study observed 148 infertile women whose infertility was unexplained. Group 1 comprised 48 patients who received oral estradiol valerate (Cyclo-Progynova 2 mg/12 h white tablets) from day 6 till ovulation was initiated with clomiphene citrate. A number of 50 participants in group 2 received oral sildenafil (Respatio 20 mg/12 h film-coated tablets) for 5 days starting the day after their previous menstrual period and finishing on the day they ovulated with clomiphene citrate. Group 3 was the control group, with 50 patients receiving clomiphene citrate (Technovula 50 mg/12 h tablets) ovulation induction from the 2nd to 7th day of cycle. All patients had transvaginal ultrasounds to determine ovulation, follicle count, and fertility. Miscarriage, ectopic pregnancy, and multiple pregnancies were monitored for three months. Results: The three groups' mean ETs differed statistically at p = 0.0004. A statistically significant difference was found between the three groups in terms of the number of follicles, with 69% of patients in group 1 having one and 31% having two or more, 76% of patients in group 2 having one and 24% having two or more, and 90% of patients in the control group having one and 10% having two or more (p = 0.038). The clinical pregnancy rates of the three groups were 58%, 46%, and 27%, respectively (p = 0.005). The distribution of all side effects was not statistically different between the three groups. Conclusion: It is possible to claim that adding oral estrogen to clomiphene citrate therapy as an adjuvant therapy can improve endometrial thickness and, as a result, increase the pregnancy rates in unexplained infertility compared to sildenafil, especially in cases where the infertility has lasted less than two years. Most people who take sildenafil end up with a mild headache. [ABSTRACT FROM AUTHOR]

Migration patterns are fundamentally linked to the spatio-temporal distributions of prey. How migrating animals can respond to changes in their prey's distribution and abundance remains largely unclear. During the last decade, humpback whales (Megaptera novaeangliae) used specific winter foraging sites in fjords of northern Norway, outside of their main summer foraging season, to feed on herring that started overwintering in the area. We used photographic matching to show that whales sighted during summer in the Barents Sea foraged in northern Norway from late October to February, staying up to three months and showing high inter-annual return rates (up to 82%). The number of identified whales in northern Norway totalled 866 individuals by 2019. Genetic sexing and hormone profiling in both areas demonstrate a female bias in northern Norway and suggest higher proportions of pregnancy in northern Norway. This may indicate that the fjord-based winter feeding is important for pregnant females before migration. Our results suggest that humpback whales can respond to foraging opportunities along their migration pathways, in some cases by continuing their feeding season well into winter. This provides an important reminder to implement dynamic ecosystem management that can account for changes in the spatio-temporal distribution of migrating marine mammals.

Background: Granulocyte colony stimulating factor (GCSF) has been introduced as an immunomodulatory agent by increasing implantation rate in vitro fertilization (IVF) patients but it has not been studied in intrauterine insemination (IUI) patients. The aim of this study is to answer the role of GCSF in implantation rate of IUI.Materials and Methods: In this prospective double-blind randomized control trial, 320 eligible patients were enrolled, who were referred to the referral infertility clinic of Shiraz University of Medical Sciences from February 2018 till the end of 2019. They were divided into two groups randomly. After collecting the demographic data, all patients received clomiphene citrate from the 5th day of the menstruation cycle for 5 days. 50-150 units of recombinant purified follicle-stimulating factor (FSH) were started from the 8th day of the cycle. Follicle monitoring was done by transvaginal sonography till a mature follicle of 18 mm or more was developed. Human chorionic gonadotropin (HCG) injection was done in both groups with intrauterine administration of 300 μg GCSF in the case group and normal saline in the control group simultaneously. After 36 hours, IUI was performed. The clinical pregnancy, miscarriage, and ongoing pregnancy rates of both groups were calculated by SPSS software.Results: The results showed improvement of clinical pregnancy rate [15.38% vs. 13.81% OR=1.17 (0.62-2.21)], miscarriage rate [3.84% vs. 5.26% OR=0.74 (0.25-2.20)] and ongoing pregnancy rate [11.53% vs. 8.55% OR=1.37 (0.65-2.92)] in the GCSF group compared to the control. However, the results revealed no statistically significance (P>0.05).Conclusion: Although it was not statistically significant, 300 μg Intrauterine GCSF administration simultaneously with hCG injection in standard IUI procedure might increase the pregnancy outcomes. Further studies are warranted (registration number: IRCT201212079281N2).

Abstract Aim OvSynch is a hormonal protocol for synchronization of estrus and use of artificial insemination (AI) at an optimal time without adverse effects on the ovaries or uterus. This study investigated the use of noninvasive color Doppler ultrasound to assess changes in uterine and vaginal blood flow during the Ovsynch program for synchronization of estrus and its relation to the pregnancy rates in Holstein cows. Materials and methods The experimental cows received an intramuscular dose of 10 μg of a GnRH analogue (G1), followed 7 days later with an intramuscular injection of synthetic prostaglandin F2α (P: PGF2α) analogue (500 μg cloprostenol sodium), and given a 10 μg, injection of the GnRH analogue (G2) i.m. 48 h after the PGF2α treatment, and the cows were bred 14-16 h after. Uterine and vaginal perfusion were investigated by performing transrectal Doppler ultrasonography of both the uterine and vaginal arteries in Holstein cows at different time points during the Ovsynch program to determine: peak systolic velocity (PSV), time-averaged maximum velocity (TAMV), the volume of blood flow (BFV), pulsatility index (PI), resistance index (RI), resistance impedance (S/D) and diameters of uterine (UA) and vaginal (VA) arteries. Steroid hormones were also assayed. Transrectal ultrasonography (TUS) was performed at 32 and 60 days to confirm the pregnancy per artificial insemination (P/AI). Results The uterine PSV, TAMV, and PV were greater at the time of the cloprostenol sodium and second GnRH injections (p

The krill surplus hypothesis of unlimited prey resources available for Antarctic predators due to commercial whaling in the 20th century has remained largely untested since the 1970s. Rapid warming of the Western Antarctic Peninsula (WAP) over the past 50 years has resulted in decreased seasonal ice cover and a reduction of krill. The latter is being exacerbated by a commercial krill fishery in the region. Despite this, humpback whale populations have increased but may be at a threshold for growth based on these human‐induced changes. Understanding how climate‐mediated variation in prey availability influences humpback whale population dynamics is critical for focused management and conservation actions. Using an 8‐year dataset (2013–2020), we show that inter‐annual humpback whale pregnancy rates, as determined from skin‐blubber biopsy samples (n = 616), are positively correlated with krill availability and fluctuations in ice cover in the previous year. Pregnancy rates showed significant inter‐annual variability, between 29% and 86%. Our results indicate that krill availability is in fact limiting and affecting reproductive rates, in contrast to the krill surplus hypothesis. This suggests that this population of humpback whales may be at a threshold for population growth due to prey limitations. As a result, continued warming and increased fishing along the WAP, which continue to reduce krill stocks, will likely impact this humpback whale population and other krill predators in the region. Humpback whales are sentinel species of ecosystem health, and changes in pregnancy rates can provide quantifiable signals of the impact of environmental change at the population level. Our findings must be considered paramount in developing new and more restrictive conservation and management plans for the Antarctic marine ecosystem and minimizing the negative impacts of human activities in the region. [ABSTRACT FROM AUTHOR]

Background: The most frequent gynecological tumors in women are uterine fibroids. The purpose of this study is to determine the prevalence of fibroid among infertile women visiting an outpatient clinic for infertility and to investigate the effects of various myoma types on fertility. Patients and method: The infertility outpatient clinic, Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, was the site of this cross-sectional study. The study group consisted of 108 women, whose ages varied from 22 to 40 years and had uterine fibroids. Patients were examined thoroughly and transvaginal ultrasound examination was done for the assessment of pathological state and uterine fibroids (number, place, and size). Result: The uterus of 31.5% of infertile women contained numerous fibroid tumors. Patients with numerous fibroids had significantly higher odds ratio of being infertile (3.24, confidence interval: 1.28-7.24). Infertile women had a significantly higher percentage of intramural fibroid despite having a significantly lower percentage of sub-serous fibroid. According to the classification of The International Federation of Gynecology and Obstetrics (FIGO), 27.8% of the patients had FIGO 5, 28.7% had FIGO 6, and 7.6% had FIGO 7. Infertile women had a significantly greater percentage of FIGO classes 2 to 5. With odds ratio of 6.6 and a confidence range of 1.34 to 32.5, patients had a significantly increased risk of infertility based on FIGO 2-5. Conclusion: Though the significance of uterine fibroids is still up for debate, it would seem that myomas lessen the chance of conception. [ABSTRACT FROM AUTHOR]

In recent decades, many significant improvements have taken place accompanying different assisted reproductive biotechnologies like estrous synchronization, artificial insemination, superovulation, cloning, embryo recovery and its transfer, in vitro fertilization, cryopreservation and transgenesis. Among these technologies, embryo transfer has achieved a great importance having produced numerous offspring from a genetically superior female. After the first successful transfer of mammalian embryos in 1890, it was approximately 60 years before significant progress became quite noticeable in the basic technology of embryo transfer in cattle. In embryo transfer process, embryo is collected from superior quality donor cattle and transferred to other recipient female cattle for complete development unless the gestation accomplishes. This technology involves the selection of donor and recipient animals, management for better breeding evaluation, embryo production, collection and transfer of embryo within a narrow window of suitable estrous time. In cattle, embryo transfer technology is widely used to amplify the reproductive rates of genetically improved superior females, planed mating, twinning, disease control, better pregnancy rate in repeat breeder cattle and increment of production of farm and reproductive rates. However, embryo transfer is widely used owing to its potential benefits. Hormonal protocol and synchronization improvements increase the embryo production rates via superovulation. This review details the embryo production technique, transfer of embryo from donor to recipient and the factor that are necessary for transfer of embryo from donor to recipient for production of offspring. Previously limited information existing regarding embryo transfer and its significance in farm animals therefore, in future this review might be helpful in improving the reproductive potential of farm animals. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of age at weaning of calves on non‐esterified fatty acids (NEFA) and reproductive parameters of beef cows. Animals (n = 65) were randomly assigned to three treatments after calving: hyper‐early weaning (W30) at 32 ± 0.89 days, early weaning (W75) at 77 ± 0.95 days, and conventional weaning (W180) at 183 ± 0.82 days. Body weight (BW) and body condition score (BCS) were evaluated at parturition (AP) and at 30, 45, 64, 81, 100 and 115 days postpartum (dPP). Blood samples were collected to analyze NEFA levels and progesterone (P4) at 30, 45, 64 and 81 dPP. Higher BW and BCS were observed from 64 to 115 dPP in W30 cows than W180 ones (p < 0.05). Cows subjected to W30 condition had higher levels of NEFA at 30 dPP compared to 64 and 81 dPP (p < 0.05). We also observed that cows from W180 group showed decreased levels of NEFA at 30 dPP compared to 45 (p < 0.01) and 64 dPP (p < 0.05). The highest P4 level was observed at 64 dPP in W30 cows compared to W75 and W180 (p < 0.05). We also observed higher CR of W30 (86%) compared to W180 (47%) at 45 dPP (p < 0.05). The overall pregnancy rate (PR) was higher for W30 (95.5%) than W180 (73.9%). In addition, higher BW at calving and P4 levels at 30 dPP were positively correlated with the possibility of pregnancy (p < 0.05). Improvement in BW and BCS were observed in cows subjected to hyper‐early weaning management. However, levels of NEFA decreased as the postpartum period progressed. We concluded that cows who weaned calves hyper‐early have greater chances of increasing cyclicity and PRs. [ABSTRACT FROM AUTHOR]

Human chorionic gonadotropin (hCG) has been used to improve goats reproductive efficiency. This study aimed to (i) evaluate if hCG administered by the intramuscular (i.m.) or intravaginal (i.vag.) route can be detected by a rapid β‐hCG test in blood plasma samples and (ii) document ovarian effects of hCG administered by both routes at the time of artificial insemination (AI) performed 60 h after oestrus synchronization in goats. Twenty‐two Alpine goats received two i.m. injections of 30 μg of d‐cloprostenol (Prolise®, Tecnopec, São Paulo, Brazil) 7.5 days apart. One day after the onset of oestrus (at the time of AI), the goats were randomly allocated to one of the three groups that received: control (n = 7): 0.3 ml of saline solution intravaginally; hCGi.m. (n = 7): 300 IU of hCG (Vetecor®; Hertape‐Calier, São Paulo, Brazil) i.m. and hCGi.vag. (n = 8): 300 IU of hCG deposited intravaginally. Blood samples were drawn at −1, 3, 6, 9 and 24 h after as well as on days 3, 7, 10, 13, 17 and 21 after hCG treatment/AI. All animals tested negative for hCG (ECO Diagnóstica, Corinto, Brazil) at −1 h, and all control animals tested negative throughout the entire blood collection period. All hCGi.m. animals tested positive from 3 h until D3 post‐AI but only 50% of hCGi.vag. goats tested positive during the present study. In all animals studied, mean circulating P4 concentrations increased (p <.05) from D3 to D7 after AI and then declined (p <.05) from D10 to D17 in control and hCGi.m. groups and from D17 to D21 in the hCGi.vag. group. Total cross‐sectional luteal area (CLA), mean colour Doppler area (DA), DA/CLA, mean high‐velocity Doppler area and HVDA/CLA all declined (p <.05) by D17–D21 in all animals studied. In summary: (i) human chorionic gonadotropin could consistently be detected in blood samples using the rapid β‐hCG test only in the hCGi.m. group; and (ii) there were no significant differences in the mean pregnancy rate, circulating P4 concentrations and various luteal parameters studied among Control, hCGi.m. and hCGi.vag. dose. [ABSTRACT FROM AUTHOR]

Simple Summary: Among equids, the mule (jackass stallion × mare) is the most common hybrid, followed by the hinny (horse stallion × jenny). This study describes the outcome of inseminating mares and jennies with either fresh horse or donkey semen of proven fertility. Pregnancy rates in horse females were significantly higher than in donkey females, while horse and donkey males did not affect pregnancy rates. Overall, intraspecific pregnancy rates were significantly higher than interspecific ones. Horses and donkeys differ phenotypically and karyotypically, although they can interbreed freely. Eight Standardbred mares and nine Amiata donkey jennies were included in the study. Semen was collected from two horses and two donkey stallions of proven fertility. A first pregnancy diagnosis was performed on day 10 after ovulation and repeated every day until embryo detection or until day 16. Irrespectively of the sire species, pregnancy rates in horse females (20/30, 66.7%) were significantly higher than in donkey females (19/70, 27.1%) (p < 0.05), while horse and donkey males did not affect pregnancy rates. Comparing overall intraspecific and interspecific AI, pregnancy rates were 25/37 (67.6%) and 14/63 (22.2%), respectively (p = 0.0001). The lowest pregnancy rate was obtained when inseminating jennies with horse stallion semen (8/49, 16.3%). No statistical differences were found when comparing embryo diameters, day at first pregnancy diagnosis, or in vitro embryo morphological quality among groups. In this study, much poorer results were obtained with jennies than with mares. Interspecific AI resulted in lower pregnancy rates than intraspecific Al, and AI to produce hinny hybrids resulted in the lowest pregnancy rate. Further studies are required to better understand the mechanism involved in such different outcomes in relation to intra- and interspecific breeding in domestic equids. [ABSTRACT FROM AUTHOR]

The aim of the present study is to compare the endometrial thickness measurements taken on the day of oocyte pickup (OPU) with those observed during frozen embryo transfer cycles conducted with hormone replacement therapy in patients undergoing embryo freezing after IVF treatment. Additionally, we aimed to evaluate the correlation between the percentage difference in endometrial thickness across these cycles and the clinical pregnancy rates. This retrospective study was carried out at the Health Sciences University, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital IVF Clinic between 2007 and 2024. A total of 498 patients with an endometrial thickness of >7 mm during their embryo transfer cycles were included in the study. Data on the patients' age, obstetric history, infertility reasons, IVF protocols, measurements of endometrial thickness, and clinical pregnancy outcomes were recorded. The endometrial thickness measurements taken on the day of oocyte pickup (OPU) were compared with those observed during frozen embryo transfer cycles conducted with hormone replacement therapy in patients undergoing embryo freezing after IVF treatment. The percentage change in endometrial thickness from the OPU day to the hormone replacement therapy-assisted frozen embryo transfer cycles was calculated and categorized into increasing and decreasing percentile ranges. No significant difference was observed in age, body mass index(BMI), thickness measurements on OPU day and embryo transfer day between patients with and without positive b-hCG results. Changes in endometrial thickness were evaluated as increasing and decreasing, with increments assessed in percentile ranges. A significant increase in b-hCG positivity was found in patients with an endometrial thickness increase of 10% or more, and 15% or more (Table 1). Over the last decade, advancements in effective and safe embryo vitrification techniques, along with efforts to prevent OHSS and the increase in preimplantation genetic diagnosis, have led to a significant rise in the global adoption of "freeze all" approach and frozen embryo transfer (FET) cycles. Despite the increase in FET cycles, the optimal protocol for endometrial preparation remains a topic of debate. It is crucial to follow an individualized approach for each patient to enhance live birth rates after FET cycles. This study concludes that a minimum of 10% increase in endometrial thickness on the day of embryo transfer compared to the thickness on OPU day significantly enhances the likelihood of b-hCG positivity.The results regarding the rates of endometrial thickness aim to minimize the financial and emotional burden on patients by facilitating individualized FET cycle selection, making informed embryo transfer decisions, and determining the optimal endometrial thickness, thus preventing unnecessary FET cycle cancellations. [ABSTRACT FROM AUTHOR]

The conception rate is defined as the aptitude of a female to romaine pregnant after the first A.I. and represents the proportion between the number of pregnant cows at first A.I and the number of cows inseminated in that period. In our experiments of estrus induction and synchronization, in order to increase the pregnancy rates, we used the Ovsynch protocol and other protocols for PgF2α and GnRH. In order to establish the pregnancy rates, the number of females that have not return in heats after A.I. were taken in consideration. The conception rates were 45.5 – 52.6%. The estrus synchronization offers the possibility to increase the pregnancy rates at first service after calving and creates the possibility to inseminate at certain time without heat detection.

To determine the effect of hormonal drugs on the pregnancy rates of mares, authors analyzed this indicator in natural (n=303) and stimulated cycles (n=170). They used cloprostenol preparations to shorten the diestral period, and human chorionic gonadotropin [hCG] to induce ovulation. Natural cycles are divided into groups, depending on the duration – normal and short (19–24 and 12–18 days, respectively). Stimulated cycles for the following groups: (1) short (8–18 days); (2) normal (19–24 days) with the use of cloprostenol and hCG; (3) normal – with the use of hCG only. Short, both natural and stimulated cycles, are divided into groups – with normal (4–6 days) and short estrus (2–3 days). The analysis of natural and stimulated cycles showed that the level of pregnancy rates in stimulated cycles (73.5%–80.8%) corresponds to this indicator in normal natural cycles (79.6%). In natural short cycles, the pregnancy rate significantly decreases (26.3% ± 7.1%). When analyzing short cycles, it turned out that, both in natural and stimulated cycles, the pregnancy rate depends on the length of the estrus and decreases in cycles with a short estrus. In general, the difference in pregnancy rates was 41.0% (p ≤ 0.001). In short stimulated cycles, with an estrus length of 4–6 days, the pregnancy rate is higher (91.5% ± 4.06%) than in cycles with an estrus of 2–3 days (51.7% ± 9.3%). Thus, the shortening of the estrous period in stimulated cycles has a significant effect on the pregnancy rate.

Objective The present study evaluated the efficiency of embryo development and pregnancy of somatic cell nuclear transfer (SCNT) embryos using different source-matured oocytes in Camelus dromedarius. Methods Camelus dromedarius embryos were produced by SCNT using in vivo- and in vitro- matured oocytes. In vitro embryo developmental capacity of reconstructed embryos was evaluated. To confirm the efficiency of pregnancy and live birth rates, a total of 72 blastocysts using in vitro- matured oocytes transferred into 45 surrogates and 95 blastocysts using in vivo- matured oocytes were transferred into 62 surrogates by transvaginal method. Results The collected oocytes derived from ovum pick up showed higher maturation potential into metaphase II oocytes than oocytes from the slaughterhouse. The competence of cleavage, and blastocyst were also significantly higher in in vivo- matured oocytes than in vitro- matured oocytes. After embryo transfer, 11 pregnant and 10 live births were confirmed in in vivo- matured oocytes group, and 2 pregnant and 1 live birth were confirmed in in vitro- matured oocytes group. Furthermore, blastocysts produced by in vivo-matured oocytes resulted in significantly higher early pregnancy and live birth rates than in vitro-matured oocytes. Conclusion In this study, SCNT embryos using in vivo- and in vitro-matured camel oocytes were successfully developed, and pregnancy was established in recipient camels. We also confirmed that in vivo-matured oocytes improved the development of embryos and the pregnancy capacity using the blastocyst embryo transfer method.

BACKGROUND Depression and anxiety are highly prevalent among individuals struggling with infertility. Thus, numerous psychological interventions have been adapted to infertility, with the aim of relieving distress as well as increasing pregnancy rates. OBJECTIVE AND RATIONALE This systematic review and meta-analysis aimed to identify all randomized controlled trials (RCTs) evaluating the effect of psychological interventions on infertility-related distress and pregnancy rates among individuals and/or couples with infertility and to analyse their overall effect. It also sought to examine potential treatment moderators, including intervention length, format and therapeutic approach. SEARCH METHODS An electronic search of 11 databases, including MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials, was performed for studies published until January 2022. The inclusion criteria were RCTs conducted on humans and published in English. Psychological outcomes of interest included anxiety, depression, infertility-related distress, wellbeing and marital satisfaction. The Cochrane Risk of Bias tool was used to assess study quality, and the Grading of Recommendations Assessment, Development and Evaluation was used to assess the overall quality of the research evidence. OUTCOMES There were 58 RCTs in total, including 54 which included psychological outcomes and 21 which assessed pregnancy rates. Studies originated from all regions of the world, but nearly half of the studies were from the Middle East. Although a beneficial effect on combined psychological outcomes was found (Hedge's g  = 0.82, P < 0.0001), it was moderated by region (P  < 0.00001) such that studies from the Middle East exhibited large effects (g  = 1.40, P  < 0.0001), while the effects were small among studies conducted elsewhere (g  = 0.23, P  < 0.0001). Statistically adjusting for study region in a meta-regression, neither intervention length, therapeutic approach, therapy format, nor participant gender (P  > 0.05) moderated the effect of treatment. A beneficial treatment effect on pregnancy (RR (95% CI) = 1.25 (1.07–1.47), P  = 0.005) was not moderated by region, treatment length, approach or format (P  > 0.05). Largely due to the lack of high quality RCTs, the quality of the available evidence was rated as low to moderate. WIDER IMPLICATIONS This is the first meta-analysis of RCTs testing the effect of psychological interventions on infertility-related distress and pregnancy rates. These findings suggest that in most regions of the world, psychological interventions are associated with small reductions in distress and modest effects on conception, suggesting the need for more effective interventions. These findings must be considered in light of the fact that the majority of the included RCTs were deemed to be at high risk of bias. Rigorously conducted trials are needed. [ABSTRACT FROM AUTHOR]

ObjectiveThe need of luteal support after FET is no longer to be proven. Different routes of progesterone administration are available with interindividual differences in metabolization and serum progesterone levels, the latter being highly correlated with pregnancy and delivery rates. The administration of 2 different routes of progestogen significantly improves success rates in FET. The aim of the current study was to investigate the added value to combine intramuscular administration of progesterone to dydrogesterone in fresh embryo transfer.MethodsThis is a retrospective study from prospectively collected data. Patient, aged between 18 and 43 years old, had received a fresh blastocyst transfer between January 2021 and June 2021. In the first group, all patients received only oral dydrogesterone 10mg, three times a day, beginning the evening of oocyte retrieval. In the second group, patients received, in addition to dydrogesterone, a weekly intramuscular injection of progesterone started the day of embryo transfer. Primary endpoint was ongoing pregnancy rate.Results171 fresh single blastocyst transfers have been performed during this period. 82 patients were included in “dydrogesterone only” and 89 patients in “dydrogesterone + IM”. Our two groups were comparable except for body mass index. After adjustment on BMI, our two groups were comparable regarding implantation rate, early pregnancy rate (46.1 versus 54.9, OR 1.44 [0.78; 2.67], p=0.25) miscarriage rate, ongoing pregnancy rate (30.3 versus 43.9, OR 1.85 [0.97; 3.53] p= 0.06).ConclusionUsing systematically long acting intramuscular progesterone injection in addition to oral dydrogesterone as luteal phase support seems to have no significant impact on IVF outcomes when a single fresh blastocyst transfer is performed.

Background: The influence of thyroid-stimulating hormone (TSH) on gestational outcomes have been studied and checked whether differing TSH levels are relevant on human reproduction outcomes. International guidelines recommend TSH values <2.5 mIU/L in women trying to conceive, since values above this level are related to a higher frequency of adverse reproductive outcomes. This study aimed to evaluate whether TSH values correlate with different gestational outcomes in euthyroid infertile women without autoimmune thyroid disease. Methods: A retrospective cohort study was conducted involving 256 women who underwent in vitro fertilization (IVF) treatment. The participants were divided into two groups: TSH 0.5-2.49 mIU/L (n=211) and TSH 2.5-4.5 mIU/L (n=45). The clinical data, hormonal profiles and reproductive outcomes were compared between groups. Additionally, a systematic review with metaanalysis following the PRISMA protocol was carried out in PubMed/MEDLINE, EMBASE, and SciELO, with no time or language restrictions, for articles comparing TSH groups named “low TSH” (<2,5 mIU/L) and “high TSH” (≥2.5 mIU/L). A meta-analysis of proportions was performed with pooled estimates expressed as relative risk (RR) of events and a random effects model. Results: Age, BMI, free thyroxine levels (FT4) hormonal profile and IVF outcomes were not different between groups, neither gestational outcomes (p=0.982). Also, no difference was observed when the TSH and FT4 levels were compared between patients with positive or negative gestational outcomes (p=0.27 and p=0.376). Regarding the systematic review with meta-analysis, 17 studies from 2006 to 2022 were included, and added by this original retrospective research comprising 13.247 women undergoing IVF. When comparing the proportions of clinical pregnancy between the TSH groups, no significant difference was found (RR 0.93, 95% CI 0.80–1.08), with high between studies heterogeneity (I²: 87%; t² : 0.0544; p<0.01). The number of deliveries was not significantly different between groups, despite a trend towards higher frequency in the high-TSH group (RR 0.96, 95% CI 0.90–1.02). Conclusion: Variation in TSH levels within the normal range was not associated with pregnancy and delivery rates in women, without autoimmune thyroid disease, who underwent IVF treatment. [ABSTRACT FROM AUTHOR]

Background: Granulocyte colony stimulating factor (GCSF) has been introduced as an immunomodulatory agent by increasing implantation rate in vitro fertilization (IVF) patients but it has not been studied in intrauterine insemination (IUI) patients. The aim of this study is to answer the role of GCSF in implantation rate of IUI. Materials and methods: In this prospective double-blind randomized control trial, 320 eligible patients were enrolled, who were referred to the referral infertility clinic of Shiraz University of Medical Sciences from February 2018 till the end of 2019. They were divided into two groups randomly. After collecting the demographic data, all patients received clomiphene citrate from the 5th day of the menstruation cycle for 5 days. 50-150 units of recombinant purified follicle-stimulating factor (FSH) were started from the 8th day of the cycle. Follicle monitoring was done by trans-vaginal sonography till a mature follicle of 18 mm or more was developed. Human chorionic gonadotropin (HCG) injection was done in both groups with intrauterine administration of 300 μg GCSF in the case group and normal saline in the control group simultaneously. After 36 hours, IUI was performed. The clinical pregnancy, miscarriage, and ongoing pregnancy rates of both groups were calculated by SPSS software. Results: The results showed improvement of clinical pregnancy rate [15.38% vs. 13.81% OR=1.17 (0.62-2.21)], miscarriage rate [3.84% vs. 5.26% OR=0.74 (0.25-2.20)] and ongoing pregnancy rate [11.53% vs. 8.55% OR=1.37 (0.65-2.92)] in the GCSF group compared to the control. However, the results revealed no statistically significance (P>0.05). Conclusion: Although it was not statistically significant, 300 μg Intrauterine GCSF administration simultaneously with hCG injection in standard IUI procedure might increase the pregnancy outcomes. Further studies are warranted (registration number: IRCT201212079281N2). [ABSTRACT FROM AUTHOR]

STUDY QUESTION How does nucleus status at the two-cell stage predict blastocysts formation and clinical outcome after single blastocyst transfer? SUMMARY ANSWER Binucleated embryos at the two-cell stage (2BI) show higher rates of good quality blastocyst formation, pregnancy and live birth compared to those with one nucleus in each blastomere (2MONO), whereas true multinucleated embryos at the two-cell stage (2MULTI) show lower rates of good quality blastocyst formation and pregnancy compared to 2MONO embryos. WHAT IS KNOWN ALREADY The introduction of time-lapse culture has made it possible to study nucleus status at the two-cell stage more consistently and it shows that multinucleation at the two-cell stage (2MN) is a common event. The effect of 2MN is still unclear. High numbers of 2MN with the potential to develop to blastocysts that become clinical pregnancies and result in birth of healthy babies with no impaired perinatal outcome have been reported. However, some studies have found 2MN to be associated with impaired implantation and live birth. Furthermore, knowledge on how the different subgroups of multinucleation affects the IVF outcome is limited. STUDY DESIGN, SIZE, DURATION A non-interventional retrospective study was performed in a public fertility clinic. Blastocyst formation data from 223 women attending their first IVF cycle between May 2016 and December 2018, and clinical outcome data from 1314 single blastocyst transfers between May 2014 and December 2018 were used for the study. Fresh and frozen-thawed embryo transfers were included. PARTICIPANTS/MATERIALS, SETTING, METHODS Embryos were cultured until the blastocyst stage in a time-lapse incubator and nucleus status at the two-cell stage, the Gardner score and other morphokinetic parameters were annotated. We compared blastocyst development and clinical outcome, including positive hCG, ongoing pregnancy and live birth, of embryos with 2BI and/or 2MULTI blastomeres to 2MONO embryos. MAIN RESULTS AND THE ROLE OF CHANCE Embryos with 2BI in one blastomere (2BI1) were twice as likely to develop to good quality blastocysts (odds ratio (OR) 2.54, 95% CI 1.30–4.95, P  = 0.006) compared to 2MONO embryos. Embryos with 2MULTI in both blastomeres (2MULTI2) were significantly less able to develop to good quality blastocysts (OR 0.38, 95% CI 0.23–0.63, P  < 0.001) compared to 2MONO embryos. Embryos with 2BI in both blastomeres (2BI2) had a significantly better chance of resulting in a positive hCG (OR 2.40, 95% CI 1.11–5.20, P  = 0.027), ongoing pregnancy (OR 2.79, 95% CI 1.29–6.04, P  = 0.009) and live birth (OR 3.16, 95% CI 1.43–6.95, P  = 0.004) compared to 2MONO blastocysts after single blastocyst transfer. In contrast, 2MULTI2 embryos were significantly less likely to result in a positive hCG (OR 0.58, 95% CI 0.35–0.97, P  = 0.036) and ongoing pregnancy (OR 0.51, 95% CI 0.28–0.94, P  = 0.030) compared to 2MONO blastocysts. LIMITATIONS, REASONS FOR CAUTION Discrepancies among the existing studies regarding the definition of multinucleation may lead to different conclusions. Even though the distinction between binucleation and true multinucleation was a strength in our study design, a further distinction between true multinucleated and micronucleated embryos could be interesting to investigate in future studies. Also, we included any anucleated embryos in the 2MONO group. For the study of clinical outcomes, the patients were allowed to be included with more than one transfer cycle. Both fresh and thawed transfers were included. WIDER IMPLICATIONS OF THE FINDINGS We find it important to discriminate between binucleation and true multinucleation when evaluating embryo nucleus status at the two-cell stage. Embryos displaying 2BI1 and 2BI2 have significantly better good quality blastocyst formation rates and clinical outcome after single blastocyst transfers, respectively. 2MULTI2 embryos have impaired blastocyst development potential and poorer clinical outcomes. STUDY FUNDING/COMPETING INTEREST(S) H.S.N. received an unrestricted grant from Merck for 3 months' normal salary for a medical Doctor (A.L.T.) to write the manuscript. Merck was not involved in the study design, analysis, interpretation of data, writing the paper or the decision to submit the manuscript for publication. H.S.N. has received speaker's fees from Ferring Pharmaceuticals, Merck Denmark A/S, Astra Zeneca, Cook Medical and Ibsa Nordic (outside the submitted work). N.l.C.F. has received a grant from Gedeon Richter (outside the submitted work). The other authors did not report any potential conflicts of interest. All authors declared no conflicts of interest regarding this work. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

BackgroundThe influence of thyroid-stimulating hormone (TSH) on gestational outcomes have been studied and checked whether differing TSH levels are relevant on human reproduction outcomes. International guidelines recommend TSH values

Introduction: The bovine productive system and its parameters have values that are fundamental for herd profitability and sustainability. These can be affected by environmental conditions. To improve reproductive indeces, drugs are used: releasing hormone analogues (GnRH) and progestogens that promote ovulation. Objective: To evaluate the effect of the administration of drugs to stimulate ovarian function on short-term pregnancy rates in a herd in the municipality of Arauca, Arauca. Methods: This work was carried out between May and December 2023 at the end of the rainy season with an average temperature of 31 °C, in a mestizo cattle herd with a racial variety, located in Arauca, Arauca. Thirty-two randomly selected calving cows aged 6±3.2 years, weighing 300±37 kg, body condition between 2.5 and 3.5 were used. The animals were managed under a feeding regime of savanna grazing, minerals and water ad libitum. They were divided in two groups 17 treated and 15 untreated. The treated were divided into two subgroups: treated group1 (n=9) was given a vaginal implant of progesterone plus estrogen, which was withdrawn after 9 days, and treated group2 (n=8) an intramuscular GnRH analogue. Each batch was left with one bull, and genital check-up was performed at 4 and 6 months to evaluate the pregnancy rate. Results and Discussion: 76.4% of treated cows became pregnant, compared to 13.3% of untreated cows, showing a significant difference (P=0.001). Among the treatments, 70% of the cows with progesterone and 85.7% with GnRH became pregnant, with no significant difference between them (P=0.865). Eighty-eight percent of pregnancies occurred in the first 4 months post-treatment. Conclusion: The use of ovulation inducing drugs has a positive effect on ovarian function as evidenced by the increase in pregnancy rate, suggesting simple and effective strategies for the reproductive management of cattle according to the climate of the region. Similar research in the dry season will evaluate how temperature and humidity affect pregnancy. [ABSTRACT FROM AUTHOR]

The luteal vasculature plays a critical role in corpus luteum (CL) function and provides important information on the physiology and pathophysiology of this structure. To quantify the blood flow of the luteal tissue, Doppler ultrasound is used to detect the flow of red blood cells through the blood vessels. The objective of the present study was to determine the degree of irrigation of the CL evaluated by Doppler ultrasound on the day (D0) of embryo transfer (ET) and 25 days post-transfer and its relationship with the percentage of early gestation in Holstein recipient cows. Thirty multiparous, non-lactating Holstein cows were used as in vitro embryo recipients. The blood supply rate of the CL and the percentage of gestation were evaluated. The corpora lutea were categorized into 1 (high), 2 (medium) and 3 (low) according to the degree of blood supply. The percentage of cows with these degrees of CL irrigation on the day of transfer were 50% (15/30), 23.3% (7/30) and 27.7% (8/30). On day 25 post-transfer they were 33.3% (10/30), 43.3% (13/30) and 23.3% (7/30), respectively. Additionally, the percentage of early gestation (25 days post-transfer) was evaluated for grades 1, 2 and 3 of CL blood supply, whose results were: 20% (6/30), 6.6% (2/30) and 0%, respectively. It was possible to conclude that the Holstein breed recipients classified in high degree of CL blood irrigation, presented better (P < 0.05) percentage of gestation of embryos of in vitro origin. [ABSTRACT FROM AUTHOR]

Abstract Background The decision of whether frozen embryo transfer (FET) should be performed in the cycle immediately after OPU or at least one cycle later is controversial. FET could improve pregnancy rates in IVF; however, how much time is needed for the endometrium to return to optimal receptivity after ovarian stimulation is not known. Methods Electronic search in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials to identify studies providing data on the influence of the interval between embryo freezing (or OPU) and FET in FET cycles published between January 1, 2007, and February 1, 2020. Main findings Data analyzed indicated that in the immediate FET cycles, there was a trend to an increased biochemical pregnancy rate (RR = 1.08; CI = 1.00‐1.18), whereas the clinical pregnancy rate was somewhat higher, but without reaching statistical significance (RR = 1.07; CI = 0.99‐1.15). The live birth rate was similar in the two groups (RR = 1.05; CI = 0.95‐1.15), as was the implantation rate (RR = 0.98; CI = 0.83‐1.16). Stratifying by embryo stage or FET type (freeze‐all or FET after failed fresh transfer) showed no differences. Conclusion Systematically delaying FET does not offer benefits to IVF outcomes. In addition, immediate transfer is associated with a nonsignificant trend to better clinical pregnancy rate and it also avoids the psychological effects of prolonging the stress on prospective parents.

Objective: To study the impact of follitropin delta for ovarian stimulation on embryo development and quality compared with that of follitropin alfa or beta in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. Design: Retrospective cohort study Setting: University-affiliated, hospital-based fertility clinic Patient(s): A total of 403 IVF/ICSI cycles were conducted from September 1, 2018 to December 31, 2019. Cycles were grouped on the basis of stimulation with follitropin delta vs. follitropin alfa or beta. Intervention(s): None. Main Outcome Measure(s): Embryo parameters and clinical pregnancy and implantation rates. Result(s): Ovarian stimulation using follitropin delta resulted in no statistically significant difference in day 3 embryo quality between the control group and follitropin delta group (median 0.50 vs. 0.54 for good quality embryos and median 0.25 vs. 0.20 for intermediate quality embryos). Although on initial analysis there was a lower proportion of good quality blastocysts in the follitropin delta group than in the control group (0.11 vs. 0.22), this difference was no longer present when day 3 after fertilization vitrification and transfer cycles were excluded (0.26 vs. 0.33 follitropin delta vs. control). The clinical pregnancy rates and clinical implantation rates were similar in both groups in fresh transfer cycles. Conclusion(s): Stimulation with follitropin delta in IVF/ICSI cycles resulted in similar embryo development and pregnancy rates compared with those of stimulation with follitropin alfa or beta.

This study retrospectively analysed the effects of different environmental factors such as the photoperiod, temperature/humidity index of 19 years of a commercial embryo transfer programme performed in central Italy. From 340 donors of different breeds and aged between 2 and 25 years, 576 embryos of an excellent or good quality were obtained by uterine flushing on days 7–8 after ovulation. The embryos were transferred to 259 recipients, aged between 2 and 16 years, and belonging to different breeds. Both the donors and the recipients were employed for several cycles/years. At the time of transfer, the recipients were in diestrus, from day 4 to day 8 after ovulation, and were classified as excellent or good based on clinical examination findings. Out of the total number of embryos transferred, 437 pregnancies were obtained at 14 days (75.9%), with 48/437 (10.1%) embryonic losses at 40 days; with no significant differences among years. Significant differences (p <.05) were observed between 14‐day pregnancy rates for transfers performed during the spring transition and breeding seasons (77.1%) compared to those performed during the autumn transitional season (57.9%). No effect of temperature/humidity index was found on pregnancy rates or pregnancy losses after the transfer to the recipients (p >.05). Embryo transfer during autumn was less successful than the transfers performed during the spring transition and the breeding season. [ABSTRACT FROM AUTHOR]

Abstract A belief exists that transferring multiple embryos can improve pregnancy rates. However, this concept is flawed. Multiple factors affect outcomes when transferring embryos, endometrial receptivity, and rates of aneuploidy among them. In this article, we will discuss how factors can affect outcomes at IVF that are independent of the number of embryos transferred. It is important to understand the role of accessory factors on pregnancy rates to be able to counsel patients as per the number of embryos that should be transferred. An understanding of this concept will also lead to a realistic understanding of how multiple embryo transfers may result in better cumulative pregnancy rates than a single transfer of multiple embryos. Finally, we will present a SWOT analysis diagram to help guide clinical decision-making.

Abstract Background A recently published Position Statement (PS) by the Preimplantation Genetics Diagnosis International Society (PGDIS) regarding utilization of preimplantation genetic testing for aneuploidy (PGT-A) in association with in vitro fertilization (IVF) contained inaccuracies and misrepresentations. Because opinions issued by the PGDIS have since 2016 determined worldwide IVF practice, corrections appear of importance. Methods The International Do No Harm Group in IVF (IDNHG-IVF) is a spontaneously coalesced body of international investigators, concerned with increasing utilization of add-ons to IVF. It is responsible for the presented consensus statement, which as a final document was reached after review of the pertinent literature and again revised after the recent publication of the STAR trial and related commentaries. Results In contrast to the PGDIA-PS, we recommend restrictions to the increasing, and by IVF centers now often even mandated, utilization of PGT-A in IVF cycles. While PGT-A has been proposed as a tool for achieving enhanced singleton livebirth outcomes through embryo selection, continued false-positive rates and increasing evidence for embryonic self-correction downstream from the testing stage, has led IDNHG-IVF to conclude that currently available data are insufficient to impose overreaching recommendations for PGT-A utilization. Discussion Here presented consensus offers an alternative to the 2019 PGDIS position statement regarding utilization of preimplantation genetic testing for aneuploidy (PGT-A) in association with in vitro fertilization (IVF). Mindful of what appears to offer best outcomes for patients, and in full consideration of patient autonomy, here presented opinion is based on best available evidence, with the goal of improving safety and efficacy of IVF and minimizing wastage of embryos with potential for healthy births. Conclusions As the PGDIS never suggested restrictions on clinical utilization of PGT-A in IVF, here presented rebuttal represents an act of self-regulation by parts of the IVF community in attempts to control increasing utilization of different unproven recent add-ons to IVF.

The pregnancy rate (PR) is nowadays the most informative reproductive parameter, as it encompasses the proportion of cows that become pregnant from the total number of cows eligible for insemination in each estrous cycle. In the international scientific literature, there are several analyses concerning PR change effects on the profitability of dairy herds. In this study, the economic consequences of PR changes in a dairy herd under intensive management was calculated. We developed a mathematical model, based on the Monte Carlo simulation model, to estimate herd performance and economic utility using different pregnancy rates (between 15 and 30). The simulation was done using a fixed conception percentage of 30, so the increment in pregnancy rate only depended on the efficiency of estrus detection (EED) increase. In the generated model scenarios, PR increase had a positive effect on the annual cow income per year; however, the extra income had a quadratic trend with a revenue decline, when PR reached 20 %. So for every percentage point, where PR was increased from 15 to 20 %, an additional cow income of USD 40.46 per year was generated. Furthermore, the additional income for every percentage point, when the PR was increased from 20 to 25 % was USD 21; and USD 6.88, when the increase was from 25 to 30 %. We can conclude that any changes in herd management to increase the EED and thereby the PR should have lower costs compared with the expected benefits; otherwise, they will diminish their usefulness. [ABSTRACT FROM AUTHOR]

To investigate the usage and the efficacy of vitamins as primary or adjuvant treatment in infertile men with varicocele. A systematic search in PubMed, the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cochrane Library with the terms (varicocele) AND (vitamins) was performed. We searched for studies: a) reporting the administration of vitamins (individually or as part of a complex) in men with varicocele and infertility, b) primarily or adjuvant to invasive treatment, and c) reporting the impact on semen parameters and/or pregnancy rates. Exclusion criteria were animal, adolescent and non-English studies, grey literature and trials reporting abstracts only. Seven studies were identified eligible for qualitative analysis. All studies were randomised except one (case series). Vitamins were administered dominantly as part of antioxidant complex and only two studies used vitamins (C and E, respectively) as sole agent. In two studies, vitamin monotherapy resulted in improvement in semen quality, but the effect on pregnancy rates is unknown. One study reported no efficacy of adjuvant multivitamin treatment after embolisation in terms of both semen quality and pregnancy rates. Finally, four studies reported a positive effect of vitamins on semen parameters after varicocelectomy, but the effect on pregnancy rates is conflicting; one study reported improved pregnancy rates with adjuvant treatment, two studies did not evaluate the pregnancy rates, and in one study the outcome was unclear due to missing data. Vitamins have been used mostly as part of an antioxidant panel for the management of infertile men with varicocele. Most studies have found a positive impact on semen parameters in selected men with varicocele and infertility, as primary or adjuvant treatment. However, the clinical benefit of vitamins administration on pregnancy rate is under-evaluated and should be the target of future research. [ABSTRACT FROM AUTHOR]

Abstract Background An age-matched controlled study, to assess the outcome of IVF/ICSI in low and extremely low AMH levels in different age groups by comparing the live birth rate Materials and methods An age-matched controlled study was done at the Egyptian IVF center, Cairo, Egypt, including 306 infertile women with low AMH levels undergoing IVF/ICSI and an age-matched number of women with normal AMH. The live birth rate in the different age groups according to the AMH level was compared. Results There was no significant difference between LBR in the extremely low AMH arm (11.43%) and low AMH (16.4%) (P = 0.24). The LBR was 30.4% in women with normal AMH as compared to 14.7% in all women with AMH below 1 pg/ml (P = 0.002). The LBR was significantly higher in women below the age of 35 years and women of 35-40 years with normal AMH (33.2% and 31.7%) as compared to LBR in the corresponding age groups with low AMH (18.6% and 13.3%). Conclusions There was no difference in the outcome of IVF between patients with low and extremely low AMH levels. Women with normal AMH level resulted in a higher pregnancy rate as compared to women with low AMH level in the same age group. Age is important in determining prognosis of IVF in patients with low levels of AMH.