Assisted Reproduction Treatment Research Articles

The impact of age and number of oocytes retrieved on the cumulative live birth rate in women with poor ovarian response: A 15-year study

BackgroundApproximately 15 % of women undergoing assisted reproductive treatment (ART) fall in the category of poor ovarian reserve defined as the retrieval of three or fewer oocytes following conventional ovarian stimulation with a daily gonadotrophin dose of 150–450 international units, according to the Bologna criteria. Low number of oocytes collected is, therefore, likely to translate to low chance of successful ART treatment. ObjectivesThe objective of the study was to assess if age and number of oocytes retrieved influence the cumulative live birth rate (LBR) in women with poor ovarian response (POR) to controlled ovarian hyperstimulation. Study designWe have used anonymised, prospectively collected data spanning July 2004 until June 2019 on consecutive in vitro fertilisation (IVF) and intra-cytoplasmic sperm injection (ICSI) cycles performed at a tertiary fertility treatment unit. Women who underwent conventional ovarian stimulation with a starting daily gonadotrophin dose of 150–450 IU in their first or second IVF cycle where 1–3 oocytes were retrieved were included in the study, with women where four oocytes were retrieved formed a comparative control group. Only one cycle per patient was included. ResultsA total of 2,516 fresh IVF or ICSI cycles were analyzed. The overall clinical pregnancy and LBR in the cohort of included women were 16.4 % and 12.6 % respectively. The cumulative LBR per patient included was 13.1 %. When adjusting for age, treatment type, FSH at baseline, and daily gonadotrophin dose, a significant increase in cumulative LBR was observed for two (OR 2.63, 95 % CI 1.43–4.81), three (OR 3.74, 95 % CI 2.09–6.68) and four (OR 5.3, 95 %CI- 3.01–9.35) oocytes collected, compared to one oocyte only. A significantly lower chance of successful outcome was noted in women 43–45 years old versus younger age groups, irrespective of number of oocytes collected. ConclusionsIn this large cohort of women with POR, both age and number of oocytes retrieved are independent factors influencing the cumulative LBR after IVF treatment. Irrespective of age, retrieval of one additional oocyte is associated with an increase in the cumulative LBR per oocyte retrieval.

Outcomes of first assisted reproductive technology treatment in infertile women with and without antinuclear antibodies: A prospective cohort study

BackgroundIt has been shown that antinuclear antibodies (ANAs) are associated with adverse reproductive events. The presence of ANAs may reduce the pregnancy rate in women undergoing assisted reproductive technology (ART) treatment. MethodsThis study aimed to investigate the potential effect of ANAs on the outcomes of infertile women undergoing in-vitro fertilization and embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI) for the first time. In total, 907 women were enrolled, with 192 (21.14 %) cases in the ANA+ group and 715 (78.86 %) cases in the ANA- group. Baseline data were collected, and associations between ANAs and oocyte maturation rate, high-quality embryo rate, clinical pregnancy rate, live birth rate and miscarriage rate were analysed. ResultsCompared with the ANA- group, the ANA+ group had a considerably lower oocyte maturation rate (0.69 ± 0.31 vs 0.77 ± 0.26; P = 0.003) and a lower high-quality embryo rate (0.53 ± 0.30 vs 0.78 ± 0.92; P < 0.01). ANAs had no effect on clinical pregnancy rate, live birth rate and miscarriage rate in infertile women receiving ART for the first time. ConclusionsThese findings suggest that ANAs reduce oocyte maturation rate and high-quality embryo rate in infertile women undergoing IVF-ET/ICSI for the first time, but do not have a significant effect on clinical pregnancy rate, live birth rate and miscarriage rate. When testing for ANAs is part of the planned treatment protocol, this should be undertaken in advance of starting IVF-ET/ICSI.

Intimate partner violence in the context of infertility: voices from women seeking assisted reproductive technology treatment and clinicians' perspectives.

The interplay between infertility and intimate partner violence (IPV) is a pressing global health issue, yet qualitative evidence on this phenomenon is limited. In order to measure and prevent IPV, it is pivotal to explore and integrate perceptions and experiences from those women with infertility themselves on IPV definition and its phenomenal manifestations in the context of infertility. This study is undertaken as part of a year-long ethnographic research based ata reproductive medicine center in Beijing, China from July 2022 to July 2023. Individual interviews with women attending ART outpatient clinics and with clinicians involved in infertility treatment were conducted. Grounded Theory methodology was used to guide data analysis, which entailed a three-step analytical approach. A total of 37 women and five clinicians were interviewed. Incomplete conceptualization of IPV and high mental stress among patients were evident. IPV against women with infertility has been shown to be a specific and severe form of IPV. The phenomenal manifestation of IPV in the context of infertility often takes the form of psychological abuse, including stonewalling, threats of divorce, and non-compliance with ART treatment. The study revealed that the burden of fertility disproportionately falls on women, often intensified by the involvement of other family and cultural norms, exacerbating gender inequalities and IPV risks. Findings from this study calls for an immediate and comprehensive response in healthcare practice. IPV screening, health education, and structural interventions should be introduced to prevent and mitigate this issue.

The new ice age: the promise and challenges of rapidoocyte warming protocols.

Oocyte cryopreservation has transformed assisted reproductive technology, providing enhanced flexibility and efficacy in assisted reproductive technology treatments. The shift from traditional slow freezing to vitrification has markedly improved survival rates by preventing ice crystal formation, which can damage cellular structures. Despite these advances, rapid warming of vitrified oocytes remains a challenge due to the unique sensitivity of oocytes to thermal and osmotic stress, which can compromise spindle integrity and developmental competence. Recent studies indicate that using both rapid vitrification and rapid warming protocols may reduce processing time and enhance workflow efficiency, yet the impact of rapid warming on oocytes previously cryopreserved using standard methods is not fully understood. Although promising results have emerged from preclinical and clinical studies using rapid warming on embryos, the applicability to human oocytes requires further research. For oocytes, establishing a universal rapid warming protocol that balances efficiency and safety is essential, especially considering the millions of oocytes already preserved with conventional techniques.

Role of PRMT5 mediated HOXA10 arginine 337 methylation in endometrial epithelial cell receptivity

A successful embryo implantation relies heavily on the receptivity of the endometrial epithelium, a process regulated by various molecular mechanisms. Evaluating endometrial receptivity in infertility patients undergoing assisted reproductive treatment, particularly those with adenomyosis related infertility, poses significant challenges due to limitations associated with conventional assessment methods. In this study, we collected residual endometrial epithelial cells from the tips of embryo transfer catheters in patients with adenomyosis related infertility. High throughput sequencing revealed a marked downregulation of protein arginine methyltransferase 5 (PRMT5) in these cells. Functional assays demonstrated that PRMT5 interacts with and methylates homeobox A10 (HOXA10), a crucial transcription factor for endometrial receptivity and implantation. The methylation of HOXA10 at arginine 337 by PRMT5 enhances its stability and promotes the transcriptional activation of genes essential for endometrial differentiation and adhesion. The downregulation of PRMT5 led to decreased HOXA10 activity, resulting in impaired endometrial receptivity and subsequent implantation failure. These findings elucidate a critical pathway where PRMT5 downregulation negatively impacts HOXA10 function, providing new insights into the molecular mechanisms underlying implantation failure in adenomyosis related infertility. This study not only advances our understanding of the regulatory mechanisms governing endometrial receptivity but also identifies potential therapeutic targets for enhancing endometrial function in affected patients.

EMPIRICAL INDICATORS FOR CONSTRUCTING SOFTWARE FOR IMPLEMENTING THE SYSTEMATIZATION OF NURSING CARE IN ASSISTED REPRODUCTION

Infertility is defined as the inability to develop a successful pregnancy through sexual intercourse or artificial insemination within a period of 12 months or more. Nursing is involved in the implementation of assisted reproduction treatments. In this sense, the use of software provides support in the documentation of the actions that govern care, in addition to assisting in the elaboration of clinical judgment, which can result in better quality care. Thus, the objective was to identify the empirical indicators of women undergoing assisted reproduction techniques in order to structure a support software for the Systematization of Nursing Care for these women. This is a methodological research through the identification of empirical indicators related to women undergoing Assisted Reproduction techniques. As a result, a sample of 40 articles was obtained, from which 166 indicators were extracted. A total of 166 empirical indicators were obtained, of which 74 represented psychobiological needs, 88 psychosocial needs and 4 IES psychospiritual needs. Therefore, from the identification of altered empirical indicators of women undergoing assisted reproduction techniques in light of the theory of Basic Human Needs, it will be possible to develop valid software for Systematization of Nursing Care for women undergoing assisted reproduction techniques.

Analyzing assisted reproductive treatment representations in Italy and Spain through newspapers.

With the increase in infertility cases recorded over the last 20 years, there is a considerable demand for assisted reproductive treatments (ART). However, there is significant variation in the availability of such treatments across different countries. Legislation on assisted reproduction is influenced by various cultural expressions, making it seemingly impossible to create a single representation adaptable to different contexts. This work investigates the cultural representations of ART in Italy and Spain. We collected 1,735 articles from two Italian and Spanish newspapers, with all the articles containing the respective translation of ART from 2013 to 2022. The two corpora were analyzed using the Emotional Text Mining (ETM) methodology. The analysis produced 3 clusters in the Italian corpus and 5 clusters in the Spanish corpus. From the Italian results, a view of ART emerged that is linked to ethical limitations and the ideal of the traditional family. In contrast, the Spanish results depict ART in terms of community, rights, public health, and birth seen in itself. In conclusion, this study highlights the strong differences between Italian and Spanish cultures regarding ART. The results could be used to improve clinical practices and legislation surrounding ART.

Biallelic variants in α-tubulin isotypes cause female infertility characterised as recurrent preimplantation embryo arrest

BackgroundRecurrent preimplantation embryo developmental arrest (RPEA) is the most common phenotype in assisted reproductive technology treatment failure associated with identified genetic abnormalities. Currently known maternal genetic variants explain only a...

Association of specific PM2.5 chemical constituents and ozone exposure with pregnancy outcomes in women undergoing assisted reproductive technology treatment in central China

The associations of air pollutants exposure with assisted reproductive technology (ART) pregnancy outcomes are mixed, and the effects of specific components of fine particulate matter (PM2.5) and ozone (O3) are not well understood. We conducted a retrospective longitudinal study to explore the association of PM2.5 constituents and O3 exposure with three ART outcomes among women undergoing ART treatment. The exposure window was segmented into five periods corresponding to the cycle of ovarian stimulation and oocyte retrieval procedure. Generalized linear mixed model (GLMM) was applied to explore the relationships between PM2.5 constituents, O3, Normalized Vegetation Index (NDVI) exposure and three ART outcomes. The combined effect of PM2.5 constituents was evaluated by the quantile g (qg)-computation. We also explored the modifying effect of different covariate. Elevated exposure level of PM2.5 (OR = 0.915, 95% CI: 0.859, 0.974) and its constituents (BC: 0.905, 95% CI: 0.840, 0.975; OM: 0.910, 95% CI: 0.848, 0.976; NO3−: 0.909, 95% CI: 0.850, 0.972, SO42−: 0.905, 95% CI: 0.846, 0.968, and NH4+: 0.902, 95% CI: 0.842, 0.966) exposure throughout the year before oocyte retrieval (period 1) was correlated with a reduced odds ratio (OR) of live birth with statistical significance. Similarly, for each interquartile range (IQR) increase in O3 exposure during periods 2 (85 days prior to oocyte retrieval), 3 (30 days prior to oocyte retrieval), 4 (oocyte retrieval to embryo transfer) and 5 (embryo transfer to hCG test) was significantly related to a decreased OR of live birth. Especially, participants who underwent fresh embryo transfer cycles and received two cleavage-stage embryo transfer, and were younger than 30 years old, showed a higher susceptibility to particulate matter. Findings from this study suggest that PM2.5 constituents and O3 exposure may have adverse effects on the ART outcomes, highlighting the importance of identifying critical exposure periods for various air pollutants and the need for meticulous management of particulate matter.

First-trimester uterine artery pulsatility index and preeclampsia risk in pregnancies after artificial frozen embryo transfer: analysis of over 27,000 pregnancies

Accumulating evidence indicates that pregnancies after Artificial Cycle Frozen Embryo Transfer are associated with an increased risk of preeclampsia. Uterine Artery Doppler, along with maternal factors and serum biomarkers, is a crucial biomarker for first-trimester preeclampsia screening, aiding in identifying "high-risk" patients. Guidelines strongly recommend administering aspirin (150mg/day) in these women, owing to robust evidence demonstrating a 62% reduction in the incidence of preeclampsia. Although previous studies suggested lower Uterine Artery Pulsatility Index after Frozen Embryo Transfer, no previous studies explored the impact of the type of endometrial preparation in Uterine Artery Doppler or its influence on estimating 1st-trimester preeclampsia risk. The study aims to evaluate the possible impact of endometrial preparation for frozen embryo transfer on the Uterine Artery Pulsatility Index during the first-trimester preeclampsia screening. This is a retrospective single-center study including 27289 singleton pregnancies (naturally conceived or after assisted reproductive treatment) who underwent the 1st-trimester ultrasound screening at our University Hospital between January 2010 and May 2023. Overall, 27289 pregnancies were included: 23410 naturally conceived and 3879 following assisted reproductive technologies including 391 after ovulation induction and intrauterine insemination, 888 in-vitro fertilization and fresh embryo transfer, and 2600 natural or artificial frozen embryo transfer cycles. An Analysis of covariance (ANCOVA) was conducted to assess if there is an association between the UtAPI value and the mood of conception, adjusting for confounding factors (age, weight, smoking, and oocyte donation). Overall, pregnancies after artificial frozen embryo transfer demonstrated significantly lower 1st-trimester Uterine Artery Pulsatility Index as compared with all other modes of conception in a multivariable regression analysis adjusted for age, weight, smoking, and oocyte donation. The percent difference was 22.6 [CI95%: 20,6; 24,5] compared to naturally conceived pregnancy, 24.5 [CI95%:20,7; 28,1] to Ovulation Induction or intrauterine insemination, 24.8 [CI95%: [22,9; 27,6] to fresh Embryo Transfer and 21.7 [CI95%: [17,6; 25,5] compared to Natural Cycle Frozen Embryo Transfer. When calculating the risk for initiating preventive aspirin administration, the number of patients with increased risk (>1/100) who initiated prophylactic aspirin was significantly lower in the artificial cycle frozen embryo transfer group (7.8% vs 16.0% in natural cycle p<0.001 vs. 11.0% in Fresh embryo transfer p=0.01 vs. 10.5% in ovulation induction or intrauterine insemination p=0.14 vs. 9,3% in naturally conceived pregnancy p=0.03). Surprisingly although significantly fewer patients were considered at high risk for preeclampsia in the Artificial Cycle Frozen Embryo Transfer group, analysis of the actual incidence of preeclampsia demonstrated three times higher preeclampsia incidence in Artificial Cycle group 5.3% (122/2284) as compared with naturally conceived 1.4 % (321/23410), Ovulation Induction and intrauterine insemination 1.3 % (5/391) or Natural Cycle pregnancies 1.6 % (5/316) and more than two times higher when compared to fresh Embryo Transfer pregnancies 2.3 % (20/888), p<0.001. Pregnancies following frozen embryo transfer in artificial cycle are associated with significantly lower Uterine Artery Pulsatility Index during 1st-trimester preeclampsia screening. This results in a significantly lower number of patients being classified as high-risk for developing preeclampsia, despite accumulating evidence that artificial cycles are linked to an increased risk of preeclampsia. Therefore, the first-trimester preeclampsia risk algorithm should be adjusted to accurately assess risk for those undergoing Artificial Cycle Frozen Embryo Transfer, to prevent the under-treatment of patients who are at very high risk of developing preeclampsia and may benefit from prophylactic aspirin.

“Try until the last?”—the relevance of fresh embryo transfer outcomes for subsequent same-cohort vitrified–warmed cycles

PurposeTaking into consideration earlier attempts at assisted reproduction and previous pregnancies allows a more differentiated approach when counseling couples regarding their chances in assisted reproductive treatments. The aim of this study was to investigate whether the outcome of fresh embryo transfers affects subsequent same-cohort vitrified–warmed cycles.MethodsThis retrospective cohort study analyzes the outcome of all fresh and frozen embryo transfers (n = 8118) between January 1, 2011, and December 31, 2022. All women who received fresh or frozen embryo transfers at Kepler University Hospital Linz were included. The use of donor eggs, previously cryopreserved oocytes, and freeze-all cycles were excluded from the analysis.ResultsPositive serum βhCG after a fresh cycle has a significant impact on the chances of positive βhCG in a subsequent vitrified–warmed cycle (36.3% [33.2%, 39.5%]; P = 0.002). Negative βhCG after a fresh cycle does not predict the outcome of the following same-cohort embryo transfer (33.1% [30.7%, 35.7%], P = 0.726). Pregnancy rates of the first, second, third, and fourth same-cohort vitrified–warmed embryo transfer remain continuously high, with 32.8%, 30.8%, 28.9%, and 27.1%, respectively.ConclusionsPositive serum βhCG after a fresh embryo transfer has a positive predictive value for the outcome of a subsequent vitrified–warmed embryo transfer. Couples with a negative fresh cycle should not be discouraged from continuing fertility treatment using same-cohort frozen embryos.Trial registrationThis study was prospectively registered at the German Clinical Trials Register on September 5, 2023 (DRKS00032552).

Attitudes and preferences towards erectile dysfunction treatment among men with fertility needs: insights from a clinical study.

Erectile dysfunction (ED) is prevalent among males experiencing fertility challenges, yet attitudes towards actively treating ED in this group are under-researched. From a cohort of 1256 men with reproductive needs, 303 were identified with ED. The survey encompassed 296 respondents who correctly completed the second questionnaire, revealing that 50.3% sought ED treatment, with higher ED severity increasing the likelihood of seeking treatment. Infertile men were more likely to seek treatment than those with pregnancy loss (OR 3.18, 95% CI 1.74-5.83). Men with normal semen parameters were more open to ED therapy (OR 3.02, 95% CI 1.69-5.36), whereas those undergoing Assisted Reproduction Treatment were less inclined (OR 0.32, 95% CI 0.18-0.58). PDE-5 inhibitors (PDE-5Is) were preferred by 51.0% of those seeking treatment, with 29.7% of men with pregnancy loss and 60.1% of infertile men choosing PDE-5Is as their first option. Concerns included potential adverse effects of PDE-5Is on fetal health (78.7% of men with pregnancy loss) and on sperm quality (44.2% of infertile men). In conclusion, the different fertility requirements, semen parameters, and whether received ART are significant factors influencing the acceptance of treatment, PDE-5Is utilization among individuals in men with couple pregnancy loss is notably limited.

Transgenic Drosophila Expressing Active Human LH Receptor in the Gonads Exhibit a Decreased Fecundity: Towards a Platform to Identify New Orally Active Modulators of Gonadotropin Receptor Activity.

The gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH) and their receptors are major regulators of reproduction in mammals and are absent in insects. We previously established transgenic Drosophila lines expressing a constitutively active human LH receptor variant (LHRD578Y) and the wild-type receptor (LHRwt; inactive in the absence of an agonist). That study showed that ubiquitously expression of LHRD578Y-but not of LHRwt-resulted in pupal lethality, and targeted expression in midline cells resulted in thorax/bristles defects. To further study the Drosophila model for an in vivo drug screening platform, we investigated here whether expressing LHRD578Y in the fly gonads alters reproduction, as shown in a transgenic mice model. The receptor was expressed in somatic cells of the gonads using the tissue-specific traffic jam-Gal4 driver. Western blot analysis confirmed receptor expression in the ovaries. A fecundity assay indicated that the ectopic expression of LHRD578Y resulted in a decrease in egg laying compared to control flies carrying, but not expressing the transgene (~40% decrease in two independent fly lines, p < 0.001). No significant reduction in the number of laid eggs was seen in flies expressing the LHRWT (<10% decrease compared to non-driven flies, p > 0.05). The decreased egg laying demonstrates a phenotype of the active receptor in the fly gonads, the prime target organs of the gonadotropins in mammals. We suggest that this versatile Drosophila model can be used for the pharmacological search for gonadotropin modulators. This is expected to provide: (a) new mimetic drug candidates (receptor-agonists/signaling-activators) for assisted reproduction treatment, (b) blockers for potential fertility regulation, and (c) leads relevant for the purpose of managing extra gonadotropic reported activities.

The impact of advanced paternal age on the live birth rate in patients undergoing Assisted Reproduction treatment: Findings from an analysis at a public reproductive center in Brazil.

Human reproduction presents a challenge for our species, as evidenced by the escalating rates of infertility. This trend has prompted inquiries into diverse strategies aimed at mitigating infertility and enhancing conception rates. Despite the extensive research on advanced maternal age as a risk factor for reproductive outcomes, paternal age has historically garnered comparatively less attention. The aim of this study was to assess the impact of paternal age on embryos and its subsequent repercussions on fertilization rate, biochemical pregnancy, clinical pregnancy, and live birth rate in individuals undergoing assisted reproductive treatment in a public reproductive center located in Brazil. This investigation adopted a retrospective cohort, cross-sectional, analytical design, utilizing the analysis of secondary data, covering the period from July 2015 to July 2021. A total of 350 couples grappling with infertility and undergoing intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) were included in the analysis. Examination of age groups revealed a notable correlation between the ages of women and men (correlation coefficient R=0.12, p<0.0001). In the analysis of IVF techniques, a discernible trend towards a negative correlation with paternal age was observed, signifying that higher paternal age was linked to lower fertilization rates (p=0.004). Advanced paternal age significantly impacts full-term birth rates in IVF procedures, emphasizing the need for preconception public health advisories that underscore the risks associated with delaying parenthood for both men and women, particularly among those necessitating assisted reproductive techniques.

Out-of-pocket fertility preservation expenses: data from a Japanese nationwide multicenter survey

BackgroundThe expenses related to fertility preservation or subsequent assisted reproductive treatments are significant for adolescents and young adult patients in Japan’s current healthcare system. With fertility preservation becoming more widespread in developed countries, it is expected that these costs will be covered by insurance or subsidies. It is critical for patients, healthcare providers, and the government to know the costs that patients will be responsible for. In Japan, the costs of fertility preservation and subsequent assisted reproductive technology are not covered by insurance, but patients can apply for subsidies from the local and central governments if certain conditions are met. Presently, the above-mentioned costs, as well as the amount paid by the patient, vary by facility. Therefore, it is essential to ensure patients’ continued access to necessary medical care despite the associated costs.MethodsIn this study, questionnaires were mailed to 186 certified fertility preservation facilities in Japan to assess patients who had undergone fertility preservation or assisted reproduction. The questionnaires were sent between October 27, 2023 and March 31, 2024, with 140 of the 186 facilities responding (response rate: 75.3%).ResultsOur findings show that approximately one-third of the costs was borne by the patients.ConclusionGiven these circumstances, sustainable pricing and insurance coverage are necessary for both patients and facilities.

Processing imbalanced medical data at the data level with assisted-reproduction data as an example

ObjectiveData imbalance is a pervasive issue in medical data mining, often leading to biased and unreliable predictive models. This study aims to address the urgent need for effective strategies to mitigate the impact of data imbalance on classification models. We focus on quantifying the effects of different imbalance degrees and sample sizes on model performance, identifying optimal cut-off values, and evaluating the efficacy of various methods to enhance model accuracy in highly imbalanced and small sample size scenarios.MethodsWe collected medical records of patients receiving assisted reproductive treatment in a reproductive medicine center. Random forest was used to screen the key variables for the prediction target. Various datasets with different imbalance degrees and sample sizes were constructed to compare the classification performance of logistic regression models. Metrics such as AUC, G-mean, F1-Score, Accuracy, Recall, and Precision were used for evaluation. Four imbalance treatment methods (SMOTE, ADASYN, OSS, and CNN) were applied to datasets with low positive rates and small sample sizes to assess their effectiveness.ResultsThe logistic model’s performance was low when the positive rate was below 10% but stabilized beyond this threshold. Similarly, sample sizes below 1200 yielded poor results, with improvement seen above this threshold. For robustness, the optimal cut-offs for positive rate and sample size were identified as 15% and 1500, respectively. SMOTE and ADASYN oversampling significantly improved classification performance in datasets with low positive rates and small sample sizes.ConclusionsThe study identifies a positive rate of 15% and a sample size of 1500 as optimal cut-offs for stable logistic model performance. For datasets with low positive rates and small sample sizes, SMOTE and ADASYN are recommended to improve balance and model accuracy.

Significance of FSHR and LHCGR gene polymorphisms on clinical outcomes in gonadotropin-releasing hormone antagonist protocol with freeze-all strategy: A case-control study.

Follicle-stimulating hormone receptor (FSHR) and luteinizing hormone/choriogonadotropin receptor (LHCGR) are integral to ovarian function, facilitating follicle development and maturation through their respective hormonal interactions. The influence of receptor polymorphisms on the outcomes of freeze-all cycles remains unclear. This study investigates the impact of FSHR N680S and LHCGR N312S polymorphisms on clinical outcomes in freeze-all cycles. Women undergoing controlled ovarian stimulation for assisted reproductive technology participated in this study. They were administered a gonadotropin-releasing hormone antagonist protocol, with recombinant follicle-stimulating hormone (rFSH) dosages adjusted according to age, body mass index, antral follicle count, and individual hormonal responses. Additionally, human menopausal gonadotropin dosages were tailored based on the LHCGR N312S genetic variant. Analysis revealed no significant differences in age, body mass index, antral follicle count, or marital status across the genotypes of FSHR N680S and LHCGR N312S. However, notable differences were observed in the rFSH dosage required daily and in total among the FSHR polymorphism genotypes. Genotypes of the LHCGR polymorphism correlated with fewer stimulation days. A significant interaction was observed between the 2 polymorphisms concerning total rFSH dosage. The presence of serine in the FSHR polymorphism was associated with higher rFSH dosage requirements. Both FSHR N680S and LHCGR N312S polymorphisms significantly influenced clinical pregnancy and live birth outcomes in freeze-all cycles, underscoring the potential of a pharmacogenomic approach to optimize hormone supplementation in controlled ovarian stimulation protocols during assisted reproductive technology treatments.

High frequency of persistent placenta previa in pregnancies conceived by assisted reproductive technology treatment. What is the cause?: A retrospective cohort study.

High frequency of persistent placenta previa in pregnancies conceived by assisted reproductive technology treatment. What is the cause?: A retrospective cohort study.

Impact of the Zika virus on male fertility and medically assisted reproduction treatment

Impact of the Zika virus on male fertility and medically assisted reproduction treatment

Novel and recurrent hemizygous variants in BCORL1 cause oligoasthenoteratozoospermia by interfering transcription.

Oligoasthenoteratozoospermia (OAT) is a common cause of male infertility, of which the causes remain largely unknown. Recently, BCORL1 was identified as a contributor to male infertility from non-obstructive azoospermia (NOA) to OAT. To identify novel and hotspot variants in BCORL1 from infertile men with OAT and reveal their outcomes of assisted reproductive treatments (ARTs). Forty-six infertile men characterized by OAT were recruited from 2017 to 2022. Variants in OAT patients were identified by whole-exome sequencing (WES) and verified by Sanger sequencing. Papanicolaou staining was used for sperm morphology analysis. Pathogenicity of BCORL1 variants were analyzed by bioinformatics analysis, and further confirmed in vitro by using recombinant plasmids and cells. Meanwhile, ARTs were performed on these patients to investigate the appropriate clinical treatment strategy. We identified a novel hemizygous missense variant (NM_021946: c.G4171A; p.G1391R) and a recurrent variant (NM_021946: c.T2615G; p.V872G) in BCORL1 from four OAT patients. Notably, routine semen assessment and Papanicolaou staining revealed a special OAT phenotype of patients with BCORL1 variants, whose rare mature sperm characterized by acephalic and abnormal acrosome. Pathogenicity analysis showed the interaction between BCORL1 with histone deacetylases (HDACs) were disrupted after variance, accompanied with epigenetic alterations and finally the orderly transcriptions of spermatogenetic genes were interfering. Besides, clinical record presented the poor outcomes of ARTs in these patients with BCORL1 variants. Our findings further expand the variant spectrum of BCORL1 related to OAT, and provide new evidences that BCORL1 acts as an important transcriptional regulator, participating in epigenetic regulation and directing the expression of key genes throughout spermatogenesis. The outcomes of ARTs will facilitate the genetic counseling and clinical treatment of infertile men with BCORL1 variants in the future.