Assisted Reproductive Technology Research Articles

Application of disposable digital hysteroscope for outpatient hysteroscopy in women undergoing artificial assisted reproductive procedures: a clinical research

BackgroundHysteroscopy is the preferred method for the diagnosis and treatment of uterine diseases. With the increasing demand for outpatient hysteroscopy, disposable digital hysteroscopy has emerged, which can meet the requirements of diagnosis and treatment integration, and greatly reduce the labour and storage costs.MethodsA total of 108 outpatients who underwent hysteroscopy using disposable digital hysteroscope were divided into two groups: the non-porous group (group A, n=49) and the married with child group (group B, n=59). The patients’ general information and clinical data were recorded and statistical analysis was performed.ResultsNo differences were found between the age, weight, body mass index, menopausal status and indication for hysteroscopy of the two groups. The most common indication was embryo transfer failure. The surgical success rate of 108 patients was 100%, the concordance rate between hysteroscopic diagnosis of chronic endometritis and pathological diagnosis was 94.44% (68/72), while the false positive rate stood at 38.89% (14/36). Additionally, incidental findings rate for endometrial polyps was 92.00% (23/25) with a low false positive rate of only 6% (5/83). The mean visual analogue scale score of group A was 2.285±0.180, which was not significantly different from group B (p=0.483, 95% CI(−0.60-0.44)). The pregnancy rate among patients who received assisted reproductive technology and were followed up for 1 year after surgery was 66.67% (40/60), while the abortion rate stood at 5.00% (3/60).ConclusionsThe disposable digital hysteroscope is a valuable and effective tool for outpatient hysteroscopy.

Feline cumulus cells and oocytes show massive accumulation of lipid droplets and upregulation of PLIN2 expression after in vitro maturation

This study investigates lipid content and expression of genes involved in lipid metabolism in feline cumulus cells and oocytes before and after in vitro maturation (IVM). Domestic cats represent valuable models in reproductive research, yet the efficiency of in vitro embryo production remains suboptimal, with contributing factors still under investigation. We characterized lipid droplets (LDs) in oocytes collected from adult queens, both before and after IVM, using confocal microscopy with Bodipy 493/503 staining. We also quantified the expression of four genes involved in regulation of lipid metabolism. Our findings revealed a substantial accumulation of LDs and a significant upregulation of PLIN2 expression in both cumulus cells and oocytes following IVM. The number and total area of LDs and fluorescence intensity increased markedly in oocytes at the MII stage, while the average LD diameter decreased. Similarly, cumulus cells showed an increase in number and total area of LDs post-IVM, suggesting their involvement in oocyte maturation by modulating lipid homeostasis. This study presents the first detailed characterization of lipid droplet dynamics in feline oocytes and cumulus cells, providing insights into metabolic processes during IVM, which are critical for optimizing assisted reproductive technologies in felids.

Astaxanthin improves assisted reproductive technology outcomes in poor ovarian responders through alleviating oxidative stress, inflammation, and apoptosis: a randomized clinical trial

BackgroundPoor ovarian response (POR) to controlled ovarian stimulation (COS) remains challenging, especially in advanced-age women with diminished ovarian reserve, resulting in low live birth rates. Many patients prefer to conceive with their eggs, underscoring the need for improved treatments. This study explores astaxanthin potential as a COS adjuvant to improve ovarian response and assisted reproductive technology (ART) outcomes, considering its impact on oxidative stress (OS), inflammation, and apoptosis, which are key factors in POR.MethodsIn this randomized, triple-blind, placebo-controlled trial, 60 infertile POR patients from POSEIDON Group 4 (the poorest prognosis category, age > 35 and poor ovarian reserve (anti-müllerian hormone < 1.2 ng/ml or antral follicle count < 5) undergoing intracytoplasmic sperm injection were enrolled. Patients were assigned to receive either 12 mg/day AST or placebo for eight weeks. All patients underwent a gonadotropin-releasing hormone antagonist regimen for COS. ART outcomes were compared between groups. Blood serum and follicular fluid (FF) were analyzed for OS markers (superoxide dismutase [SOD], total antioxidant capacity [TAC], and malondialdehyde [MDA]), and pro-inflammatory cytokines (interleukin-6 [IL-6], interleukin-8 [IL-8], and vascular endothelial growth factor [VEGF]) via enzyme-linked immunosorbent assay kits, and cell-free DNA [cfDNA] (apoptotic marker) via ALU quantitative polymerase chain reaction.ResultsAfter the intervention, the AST group exhibited a significant elevation in serum (P = 0.013) and TAC (P = 0.030), accompanied by a significant reduction in serum MDA (P = 0.005). No significant differences between AST and placebo groups were observed in OS markers in FF. AST group showed significant reductions in the serum IL-6 (P < 0.001), IL-8 (P = 0.001), and VEGF (P = 0.002) levels following AST therapy. In the AST group, FF levels of IL-6 (P = 0 < 001), IL-8 (P = 0.036), VEGF (P = 0.006), and cfDNA (P < 0.001) were significantly lower than in the placebo group. Between-group comparisons showed significant differences in the alterations of serum SOD (P = 0.027), IL-6 (P < 0.001), and IL-8 (P = 0.035) levels between AST and placebo groups. The AST group showed significant increases in the number of retrieved oocytes (P = 0.003), MII oocytes (P = 0.004), frozen embryos (P = 0.037), and high-quality embryos (P = 0.014) compared to the placebo group.ConclusionAST shows promise as a COS adjuvant therapy, potentially enhancing some ART outcomes in POR through alleviating OS, inflammation, and apoptosis.Trial registrationClinical trial registration number: IRCT20230223057510N1, URL: https://irct.behdasht.gov.ir/trial/68870, registration date: 2023 March 16.Graphical

The progesterone prime protocol: an affordable option for ICSI in Egypt

BackgroundThe two main input indicators needed to assess the success of assisted reproductive technology (ART) strategies are cost-effectiveness and clinical outcome. Therefore, we focused in our study on the direct cost associated with the Progesterone Prime Ovulation Induction Protocol (P-P-OP protocol) compared to other protocols, and the clinical outcomes of this strategy were measured in their effect on implantation and pregnancy rates.MethodsA pilot single-armed study was conducted on 47 infertile women coming for an ICSI cycle. Progesterone priming was started with 10 mg dydrogesterone along with HMG 150–300 IU from the second day of the menstrual cycle and was maintained until the day of ovulation trigger. The primary outcome was the cost per cycle, while the secondary outcome was the clinical pregnancy rate. The cost per cycle, including the cryopreservation cost, was calculated for economic evaluation.ResultsPer each cycle, the number of retrieved oocytes was 14.87 ± 8.09, the number of mature oocytes was 9.81 ± 4.67, the number of total embryos was 8.74 ± 4.28 (grade A = 67.40%, grade B = 11.92%, grade C = 20.68%), and the number of transferred embryos was 2.43 ± 0.68. The clinical pregnancy rate in our study was 42.5%. Economically, the cost of the P-P-OP protocol for each patient was only 56 USD.ConclusionThe P-P-OP protocol is a simplified approach suitable for freeze-only strategies, offering the benefits of positive results, fewer injections, lower costs, and increased patient convenience.

Treatment of human sperm with GYY4137 increases sperm motility and resistance to oxidative stress.

Hydrogen sulfide (H2S) has been shown to play a significant role in oxidative stress across various tissues and cells; however, its role in sperm function remains poorly understood. This study aimed to investigate the protective effect of GYY4137, a slow-releasing H2S compound, on sperm damage induced by H2O2. We assessed the effects of GYY4137 on motility, viability, lipid peroxidation and caspase-3 activity in human spermatozoa in vitro following oxidative damage mediated by H2O2. Spermatozoa from 25 healthy men were selected using a density gradient centrifugation method and cultured in the presence or absence of 10 μM H2O2, followed by incubation with varying concentrations of GYY4137 (0.625-2.5 μM). After 24 h of incubation, sperm motility, viability, lipid peroxidation, and caspase-3 activity were evaluated. The results indicated that H2O2 adversely affected sperm parameters, reducing motility and viability, while increasing oxidative stress, as evidenced by elevated lipid peroxidation and caspase-3 activity. GYY4137 provided dose-dependent protection against H2O2-induced oxidative stress (OS). We concluded that supplementation with GYY4137 may offer antioxidant protection during in vitro sperm preparation for assisted reproductive technology.

Risk Factors for Prematurity and Congenital Malformations in Assisted Reproductive Technology Pregnancies-A Retrospective Study.

Background: Assisted reproductive technology (ART) nowadays plays a major role in the treatment of infertility, with the most frequently used techniques being in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). The objective of this study is to analyze pregnancies achieved using these ART techniques and their correlations with the prematurity and congenital malformations rates. Methods: This is an observational retrospective longitudinal study that includes 814 newborns conceived through an ART, namely IVF or ICSI. Results: Using a multivariate logistic regression analysis mode, there is a higher prematurity rate in twin pregnancies OR 16 (95% CI 10.7, 23.8), donor conception OR 1.8 (95% CI 1.1, 3.3) and PIH pregnancy OR 2.6 (95% CI 1.5, 4.5). The odds of malformations in these ART pregnancies are increased by the stage of the embryo (day 3) OR 2.6 (95% CI 1.3, 5.2), fresh embryo transfer OR 2 (95% CI 1.2, 3.4) and donor conception OR 2.3 (95% CI 1.2, 4.4). The ART used (IVF/ICSI) does not influence the prematurity or birth defects rate. Conclusions: Donor conception is found to increase the odds of both prematurity and congenital malformations. The ART used (IVF/ICSI) does not influence the prematurity or birth defects rate.

Evaluation of the effect of an amniotic membrane derived bio-nano product (LifeCell) on human endometrial cells proliferation and gene expression: An in-vitro study

ObjectiveSuccessful assisted reproductive technology (ART) requires a receptive endometrium with appropriate thickness and the presence of specific cytokines, chemokines, and growth factors. Despite advancements in ART, the success rates remain suboptimal, particularly in individuals with thin endometrium resistant to treatment. In this study, we evaluated the potential effects of LifeCell, a product of BioNano Technology, on the growth, development, and acceptance of endometrial cells. Study designWe cultured endometrial cells in a defined medium with different concentrations of LifeCell and examined cell growth, development, and the expression of genes involved in endometrial receptivity. ResultsCo-culture of primary human endometrial cells with 5 % Life cell solution significantly stimulated the endometrial cell growth, development and receptivity genes expression. The expression levels of FGF2 and CSF in the 72 h co-cultured were significantly increased compared with other groups (P < 0.01). HOXA10 and LIF significantly increased in the 72 h co-cultured compared with 24 h co-cultured and control groups but had no significant level compared with 48 h cocultured. HOXA10 significantly increased in the 48 h cocultured compared with control group. IL-6 and Hb-EGF increased in the 48 h co-cultured compared to other groups but had no significant level. VEGF increased in the treated groups compared to control but had no significant level. The expression of OPN, unlike the other genes, decreased in the treated group compared to the control, which was not significant. ConclusionsThese findings suggest that LifeCell may be a potential option for patients with treatment-resistant thin endometrium in cases of infertility.

Queer, Migrant Non-Parenthood in Désorientale by Négar Djavadi and Gabrielle by Agnès Vannouvong

Abstract Désorientale (2016) by Franco-Iranian author Négar Djavadi and Gabrielle (2015) by Franco-Lao-Thai author Agnès Vannouvong both emerge at a moment when queer people have some rights (marriage and adoption) but no access to assisted reproductive technology (ART). They take up the issue of what I term “political infertility,” rebuking the notion of queerness as an unproductive sexuality. These novels’ queer (migrant) characters experience compounded forms of exclusion, along the lines of race, gender, sexuality, and cultural difference. I explore how the queer (migrant) nonparent speaks to a particular precarity within a system of power, revealing the complex way in which the nonparent is entrapped by competing modes of legitimatization, visibility, and access to full and fulfilled subjecthood.

Research Progress on Luteinizing Hormone and Polycystic Ovary Syndrome

Polycystic ovary syndrome is a common endocrine disease in women of childbearing age, with an incidence of about 6% to 10%, which is the main cause of anovulatory infertility. With the development of assisted reproductive technology, up to 60% of patients with polycystic ovary syndrome need to be pregnant successfully through in vitro fertilization and embryo transfer. Ovarian controlled ovulation induction is an important process in assisted reproductive therapy. Luteinizing hormone plays an important role in the development and maturation of follicles in the ovary, and high levels of luteinizing hormone have a negative effect on pregnancy outcome. at present, it is still controversial that the appropriate level of luteinizing hormone will improve the pregnancy outcome, and the mechanism of how luteinizing hormone affects the pregnancy outcome is still unclear. This article will mainly review the above two aspects in order to provide reference for clinical research in the future.

Long-Term Impact of Infertility and Assisted Reproductive Technology on Cardio-Renal Health in Sweden

Abstract Background The use of Assisted Reproductive Technology (ART), such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), is rising in Europe. These treatments involve high doses of hormones to increase oocyte collection. While most safety studies in women have focused on cancer risks, the association with cardio-renal diseases remains under-explored. This study examines whether the use of ART is linked to coronary ischemic disease (CHD), stroke, brain hemorrhage, other cerebrovascular diseases, chronic kidney disease, and aortic aneurysm/dissection, while also exploring the association between infertility and these conditions. Methods A nationwide cohort study was conducted using Swedish national registries, following all nulliparous women who gave birth between 1982 and 2002 until the end of 2017. Descriptive statistics and inverse probability weighted Kaplan-Meier curves to adjust for body mass index, maternal age, country of origin, smoking, and year of delivery, were used to compare 1) women who conceived with or without ART, 2) women who used IVF or ICSI respectively to women with known infertility that conceived without ART, and 3) women with and without known infertility. Results Compared to all other women, women undergoing ART were at elevated risk for CHD, stroke, and other cerebrovascular diseases, but after adjustment for underlying risk factors, including infertility, no substantial differences were seen. As a group, women with known infertility were at elevated risk of CHD and stroke, also after adjustment for known background factors. Conclusions Data suggest that the use of ART does not increase the long-term risk of cardio-renal diseases. Nonetheless, infertility itself is associated with a higher risk of CHD and stroke. Key messages • Infertility, more so than the use of ART, is linked to elevated risks of CHD and stroke. • Preventive measures for these conditions should be considered for women with infertility.

The effect of depression on the outcome of infertile females underwent the first In Vitro Fertilization procedure

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

Evaluation of male reproductive hormones of Kalahari Red and Kalawad goat bucks as affected by age and season under tropical conditions.

Comprehensive understanding of reproductive hormones and environmental cues with their relationship is essential for efficient production in livestock sectors involving either assisted or natural reproductive methods. This study evaluated the effects of age and seasonal-associated changes in the blood concentrations of testosterone and follicle stimulating hormone (FSH) of male Kalahari Red (KR) andKalawad(KW)-crossbred goats. Based on a 2 × 3 × 4 factorial arrangement, a total of 42 bucks (KR n = 21 and KW n = 21) were allotted into three age groups (> 1 ≤ 2years, > 2 ≤ 3years and > 3 ≤ 4years) with seven KR bucks and seven KW bucks each per age group; reared under different seasons (early rainy, late rainy, early dry and late dry). The animals were managed semi-intensively, kept in an open-ventilated pen and subjected to same nutritional regime throughout the one-year experimental period. Follicle stimulating hormone and testosterone concentrations were analyzed in serum samples. Data obtained reproductive hormones were subjected to three-way Analysis of Variance using SAS 1999. Results show that breed had a significant effect (p < 0.05) on both serum FSH and testosterone concentrations. The highest FSH (0.49 ± 0.02ng/mL, 0.45 ± 0.01ng/mL, 0.41 ± 0.1ng/mL and 0.47 ± 0.07ng/mL) mean values (P > 0.05) were observed in KR in September, October, November and May, respectively while the highest (2.6 ± 0.02ng/mL) testosterone concentration in KW (p < 0.05) was obtained in December. Testosterone had irregular patterns between breeds and months of sampling. FSH was at peak (p > 0.05) in KR during the late rainy season at all ages while the values of FSH concentration in KW were not significantly different at all ages and seasons. The highest (2.05 ± 0.11ng/mL) serum testosterone mean value in KW peaked (p < 0.05) age > 3 ≤ 4years during the late rainy season. Testosterone concentration was lower and steady at all ages during rainy seasons in KR but started fluctuating during the early dry season. The least mean (0.62 ± 0.07ng/mL and 0.68 ± 0.05ng/mL) were recorded (p > 0.05) in KW during the late dry season at age > 2 ≤ 3 and > 3 ≤ 4years respectively. In KR and KW goat breeds raised under tropical condition, the high seasonal variations were responsible for the fluctuations in the reproductive hormones which resultantly altered or lowered the sexual activity of the animals at certain season(s).

Awareness and acceptability of assisted reproductive technology among non-medical tertiary students in a low-resource setting

BackgroundAssisted Reproductive Techniques (ART) have significantly advanced infertility treatment worldwide. However their availability and use in sub-Saharan Africa, remains limited although infertility is highly prevalent, with significant psycho-social challenges including stigma. This study assessed the awareness, attitudes, and perceptions of ART among non-medical tertiary students in Ghana.MethodA cross-sectional study was conducted among non-medical students in tertiary institutions in Ghana. Pre-tested questionnaires were administered to both post-graduate and undergraduate students after obtaining informed consent. Ethical approval was obtained from the Review Board at Community Health Department of the University of Ghana Medical School. The data collected was analyzed using SPSS (version-27) and the results presented using frequency tables, graphs, and charts. significance was P-value below 0.05 was considered statistically significant.ResultsOverall, 196 participants from the two largest universities and other tertiary institutions in Ghana took part in this study. Majority (63.5%) of respondents demonstrated awareness on ART services, but 60.3% showed poor knowledge of the types of ART. Males generally exhibited lower knowledge of ART services compared to females, and knowledge of ART services showed an inverse relationship with age. In-vitro fertilization (IVF) was the most widely recognized and recommended ART technique, known by 65.1% of respondents who were aware of the types of ART. Most participants expressed reluctance to accept or recommend gamete donation due to religious reasons, fear of complications, and a preference for conventional means of procreation.ConclusionThe majority of tertiary students in Ghana are aware of ART for infertility treatment however, many are hesitant toward donor-gamete treatment protocols. Fear of complications and related costs pose major barriers to considering ART among the respondents. Participants unanimously suggested government subsidies and the inclusion of ART under the national health insurance coverage package.

Air Pollutants and Ovarian Reserve: A Systematic Review of the Evidence

Abstract Background Growing evidence points to an association between ambient air pollution and decreased human reproductive potential. The aim of this study was to systematically review the association between air pollutants and female ovarian reserve. Methods The literature was searched in six electronic databases through August 2023. Screening of the 75 articles retrieved for inclusion criteria resulted in the selection of 12 human observational studies that evaluated the effect of environmental pollutants on markers of female ovarian reserve. The study protocol was registered on PROSPERO (registration code CRD42023474218). Results The study design of selected studies was found to be cross-sectional (2 of 10), retrospective cohort (7 of 10), prospective cohort (2 of 10), and case-control (1 of 10). The study population was equally distributed between Asians (60%) and Americans (50%) with an Italian minority (10%). The main findings showed a higher body of evidence for the environmental pollutants PM2.5, PM10, and NO2, while a low body of evidence for PM1, O3, SO2, and a very low body of evidence for benzene, formaldehyde, and benzo(a)pyrene, yet consistently showing significant inverse association data. The overall methodological quality of the selected studies was rated moderated across the 14 domains of the NIH toolkit. Conclusions Increased exposure to air pollutants seems to be associated with reduced female ovarian reserve with evidence being strongest for pollutants such as PM2.5, PM10, and NO2. More evidence is needed to draw conclusions about causality. Key messages • Increased exposure to air pollutants seems to be associated with reduced female ovarian reserve with evidence being strongest for pollutants such as PM2.5, PM10, and NO2. • Global environmental policy programs are urgently needed to reduce the risks associated with reduced fertility such as reduced birth rates or the use of assisted reproductive technologies.

The NAD+ precursor nicotinamide riboside protects against postovulatory aging in vitro.

Postovulatory aging (POA) of oocytes is clinically significant as it mirrors the degeneration observed in maternally aged oocytes, leading to substantial impairments in oocyte quality and the success rates of artificial reproductive technology (ART). The molecular alterations associated with POA, such as the degeneration of the first polar body, an increase in perivitelline space, reactive oxygen species (ROS) accumulation, energy depletion, and chromosomal and DNA damage, underscore the urgency of finding interventions to mitigate these effects. This study aims to identify whether nicotinamide riboside (NR) can prevent POA during the process of in vitro culture and raise the success rates of ART. Taking advantage of an in vitro postovulatory oocyte aging model, we examined the morphological integrity and NAD+ levels of ovulated mouse MII oocytes after 24h of culturing. Following in vitro fertilization, we assessed the embryonic developmental potential of oocytes affected by POA. Using immunofluorescence and confocal microscopy, we measured the levels of ROS, mitochondrial function, and γH2AX. We also evaluated spindle assembly and chromosome alignment. Additionally, we detected the distribution of cortical granules to assess the metabolic and quality changes in POA oocytes with the supplementation of NR. To further our analysis, quantitative real-time PCR was conducted to measure the mRNA expression levels of antioxidant enzymes Sod1 and Gpx1 in the oocytes. With 200μM NR supplementation during in vitro culture for 24h, the oocytes from POA demonstrated reduced signs of aging-related decline in oocyte quality, including reduced ROS accumulation, improved mitochondrial function, and corrected mis-localization of cortical granules. This improvement in oocyte quality is likely due to the inhibition of oxidative stress via the NAD+/SIRT1 signaling pathway, which also helped to restore normal spindle assembly and chromosome alignment, as well as reduce the elevated levels of γH2AX, thereby potentially enhancing the embryonic development potential. Current research provides evidence that NR is an efficient and safe natural component that prevents the process of POA and is thus a potential ideal antiaging drug for raising the success rates of ART in clinical practice.

FSHB and FSHR genes variants in combination with hormones levels predict low and high ovarian response to controlled ovarian stimulation: a logistic regressive model

BackgroundPredicting the number of follicles obtained after controlled ovarian stimulation (COS) is challenging, especially considering individual variability. Since FSH is a fundamental hormone that controls growing follicle activity, genetic variants are predicted to affect ovarian response to stimulation.The aim of the studyThe purpose of this study was to analyze whether FSHB rs10835638 and FSHR rs6166 genetic variants in combination with clinical parameters might be considered as potential precise predictors of ovarian response during COS.Materials and methodsThe present study included 144 women from infertile couples who underwent assisted reproductive technologies. Women with reduced FSH and/or AMH serum levels were excluded from the study. Genotyping was carried out applying restriction fragment length polymorphism analysis.ResultsGenotypes frequencies for FSHB rs10835638 and FSHR rs6166 were GG (73%), GT (24%), TT (3%) and AA (42%), AG (39%), GG (19%), respectively. FSHR rs6166 GG genotype was shown as associated with higher early follicular phase serum FSH, LH and progesterone levels, compared to AA and AG genotypes. Logistic regressive models that simultaneously use the patient’s genetic and clinical characteristics to calculate the probability of low or high ovarian response have been developed.ConclusionThe present study suggests that rs10835638 and rs6166 genetic variants affect hypothalamic-pituitary–gonadal hormones serum levels, and together may provide an improved model for predicting an ovarian response during COS.

Diagnostic value of prenatal ultrasound screening and analysis of pregnancy outcomes in velamentous umbilical cord insertion

Objective: To explore diagnostic value of prenatal ultrasound screening in velamentous umbilical cord insertion (VCI) and its influence on perinatal outcomes, and to provide theoretical basis for clinical practice. Methods: Fifty-eight pregnant women diagnosed with VCI before or after delivery admitted to the First Affiliated Hospital of Xi'an Jiaotong University were selected from January 2012 to December 2022. The clinical features and perinatal outcomes of 45 women finally with VCI after delivery (VCI group) were retrospectively analyzed, and 225 women with normal umbilical cord attachment were selected as the control group during the same period. Results: (1) Among 58 women, 54 (93.1%, 54/58) were diagnosed with VCI by prenatal ultrasound screening, 4 patients (6.9%, 4/58) were missed; and 13 (22.4%, 13/58) were misdiagnosed. Finally, a total of 45 women were confirmed by postpartum placental examination, and 11 (24.4%,11/45) were combined with vasa previa. (2) There were no differences in age, number of pregnancies, and number of induced abortions between the two groups (all P>0.05). Compared with the control group, the rate of assisted reproductive technology [13.3% (6/45) vs 0.4% (1/225); P<0.01], and twin pregnancy rate [8.9% (4/45) vs 0.4% (1/225); P<0.01] in the VCI group were significant higher. (3) Compared with the control group, the rate of placenta previa, succenturiate placenta, vasa previa, postpartum hemorrhage, prenatal hemorrhage and postpartum intrauterine remainder in the VCI group were significant higher (all P<0.05); there was no significant difference in the incidence of placental abruption, premature rupture of membranes, fetal distress and single umbilical artery between the two groups (all P>0.05). The incidence of fetal structural abnormalities in the VCI group (4.4%, 2/45) was higher than that in the control group (1.3%, 3/225), but there was no significant difference between the two groups (P=0.195). (4) The cesarean section rate [75.0% (33/44) vs 45.1% (101/224); P<0.01], preterm birth rate [29.5% (13/44) vs 5.4% (12/224); P<0.01], rate of small for gestational age [20.5% (9/44) vs 5.4% (12/224); P<0.01] in the VCI group were significant higher. However, neonatal birth weight [(2 928±552) vs (3 353±498) g; P<0.01], and 1-minute Apgar score (median: 10 vs 10; P<0.01) in the VCI group were lower than those in the control group. Conclusions: Prenatal ultrasound screening is an important method to diagnose VCI. VCI is more prone to adverse pregnancy outcomes, such as postpartum hemorrhage, premature delivery, small for gestational age, et al. Its risk factors include twin pregnancy, assisted reproductive technology, placenta previa, and para-placenta.

Identify high-risk DOR women ≤ 35 years old following assisted reproduction technology through cutoffs of anti-mullerian hormone and antral follicle counts

BackgroundFemales with diminished ovarian reserve (DOR) have significantly lower cumulative live birth rates (CLBRs) than females with normal ovarian reserve. A subset of young infertile patients, whose ovarian reserve is declining but has not yet met the POSEIDON criteria for DOR, has not received the attention it merited. These individuals have not been identified in a timely manner prior to the initiation of assisted reproductive technology (ART), leading to suboptimal clinical pregnancy outcomes. We categorized this overlooked cohort as the “high-risk DOR” group.ObjectiveThe primary aim of this study was to identify high-risk DOR patients through anti-Mullerian hormone (AMH) and antral follicle counts (AFCs).MethodsA total of 10037 young women (≤ 35 years old) who underwent their first initial oocyte aspiration cycle at a single reproductive medicine center were included and further classified into three groups, based on the thresholds for AMH and AFC established through receiver operating characteristic (ROC) analysis and in alignment with the POSEIDON criteria. Two ROC analyses were performed to identify the cutoff values of AMH and AFC to obtain one viable embryo (one top-quality embryo or one viable blastocyst). The cutoffs of ROC were measured by sensitivity and specificity. The primary outcome was the cumulative live birth rate (CLBR) per oocyte aspiration cycle. The secondary outcomes included the number of oocytes retrieved and the number of viable embryos formed. Pearson’s chi-square tests were conducted to compare the clinical outcomes among the three groups. Furthermore, univariate logistic regression analyses were performed to investigate the associations between ovarian reserve and clinical outcomes. All of the above comparisons between the high-risk DOR and NOR were further confirmed by propensity score matching (PSM) (1:1 nearest-neighbor matching, with a caliper width of 0.02).ResultsAccording to the ROC analyses and POSEIDON criteria, the present study identified a population of high-risk DOR patients (1.20 ng/mL < AMH values < 2.50 ng/mL, with 6 ≤ AFC ≤ 10; n = 682), and their outcomes were further compared to those of DOR patients (positive control, AMH values ≤ 1.2 ng/mL, and/or AFC ≤ 5; n = 1153) and of NOR patients (negative control, 2.5 ng/mL ≤ AMH values ≤ 5.5 ng/mL, and 11 ≤ AFC ≤ 20; n = 2649). Patients in the high-risk DOR group had significantly lower CLBRs than those in the NOR group (p < 0.001) but higher CLBRs than those in the DOR group (p < 0.001). Logistic regression further demonstrated that high-risk DOR was associated with a lower likelihood of cumulative live birth chance (OR 0.401, 95% CI: 0.332–0.486, p < 0.001) than NOR was, with a greater likelihood of cumulative live birth chance (OR 1.911, 95% CI:1.558–2.344, p < 0.001) than DOR was. To investigate the effects of embryo development stage, the outcomes of D3 embryos and blastocysts were analyzed separately. Significant differences in pregnancy outcomes were detected only in D3 embryo ET cycles among the three groups (high-risk DOR vs. NOR, all p < 0.05; DOR vs. NOR, all p < 0.05). DOR/high-risk DOR did not influence the pregnancy loss rates or pregnancy outcomes (clinical pregnancy rates and ongoing pregnancy rates) per positive HCG cycle (all p > 0.05). After PSM, the differences in ovarian response and pregnancy outcomes between the high-risk DOR and NOR groups were consistent with the results before PSM.Conclusion(s)Our study revealed that the CLBR of the high-risk DOR patients was significantly lower than that of females with normal ovarian reserve and greater than that of females with DOR. The values of AMH ranging from 1.2 to 2.5 and AFC ranging from 6 to 10 appeared to constitute meaningful thresholds in females with mildly reduced ovarian reserve.

Fertilization and developmental competence of in vitro fertilized embryos from C57BL/6J mice of different ages and the impact of vitrification.

Prepubertal animals are often preferred as sources of oocytes for assisted reproductive technologies (ARTs) in laboratory mice, but the normality and developmental competence of these oocytes remain controversial. This study systematically examined in vitro fertilization competence, embryo development, and fetal development after embryo transfer (ET) using oocytes from C57BL/6J mice aged 3 to 10 weeks. Oocytes were collected from superovulated females, fertilized, and cultured in vitro for 96 h or transferred at 2-cell stage to recipient females. Additionally, fetal development was compared between unfrozen and frozen-thawed in vitro-fertilized 2-cell embryos across different age groups. The number of ovulated oocytes per animal decreased with age, while the percentage of morphologically normal oocytes was highest in 3-week-old mice (99%) compared to older ages (70-86%, P < 0.05). Although fertilization percentages were consistently high (≥ 97%), blastocyst development in vitro, the nuclear counts of blastocysts and fetal development after ET were lowest for embryos from 3-week-old mice. Development of frozen-thawed embryos to fetuses was significantly reduced compared to unfrozen embryos in all age groups, except for those from 10-week-old mice. These findings suggest that oocytes from prepubertal mice, particularly from 3-week-old mice, are less developmentally competent than those from older mice. Therefore, the age of animals for oocyte source should be carefully considered based on the specific requirements of the research or ART applications.

Control of sperm penetration using stereumamide A derived from Trichaptum fuscoviolaceum in the in vitro fertilization of pig oocytes.

Fungal metabolites are known to have potent and diverse properties such as antiviral, antidiabetic, antitumour, antioxidant, free radical scavenging, and antibacterial effects which can be utilized to treat diseases. In this study, we investigated the functional activity of stereumamide A (StA) derived from a culture broth of Trichaptum fuscoviolaceum during the in vitro fertilization (IVF) of pig oocytes, to determine its effects on sperm penetration. Oocytes matured in vitro were fertilized in the absence or presence of varying concentrations of StA (0-50 μg/ml StA). When StA was directly added into the IVF medium, significantly lower fertilization rates were seen with the 20 or 50 μg/ml StA (2.0-17.5%) treatments compared with those of 10 μg/ml StA or the controls (60.9-62.3%), whereas StA had no influence on the survival of oocytes and spermatozoa throughout the IVF process. For evaluating the control of sperm entry, mature oocytes were pre-incubated in a medium containing 20 μg/ml StA for 1 h, and then IVF was subsequently performed. The incidence of polyspermy was significantly reduced when oocytes were pre-incubated with StA (15.0% vs. 50.4-57.5% in controls). In conclusion, sperm penetration was inhibited in the medium in the presence of StA during IVF, while StA did not affect sperm motility and fertility competence. Fertilization was controlled when mature oocytes were incubated with StA prior to IVF, suggesting the possible use of the fungal metabolite in assisted reproductive technology for humans and animals.