Effect Of Assisted Reproductive Technology Research Articles

The Correlation of Paternal Age on Semen Parameters in Assisted Reproduction: A Retrospective Study in Qassim, Saudi Arabia.

In the past, fertility concerns have predominantly revolved around the effect of a woman's age on the quality of her eggs and the success of her pregnancy. While men generally retain their ability to father children throughout their lives, there is evidence suggesting a decline in natural conception rates as paternal age increases. A growing body of research indicates a potential link between advanced paternal age (APA) and various adverse outcomes, including changes in sperm genetics, reduced conception rates, higher rates of miscarriage, lower live birth rates, and even long-term health consequences in offspring. However, it remains unclear whether there is an association between APA and the effectiveness of assisted reproductive technology (ART). This study aims to shed light on the relationship between APA and semen parameters. This is a retrospective, descriptive study analyzing data from electronic medical records of men undergoing ART at a fertility clinic in Saudia Arabia(2017-2022). Men aged 21-60 with at least one semen analysis and no missing data/hormonal treatment were included. Data on age and semen parameters (count, motility, and morphology) were extracted and analyzed using Jeffreys's Amazing Statistics Program (JASP; University of Amsterdam, Amsterdam, Netherlands) (descriptive statistics, Spearman's rank correlation). Analysis of 1506 men undergoing ART revealed a mean age of 37 years (SD=6.94) and a mean sperm count of 55.0 million/mL (SD=46.05). The correlation between age and sperm count indicates a minimal association (r=0.075, p<0.01); moderate positive correlations were observed between sperm count and motility (r=0.406); count and morphology (r=0.543); and motility and morphology (r=0.458). Age may not be a major factor in overall sperm parametersfor this population, but a strong positive correlation was observed between sperm count, motility, and normal morphology. These findings suggest that these semen parameters are interconnected, with higher sperm counts potentially indicating better overall sperm quality.

Association between adenomyosis and placenta accreta and mediation effect of assisted reproductive technology on the association: A nationwide observational study.

To investigate the association between adenomyosis and placenta accreta spectrum (PAS) and to evaluate the effect of assisted reproductive technology (ART) in mediating this association. We retrieved data for singleton women from the Japanese nationwide perinatal registry between 2013 and 2019, excluding women with a history of adenomyomectomy. To investigate the association between adenomyosis and PAS among women, we used a multivariable logistic regression model with multiple imputation for missing data. We evaluated mediation effect of ART including invitro fertilization and intracytoplasmic sperm injection on the association between adenomyosis and PAS using causal mediation analysis based on the counterfactual approach. Of 1 500 173 pregnant women, 1539 (0.10%) had adenomyosis. The number receiving ART was 489/1539 (31.8%) and 117 482/1 498 634 (7.8%) in women with and without adenomyosis, respectively. The proportion of women who developed PAS was 21/1539 (1.4%) in women with adenomyosis and 7530/1 498 634 (0.5%) in women without adenomyosis. Adenomyosis was significantly associated with PAS (odds ratio [OR] 1.95; 95% confidence interval [CI] 1.26-3.00; P = 0.002). Mediation analysis showed that OR of the total effect of adenomyosis on PAS was 1.98 (95% CI 1.13-3.04), OR of natural indirect effect (effect explained by ART) was 1.15 (95% CI 1.01-1.41), and OR of natural direct effect (effect unexplained by ART) was 1.72 (95% CI 0.86-2.82). The proportion mediated (natural indirect effect/total effect) was 26.5%. Adenomyosis was also significantly associated with PAS without previa (OR 1.96; 95% CI 1.23-3.13, P = 0.005). Adenomyosis was significantly associated with PAS. ART mediated 26.5% of the association between adenomyosis and PAS.

Long-Term Effects of Assisted Reproductive Technologies on the Health and Productivity of Animals in Ethiopia

Purpose: The aim of the study was to long-term effects of assisted reproductive technologies on the health and productivity of animals in Ethiopia. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: The study found that the long-term effects of assisted reproductive technologies (ARTs) on the health and productivity of animals in Ethiopia present both opportunities and challenges. ARTs have the potential to improve livestock breeding programs, enhance genetic diversity, and increase productivity, their implementation requires careful consideration of various factors to ensure sustainable outcomes. While these technologies offer the possibility of overcoming reproductive challenges and genetic limitations, they may also pose risks such as increased rates of reproductive disorders, stress associated with handling and manipulation, and potential transmission of infectious diseases. Therefore, ongoing monitoring and evaluation of animal health and welfare are essential to mitigate any adverse effects and ensure the ethical use of ARTs in livestock production systems. Unique Contribution to Theory, Practice and Policy: Life course theory &amp; epigenetic theory may be used to anchor future studies on long-term effects of assisted reproductive technologies on the health and productivity of animals in Ethiopia. Implement rigorous monitoring and evaluation programs to assess the long-term health, welfare, and productivity outcomes of animals produced through ART. Utilize comprehensive datasets to track indicators such as disease incidence, reproductive performance, growth rates, and longevity over multiple generations. Develop evidence-based guidelines and regulations governing the ethical and responsible use of ART in animal breeding programs. Establish standards for the welfare, monitoring, and management of animals produced through reproductive technologies to ensure compliance with ethical principles and animal welfare standards.

The influence of neurovegetative and psychological characteristics of infertile patients with long-term COVID-19 on the effectiveness of assisted reproductive technologies

The connection of the long-COVID-19 symptom with violations of various systemic factors, in particular with the female reproductive system, is considered, but the number of such studies is not large. The purpose of the study is the influence of neurovegetative and psychological characteristics of infertile patients with long-term COVID-19 on the effectiveness of assisted reproductive technologies (ART). Materials and methods. The main group consisted of 80 women with infertility and "long-COVID", the comparison group - 40 patients without a history of COVID-19. In the main group, 2 subgroups were distinguished: 1 - 64 women with unsuccessful ART and 2 - 16 patients in whom ART was successful (a live birth was obtained). Socio-economic status and stress factors (questionnaire), fear of stress-19 (FCV-19S scale), autonomic dysfunction were assessed using the O.M. questionnaire. Wayne (1998), Anxiety and Depression Levels on the Hospital Anxiety and Depression Scale (HADS). The used methods of variational statistics using the Student's t-test and Fisher's angular transformation with a critical significance level of p&lt;0.05 were used to calculate the odds ratio (OR) and its confidence interval (CI). Results. Women with infertility and "long-COVID-19" are characterized by a relatively low level of socio-economic status: a lower level of income, a smaller share of entrepreneurs and housewives, not comfortable enough living conditions. These patients have a higher level of stressogenic load: comorbidity with chronic somatic pathology (58.8%), conflict situations in the family (31.3%), dissatisfaction with their sexual relationships (58.7%), a significantly higher level of fear of COVID -19 (29.73±1.31 points). Vegetative dysfunction is diagnosed in 82.5% of patients. Symptoms that are typical for "long-COVID-19" are most often noted: reduced work capacity/fatigue (82.5%), attack-like headaches (72.5%), difficulty breathing (47.5%), sleep disturbances (47 .5%). Unfavorable medico-social and psychological risk factors for the failure of ART programs in patients with "long-COVID-19" can be a point assessment of the autonomic dysfunction syndrome above 25 (OR=5.80, CI 1.22-27.64), anxiety (OR=5.80, CI 1.56-21.62), presence of depression (OR=4.20, CI 1.27-13.89), chronic somatic disease (OR=4.20, CI 1.30-13.62), conflict situations (OR=3.86, CI 1.24-12.04). Conclusions. Women with infertility and "long-COVID-19" need additional examinations to assess the medical and social status, vegetative function and psychological state, correction of detected violations. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research. No conflict of interests was declared by the authors.

Outcomes of assisted reproductive technologies in discordant couples with HIV infection in a woman

Aim. To evaluate the effectiveness of assisted reproductive technologies (art) in discordant couples with hiv-infected women.&#x0D; Materials and methods. The prospective clinical study included 432 women who received an in vitro fertilization (ivf) program. The main group included 214 subjects with hiv infection, and the control group included 218 subjects without hiv infection. In the main group, 182 "fresh" ivf/icsi (intracytoplasmic sperm injection) cycles and 162 cryocycles were performed; in the control group, 271 and 195 cycles, respectively.&#x0D; Results. The median length of HIV infection was 9.8 (5.7; 12.4) years, subclinical stage 3 of the disease prevailed (59.8%), and the duration of antiretroviral therapy was 4.5 (2.4; 8) years. The CD4+lymphocyte count [630 (496; 791) cells/μL] indicated a relatively "good" state of the immune system due to the antiretroviral therapy. In the main group, a significantly lower number of oocyte-cumulus complexes [6.5 (3; 12) and 9 (6; 15); p0.001], zygotes [4 (2; 8) and 6 (4; 10); p0.001] and blastocysts [2 (0; 2) and 4 (1; 6); p0.001] were obtained in comparison with the control group. The number of abnormally fertilized oocytes (3 or more PNs) was significantly higher in the group of HIV-infected women compared to HIV-negative ones — 0.21 (0.7) and 0.09 (0.2) (p=0.018), respectively. Evaluation of the effectiveness of "fresh" IVF/ICSI cycles showed that HIV-infected women had a significantly lower incidence of clinical pregnancy (16.5 and 32.8%; p=0.001), as well as live births (12.2 and 31.5%; p0.001). Analysis of cryocycle outcomes showed that using their own oocytes in women with HIV infection, the frequency of clinical pregnancy (27.6 and 41%; p=0.014) and childbirth (16.7 and 27.7%; p=0.021) is significantly lower than in patients without HIV infection, and in cases of using donor oocytes, these indicators are comparable between the groups (40%; p=0.910 and 25.7%; p=0.809, respectively).&#x0D; Conclusion. ART in HIV-infected women is associated with low pregnancy rates in both "fresh" and cryocycles using their own oocytes. The decrease in the oocytes/embryos obtained and the high proportion of abnormal fertilization in HIV-infected patients suggest the presence of oocyte factor as the main cause of the low effectiveness of ART programs in this group of patients.

The effect of assisted reproductive technology on postpartum bleeding: hormonal cycle frozen embryo transfer might increase blood loss.

Among assisted reproductive technologies, frozen thawed embryo transfer (FET) is associated with increased blood loss at delivery. Anesthesiologists need to be aware of new factors that affect postpartum blood loss. This study investigated whether FET cycles with or without hormonal support affect the amount of postpartum bleeding. We conducted a retrospective cohort study of patients admitted for delivery at a single university hospital between January 2015 and December 2018. Patients were divided into no-assisted reproductive technology (No-ART), hormonal cycle FET (HC-FET) and natural cycle FET (NC-FET) group. The primary outcome was the amount of blood loss after delivery (median [interquartile range]), which was compared among the three groups. Multiple regression analysis was performed to investigate the factors affecting blood loss. Between 2015 and 2018, 3187 women delivered neonates. In vaginal delivery, postpartum blood loss in the HC-FET group (1060 [830] g) was significantly greater than in the NC-FET group (650 [485] g, P = 0.001) and in the No-ART group (590 [420] g P < 0.001). Multiple linear regression analysis showed that HC-FET (P < 0.001) was one of the independent factors for the amount of bleeding. In cesarean delivery, the HC-FET group had more blood loss than the No-ART group (910 [676] g vs. 784 [524] g, P = 0.039). However, HC-FET was not an independent factor for postpartum blood loss. The HC-FET group had more blood loss than the No-ART group for both vaginal and cesarean deliveries. Furthermore, HC-FET was an independent factor that increased postpartum blood loss in vaginal deliveries.

Use of progestagens to preserve pregnancy: modern approaches

Review objectives: to summarize current and clinical data on the role of progesterone support in women at risk of miscarriage and premature pregnancy according to the standards of evidence-based medicine. Control of plasma progesterone levels is a fundamental tool for managing the effectiveness of assisted reproductive technologies. The association of a low level of serum progesterone with lower rates of current pregnancy and live birth in cycles of assisted reproductive technologies was revealed. Patients with low serum progesterone on the day of embryo transfer need individualized support of the luteal phase, which involves adding additional doses of progesterone to standard regimens.&#x0D; Vaginal micronized progesterone is currently believed to be the only progestogen that increases the likelihood of a live birth in women with bleeding in early pregnancy which has one or more miscarriages.&#x0D; Vaginal progesterone can be considered for patients with a high risk of miscarriage in the following modes: with vaginal bleeding and a history of one or more miscarriages (threatened miscarriage) – 400 mg twice a day, starting with the detection of vaginal bleeding up to 16 full weeks of pregnancy; with a history of three or more pregnancy losses of unknown etiology (habitual miscarriage) – asymptomatic patients — 200 mg twice a day up to 12 full weeks of pregnancy; patients with vaginal bleeding – 400 mg 2 times a day up to 16 weeks of pregnancy. Currently, there is no evidence of the effectiveness other forms of progesterone and other doses.&#x0D; Conclusions. Vaginal micronized progesterone demonstrated: high efficiency as a standard of luteal phase support; increasing the chance of a live birth in women with a double risk factor for miscarriage (vaginal bleeding in the 1st trimester and ≥1 previous miscarriage); the absence of safety problems for the fetus and the health of newborns when used in the early and late stages of pregnancy.

Pregnancy Outcomes of Assisted Reproductive Technology (ART) Cycle Complicated by Ovarian Hyperstimulation Syndrome (OHSS): Case Series Study.

Ovarian hyperstimulation syndrome (OHSS) is a frequent, potentially lethal side effect of assisted reproductive technology (ART), distinguished by symptoms such as ovarian enlargement, ascites, and pleural effusion. This study is designed to study the effect of assisted reproductive technology (ART) cycle complicated by OHSS on pregnancy outcomes. A case series study at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia, was executed to examine the pregnancy outcomes in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles. Fifteen patients were admitted to the IVF unit between January 2015 and December 2021. Data were retrieved from patients' medical records, and descriptive statistical methods were employed to analyze participants' data. The study assessed pregnancy outcomes for 15 female participants (mean age=31.1 years, SD=3.46) with a BMI range of 20-40 (mean BMI=29.6, SD=6.4), of whom 33.3% were classified as obese. The primary factor of infertility was anovulation (66.7%), followed by male factors (20%). About 26.7% of those affected by OHSS had moderate OHSS, and 73.3% had severe OHSS, with 100% of those with severe OHSS having undergone three embryo transfers. None of the participants developed gestational diabetes mellitus (DM), but one participant had high blood sugar levels (6.67% of total participants), with a mean glucose of 6.3±2.0. There were no instances of preeclampsia, gestational hypertension, abnormal placentas, or congenital abnormalities in newborns among the participants. Preterm deliveries were common, with 33.3% delivering between 32 and 37 weeks, 6.7% before 28 weeks, and 33.3% within 28-32 weeks. Overall, 73.3% of the participants experienced pregnancy, and the birth mode was almost evenly split between vaginal and cesarean birth. In conclusion, this research provides an exploration into the outcomes of pregnancies in women undergoing assisted reproductive technology treatments complicated by ovarian hyperstimulation syndrome. It shows anovulation as a prevalent cause of infertility and a noteworthy incidence of severe OHSS. Despite these challenges, a significant number of women were able to experience pregnancy, although preterm deliveries and abortions were common. The delivery methods were fairly balanced between vaginal birth and cesarean section. These findings underscore the necessity for more effective strategies to manage OHSS and improve pregnancy outcomes in ART procedures.

The impact of assisted reproductive technology treatment coverage on marriage, pregnancy, and childbirth in women of childbearing age: an interrupted time-series analysis

BackgroundKorea is encountering major challenges related to its declining birth rate and aging population. Various policies have been introduced to prevent further population decrease and boost the birth rate, but their effectiveness has not been verified. Therefore, this study examined the effects of assisted reproductive technology (ART) insurance coverage on marriage, pregnancy, and childbirth in women of childbearing age.MethodsAll information on marriage, pregnancy, childbirth of women of childbearing age was obtained from Statistics Korea and Korean National Health Insurance Service database. During a total follow-up period of 54 months (July 2015 to December 2019), an average of 12,524,214 women of childbearing age per month, and 29,701 live births per month were included in the analysis. An interrupted time series with segmented regression was performed to analyze the time trend and changes in outcomes.ResultsThe implementation of ART coverage policies had no significant impact on marriage or pregnancy rates. However, it did affect multiple pregnancy and multiple birth rates, which increased by 1.0% (Exp(β3) = 1.010, P-value = 0.0001) and 1.4% (Exp(β3) = 1.014, P-value = < 0.0001), respectively, compared to the pre-intervention period. Although the effect of covering ART treatment on total birth rates were not confirmed, a slightly slower decline was observed after the intervention (Exp(β1) = 0.993, P-value = < 0.0001, Exp(β1 + β3) = 0.996 P-value = 0.012).ConclusionThis study identified the effects of ART health insurance coverage policy on the rates of multiple pregnancies and births. After the policy implementation, the downward trend in the total birth rate reduced slightly. Our findings suggest that interventions to support infertile couples should be expanded to solve the problem of low fertility rates.Plain english summaryTo address the intricate problems related to low birth rates, the Korean government introduced a policy that provides financial support and health insurance coverage for assisted reproductive technology (ART) treatment for infertile couples. As a result of evaluating the effectiveness of the ART coverage policy, it led to higher rates of pregnancies and births. In addition, although the total birth rate has been continuously decreasing over time, the decline may have been slowed down slightly by this policy.

P-483 Application of RNA-sequencing based predictive model for endometrial WOI in patients with recurrent implantation failure: a prospective cohort study

Abstract Study question Is intrauterine pregnancy rate following a FET timed by the rsERT with hour precision higher than the conventional FET among patients with recurrent implantation failure? Summary answer Personalized embryo transfer (pET) guided by this newly optimized rsERT significantly improved pregnancy outcomes of patients with recurrent implantation failure (RIF). What is known already Asynchrony between blastocyst and endometrium is responsible for implantation failures. Hence, accurate prediction for endometrial window of implantation (WOI) would maximize the effectiveness of assisted reproductive technology (ART). Previously, we have established a predictive model for endometrial WOI (rsERT) by three-time points sampling from the same patient at 48-hour intervals during one menstrual cycle. To avoid multiple sampling and build a more efficient WOI prediction tool, estimation method with hour precision by single time point sampling is urgently needed. Study design, size, duration This was a two-phase strategy involving model optimization and benefit evaluation with a prospective controlled trial. The study was performed in a tertiary hospital setting between September 2018 and December 2021. In the first phase (September 2018-June 2020), 91 participants were recruited to optimize the rsERT. In the second phase (June 2020-December 2021), 176 patients with RIF were enrolled to valida the clinical efficacy of this newly optimized rsERT. Participants/materials, setting, methods First phase: endometrium samples were obtained from sampling on LH + 5, +7, +9 or P + 3, +5, +7 respectively. Samples were predicted by the rsERT. Only those in agreement with theoretical WOI timing and from whom successfully obtained intrauterine clinical pregnancy after subsequent FET were eligible. Second phase: 88 patients in the experimental group underwent pET timed by rsERT after sampling at LH + 7 or P + 5. 88 patients in the control group performed standard embryo transfer without sampling. Main results and the role of chance This newly optimized predictive model could provide hour-based results of endometrial WOI and have an average accuracy of 94.51% by using 10-fold cross validation. In the second phase, a total of 88 NGS were constructed for RNA-sequencing by using endometrial biopsy samples from RIF patients in the experimental group (n = 88). The results indicated WOI displacement in 40 of 88 (45.45%). Among them, advanced WOI occurred in two patients (2/40, 5.00%), and delayed WOI occurred in 38 patients (38/40, 95.00%). The baseline clinical parameters, including age, BMI, infertility duration, types of infertility, number of previous failed cycles, main aetiology of infertility, the prevalence of pre-implantation genetic screening/diagnosis (PGS/PGD), endometrial thickness, endometrial types, the percentage of transferred blastocysts, good-quality embryo transferred rate and number of transferred embryos were all comparable between the two groups (P &amp;gt; 0.05). The intrauterine pregnancy rate (IPR) and implantation rate (IR) of the experimental group were significantly improved compared to those of the control group (for IPR: 61.36% vs. 31.82%, RR 3.630, 95%CI 1.958-6.732, P = 0.000; for IR: 42.86% vs. 24.66%, RR 2.292, 95%CI 1.392-3.772, P = 0.001). Moreover, in the experimental group, pregnancy outcomes did not exhibit remarkable differences between the natural cycle and hormone replacement (HRT) cycle. Limitations, reasons for caution Caution is warranted due to the non-randomized design and limited sample size of the study. Besides, embryonic factors should be taken into consideration as well. Hence, a multi-center randomized controlled trial of rsERT combined with PGT is needed to further validate its clinical efficacy. Wider implications of the findings These data add a new alternative of predictive model for endometrial WOI among Chinese women. Trial registration number the National Key Research and Development Program of China

Capturing sex-specific and hypofertility-linked effects of assisted reproductive technologies on the cord blood DNA methylome

BackgroundChildren conceived through assisted reproduction are at an increased risk for growth and genomic imprinting disorders, often linked to DNA methylation defects. It has been suggested that assisted reproductive technology (ART) and underlying parental infertility can induce epigenetic instability, specifically interfering with DNA methylation reprogramming events during germ cell and preimplantation development. To date, human studies exploring the association between ART and DNA methylation defects have reported inconsistent or inconclusive results, likely due to population heterogeneity and the use of technologies with limited coverage of the epigenome. In our study, we explored the epigenetic risk of ART by comprehensively profiling the DNA methylome of 73 human cord blood samples of singleton pregnancies (n = 36 control group, n = 37 ART/hypofertile group) from a human prospective longitudinal birth cohort, the 3D (Design, Develop, Discover) Study, using a high-resolution sequencing-based custom capture panel that examines over 2.4 million autosomal CpGs in the genome.ResultsWe identified evidence of sex-specific effects of ART/hypofertility on cord blood DNA methylation patterns. Our genome-wide analyses identified ~ 46% more CpGs affected by ART/hypofertility in female than in male infant cord blood. We performed a detailed analysis of three imprinted genes which have been associated with altered DNA methylation following ART (KCNQ1OT1, H19/IGF2 and GNAS) and found that female infant cord blood was associated with DNA hypomethylation. When compared to less invasive procedures such as intrauterine insemination, more invasive ARTs (in vitro fertilization, intracytoplasmic sperm injection, embryo culture) resulted in more marked and distinct effects on the cord blood DNA methylome. In the in vitro group, we found a close to fourfold higher proportion of significantly enriched Gene Ontology terms involved in development than in the in vivo group.ConclusionsOur study highlights the ability of a sensitive, targeted, sequencing-based approach to uncover DNA methylation perturbations in cord blood associated with hypofertility and ART and influenced by offspring sex and ART technique invasiveness.

Cell-based therapy in thin endometrium syndrome

Of the known causes of uterine factor infertility, Ashermans syndrome or the so-called intrauterine synechia, chronic endometritis and endometrial hypoplastic processes are most often distinguished. Thin endometrial syndrome is characterized by a decrease in the thickness of the endometrium to 7 mm or less in the proliferative phase of the menstrual cycle and a multiple decrease in the frequency of embryo implantation.&#x0D; Numerous treatment strategies have so far been proposed for treating refractory thin endometrium syndrome. Recently, cell therapy has been proposed as an ideal alternative for endometrium regeneration, including the employment of stem cells, platelet-rich plasma, and growth factors as therapeutic agents. Single center, prospective, open-label study of efficacy of cell-based therapy in the complex treatment of thin endometrium syndrome in patients with infertility was conducted. The study involved 36 women aged 28 to 36 years, the middle age was 34.2 1.1 years. All patients included in the study received 3 cycles of intrauterine administration of a suspension of autologous stem cells isolated from bone marrow. Bone marrow was successfully aspirated from the iliac crest in all patients. Mononuclear cells was isolated by density gradient centrifugation according to the standard method. The cell material was cryopreservated and thawed immediately before administration. The procedure for intrauterine transplantation of isolated but not cultured cells was performed on the 5th7th day of the menstrual cycle. There were no significant adverse events related to harvest or administration. The thickness of the endometrium before and after treatment was 2.39 0.64 and 6.56 0.94 mm (t = 21.94, p = 0.0001), respectively. The rate of patients with an endometrial thickness of more than 7 mm after treatment was 77.8%. The effectiveness of assisted reproductive technology in patients with normal endometrial (n = 28) was 32.1%. Immunohistochemistry confirms the presence of chronic endometritis before and after treatment in 22 (61.1%) and 19 (52.8%) patients, respectively, while after treatment a significant decrease in the levels inflammatory markers was found.

Seizure Control in Women with Epilepsy Undergoing Assisted Reproductive Technology (P14-1.011)

<h3>Objective:</h3> The objective of this study was to determine the effect of assisted reproductive technology on seizure control in women with epilepsy. <h3>Background:</h3> Information available about seizure control in women with epilepsy undergoing assisted reproductive technology is sparse, limited to only a few case reports. Extrapolations are often made from situations that similarly heighten the oestrogen-progesterone ratio. <h3>Design/Methods:</h3> From a database of 3858 women who underwent in vitro fertilization (IVF) or frozen embryo transfer (FET) from January 1992–May 2021, 12 women with epilepsy were identified. Data was obtained through retrospective chart review. <h3>Results:</h3> From the 12 women identified, the median age of epilepsy onset was 20 years of age (range 25 – 42) with 6 (50%) having epilepsy onset in childhood. There were 26 embryo transfers, resulting in 14 pregnancies and 8 live births. Nine women (75%) were seizure free for &gt;2 years prior to infertility treatment. Seven women (58%) were on anti-seizure medications (ASMs) throughout fertility treatment and pregnancy with only one on polytherapy. Levels of ASMs were followed and adjusted in 3 of the 7 (43%). Eleven women (all with controlled epilepsy or epilepsy in remission) remained seizure free throughout fertility treatment. One woman, who had drug-resistant epilepsy, continued to have seizures throughout infertility treatment and pregnancy without an exacerbation of seizure frequency and with close monitoring and adjustment of ASMs. <h3>Conclusions:</h3> There was no seizure worsening in this cohort of 12 women with epilepsy undergoing assisted reproductive technology. <b>Disclosure:</b> Dr. Abdulrazaq has nothing to disclose. Dr. Ainsworth has nothing to disclose. Dr. Britton has received personal compensation in the range of $0-$499 for serving as a Online course with American Clinical Neurophysiology Society. Dr. Shenoy has nothing to disclose. Dr. Babayev has nothing to disclose. Dr. Cascino has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for International League Against Epilepsy . The institution of Dr. Cascino has received research support from Neurelis, Inc.. The institution of Dr. Cascino has received research support from Epilepsy Study Consortium. The institution of Dr. Cascino has received research support from NINDS. Dr. Cascino has received intellectual property interests from a discovery or technology relating to health care. Dr. Cascino has received publishing royalties from a publication relating to health care. Dr. Cascino has received publishing royalties from a publication relating to health care. The institution of Dr. Smith has received research support from CURE Epilepsy.

Effects of assisted reproductive technology on gene expression in heart and spleen tissues of adult offspring mouse.

Assisted reproductive technology (ART) is an important part of reproductive medicine, whose possible effects on offspring's health have drawn widespread attention in recent years. However, relevant studies are limited to postnatal short-term follow-up and lack of diverse sample sources analysis other than blood. In this study, a mouse model was used to explore the effects of ART on fetal development and gene expression in the organs of offspring in the adulthood using next-generation sequencing. The sequencing results were then analyzed. The results showed that it caused abnormal expression in 1060 genes and 179 genes in the heart and spleen, respectively. Differentially expressed genes (DEGs) in the heart are mainly enriched in RNA synthesis and processing, and the cardiovascular system development also shows enrichment. STRING analysis identified Ccl2, Ptgs2, Rock1, Mapk14, Agt, and Wnt5a as the core interacting factors. DEGs in the spleen are significantly enriched in anti-infection and immune responses, which include the core factors Fos, Jun and Il1r2. Further exploration revealed the abnormal expression of 42 and 5 epigenetic modifiers in the heart and spleen, respectively. The expression of the imprinted genes Dhcr7, Igf2, Mest and Smoc1 decreased in the hearts of ART offspring, and the DNA methylation levels of Igf2- and Mest-imprinting control regions (ICRs) increased abnormally. In the mouse model, ART can interfere with the gene expression pattern in the heart and spleen of the adult offspring and that these changes are related to the aberrant expression of epigenetic regulators.

Evaluation of the efficacy of ivf programs in women with infertility who have surgical interventions on the pelvic organs

Aim . To evaluate the effectiveness of assisted reproductive technologies in women with infertility after surgical interventions on the pelvic organs. Material and methods : We analyzed the data of 90 women who approached the Nasl Medical Center due to infertility for IVF in 2017-2020, to whom different approaches in surgical treatment and without surgical interventions on the pelvic organs in the anamnesis were applied at the first stage. Results . “A differentiated approach during the surgical stage and a complex of rehabilitation anti-adhesion measures in the postoperative period, as preparation for the IVF program, ensured a frequency of clinical pregnancy occurrence in 69% of cases, and a cumulative frequency coefficient of live births (CLBR) of 44.8% in the main group.” Conclusions . Decreased fertility of women who underwent abdominal surgery without observing organ-sparing principles and rehabilitation anti-adhesion measures justifies the wider introduction of endoscopic organ-sparing interventions on the pelvic organs with a mandatory postoperative complex of restorative measures in adolescent girls and women of reproductive age to preserve their fertility.

Effects of Assisted Reproductive Technologies on Social Behavior of BTBR Mice – A Model of Autism Spectrum Disorder

The present work is the first attempt to study the effect of such assisted reproductive technologies (ARTs), as in vitro culture of preimplantation embryos on the social behavior of offspring, using BTBR mice (BTBR T+Itpr3tf/J) as an idiopathic model of a-utism. The C57BL/6J mice were used as controls. Social behavior was studied in adult offspring mice obtained after in vitro culture and embryo transfer (ET) (groups ET-C57BL/6J and ET-BTBR). The BTBR mice demonstrated the reduced levels of social recognition and affiliation compared to C57BL/6J mice. The social affiliation and recognition test revealed that ET-C57BL/6J males had a high level of social interaction, which was of similar magnitude as in naturally conceived C57BL/6J males. However, ET-C57BL/6J and ET-BTBR females demonstrated a decrease in interest to a new stranger compared to naturally conceived controls of the same sex, which was revealed in a social recognition session of this test. Thus, the in vitro culture affected the social recognition in the offspring of C57BL/6J and BTBR mice, but only in females.

The challenges of selective fertility and carryover effects in within-sibship analyses: the effect of assisted reproductive technology on perinatal mortality as an example.

Within-sibship analyses show lower perinatal mortality after assisted reproductive technology (ART) compared with natural conception (NC), a finding that appears biologically unlikely. We investigated whether this may be attributed to bias from selective fertility and carryover effects. Using data from national registries in Denmark (1994-2014), Finland (1990-2014) and Norway and Sweden (1988-2015), we studied 5 722 826 singleton pregnancies, including 119 900 ART-conceived and 37 590 exposure-discordant sibships. Perinatal mortality at the population level and within sibships was compared using multilevel logistic regression with random and fixed intercepts, respectively. We estimated selective fertility as the proportion of primiparous women with and without perinatal loss who had a second delivery, and carryover effects through bidirectional and crosswise associations. Population analysis showed higher perinatal mortality among ART conception compared with NC (odds ratio 1.21, 95% CI 1.13 to 1.30), whereas within-sibship analysis showed the opposite (OR 0.36, 95% CI 0.31 to 0.43). Primiparous women with perinatal loss were more likely to give birth again (selective fertility) and to use ART in this subsequent pregnancy (carryover effects), resulting in strong selection of double-discordant sibships with death of the naturally conceived and survival of the ART-conceived sibling. After controlling for conception method and outcome in the first pregnancy, ART was not consistently associated with perinatal mortality in the second pregnancy. Whereas population estimates may be biased by residual confounding, within-sibship estimates were biased by selective fertility and carryover effects. It remains unclear whether ART conception contributes to perinatal mortality.

Effectiveness of endometrial scratching in infertility treatment with assisted reproductive technologies

Embryo implantation is a key factor limiting the effectiveness of assisted reproductive technologies, and depends on the quality of the blastocyst and the susceptibility of the endometrium. Various methods of treatment aimed at improving the receptivity of the uterine mucosa, including endometrial scratching, have been proposed. At the same time, the main mechanisms underlying this intervention remain unclear. Moreover, the optimal duration of exposure to the uterine mucosa and the groups of patients in which it can have a positive effect have not been determined. The study aims to investigate the main mechanisms and evaluate the effectiveness of local endometrial damage performed at various times before embryo transfer in the program of assisted reproductive technologies in women with and without a history of implantation failures based on the analysis of scientific literature. Clinical studies, systematic reviews and meta-analyses were studied in PubMed, Embase, Cochrane Library, Web of Science databases, Elsevier, Springer, Wiley publishers, on eLibrary, Research Gate platforms, in open sources of the scientific and educational segment of the Internet. The literature search was conducted by keywords: endometrial scratching, local endometrial damage, implantation failures, endometrial receptivity, assisted reproductive technologies, infertility. The search depth is 20 years. The main mechanisms of the effect of scratching on increasing endometrial receptivity include decidualization, the development of a local inflammatory reaction, as well as improved synchronization between the uterine mucosa and the transferred embryo by preventing premature maturation of the endometrium. Studies that showed a positive effect of local damage to the uterine mucosa were mainly conducted in patients with repeated implantation failures and with intervention in the luteal phase of the cycle preceding stimulation. At the same time, the work performed in a non-selective population of women and non-standardized by exposure time, in most cases, did not reveal the advantages of endometrial scratching. In this regard, additional qualitative randomized controlled trials with a large sample size and a clear identification of groups of patients for whom this intervention may benefit are required.

ЛОКАЛЬНОЕ ПОВРЕЖДЕНИЕ ЭНДОМЕТРИЯ ПЕРЕД ПЕРЕНОСОМ РАЗМОРОЖЕННЫХ ЭМБРИОНОВ У ПАЦИЕНТОК С ГИПОПЛАЗИЕЙ СЛИЗИСТОЙ ОБОЛОЧКИ МАТКИ

The study aims to examine the influence of local endometrial injury on the results of thawed embryo transfer programs in patients with endometrial hypoplasia based on the analysis of clinical cases. The author analyzes two clinical cases of performing scratching prior to the implementation of the assisted reproductive technologies program in patients with “thin” endometrium and evaluates its effectiveness. Embryo implantation is a key stage limiting the effectiveness of assisted reproductive technologies, and depends on the receptivity and selectivity of the endometrium, the quality of the blastocyst, as well as on their cross-interaction. At the same time, two-thirds of im-plantation failures may be associated with endometrium impaired susceptibility. Endometrial hypoplasia is believed to be associated with a decrease in the probability of embryo attachment. Various therapeutic approaches have been proposed to improve its receptivity. The technology of local damage to the uterine mucosa was applied before the program of assisted reproductive technologies in two patients with “thin” endometrium. Following the transfer of thawed embryos, uterine pregnancy occurred in both cases, which ended with operative delivery on time.

Effects of assisted reproductive technology on severe maternal morbidity risk in both singleton and multiple births in Korea: A nationwide population-based cohort study.

BackgroundWhether infertility treatment predicts severe maternal morbidity in both singleton and twin pregnancies is controversial. We conducted this nationwide population-based cohort study to compare pregnancies conceived through assisted reproductive technology treatments, such as intrauterine insemination or in vitro fertilization, with unassisted pregnancies.MethodsThis study included 269,930 women who experienced childbirth in 2018, using data of the National Health Insurance Service National Delivery Cohort in Korea. The primary outcome was assessed using a severe maternal morbidity algorithm developed by the Centers for Disease Control and Prevention in the United States. A modified Poisson regression was used to estimate the adjusted risk ratio of severe maternal morbidity.ResultsSevere maternal morbidity occurred in 6,333 (2.3%) of 280,612 deliveries investigated. The risk of severe maternal morbidity was approximately 1.5-fold higher among women who received in vitro fertilization (risk ratio: 1.51, 95% confidence interval: 1.36–1.68) than among fertile women. However, no significant association between intrauterine insemination and maternal morbidity was identified. Via subgroup analysis, in vitro fertilization increased the risk of severe maternal morbidity by 1.6- and 1.3-fold in singleton and multiple births, respectively (singleton: risk ratio: 1.62, 95% confidence interval: 1.43–1.83; multiple birth: risk ratio: 1.31, 95% confidence interval: 1.07–1.60).ConclusionsThis study suggested that in vitro fertilization was associated with the risk of severe maternal morbidity in both singleton and multiple births. Further research should identify patient- and treatment-specific factors that may mitigate or prevent adverse maternal health risks.