Fertility Outcomes Research Articles

MiR-361-5p regulates SLC25A24 to maintain mitochondrial function and alleviate granulosa cell dysfunction in diminished ovarian reserve.

The aim of this study was to investigate the role of miR-361-5p (a tumor suppressor) in regulating granulosa cell function by targeting SLC25A24, a key mitochondrial protein, to uncover potential therapeutic targets for diminished ovarian reserve (DOR). This study included patients undergoing assisted reproductive technology treatment at our hospital. Granulosa cells were isolated from follicular fluid, and KGN cells were used for in vitro experiments. miR-361-5p and SLC25A24 expression levels were manipulated using miRNA mimics and inhibitors, and their effects on cell viability, apoptosis, and mitochondrial function were assessed. Techniques employed included qRT-PCR, Western blot analysis, ELISA, JC-1 staining, and dual-luciferase reporter assays. Key quantitative metrics included changes in mitochondrial DNA (mtDNA), ATP production, and reactive oxygen species (ROS) levels. miR-361-5p expression was significantly lower in DOR patients' granulosa cells compared to controls (P < 0.01). miR-361-5p inhibition markedly decreased KGN cells viability and increased apoptosis (P < 0.01), while miR-361-5p overexpression had the opposite effects (P < 0.01). SLC25A24 expression was inversely correlated with miR-361-5p levels, and its knockdown reversed the effects of miR-361-5p inhibition. Additionally, miR-361-5p modulation significantly affected mitochondrial function, with its overexpression reducing ROS levels and increasing ATP production (P < 0.01). miR-361-5p plays a pivotal role in maintaining mitochondrial function and reducing KGN cells dysfunction by targeting SLC25A24. These findings offer new insights into the molecular mechanisms of DOR and highlight miR-361-5p as a potential therapeutic target to enhance ovarian reserve and improve fertility outcomes.

PFAS Exposure and Male Reproductive Health: Implications for Sperm Epigenetics.

Per- and polyfluoroalkyl substances (PFASs) are persistent environmental contaminants found in human tissues and persist in the environment, posing significant risks to reproductive health. This review examines the impact of PFAS exposure on male reproductive health, with a focus on sperm epigenetics. PFASs disrupt endocrine function by altering key reproductive hormones and impairing sperm motility, quality, and viability. Epidemiologic and animal studies highlight inconsistent yet concerning associations between PFAS exposure and semen parameters, as well as altered gene expression and DNA methylation patterns. Moreover, PFAS exposure during critical windows of development has been linked to differential impacts on male versus female pubertal development, cognitive outcomes, and reproductive physiology, emphasizing the complexity of PFAS interactions. This comprehensive analysis highlights the need for continued research into the mechanisms by which PFASs influence reproductive health and development with potential implications for sperm epigenetics. The review emphasizes the importance of understanding the epigenetic mechanisms behind these disruptions, particularly DNA methylation and its role in heritable changes. Investigating the epigenetic modifications driven by PFAS exposure is crucial for elucidating the mechanisms by which these chemicals influence reproductive health. Future research should focus on understanding these epigenetic changes in both immediate fertility outcomes and transgenerational health risks.

Oxidative Homeostasis in Follicular Fluid and Embryo Quality-A Pilot Study.

The objective of this study was to measure the different redox biomarker levels within the follicular fluid (FF) and evaluate correlations with embryo quality using the one follicle-one oocyte/embryo approach. The prospective study included 54 women (average age 34.6 ± 3.0 years). Out of the 235 mature metaphase II cells that underwent intracytoplasmic sperm injection, fertilization was achieved in 177 cells, producing 92 Grade I embryos, 26 Grade II embryos, 39 Grade III embryos, and 20 Grade IV embryos. The activities of antioxidant enzymes, superoxide dismutase, glutathione peroxidase, and glutathione transferase were significantly higher in the group consisting of lower-quality (Grades II-IV) embryos in comparison with top-quality (Grade I) embryos (p = 0.011; p = 0.021; p = 0.008, respectively). The concentration of oxidative stress markers, malondialdehyde, 8-hydroxy-2'-deoxyguanosine, and thiol groups was significantly increased in the group with lower-quality embryos (Grades II-IV) compared to top-quality embryos (0.027; 0.018; 0.021, respectively). Furthermore, a significant positive correlation between each oxidative marker and the activities of antioxidant enzymes was observed (p < 0.001). According to our findings, the best embryos and, consequently, better in vitro fertilization outcomes are linked to low levels of oxidative stress and low antioxidant enzyme activity.

Improving reproductive outcomes in frozen embryo transfer over fresh embryo transfer in women with endometrioma: A historical cohort study

Background: Endometrioma, a common manifestation of endometriosis, often indicates the severity of the disease. In vitro fertilization and embryo transfer (ET) are key therapeutic strategies for infertility associated with endometriosis. However, the optimal type of ET (frozen or fresh) and its impact on pregnancy success rates remain debated, with limited studies available. Objective: This historical cohort study aimed to compare fertility and neonatal outcomes, focusing on live birth rate (LBR), clinical pregnancy, and implantation rates in women with endometrioma-associated infertility, between fresh and frozen embryo transfer (FET). Materials and Methods: In this historical cohort study, the medical records (files) of 289 women diagnosed with endometrioma-related infertility, who underwent in vitro fertilization/intracytoplasmic sperm injection treatment at Royan Institute, Tehran, Iran between March 2016–2021 were reviewed. Ultimately, 200 files that met the established criteria were selected for review. The extracted data was then compared between groups: FET (n = 121) and fresh ET (n = 79). Results: No significant differences were observed between the groups in terms of demographic characteristics and endometrioma size. The only significant difference in fertility outcomes was the LBR, which was 36.4% for the FET group compared to 22.8% for the fresh ET group (p = 0.04). No significant differences were observed in neonatal outcomes between the groups. Overall, our study suggests that FET may lead to higher LBRs in women diagnosed with endometrioma. Conclusion: Our study suggests that FET may lead to higher LBRs in women diagnosed with endometrioma.

Oncologic and fertility outcomes in patients with juvenile granulosa cell tumor - a retrospective single centre analysis

BackgroundGranulosa cell tumors (GCTs) are rare neoplasia that account for less than 5 % of all the ovarian tumors. Juvenile GCT histotype is generally observed in adolescent and young women, representing a very rare disease, so only a paucity of data are present in literature. The aim of this study is to analyse the oncologic and fertility outcome in our case series of juvenile GCTs. MethodsClinicopathological data were retrospectively collected and analysed from a cohort of 30 patients ovarian juvenile GCTs treated at IRCCS San Gerardo dei Tintori Hospital, Monza, between 1980 and 2024. ResultsThe median age of disease onset was 21.5. Among patients enrolled in the study, 80.0 % (24/30) were stage I (16/26, 1/26 and 7/26 of stage IA, IB and IC, respectively), 6.7 % (2/30) were stage II and 13.3 % stage III (4/30). In 86.7 % (26/30) of patients, a fertility-sparing surgery was carried out, while 13.3.% (4/30) of patients underwent radical surgery. Adjuvant chemotherapy was administered in 20.0 % (6/30) of cases, while 80.0 % (24/30) were followed only with surveillance. Three patients in thirty (10.0 %) relapsed and died of disease despite multi-therapeutic approaches. All of them had advanced stages of disease at time of diagnosis. ConclusionsJuvenile GCT appears to have a good prognosis at stage I disease. However, advanced stage represents a hard challenge for clinicians, showing a high rate of relapse and mortality.

Investigating male factors and their relationships with reproductive health outcomes: a case-control study protocol for Towards Optimal Fertility, Fathering, and Fatherhood studY (TOFFFY) in Singapore

IntroductionDespite the global prevalence of low fertility rates, male contributions to fertility and reproductive health outcomes have been understudied. This study aims to investigate the male contribution to fertility and...

The role of probiotics in restoring the Th1 to Th2 ratio in women experiencing recurrent implantation failure; a double-blind randomized clinical trial.

Among the complex causes of infertility, Recurrent Implantation Failure (RIF) stands out as a challenging condition. Immunological aberrations are closely implicated in RIF, particularly the imbalance between T helper 1 (Th1) and T helper 2 (Th2) cytokines. Interest in harnessing probiotics to enhance fertility outcomes in RIF-affected women is growing. This study aimed to investigate the potential of probiotics in restoring the Th1 to Th2 ratio and enhancing implantation outcomes in women experiencing RIF. A double-blinded randomized controlled trial enrolled 50 women with a record of at least three RIFs and 50 women with successful pregnancies as a control group in our study. RIF patients were randomly assigned to either the probiotic intervention group (n=25) or the placebo group (n=25). The probiotic group administered two tablets per day for 6months the probiotic tablets that contained prebiotic. At the same time, the placebo group received an identical-looking placebo. Flow cytometry technique was used to evaluate Th1 and Th2 cell frequencies. Gene expression of IL-4, IL-10, TNF-α and IFN-ɣ was analyzed using QRT-PCR. Serum concentrations of IL-4, IL-10, TNF-α and IFN-ɣ cytokines were evaluated using the ELISA technique. Flow cytometry analysis revealed significantly higher Th1 cell percentages in RIF patients compared to healthy controls, while healthy controls exhibited more significant Th2 cell proportions. Probiotic intervention led to a reduction in Th1 cells and an increase in Th2 cells in RIF patients. ELISA analysis indicated higher proinflammatory and lower anti-inflammatory cytokines compared to controls. After probiotic treatment, TNF-α and IFN-ɣ levels decreased, while IL-10 and IL-4 levels increased in RIF patients. QRT-PCR analysis showed no significant differences in cytokine gene expression between RIF patients before intervention. After probiotic therapy, pro-inflammatory cytokine expression decreased, and anti-inflammatory cytokine expression increased. Placebo treatment resulted in limited changes. Probiotic intervention effectively modulated the Th1 to Th2 ratio in RIF patients, evidenced by reduced Th1 cell percentages, enhanced Th2 cell populations, and cytokine level adjustments. The probiotic intervention improved implantation outcomes in women with RIF, as evidenced by a higher clinical pregnancy rate in the treatment group compared to the placebo group (p=0.037). These findings highlight the potential of probiotics in restoring immune balance and improving implantation outcomes in women with RIF.

Enhancing In-Vitro Fertilization Outcomes through Machine Learning: A Comparative Analysis of Predictive Models and Dataset Evaluation

By enabling the fertilisation of eggs and sperm outside the body, in-vitro fertilisation (IVF) offers couples struggling with infertility hope through a complex medical procedure. The complex procedure involves causing the ovaries to release eggs, extracting the eggs, fertilising them with sperm in a lab environment to create embryos, and then putting the embryos into the uterus.Machine learning methodologies such as K-nearest neighbors (KNN), random forest, and support vector machine (SVM) exhibit potential in forecasting IVF outcomes and alleviating the physical and emotional burden associated with treatment. This study's objective was to examine several machine learning algorithms and assess the IVF dataset's reliability by contrasting it with other datasets. Consequently, the KNN model achieved a 64% accuracy rate, whereas the SVM, random forest, and logistic regression models obtained perfect accuracy rates of 100%. Assessing the IVF dataset using standardized data models through benchmarking helps confirm its quality, relevance, and importance, thus guiding efforts to improve IVF success rates. In essence, machine learning models are quite good at predicting the outcomes of IVF, which leads to customised reproductive therapies that improve IVF success.

Childlessness in Patients with Inflammatory Bowel Disease - Data from the Prospective Multi-center Swiss IBD Cohort Study.

This study investigates childlessness and infertility in individuals diagnosed with inflammatory bowel disease (IBD). Notably, the research reveals intriguing patterns related to gender and specific IBD subtypes. Among female patients with Crohn's disease (CD), a higher childlessness rate is observed compared to the general Swiss population. This finding prompts questions about CD's impact on reproductive health, including factors such as disease severity and treatment regimens. Conversely, women with ulcerative colitis (UC) exhibit a stable childlessness rate similar to the general population. UC, as a distinct IBD subtype, may have varying effects on fertility, influenced by disease location and duration. Healthcare providers should address reproductive concerns in IBD patients, emphasizing fertility counseling and tailored management strategies. Future research should explore medication effects on fertility outcomes, and longitudinal studies can enhance our understanding of this evolving landscape. In summary, recognizing the unique challenges faced by IBD patients allows clinicians to provide holistic care that integrates disease control and family planning, necessitating collaboration among specialists and patients.

Comparison of large single and small multiple doses of cyclophosphamide exposure in mice during early prepubertal age on fertility outcome

Cyclophosphamide (CY) exposure is known to affect the ovary and impair fertility. Clinically, treatment is generally given over multiple doses, but research models have generally used single doses. The relative effects of administering multiple small doses of CY in the prepubertal period are not elucidated. Two-week-old early-prepubertal Swiss albino female mice were administered with either large single (200 mg/Kg x 1; CY200X1) or small multiple (75 mg/Kg x 4; CY75X4) CY doses, thus a 50% higher total dose. Surviving females were assessed for estrous cyclicity, ovarian follicle reserve, oocyte functional competence, and postnatal assessment of first-generation (F1) pups. Exposure to CY75X4 reduced the loss of ovarian follicles (p < 0.05), and body weight (p < 0.001), and resulted in a larger population of cycling females (p < 0.01) with higher oocyte yield (p < 0.05) compared to CY200X1. Although CY200X1 exposed cycling females had comparable oocyte quality, and fertility index, the postnatal mortality was higher in F1 pups (p < 0.05) in comparison to the CY75X4 group. Although both strategies affect oocyte quality and functional competence similarly, CY75X4, despite the higher overall dose, results in reduced follicle loss, produces higher oocyte/blastocyst yield, and exhibits lower postnatal mortality rates, suggesting a potential advantage over CY200X1 for later fertility and offspring health. The differences in effects of the two treatment models show the need for designing animal model studies that more closely mimic the clinical administration of gonadotoxic therapies such as cyclophosphamide.

Platelet-rich plasma effects on in vitro cells derived from pediatric patients with andrological diseases

Undescended testis and testicular torsion represent two frequent andrological diseases that affect the pediatric age. Despite these testicular disorders having different causes, they both negatively influence fertility in adulthood mainly due to the accumulation of reactive oxygen species (ROS), which represents the primary molecular damage underlying their long-term effects. The gold standard of treatment for both pathologies is surgery; however, it cannot guarantee an optimal fertility outcome in all clinical cases, underscoring the need to identify effective adjuvant therapies that may target the augmented ROS levels. For this aim, we investigated the pro-proliferative and anti-oxidant effects of PRP (platelet-rich plasma), a hemoderivative product used in regenerative medicine. We confirmed the increased oxidative status in testicular tissue by directly analyzing patients’ biopsies with mass spectrometry and highlighting that three antioxidant proteins are significantly overexpressed compared to healthy testicles. Afterward, we in vitro treated cells derived from patients with cryptorchidism or testicular torsion with PRP, showing that it consistently decreases ROS levels and slightly induces cell proliferation. This study supports the potential use of PRP in patients with testis torsion or cryptorchidism, encouraging its future clinical application as adjuvant therapy to preserve the functionality of this organ by decreasing its ROS levels.

Hepatitis B virus impacts embryonic development and methylation of maternal genes in assisted reproductive technology patients.

In China, the prevalence of hepatitis B virus (HBV) infection among infertile couples is a significant clinical problem. It is necessary to determine the effect of HBV infection on embryo development. The 4301 fresh cycles and 5763 frozen embryo transfer (FET) cycles were grouped according to the couple with or without HBV infection. The embryo fertilization rate, cleavage rate, transplantable embryo rate, and rate of high-quality embryos were analysed. The methylation status of maternal antigen that embryos require (MATER), zygote arrest 1 (ZAR1) and growth differentiation factor 9 (GDF9) genes in the peripheral blood of assisted reproductive technology (ART) women was detected by methylation-specific polymerase chain reaction (MSP). The pregnancy rate of the female HBV-positive group was significantly lower than that of the HBV-negative group. The fertilization rate of intracytoplasmic sperm injection (ICSI) cycles in the male HBV-positive group was significantly lower than that of the male HBV-negative group. There were no differences in biochemistry or clinical pregnancy rates among the FET groups. The promoter methylation of GDF9 in HBV-positive ART women was higher than that in HBV-negative ART women, and that of ZAR1 in HBV-positive ART women was lower than that in HBV-negative ART women. It was a detrimental effect of HBV infection on in vitro fertilization (IVF) and ICSI treatment outcomes in women. The HBV infection was associated with the maternal genes promoting methylation.

The Role of Nutrient Supplements in Female Infertility: An Umbrella Review and Hierarchical Evidence Synthesis.

Nutrient supplements are commonly used to improve fertility outcomes by women with infertility trying to conceive spontaneously or utilising medically assisted reproduction (MAR). However, despite their widespread use and perceived safety, there is a lack of clear guidance on the efficacy and safety of these supplements for female infertility. The aim of this umbrella review was to identify the best available and most recent evidence on the efficacy and safety of nutrient supplements for female infertility to provide evidence-based guidance for clinicians and reproductive couples. Five electronic databases were searched for umbrella reviews, meta-analyses, and systematic reviews of randomised controlled trials on nutrient supplements for female infertility, published from August 2017 to January 2024. The primary outcomes were live birth, and clinical and biochemical pregnancy rates. Secondary outcomes were adverse effects including miscarriage and ectopic or multiple pregnancy. Quality assessment was performed using the A MeaSurement Tool to Assess systematic Reviews Version 2.0 (AMSTAR 2), and the certainty of evidence for outcomes were assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, where possible. Four meta-analyses were included. Multiple micronutrients and antioxidants increased live birth rates in women utilising MAR and/or trying to conceive spontaneously compared to placebo, standard or no treatment (odds ratio (OR) 2.59 and 1.81 respectively) with very low certainty evidence. L-carnitine, coQ10, melatonin, myo-inositol, NAC and vitamin D increased clinical pregnancy rates in women with PCOS and/or undergoing MAR compared to placebo, standard or no treatment (odds ratio (OR) 11.14, 2.49, 1.66, relative risk (RR) 1.52, OR 2.15, and 1.49 respectively) with very low certainty evidence. Vitamin D did not increase biochemical pregnancy rates in women utilising MAR with very low certainty evidence. NAC, vitamin D, and pooled antioxidants had no effect on miscarriage rates or multiple pregnancy rates in women trying to conceive spontaneously or utilising MAR, with low to very low certainty evidence. Pooled antioxidants had no effect on ectopic pregnancy rates in women trying to conceive spontaneously or utilising MAR, with low certainty evidence. The available evidence is insufficient to recommend nutrient supplementation to improve female infertility in women trying to conceive naturally and those utilising MAR. However, there is currently no indication that these nutrients pose any risk of significant harm. PROSPERO (CRD42022365966) 20 October 2022.

Effect of Autologous Platelet-Rich Plasma (PRP) on Endometrial Thickness of Wistar Rats Under Antagonist Protocol in In Vitro Fertilization

Introduction:The advancement of Assisted Reproductive Technology (ART) has significantly improved fertility outcomes, particularly through In Vitro Fertilization (IVF). One critical factor influencing IVF success is the health and receptivity of the endometrium. This study aimed to evaluate the effect of Autologous Platelet-Rich Plasma (PRP) on endometrial thickness in Wistar rats subjected to an antagonist protocol during IVF. Methods:This experimental study used a randomized post-test only con- trolled group design involving 40 Wistar rats, divided into two groups: the treatment group (administered PRP) and the control group (no PRP admin- istration). Endometrial thickness was measured using histomorphometry, and the results were analyzed using the Mann-Whitney test. Result: A total of 40 rats were included in the study. PRP administration significantly increased endometrial thickness in rats subjected to the IVF antagonist protocol compared to the control group (p &lt; 0.001). The mean endometrial thickness in the treatment group was 335.5 ± 32.2 μm, while in the control group, it was 228.5 ± 42.7 μm. Conclusion:Autologous Platelet-Rich Plasma (PRP) significantly increases endometrial thickness in Wistar rats under the IVF antagonist protocol, suggesting its potential in enhancing IVF success. This finding has important implications for the field of reproductive medicine.

International Symposium on Ruminant Physiology: Paternal Nutrient Supply: Impacts on Physiological and Whole Animal Outcomes in Offspring.

Recent evidence suggests that environmental factors experienced by sires can be transmitted through the ejaculate (seminal plasma + sperm) into the female reproductive tract, influencing fertilization, embryo development, and postnatal offspring outcomes. This concept is termed paternal programming. In rodents, sire nutrition was shown to directly alter offspring outcomes through sperm epigenetic signatures, DNA damage/oxidative stress, cytokine profiles, and/or the seminal microbiome. Response variables impacted in rodent models, including adiposity, muscle mass, metabolic responses, and reproductive performance, could have major productivity and financial implications for producers if these paternal programming responses are also present in ruminant species. However, a paucity of data exist regarding paternal programming in ruminants. The limited data in the literature mainly point to alterations in sperm epigenome as a result of sire diet or environment. Global nutrition has been implicated in ruminant models to alter seminal cytokine profiles, which could subsequently alter the uterine environment and immune response to mating. Several reports indicate that embryo development and epigenetic signatures can be impacted by sire plane of nutrition and inclusion of specific feed ingredients into diets (polyunsaturated fatty acids, folic acid, and rumen protected methionine). Models of sheep nutrition indicate that addition of rumen protected methionine can impact DNA methylation and offspring performance characteristics extending to the F3 generation, and that divergent planes of sire nutrition can cause altered hormone profiles and insulin/glucose metabolism in offspring. There are almost unlimited opportunities for discovery in this area, but researchers are encouraged to target critical questions such as whether and the extent to which paternal programming effects are present in common management scenarios, the mechanisms by which paternal programming is inherited in ruminants, and whether the effects of paternal nutrition interact with those of maternal nutrition to influence offspring physiology, whole animal outcomes, and herd or flock productivity.

Exploring the association between gender equality in the family and fertility intentions: an explanation of the findings in low-fertility countries

Previous research has demonstrated a positive association between gender equality in the family and fertility measures. However, this association may vary when different features of gender equality in the family, such as the division of housework and childcare, are analyzed. Furthermore, it has been argued that individuals may have different perceptions regarding housework and childcare, which can further explain how the division of these activities is associated with fertility outcomes. We performed a microlevel investigation of the association between the division of housework and childcare and fertility intentions with the aim of identifying patterns (or their absence) in the association. We hypothesized that a more equitable division of tasks is associated with increased fertility intentions. We used data from the first round of the Generations and Gender Survey (GGS) in ten countries: Germany, Belgium, Austria, France, Lithuania, Poland, Romania, Russia, Bulgaria, and Georgia. Our samples included individuals who were in heterosexual relationships and had one child. We employed binary logistic regression for analysis. Overall, our findings suggested that a more equitable division of housework was associated with an increased likelihood of intending to have a second child. Conversely, a less equitable division of childcare was associated with a decreased likelihood of intending to have a second child. Owing to the discussion of the diverse perceptions that individuals may hold regarding housework and childcare, this study contributes to the literature by proposing a theoretical explanation for the patterns observed in our results. The results align with those of previous studies indicating that childcare is generally viewed as enjoyable and rewarding, whereas housework tends to be negatively evaluated and linked to perceptions of unfairness and inequality. Consequently, a more equitable division of housework may reduce work‒family conflict and potentially be associated with increased fertility intentions. In contrast, if childcare is perceived as fulfilling, engaging in more childcare activities may lead to increased fairness rather than unfairness, leading to the association between less equal division of childcare and increased fertility intentions.

Relationship between Fertility Diet Score Index Items and Ovulation in Women with Polycystic Ovary Syndrome: A Narrative Review

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, characterized by ovarian dysfunction and a leading cause of infertility due to ovulatory issues. Lifestyle interventions, including dietary modifications, exercise, and weight management, are considered first-line therapies for women with PCOS; however, the optimal treatment remains unidentified. The Fertility Diet (FD), introduced in 2007, represents a dietary approach that may positively impact fertility by emphasizing specific micronutrients, dietary composition modifications, weight management, and increased physical activity. This narrative review aims to evaluate how various components of the Fertility Diet influence ovulation and overall fertility, assessed through a fertility diet score. The findings of this study suggest that adherence to the Fertility Diet, particularly higher intake of the monounsaturated to trans-fat ratio, and increased vegetable protein intake, may positively influence fertility outcomes in individuals with PCOS. In contrast, high consumption of animal protein and high glycemic load food may have adverse effects. However, the current evidence remains insufficient for definitive conclusions, warranting further interventional studies to explore this relationship.

Effects and safety of propofol intravenous anesthesia in transvaginal oocyte retrieval on outcomes of in vitro fertilization and embryo transplantation.

Propofol, a widely utilized anesthetic, is employed to alleviate pain and anxiety in outpatient oocyte retrieval procedures. However, its potential impact and safety profile in the context of in vitro fertilization and embryo transfer (IVF-ET) remain unclear. This retrospective study enrolled 1187 patients undergoing IVF-ET, and divided into two groups depending on whether they received propofol (propofol group, n=140) or not (control group, n=1047) for anesthesia during oocyte retrieval. The baseline characteristics were comparable between the groups. Compared with control group, the number of oocytes retrieved in propofol group was more (p=0.012), while both the estradiol (E2) level on the trigger day and the pre-ovulatory follicle count were higher in propofol group ((p<0.01). Additionally, the rate of preterm delivery was significantly higher in the propofol group (p<0.001). To further analyze the effect of propofol on the oocyte retrieval rate, patients were divided into three subgroups depending on the pre-ovulatory follicle count (≤10, 11-20, and >20) to eliminate the influence of inconsistency in the estimation of the pre-ovulatory follicle count between the two groups. Analysis revealed that the use of propofol during oocyte retrieval was particularly advantageous in the subgroup with a pre-ovulatory follicle count of 11-20, yielding a higher oocyte retrieval rate (p<0.001). The use of propofol in oocyte retrieval did not adversely affect fertilization, embryo quality, or clinical outcomes. Moreover, it was found to increase the oocyte retrieval rate among patients with an estimated pre-ovulatory follicle count of 11-20. These findings offer valuable evidence supporting the clinical application of propofol in oocyte retrieval procedures.

Comparison of hysteroscopic adhesiolysis with electrosurgery instrument or hysteroscopic scissors in the treatment of intrauterine adhesions of infertile or recurrent pregnancy loss women.

To investigate pregnancy outcomes following hysteroscopic adhesiolysis (HA) in patients with recurrent pregnancy loss (RPL) or infertility. Retrospective cohort study. University-affiliated hospital. According to the inclusion and exclusion criteria of this study, finally, a total of 461 subjects were included. HA performed using either an electrosurgical instrument or hysteroscopic scissors. Pregnancy outcomes post-HA. A total of 461 patients were included in the study, with follow-up periods ranging from 1 to 6years. The mean age was 29.48 ± 3.25years. Hysteroscopic scissors demonstrated greater efficiency in restoring the uterine cavity compared to electrosurgical instruments (88.1% vs. 80.0%, p = 0.025). Post-HA, the pregnancy rate was approximately 75.3% (347/461), with a live birth rate of 55.9% (251/449). No significant differences were found between the electrosurgical instrument and hysteroscopic scissors groups regarding improvements in menstrual flow or fertility outcomes (all p > 0.05). Kaplan-Meier time-dependent cumulative curves for pregnancy and live birth rates after HA indicated that over 50% of patients achieved pregnancy within one year, with the pregnancy rate plateauing at 2years and the live birth rate at 3years. Our findings suggest that HA can improve fertility outcomes for patients with RPL or infertility within 2 to 3years following surgery. Hysteroscopic scissors proved more effective than electrosurgical instruments in restoring the uterine cavity, although no differences were observed between the techniques in terms of menstrual flow or fertility improvements. All in all, our study suggests that standardized HA procedures, the implementation of proactive intraoperative and postoperative measures to prevent the recurrence of intrauterine adhesions (IUA), and an active conception plan following HA are key factors in improving reproductive outcomes for these patients with RPL or infertility.

Adenomyosis, especially in its focal nature, hampers implantation and live birth rate after single euploid embryo transfer.

The primary objective of this study was to assess if uterine adenomyosis impacts live birth rate per euploid embryo transfer. The secondary objectives included addressing obstetric and perinatal outcomes in the study group. This was a multicenter and retrospective cohort study in which 228 patients diagnosed with adenomyosis undergoing single euploid embryo transfer between 2016 and June 2023 were included and matched on 1:1 ratio to control patients without ultrasonographic diagnostic criteria for adenomyosis. A significant higher live birth rate per embryo transfer was observed in controls compared to women with adenomyosis: 107/228 (46.9%) versus 56/228 (24.6%), respectively (odds ratio (OR) = 2.71, 95% confidence interval [CI]: 1.73-4.13, p < 0.001). When dividing adenomyotic patients regarding the nature of the disease, a higher live birth rate per transfer was described in diffuse adenomyosis compared to focal adenomyosis: 47/166 (28.3%) versus 9/62 (15%), respectively (OR = 2.32, 95% CI: 1.03-5.78, p = 0.034). Described differences were constant even when correcting for multiple variables. There was no statistically significant difference in childbirth delivery method (vaginal vs. cesarean section) between the adenomyosis and control groups. Mean gestational age at the time of delivery, newborn size and weight, and incidences of low birth weight, preterm birth, and admission to the neonatal intensive care unit did not differ between the two groups. In addition, invitro fertilization (IVF) and perinatal outcomes were similar in patients with diffuse compared with focal adenomyosis. Adenomyosis, especially focal adenomyosis, affects clinical but may not affect perinatal outcomes after single euploid embryo transfer.