Vitro Fertilization Research Articles

Is germline genome-editing person-affecting or identity-affecting, and does it matter?

Writers have debated whether germline genome-editing is person-affecting or identity-affecting. The difference is thought to be ethically relevant to whether we should choose genome-editing or choose preimplantation genetic diagnosis and embryo selection, when seeking to prevent or produce bad conditions (e.g., cystic fibrosis, or deafness) in the individuals who will grow from the embryo edited or selected. We consider the very recent views of three prominent bioethicists and philosophers who have grappled with this issue. We claim that both sides are right, but that the sense in which genome-editing is person-affecting is less important, morally, when the aim is to have healthy children. Since this is the predominant objective of engaging in embryo selection and genome-editing, and since there are certain risks, at least for now, with genome-editing, it remains better, morally, to engage in embryo selection than genome-editing.

Nomogram to predict cumulative live birth rate following in vitro fertilization/intracytoplasmic sperm injection cycles in patients with endometriosis

BackgroundThe success of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in endometriosis patients varies widely, and predicting the likelihood of achieving a live birth remains a clinical challenge. This study aims to develop a predictive nomogram for assessing the cumulative live birth (CLB) rate following IVF/ICSI cycles among patients with endometriosis.MethodA retrospective cohort study was conducted to analyze the clinical data of 1457 patients with endometriosis after IVF/ICSI treatment from January 2017 to August 2022. The patients were divided into a training set (70%) and a validation set (30%) using a random number table. Univariate analysis and multifactorial logistic regression analysis were employed to identify relevant predictive factors affecting CLB rate. A predictive model was then established based on the identified factors.ResultsUnivariate analysis and multifactorial logistic regression analysis revealed that patients with concurrent adenomyosis had a decreased CLB rate (OR = 0.51, 95% CI: 0.31—0.82). As the duration of infertility increased, the CLB rate decreased (OR = 0.93, 95% CI: 0.88—0.99). Higher numbers of fertilized oocytes and high-quality embryos were associated with an increased likelihood of CLB. A nomogram predictive model for CLB rate, based on age, concurrent adenomyosis, duration of infertility, number of fertilization, and number of high-quality embryos, was developed. The area under the curve (AUC) for the training set and validation set was 0.823 (95% CI: 0.798–0.849) and 0.773 (95% CI: 0.729–0.818), respectively. The stratified analysis demonstrated the applicability of the model in the validation cohort.ConclusionThis predictive nomogram for CLB rate in patients with endometriosis provides valuable and precise information for personalized decision-making, which could be a visual and easily applied tool for IVF/ICSI counselling.

Endometrial scratching before euploid embryo transfer: a case-control study.

To evaluate the effect of endometrial scratching on in vitro fertilization (IVF) success rates in women undergoing frozen embryo transfer with preimplantation genetic testing for aneuploidy (PGT-A). Biopsy was performed at oocyte retrieval in cases and compared to those who did not undergo scratching (controls). Endpoints included pregnancy loss, total pregnancy, clinical pregnancy rate (CPR), ongoing pregnancy rate/live birth rate (OPR), and the incidence of chronic endometritis (CE). Women in case and control groups had similar characteristics, such as age, body mass index, and parity. Overall total pregnancy rate was 82.43% following single euploid embryo transfer in cases compared to 85.7% in controls (p = 0.57; OR = 1.27; 95% CI = 0.565 to 2.78). CPR was 73.3% and 76.2% (p = 0.62; OR = 1.18; 95% CI = 0.594 to 2.29), and OPR between groups was 64.8% and 72.3% (p = 0.28; OR = 1.42; 95% CI = 0.74 to 2.7). First trimester loss rate was similar at 16.9%% and 15.5%%, respectively (p = 0.82). Subjects who underwent scratching closer to their frozen embryo transfer (≤ 3months) had a similar overall pregnancy rate to those with a longer delay between retrieval and frozen embryo transfer (> 3months 81.4% vs.87.5%; p = 0.56). CE incidence was 10.8% (8 out of 74; 95% CI = 5.5% to 19.9%). The odds of having a second trimester loss were significantly higher in the scratch group compared to controls (p = 0.03; OR = infinity; 95% CI = 1.3 to infinity). Endometrial scratching before frozen euploid embryo transfer did not influence pregnancy outcome but increased the chances of second trimester loss. CE was a frequent finding in those undergoing endometrial scratching at the time of retrieval.

Dual Trigger in IVF—A SWOT Analysis

The typical agent used for final oocyte maturation and resumption of meiosis in in-vitro fertilisation (IVF) has been human chorionic gonadotropin (hCG). This acts as a surrogate for the physiological spontaneous luteinising hormone (LH) surge. Gonadotropin-releasing hormone agonist (GnRH-a) has been used as an alternative trigger in cycles where endogenous LH control is achieved using GnRH-antagonist and has been shown to be an effective method of reducing the risk of OHSS. However, GnRHa trigger is associated with poor corpus luteum function, leading to impaired endometrial receptivity. A combination of a GnRHa and hCG (dual trigger) was proposed to improve IVF cycle outcomes, especially in poor and normo-responder patients. Dual trigger aims to provide a more physiological alternative to HCG-only trigger while obviating some of the problems associated with GnRHa alone. Clinical evidence now supports the value of dual trigger where there has been a previous low proportion of mature eggs or where there is a suboptimal LH response to GnRHa alone. In poor responders, dual triggers could be considered as an effective first line. Dual trigger allows for comparable outcomes in normal and high responders, allowing the possibility of fresh embryo transfer with good clinical pregnancy and live birth rates while minimising OHSS risk.

The Impact of BMI on PCOS Patients and Transcriptome Profiling and Bioinformatic Analysis of Granulosa Cells in PCOS Patients with High and Low BMI.

To explore the impact of high body mass index (BMI) on the embryo quality and clinical outcomes of polycystic ovary syndrome (PCOS) patients, and the possible genes involved. Patients who underwent in-vitro fertilization (IVF) treatment and embryo transfer in our center from November 2014 to September 2023, were divided into low BMI PCOS (LBP) group, high BMI PCOS (HBP) group, and high BMI control (HBC) group. Transcriptome sequencing was performed in eight PCOS patients' granulosa cells (GCs). A total of 812 IVF/intracytoplasmic sperm injection (ICSI) cycles in the embryo part; and 489 fresh, 634 frozen-warmed embryo transfer (FET) cycles from the clinical part were included. The ICSI normal fertilization rate of HBP group was decreased compared to LBP and HBC groups (p = 0.013&0.008). The IVF blastocyst development rate in HBP group was lower than LBP group (p = 0.01). The preterm birth rate in HBP group was higher than in LBP (30.66% vs. 16.48%, p = 0.041) and HBC groups (30.66% vs. 11.34%, p = 0.002), the adjusted OR (AOR) of preterm birth and BMI was 1.124 (p = 0.023) in FET cycles. Transcriptome sequencing result of GCs showed that differentially expressed miRNAs/lncRNA/circRNA/mRNAs in two PCOS groups were 61, 450, 83, and 568, respectively. The hub genes analysis, enrichment analysis and competing endogenous RNA network revealed that cell cycle, oocyte maturation, systemic lupus erythematosus, oxidative phosphorylation, and mitogen-activated protein kinases (MAPK) signaling pathways had important roles in the embryo development and pregnancy process. The combined effect of PCOS and obesity reduced oocyte quality and embryonic development potential, finally led to poorer clinical outcomes.

Increased apoptosis in late-developing in vitro fertilized bovine blastocysts decreases successful pregnancy.

Pregnancy in cattle after embryo transfer (ET) is influenced by several factors, including embryo quality. Therefore, preparing high-quality embryos with the greatest developmental potential is essential for achieving a successful pregnancy after ET. Meanwhile, blastocysts produced by in vitro fertilization (IVF) procedure have different developmental speed during in vitro culture (IVC) and they exhibited different competence in the establishment of pregnancy. This study aimed to identify the comparative features of early-, mid-, and late-developing bovine IVF blastocysts, when they first appeared at Day 7, 8, and 9 during IVC, respectively. In addition, the correlations between their molecular features and pregnancy ability were analyzed. The results showed no difference in the morphological characteristics, including total cell count and diameter, between the Day 7, 8, and 9 blastocysts. However, the pregnancy rate post-ET was significantly different between the groups at 51.7%, 36.7%, and 17.8% for Day 7, 8, and 9 blastocysts, respectively. During early embryo development, late-developing blastocysts demonstrated a reduced cell count in the inner cell mass and decreased expression of the early embryo developmental genes (Oct4 and Sox2) compared with the early- and mid-developing blastocysts. In addition, the number of apoptotic cells and apoptosis-related gene expression (increased Bax and decreased Bcl2) gradually elevated from the Day 7 to Day 9 blastocysts. However, there was no difference in mitochondrial activity and mitochondria-relevant gene expression (Tfam and Cox1) between the groups. Correlation analysis identified a significantly negative correlation between the pregnancy rate and the blastocysts' degree of apoptosis, indicating that the low pregnancy ability of late-developing blastocysts was mainly caused by increased apoptosis. This study's results may contribute to the field of animal biotechnology by assisting in establishing an improved strategy for bovine ET with IVF embryos.

The clinical value of short-term insemination: a retrospective analysis of 3496 patients

BackgroundThe safety and effectiveness of short-term insemination remain a subject of controversy. This study aims to investigate the impact of short-term insemination on both embryo quality and pregnancy outcomes and whether it is necessary to apply short-term insemination to all patients underwent in vitro fertilization (IVF).MethodsA retrospective analysis was conducted on 3,496 patients from two centers over the period January 2016 to December 2022. Of these, 1307 patients underwent IVF, 1656 patients were treated with short-term IVF, 166 patients received early rescue intracytoplasmic sperm injection (R-ICSI) and 367 patients were treated with ICSI. The clinical and neonatal outcomes were compared between the two groups.ResultsThe rate of high-quality embryos was significantly lower in the short-term IVF group compared to the routine IVF group (59.89% vs. 68.16%) (P = 0.000), the rate of blastocyst formation was significantly lower in the short-term IVF group compared to the routine IVF group (44.99% vs. 61.34%) (P = 0.000). There were no significant differences in clinical outcomes or neonatal outcomes between the two groups, irrespective of whether fresh or frozen embryos were used (both P > 0.05). The incidence of ≥ 3PN demonstrated no significant difference between the early R-ICSI and ICSI groups (1.04% vs. 0.66%) (P = 0.114), furthermore, the clinical outcomes were similar in both groups, for both fresh and frozen embryos (both P > 0.05).ConclusionsFor patients with primary fertility, short-term IVF combined with early R-ICSI can effectively prevent potential low fertilization or fertilization failure, reduce the risk of patients with no transferable embryo, avoid the waste of resources and had no adverse effects on neonatal outcomes. However, short-term IVF reduced the oocytes utilization rate in one single oocyte pick-up cycle, for patients with no risk factors for fertilization failure, the overnight fertilization is still one of the most important ways of insemination worthy of affirmation.Trial registrationNA.

Association of insulin resistance surrogates with live birth outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization

BackgroundInsulin resistance (IR) is a common pathophysiologic feature in patients with polycystic ovary syndrome (PCOS). However, there have been no studies investigating the association of IR surrogates with pregnancy outcomes in women with PCOS undergoing in vitro fertilization (IVF). Therefore, we explored the association between these factors among PCOS patients.MethodsWe conducted a retrospective study that included patients with PCOS who underwent IVF at a university-affiliated hospital. Blood samples and physical examinations are collected at reproductive center on fasting in the morning of the 2nd to 4th day of the menstrual cycle prior to medication. We categorized participants into “Non-IR group” (HOMA-IR < 2.2) and “IR group” (HOMA-IR ≥ 2.2). The association of IR surrogates [triglyceride-glucose-body mass index (TyG-BMI), triglyceride-glucose (TyG) and homeostasis model assessment (HOMA-IR)] with IVF outcomes was evaluated by regression model analysis. Moreover, we also performed sensitivity analyses with stratification and interaction tests. The primary outcome variable was the live birth rate.ResultsA total of 543 PCOS patients were finally included in the study. In all three regression models for the fresh embryo transfer (ET) cycles, all three IR surrogates showed stable negative correlations with live birth rate (in Model III: TyG-BMI OR = 0.99, 95% CI: 0.98 ~ 0.99; TyG OR = 0.47, 95% CI: 0.27 ~ 0.82; HOMA-IR OR = 0.84, 95% CI: 0.72 ~ 0.97; all P < 0.05), and this association was stable across all subgroups of the population (all P-interaction > 0.05). However, this relationship did not exist in frozen-thawed embryo transfer (FET) cycles. Furthermore, our study found that TyG-BMI was superior to TyG and HOMA-IR in predicting the rate of live birth in fresh ET cycles [TyG-BMI: 0.64 (95% CI: 0.58, 0.69) vs. TyG: 0.61 (95% CI: 0.55, 0.67) vs. HOMA-IR: 0.60 (95% CI: 0.55, 0.67)].ConclusionsOur study revealed that the three IR surrogates (TyG-BMI, TyG and HOMA-IR) were negatively associated with the live birth rates in fresh ET cycles. However, this relationship did not exist in FET cycles. Furthermore, our study found that TyG-BMI was superior to TyG and HOMA-IR in predicting the rate of live birth in fresh ET cycles.

Prolonged Ovarian Stimulation Does Not Worsen Neonatal Outcomes After Fresh Embryo Transfers.

To investigate the relationship between prolonged ovarian stimulation and neonatal outcomes after autologous fresh embryo transfer (fET). A retrospective cohort study. University-affiliated centres. 3529 patients underwent autologous invitro fertilisation (IVF) cycles between August 1, 2016 and December 31, 2022, with a live singleton birth after fET. Univariate and multivariate regression analyses were used to determine the relationship between prolonged ovarian stimulation and neonatal outcomes. Propensity score matching (PSM) was applied to evaluate independent effects. Neonatal outcomes. Multivariate regression showed no significant association between simulation duration and birthweight (adjusted β: 4.19, 95% confidence interval [CI]: -13.86 to 22.23; p = 0.6494) or gestational age (GA) (adjusted β: -0.01, 95% [CI]: -0.09 to 0.06; p = 0.7403) Categorical analysis of neonatal outcomes, including low birthweight (LBW) (adjusted Odds Ratio [OR]: 0.94, 95% [CI]: 0.70 to 1.25; p = 0.6501), macrosomia (adjusted OR: 0.95, 95% [CI]: 0.78 to 1.16; p = 0.6294), small for gestational age (SGA) (adjusted OR: 0.95, 95% [CI]: 0.75 to 1.19; p = 0.6465), large for gestational age (LGA) (adjusted OR: 1.02, 95% [CI]: 0.85 to 1.21; p = 0.8542) and preterm (adjusted OR: 0.93, 95% [CI]: 0.77 to 1.11; p = 0.4191), revealed no associations with stimulation duration. PSM analysis confirmed these findings. Prolonged ovarian stimulation does not appear to increase adverse neonatal outcomes in singleton newborns after autologous fET.

Artificial intelligence-driven analysis of embryo morphokinetics in singleton, twin, and triplet pregnancies.

In recent years, the transfer of more than one embryo has become less frequent to diminish multiple pregnancies. Even so, there is still a risk of one embryo splitting into two or even three. This report presents the case of a triamniotic monochorionic gestation in a 35-year-old woman, obtained after the transfer of a single day 5 embryo that had been previously hatched with a laser and subsequently transferred in a fresh IVF cycle. The morphokinetics of this embryo as well as another eight that produced monozygotic twins were compared with nine embryos that achieved singleton gestations. An artificial intelligence (AI) system was used to perform this analysis objectively. Embryo divisions leading to multiple gestations were slower across all analysed parameters. This was most evident in the time taken to reach the 5-cell stage (t5) (48.74 ± 3.21 versus 44.69 ± 5.61 h) and the morula stage (tM) (85.08 ± 10.00 versus 78.13 ± 5.35 h). Moreover, blastocyst diameter (161.80 ± 26.50 versus 179.10 ± 25.88 μm) and area (21684 ± 7267.4 versus 26516 ± 7254.8 μm2) were smaller in these embryos, but the differences did not reach statistical significance. This is the first report, to our knowledge, to use AI to analyse and compare morphokinetic parameters between singleton pregnancies and a group of embryos that produced twin and triplet pregnancies.

Sperm vitrification in horses and donkeys.

Sperm vitrification is an alternative freezing method, which includes high cooling rates and non-permeable cryoprotectants agents. The first attempt in equids was using the spheres technique by directly dropping small volumes of the sperm into liquid nitrogen. Later, vitrification was developed using 0.25 mL straws with outer covers, which resulted in similar progressive motility when compared to conventional freezing in donkeys (44.3 ± 15.0 % vs. 44.7 ± 18.2 %) or even higher in horses (48.2 ± 2.3 % vs. 37.3 ± 2.2 %). Subsequently, the vitrification of larger volumes of sperm in 0.5 mL straws was evaluated, but the results showed poor sperm quality after different warming procedures. Finally, fertility was assessed in vitro and in vivo. In horses, the sperm fertilizing capacity was assessed utilizing heterologous in vitro fertilization (IVF) and vitrified sperm showed the ability to penetrate cattle oocytes, leading to pronuclear formation and hybrid embryo cleavage. In donkeys, fertility trials were conducted in vivo on a small group of jennies, showing no statistically significant difference in pregnancy rates between artificial insemination (AI) with vitrified semen (22%) or frozen semen (10%); however, the uterine inflammatory response after AI with vitrified semen solved faster than frozen semen. In conclusion, sperm vitrification has been optimized in horses and donkeys using 0.25 mL straws with outer covers and can be considered as an alternative to conventional freezing.

ERK activation dynamics in maturing oocyte controls embryonic nuclear divisions in Caenorhabditis elegans.

ERK activity oscillates between sustained activation during oocyte formation and transient inactivation during oocyte maturation, fertilization, and early embryogenesis. Consequences of ectopic ERK activity upon oocyte maturation and in early embryogenesis are unknown. We show, in Caenorhabditis elegans, that ectopic ERK activity upon oocyte maturation (metaphase I oocytes) results in embryos with abnormalities in nuclear divisions leading to embryonic death. We uncover that ERK directly phosphorylates Polo-like kinase I (PLK-1), on Serine 404, to inhibit nuclear envelope breakdown (NEBD) in early embryogenesis. The RAS/ERK/PLK-1 pathway poisons zygotic NEBD and inhibits the merging of parental genomes, underlining the importance of turning off ERK prior to embryogenesis. Given the conserved nature of both ERK signaling to oocyte development and PLK1 to embryonic divisions, this work has implications for women undergoing invitro fertilization (IVF) where ectopic ERK activation during superovulation through hormonal stimulation may diminish oocyte quality and influence zygotic development.

The perception of artificial intelligence and infertility care among patients undergoing fertility treatment.

To characterize the opinions of patients undergoing infertility treatment on the use of artificial intelligence (AI) in their care. Patients planning or undergoing in vitro fertilization (IVF) or frozen embryo transfers were invited to complete an anonymous electronic survey from April to June 2024. The survey collected demographics, technological affinity, general perception of AI, and its applications to fertility care. Patient-reported trust of AI compared to a physician for fertility care (e.g. gamete selection, gonadotropin doing, and stimulation length) were analyzed. Descriptive statistics were calculated, and subgroup analyses by age, occupation, and parity were performed. Chi-squared tests were used to compare categorical variables. A total of 200 patients completed the survey and were primarily female (n = 193/200) and of reproductive age (mean 37years). Patients were well educated with high technological affinity. Respondents were familiar with AI (93%) and generally supported its use in medicine (55%), but fewer trusted AI-informed reproductive care (46%). More patients disagreed (37%) that AI should be used to determine gonadotropin dose or stimulation length compared to embryo selection (26.5%; p = 0.01). In the setting of disagreement between physician and AI recommendation, patients preferred the physician-based recommendation in all treatment-related decisions. However, a larger proportion favored AI recommendations for gamete (22%) and embryo (14.5%) selection, compared to gonadotropin dosing (6.5%) or stimulation length (7.0%). Most would not be willing to pay more for AI-informed fertility care. In this highly educated infertile population familiar with AI, patients still prefer physician-based recommendations compared with AI.

Comparison of Pregnancy Associated Plasma Protein A (PAPP-A) Levels in IVF-Induced Pregnancies and Physiological Pregnancies: A Case- Control Study

Introduction: Infertility is an important issue in reproductive health. In the field of reproductive medicine, In vitro Fertilization (IVF) stands out as a central approach to helping infertile couples. Pregnancy-associated Plasma Protein-A (PAPP-A) levels increase progressively throughout pregnancy until delivery. Therefore, the present study aimed to conduct a detailed examination and comparison of PAPP-A levels between women who have undergone IVF treatment due to infertility and those with natural pregnancies, all of whom have been referred to the Gynecology and Infertility Clinic of Besat Hospital in 2020. Methods: The present case-control study was conducted on women with IVF-induced pregnancies and those with physiological pregnancies who have been referred to the Gynecology and Infertility Clinic of Besat Hospital in 2020. Pregnant women who did not have a complete medical record and had a history of other diseases were excluded from the study. In this study, venous blood was collected from the pregnant women, and the serum level of the PAPP-A marker was checked. This information was recorded in their medical records and then subjected to statistical analysis. Results: For this purpose, 28 pregnant women by IVF and 34 physiological pregnant women were included in the study. There was a significant relationship between the type of pregnancy (IVF and physiological pregnancy) and the serum level of PAPP-A dispersion based on the KID test, and 70.59% of pregnancies were physiological at the level of 0.5-0.9. Based on the results of the ROC curve test, the cut-off point of the serum level of PAPP-A in pregnancy caused by IVF and physiological pregnancy was 0.63. This means that in 90.91% of people whose serum level of PAPP-A was less than 0.63, the method of pregnancy was IVF. Conclusion: The results of the present study have revealed the serum level of PAPP-A to be different depending on the type of pregnancy, and it has been found to be significantly higher in pregnant women with physiological pregnancy than in pregnancy due to IVF.

FERTILITY CARE IN LOW AND MIDDLE INCOME COUNTRIES: Embryologists' practices of care in IVF-clinics in sub-Saharan Africa.

Despite the centrality of the role of embryologists in in vitro fertilization (IVF), there is relatively little literature on the nature of their work. In this article, we draw on results from a large ethnographic study on the emerging IVF industry in South Africa and reproductive travel in sub-Saharan Africa (SSA), where IVF clinics and embryologists are scarce. Drawing on qualitative interviews with 11 embryologists, who work(ed) in SSA, we illustrate how their care practices are produced through the interaction of people and things. We emphasize the importance of context in shaping their practices, including the shortage of embryologists, the need to set up 'first' clinics in their respective countries, the paucity of trained counsellors in clinics and the mobility of IVF staff. The embryologists we interviewed performed multiple tasks on top of their laboratory work, including entrepreneurial tasks, advocacy, training, development of regulations, mentoring and patient counselling. They enacted care in several ways, towards gametes and embryos, patients, clinics and the profession. These multiple tasks and care practices make for dynamic and fulfilling careers of the interviewed embryologists but also stretch their capacities. They also raise questions about their contribution to the scarcity of embryological work in SSA. If access to IVF is to be achieved in the SSA region, more embryologists need to be trained and retained. Embryologists play a central role in IVF. Yet, there is limited knowledge about the nature of their work. We examine the work of embryologists in SSA, where IVF clinics and embryologists are scarce. Based on qualitative interviews conducted with 12 embryologists, we illustrate the multiple tasks they perform on top of their laboratory work: entrepreneurial tasks, advocacy, training, development of regulations, mentoring and patient counselling. Context is important in shaping these practices. This includes the shortage of embryologists in the SSA region, the need to set up 'first' clinics in their respective countries, the lack of trained counsellors in clinics and the mobility of IVF staff. These multiple tasks, while professionally fulfilling, raise questions about their contribution to the scarcity of embryological work in SSA, which contributes to the limited access to IVF in this region.

Evaluation of utilization of amplified blastocoel fluid DNA gel electrophoresis band intensity as an additional minimally invasive approach in embryo selection: A cross-sectional study

Background: Embryo selection for transfer is critical in assisted reproduction. The presence of DNA in the blastocoel cavity of human blastocysts is assumed to be a consequence of common preimplantation chromosomal abnormalities. Objective: This study examined the relationship between the amount of blastocoel fluid (BF) DNA and the band intensity of amplified BF-DNA in gel electrophoresis, considering the influence of ploidy status. Materials and Methods: This cross-sectional study categorizes blastocysts into 2 groups based on the array comparative genomic hybridization results by trophectoderm biopsy -the euploid and aneuploid group. After morphological scoring, a biopsy of BF was performed for whole genome amplification, followed by an assessment of band intensity and BF-DNA quantification. The relationship between BF-DNA levels, band intensity, and ploidy status were analyzed. Results: The level of BF-DNA was higher in the aneuploid group compared to the euploid group, but the difference was not statistically significant (p = 0.2). We observed that the band intensity was affected by the ploidy status of the embryos, although this difference was not statistically significant (p = 0.059). Notably, electrophoresis band of all embryos with chromosomal loss was strong. No correlation was observed between embryo morphology and chromosomal ploidy (p = 0.8). Conclusion: Our findings indicate that BF-DNA band intensity on agarose gel is not currently applicable for preimplantation embryo selection. It seems that embryos with chromosomal loss are more prone to DNA release to BF. The disrelation between embryo morphology and ploidy status represents the necessity of minimally invasive embryo screening methods based on ploidy status.

Preconception carrier screening in couples seeking in vitro fertilization: exploring the patient perspective

Research questionWhat is the level of understanding, and what are the attitudes and considerations regarding preconception carrier screening (PCS) among patients seeking in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI)? DesignA mixed methods design was used. Nine interviews were conducted with couples or individual partners (N = 16) who had an intake for IVF/ICSI in the two years prior to this study. A questionnaire was completed by 115 participants. No actual PCS was offered. ResultsAll interviewed couples expressed a positive attitude towards PCS, and over half of the respondents would pursue or seriously consider pursuing PCS if possible. Some couples falsely believed that PCS could identify a cause for their fertility problems and increase their chances of conceiving. The desire to make an informed reproductive decision was the most important argument in favour of PCS. The primary argument against PCS was the apprehension of being confronted with reproductive dilemmas. The longer the delay in their IVF/ICSI treatment required to perform PCS, the more couples would be inclined to decline screening. Participants preferred receiving information about PCS from a medical specialist at an early stage in their IVF/ICSI treatment. ConclusionAlthough attitudes towards PCS were generally positive, some concerns were raised about treatment delays and potential reproductive dilemmas, and some couples had misconceptions about the purpose of screening within the context of their IVF/ICSI treatment. These findings highlight the importance of tailoring the information and counseling to the specific needs of IVF/ICSI patients.

Towards homogenous multiwell plate based pH sensors using a responsive triangulenium dye and an ATTO-647 reference dye.

pH remains the most important chemical parameter and must be monitored for positive outcomes in areas as different as cheese making and in vitro fertilisation (IVF). Where blood gas analysers enable patient monitoring, starter cultures in cheese manufacturing are still monitored using conventional pH electrodes. Here, we present a homogeneous multiwell plate sensor for monitoring pH, with the same sensitivity as a pH electrode. The homogenous sensor operates in small liquid samples and uses two components: a pH responsive triangulenium dye on a polystyrene nanoparticle, and a freely diffusing commercial reference dye. Sensor measurements were made in triplicate to investigate and document the performance and robustness of the individual components, before we moved on to investigate the multiwell plate sensor design. The pH sensor was first tested in cuvettes, before moving to microwells and smaller volumes. The target is to monitor pH in IVF cultures, and the sensor proved to be operational in the pH range found in in vitro fertilisation buffers, but the references dye was shown not to be suitable for sensors. We conclude that the homogeneous sensor design is sound, but reaching the required precision of ΔpH = 0.01 can only be done with a different reference dye.

Exploring potential pathways from oxidative stress to ovarian aging.

In developed nations, women have increasingly deferred childbearing, leading to a rise in demand for infertility treatments and the widespread use of assisted reproductive technologies. However, despite advancements in in vitro fertilization (IVF), live birth rates among women over 40 remain suboptimal. Mitochondrial dysfunction is widely recognized as a key factor in the processes driving the age-related deterioration in both the quantity and quality of oocytes. We aim to summarize current insights into ovarian aging, with a particular focus on pathways that impair mitochondrial function, and explore directions for future research. Electronic databases were searched for articles published up to June 30, 2024. Ongoing ovulation, luteolysis, and menstruation trigger exogenous reactive oxygen species (ROS)-mediated oxidative stress that damages mitochondrial DNA. This, in turn, reduces nuclear gene expression, compromises mitochondrial oxidative phosphorylation, and diminishes adenosine 5' triphosphate production. Persistent endogenous ROS further exacerbate mitochondrial DNA damage and aneuploidy, ultimately causing irreversible chromosomal abnormalities, leading to oocyte aging. We have delineated the pathway from oxidative stress to ovarian aging. Early detection and management of ovarian aging present challenges and opportunities to enhance IVF treatment strategies.

Placental pathology of IVF-conceived dichorionic diamniotic twins after fresh embryo versus frozen-thawed transfer

IntroductionTo compare histopathological findings of placentas of dichorionic diamniotic twin pregnancies of in-vitro fertilization (IVF), conceived after fresh embryo transfer (ET) and frozen-thawed ET. MethodsThis retrospective study compared dichorionic diamniotic twin IVF pregnancies that resulted in livebirths during 2010-2022. The placental findings were classified according to definitions curated by the 2016 Amsterdam Placental Workshop Group Consensus Statement. A multivariate logistic analysis was constructed to estimate the odds ratios (OR) of placental histopathology abnormal findings, adjusted for maternal age, body mass index and nulliparity. ResultsThe mean gestational age at birth was lower following fresh ET pregnancies (n=236) than frozen-thawed ET pregnancies (n=122) (34.89 vs 35.77 weeks, p=0.003). For the fresh ET compared to the frozen-thawed ET group, rates were higher of preterm birth (69.5% vs. 55.7%, p=0.011), low birthweight (71.6% vs 57.4%, p<0.001) and very low birthweight (14.2% vs 9.0%, p value one sided=0.029). For the fresh ET compared with the frozen-thawed ET group, the rates were higher of maternal vascular lesions (20.3% vs. 11.5%, p=0.003), placental hemorrhage (12.7% vs. 7%, p=0.021), and villous lesions related to maternal vascular lesions (7.2% vs. 3.7%, p value one sided=0.04). A multivariate logistic analysis showed a higher risk of maternal or neonatal vascular lesions for twin pregnancies after fresh ET than frozen-thawed ET (adjusted OR=1.91, 95% CI 1.26-2.92, p=0.011). ConclusionsFollowing fresh ET compared to frozen-thawed ET, obstetrical and neonatal outcomes were worse, and the risk of maternal vascular lesions was greater.