In Vitro Fertilization Outcomes Research Articles

The effects of GnRH analogues on endometrial receptivity: a comprehensive study.

Endometrial receptivity is a critical determinant of successful embryo implantation and pregnancy. Gonadotropin-releasing hormone (GnRH) analogues are widely used in in vitro fertilization (IVF) but their effects on endometrial receptivity remain incompletely understood. This study aims to investigate the impact of GnRH analogues on endometrial receptivity through various in vitro models. Endometrial samples were collected across various stages of the menstrual cycle. The expression of the gonadotropin-releasing hormone receptor (GnRHR) was analyzed and quantified. A 3D endometrial model was constructed, and effects of GnRH analogues on trophoblast adhesion, as well as on the expression of markers related to endometrial receptivity, were assessed. The results indicate that GnRHR expression is higher in epithelium in the secretory phase. However, no significant difference in the adhesion of trophoblast cell spheres to endometrial cells across different GnRH analogue concentrations was observed. GnRH analogues did not affect gene mRNAs expressions or protein levels either. Proteomic analysis revealed a downregulation of ITGAE in the antagonist regimen and an upregulation of FAAH2 in the agonist regimen. This study suggests that GnRH analogues at different physiological concentrations used in IVF protocols do not significantly impact primary markers of endometrial receptivity. However, the use of antagonist may have an adverse effect on endometrial receptivity. Further research is required to elucidate indirect mechanisms by which GnRH analogues might affect endometrial receptivity and IVF outcomes.

Identification of potential therapeutic targeting in ovarian aging from genetic screening with clinical validation.

To screen drug targets of ovarian aging from agenetic perspective. Systematic analyses were conducted with cis-expression quantitative trait loci data of druggable genes extracted as instrument variables. Summary statistics were from large genome-wide association studies for age at menopause. The following colocalization analysis was utilized to examine whether identified genes and ovarian aging shared causal variants. Furthermore, clinical validation was conducted by comparing expression of identified genes in granulosa cells from women with normal or diminished ovarian reserve (DOR) who went through in vitro fertilization (IVF) and by evaluating correlation of targeted gene expression with ovarian function and IVF outcomes. Moreover, single-nuclear RNA (snRNA) seq and drug database were analyzed to find target cells within the ovary and potential drugs targeting identified genes. Systematic analyses identified five therapeutic targets of ovarian aging, including four protective factors (BRCA1, KLHL18, PNP, SRPK1) and one risk factor (PDIA3). The change in expression level of four protective factors has been verified in clinical validation. Particularly, both BRCA1 and SRPK1 have been downregulated among advanced-aged women with DOR and were positively correlated with anti-Müllerian hormone and antral follicle count. Specific target cells and potential small molecule targeted drugs of these genes were identified through snRNA analysis and searching in the drug database. By systematic genetic analyses combined with clinical validation, we identified five potential druggable genes for ovarian aging, providing theoretical basis and promising direction of therapeutic genetic targets for ovarian aging in the future.

Infertile women with a history of fertility-sparing surgery for borderline ovarian tumors: IVF outcomes and the association between IVF and tumor recurrence

BackgroundBorderline ovarian tumors (BOTs) are neoplasms of low malignant potential that predominantly affect women of reproductive age. Fertility preservation through fertility-sparing surgery is widely practiced; however, concerns remain regarding the risk of tumor recurrence and the reproductive outcomes following in vitro fertilization (IVF). This study aimed to evaluate IVF/ intracytoplasmic sperm injection (ICSI) outcomes in BOTs patients post-FSS and to assess the association between ovarian stimulation parameters and tumor recurrence.MethodsIn this retrospective cohort study conducted at Sixth Hospital of Sun Yat-sen University from May 2010 to May 2023, 65 women with a history of FSS for BOTs who underwent IVF/ICSI were identified. After propensity score matching, 61 BOTs patients were compared with 181 control patients without ovarian tumors. Key outcomes evaluated included ovarian stimulation parameters, live birth rates, neonatal outcomes and risk factors for tumor recurrence.ResultsThe BOTs and control groups exhibited similar outcomes regarding the number of oocytes retrieved, the quality and number of embryos, and live birth rates from the first IVF/ICSI cycles. The cumulative live birth rate over 13 years and neonatal parameters (gestational age, birth weight, and body length) were also comparable between groups. Tumor recurrence was observed in 8.62% of BOTs patients, with no significant association identified between recurrence and ovarian stimulation parameters or peak estradiol levels.ConclusionsIVF/ICSI following fertility-sparing surgery for BOTs patients yields reproductive and neonatal outcomes comparable to those in patients without BOTs and does not increase the risk of tumor recurrence. These findings support the safety and efficacy of IVF as a fertility treatment option for BOTs patients after conservative surgery. Further prospective studies with larger cohorts are warranted to validate these results and refine ovarian stimulation strategies.Clinical trial numberNot applicable.

Origin and development of uniparental and polyploid blastomeres.

Origin and development of uniparental and polyploid blastomeres.

Plasma Rich in Growth Factor (PRGF) Therapy for Endometrial Receptivity: A Promising Approach in In vitro Fertilization (IVF) for Infertility with Uterine Polyps

ABSTRACT This case study involved a 28-year-old woman with primary infertility, chronic abnormal vaginal bleeding, recurrent miscarriages, and uterine polyps. After undergoing hysteroscopic polypectomy to remove the polyps, plasma rich in growth factors (PRGF) therapy was administered to enhance endometrial thickness. Following the therapy, the endometrial thickness increased to 7 mm, leading to successful implantation and a positive pregnancy outcome. PRGF therapy was integrated into the in vitro fertilization (IVF) process, including ovum pickup, intracytoplasmic sperm injection (ICSI), and embryo transfer. PRGF releases growth factors, such as platelet-derived growth factor and transformation growth factor (TGF-β1), which play key roles in repairing endometrial tissue, promoting cell proliferation, and enhancing the function of primary cells involved in tissue regeneration. Although the short-term results in this case are promising, further research is necessary to investigate the long-term effects of PRGF therapy on IVF outcomes, including implantation success, biochemical pregnancies, and ongoing pregnancies. PRGF therapy shows promise as a complementary treatment in IVF protocols, particularly for patients with thin endometrial linings or uterine polyps. It offers a safe, minimally invasive, and cost-effective approach to improving endometrial receptivity and enhancing IVF success rates. However, further studies are needed to validate its long-term efficacy and its role in improving overall reproductive outcomes.

Age-related peculiarities of blood parameters in women and their impact on the outcome of in vitro fertilization programs

Objective. Despite the existence of a wide list of indicators that determine the favorable outcome of in vitro fertilization (IVF) programs, their effectiveness remains in the range of 30—40%. Due to the need for more accurate prediction of results and identification of parameters that require therapeuical correction, the purpose of this study was to study the data of routine general and biochemical blood tests to identify additional prognostic criteria for IVF. Material and methods. A retrospective analysis of the medical examination results of 301 women who underwent assisted reproductive technologies (ART) programs at the Regional Perinatal Center in Kursk in 2021 was carried out. According to the National ART Registry of 1995, the patients were divided into three age groups: 1) under 25 years, 2) from 26 to 35 years, and 3) 36 years and older. Results. The concentration of erythrocytes, hemoglobin, hematocrit and glucose levels significantly differed between the three studied groups (p<0.002). Red blood counts and glucose levels were significantly higher in women over 36 years of age compared to women 26—35years of age (p<0.0006). In the second group, the concentration of erythrocytes and hemoglobin positively correlated with the number of oocytes (p=0.012), AMH (p=0.004; p=0.002) and negatively with the thickness of the endometrium (p=0.00064). In the third group, a positive correlation was found between glucose levels and endometrial thickness (p=0.045). Conclusions. In this study, for the first time, age-related changes in a number of parameters of general and biochemical blood tests of women of the reproductive period were revealed, that have prognostic significance for determining the outcome of IVF. An increase in red blood parameters in the older age group is indicative of hypoxic changes that require additional correction in the form of oxygen therapy or the appointment of drugs that improve blood supply and oxygenation of the uterus. In women aged 26—35years, an increase in the concentration of erythrocytes and hemoglobin to the upper limit of the normal range and above (≥140 g/l) predicts receiving more oocytes, but a smaller thickness of the endometrium. The probability of successful implantation in this case did not exceed 10%.

The positive rate of antisperm antibody and its impact on IVF/ICSI embryo culture.

To explore the prevalence of antisperm antibodies(ASA) and its impact on the embryo culture outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), a retrospective analysis of the Center for Reproductive Medicine's data was conducted. 8265 semen samples were detected for ASA using mixed antiglobulin reaction (MAR). In addition, 934 IVF/ICSI cycles were included to compare the effects of ASA on embryo culture outcomes during IVF/ICSI, including normal fertilization rate, D3 good-quality embryo rate, available blastocyst formation rate, and available embryo rate. The positive rate of ASA in semen was relatively low, about 1.03%. We found ASA may weaken the normal fertilization rate of IVF cycles. In addition, there was no statistical difference in outcomes between the positive groups and negative groups of ICSI cycles with a threshold 10% in ASA, but ASA significantly reduced the normal fertilization rate and D3 good-quality embryo rate of ICSI cycles with a threshold 50% in ASA. It was speculated that the high ratio of rescue ICSI cycles resulted in the poor embryo culture outcomes. We supposed that the higher of the ASA positive rate, the higher of the likelihood of fertilization failure of IVF. Comparing with IVF, ICSI is more recommended as a fertilization method for ASA positive patients who need assisted reproductive technology. ASA may have a negative impact on the embryo culture outcomes of IVF. Therefore, for ASA positive patients who require IVF/ICSI treatment, it is suggested embryologists wash the sperm thoroughly and use short-term fertilization of IVF or conventional ICSI to assist with pregnancy.

Comparison of Assisted Hatching Techniques and Their Impact on Clinical Pregnancy Outcomes with Optimization Strategies in In Vitro Fertilization

ABSTRACT Background: Infertility is a prevalent reproductive issue, often requiring assisted reproductive techniques (ART) such as in vitro fertilization (IVF). Implantation failure remains a major challenge, especially in women of advanced maternal age, those with previous IVF failures, or embryos with a thick zona pellucida. Assisted hatching (AH) is a technique designed to improve implantation rates by facilitating embryo hatching. However, its effectiveness remains uncertain, particularly concerning live birth rates. Objectives: This study aims to evaluate the impact of assisted hatching techniques—laser hatching and mechanical hatching—on clinical pregnancy outcomes and implantation success in women with advanced maternal age, recurrent IVF failures, or embryos with a thick zona pellucida. The study also seeks to compare these techniques with a control group receiving no AH. Methodology: A total of 180 participants will be divided into three groups: laser hatching, mechanical hatching, and a control group (no assisted hatching), with 60 participants in each group. Embryos will be assessed for suitability, and AH will be performed using laser or mechanical techniques. Following embryo transfer, clinical pregnancy outcomes and implantation rates will be monitored and compared across the groups. Expected Results: It is anticipated that assisted hatching, particularly laser-assisted hatching, will lead to higher implantation and clinical pregnancy rates compared to the control group. The study aims to establish whether AH can significantly enhance IVF success in specific patient populations. Study Implications: Findings from this research could provide valuable insights into optimizing assisted hatching techniques for improving IVF outcomes. If AH proves beneficial, it may be recommended as a standard adjunct in ART, particularly for high-risk patient groups. Additionally, the study will contribute to understanding the limitations and cost-effectiveness of AH in clinical practice.

Outcome of IVF Treatment of Couples Attending the HOPE and Lab Aid IVF Clinic, Dhaka

Background & objective: Infertility is a major reproductive health issue affecting millions of couples globally, with significant psychological and social implications. Estimates suggest that 15% of couples experience infertility in South Asia, including Bangladesh. Despite advances in assisted reproductive technologies (ART), particularly in vitro fertilization (IVF), there is a lack of comprehensive data on the demographics and clinical characteristics of couples seeking these services in Bangladesh. This study aimed to evaluate the demographic and clinical profiles of couples undergoing IVF treatment at IVF Clinics in Dhaka to assess the treatment outcomes. Methods: This cross-sectional observational study was conducted from January to December 2024, enrolling 126 couples aged 18 to 45 years seeking IVF due to primary or secondary infertility. Participants completed a structured questionnaire capturing demographic information, infertility history, clinical assessments, and IVF treatment protocols. Couples were excluded if they had anatomical abnormalities requiring surgical intervention, previous IVF treatment at another facility, or significant medical comorbidities. Data analysis involved descriptive statistics to summarize demographic and clinical characteristics, and outcomes such as clinical pregnancy rates and live birth rates were recorded. Results: The study revealed that participants had a mean age of 32.6 years, with approximately 40% aged 20 to 30 years and 41.3% aged between 30 and 40 years. Over 70% of participants experienced primary infertility, with the average duration of infertility being 8.9 ± 4.4 years. Common reasons for delaying IVF included a lack of knowledge (44.4%) and inadequate resources (23.8%). Following IVF, the overall pregnancy test positivity rate post-IVF was 37%, and more than one-third (35.7%) of cases showed a gestational sac on ultrasound. Over one-third (37.3%) achieved clinical pregnancy, with 21(44.6%) progressing to full-term pregnancies, leading to 19 singleton births and 2 multiple births. Of the conceived cases, there were 13(27.7%) spontaneous abortions and 9(19.1%) instances of blighted ovum. Additionally, 3 cases (6.4%) resulted in preterm labor, and 3(6.4%) were ectopic pregnancies. Conclusion: This study highlights key demographic and clinical features of couples undergoing IVF treatment in Dhaka, Bangladesh, revealing a high prevalence of primary infertility and significant barriers to accessing IVF due to limited knowledge and resources. While the conception rate is acceptable, the success rates are notably lower than global averages, indicating a need for further research to improve IVF outcomes for couples struggling to conceive. Ibrahim Card Med J 2024; 14(1): 28-34

Study Protocol: Evaluation of AI-Driven Grading Compared to Manual Grading in Predicting Embryo Viability and Successful Implantation and Clinical Pregnancy Outcomes in IVF Using Static Microscopic Images

ABSTRACT Background: Infertility affects 8–12% of couples globally, with 5–10% seeking Assisted Reproductive Technology (ART) annually. In-vitro fertilization (IVF) is the most common infertility treatment, involving the retrieval of oocytes and their fertilization in a laboratory setting. Embryo selection, crucial for IVF success, is traditionally performed manually by embryologists using the Gardner Scale. However, this process is subject to variability. Time-lapse microscopy and artificial intelligence (AI)-based methods are being explored for improved embryo selection, though AI’s full potential has not been realized across diverse clinical settings. Objectives: The primary objective of this study is to compare AI-based embryo grading with conventional manual grading by embryologists in predicting clinical pregnancy outcomes. Methodology: This prospective study will be conducted at an IVF clinic in Sawangi, Wardha, Maharashtra, involving 222 participants aged 23–40 years undergoing Intra-Cytoplasmic Sperm Injection (ICSI). Embryos on Day 5 (blastocyst stage) will be imaged and graded using Life Whisperer Genetics (LWG), an AI-based tool, and by skilled embryologists using the ASEBIR criteria. The success rate of clinical pregnancy, confirmed by the presence of a gestational sac, will be the primary outcome. Expected Results: The study is expected to show increased predictive efficiency, rigor, and consistency with AI-driven grading of Day 5 embryos, providing a more economical solution for IVF. Study Implications: This study focuses on enhancing embryo selection using Life Whisperer Genetics (LWG), which could potentially improve embryo assessment in IVF. Further research is needed to incorporate other embryonic developmental stages for a more comprehensive evaluation process.

Association of pentachlorophenol in urine and follicular fluid with ovarian reserve and reproductive outcomes among women undergoing in vitro fertilization based on a prospective cohort study.

Association of pentachlorophenol in urine and follicular fluid with ovarian reserve and reproductive outcomes among women undergoing in vitro fertilization based on a prospective cohort study.

Ambient temperature in relation to ovarian reserve and early outcomes following ovarian stimulation and in vitro fertilization.

Ambient temperature in relation to ovarian reserve and early outcomes following ovarian stimulation and in vitro fertilization.

Correlation analysis of a novel artificial intelligence optical microscope-assisted semen assessment system with IVF outcomes.

On the day of fresh oocyte retrieval in in vitro fertilization (IVF) cycles, a novel portable artificial intelligence optical microscope (AIOM) was employed to assist in the assessment of semen parameters. This study analyzed the correlation between sperm kinetic and morphological parameters with short-term IVF outcomes. Additionally, it explored whether these parameters could serve as predictive indicators for rescue intracytoplasmic sperm injection (R-ICSI) in IVF patients. A retrospective analysis was conducted on patients undergoing short-term IVF at the West China Second Hospital of Sichuan University between May 2021 and May 2024. Based on fertilization outcomes, the short-term IVF patients were categorized into a successful fertilization group (group A, n = 281) and a group requiring R-ICSI after failed fertilization (group B, n = 49). AIOM was utilized to analyze semen parameters including pH, sperm concentration, sperm motility parameters, sperm movement trajectory parameters, and sperm morphological parameters. The study further investigated the correlation between these short-term IVF fertilization-related laboratory indicators and IVF outcomes. No statistically significant difference was observed in semen pH between the two groups. However, there were significant differences in sperm concentration and the majority of motility parameters. Specifically, compared to group A, patients in group B exhibited lower sperm concentration (p = 0.01), motility (p = 0.01), local motility (p = 0.01), progressive motility (PR) (p = 0.00), total motility (p = 0.01), and amplitude of lateral head displacement (ALH) (p < 0.01), along with higher immotility (p = 0.00). No statistically significant differences were found between the two groups in other sperm motility, velocity, or trajectory parameters. Additionally, sperm morphological parameters were also associated with short-term IVF fertilization outcomes. Compared to group A, group B had higher sperm head length mean (p < 0.01), head perimeter mean (p < 0.01), and head area mean (p = 0.01), as well as lower tail length mean (p = 0.01). Multivariate regression analysis of fertilization outcomes indicated that higher immotility (p = 0.01) and head length mean (p < 0.01), along with lower tail length mean (p = 0.04), were independent risk factors affecting successful short-term IVF fertilization. Notably, head length mean showed a significant negative correlation with polyspermy rate (p < 0.01), whereas tail length mean was significantly positively correlated with polyspermy rate (p < 0.01). Optimization of semen parameters with AIOM at the time of fertilization is significantly associated with short-term IVF fertilization outcomes. Abnormal semen parameters at fertilization-specifically, higher immotility and head length mean, along with lower tail length mean-can be considered risk factors for fertilization failure and may serve as predictive indicators for potential R-ICSI.

Elastography in Reproductive Medicine, a Game-Changer for Diagnosing Polycystic Ovary Syndrome, Predicting Intrauterine Insemination Success, and Enhancing In Vitro Fertilization Outcomes: A Systematic Review.

Background: Elastography is an ultrasound-based imaging technology that allows for quantitative measurement of tissue stiffness and elasticity. In reproductive medicine, it is a potential non-invasive method for assessing ovarian activity, uterine contractility, and endometrial receptivity. While conventional ultrasound provides anatomical and vascular information, it does not assess biomechanical properties, which are important for understanding polycystic ovary syndrome (PCOS), predicting intrauterine insemination (IUI) success, and determining endometrial receptivity in in vitro fertilization (IVF). Methods: A systematic review was conducted in accordance with the PRISMA principles, and the protocol was recorded in PROSPERO. A comprehensive literature search was conducted across several databases to uncover studies that used real-time elastography (RTE) or shear wave elastography (SWE) for PCOS diagnosis, IUI result prediction, or endometrial receptivity evaluation in IVF. The risk of bias was assessed using the ROBINS-I technique. Results: Four studies fulfilled the inclusion criteria. One study indicated that PCOS patients had considerably increased ovarian stiffness, which supports elastography as a diagnostic marker. Another study found that increased uterine flexibility and decreased contractility were related with better IUI outcomes. A retrospective cohort research discovered that non-uniform endometrial echogenicity had no influence on IVF results. Furthermore, SWE successfully evaluated endometrial receptivity in unexplained infertility, with higher stiffness being related to reduced implantation potential. Conclusions: Elastography gives real-time, quantitative insights into reproductive biomechanics, with potential applications in infertility diagnosis and ART improvement. However, the absence of defined imaging procedures and confirmed clinical criteria prevent its broad use. More large-scale prospective investigations are required to improve elastographic parameters and define diagnostic cutoffs for clinical use.

Altered Expression of Interleukin-6, Glycodelin A and Heparin-Binding Epidermal Growth Factor, in The Endometrium of Women with Hydrosalpinx: A Case-Control Study.

Hydrosalpinx is a recognized condition affecting the fallopian tubes, which decreases the embryo implantation rate and success in in vitro fertilization (IVF) outcomes. It can manifest detrimental effects through inflammatory conditions in the uterine endometrium that may lead to alterations in the expression of transcription factors and cytokines such as; Interleukin-6 (IL-6), Glycodelin A (GdA), and Heparin-binding epidermal growth factor (HB-EGF) involved in endometrial receptivity (ER) and embryo implantation. The alterations of these markers in the endometrium of patients with hydrosalpinx have not been investigated. Therefore, we aimed to evaluate the mRNA expression level of IL-6, HB-EGF, and GdA in the endometrium of women exposed to hydrosalpinx fluid (HF) compared to the fertile group. In this case-control study, 30 subjects were enrolled for this study: fifteen patients with communicating hydrosalpinx (aged between 20-37 years old) were compared with 15 fertile aged-matched egg donor women as the control group. All subjects underwent uterine endometrial sampling by Pipple on days 19-24 of the menstrual cycle. Gene expression was quantitatively analyzed using a real-time polymerase chain reaction (PCR) technique. Data analysis was conducted using the Wilcoxon rank test. The mRNA expression level of IL-6 showed a significant increase in patients with hydrosalpinx compared to the control group (P=0.022). HB-EGF gene expression was significantly reduced in the hydrosalpinx group compared to fertile women (P=0.007). There was an insignificant decrease in GdA mRNA expression level compared to healthy fertile controls (P=0.419). The presence of hydrosalpinx led to an alteration in the expression of endometrial IL-6, HB-EGF, and GdA mRNA levels in the implantation window, which may explain the reduced implantation rate and success in IVF outcome.

Ovarian Activation Surgical Techniques for Women with Premature Ovarian Insufficiency or Poor Ovarian Response: A Systematic Review.

In vitro fertilization (IVF) with egg donation often stands as the sole treatment option for women with premature ovarian insufficiency (POI) or poor ovarian response (POR); for this reason, alternative techniques are being developed, among which stand surgical techniques for ovarian activation. The aim of the present study was to evaluate the effectiveness of surgical techniques for ovarian activation in patients affected by POI or POR. In this systematic review study, a comprehensive search of the literature was carried out on the principal databases. Only original studies reporting the treatment of POI or POR using surgical techniques for ovarian activation in human subjects were deemed eligible for inclusion in this qualitative analysis. Overall, 187 patients with POI and 65 patients with POR were treated with experimental surgical techniques. Among the POI patients, 10 pregnancies and 8 live births were achieved. In the POR group, 18 pregnancies were reported with 14 live births. Ovarian fragmentation (OF) appears to be a promising method for treating POI, although large sample randomized controlled trials (RCTs) are necessary to confirm this hypothesis. Regarding POR, surgical techniques do not improve IVF outcomes, and thus should not be proposed, although they may lead to a slight increase in ovarian reserve markers as compared with before treatment. Both clinical and basic science studies are highly demanded to better understand the molecular mechanisms underlying some partially promising results, with the aim of improving currently available techniques.

Predictive value of homocysteine levels in embryo culture media for embryo selection in infertile patients with endometriosis.

To investigate the possible ability of homocysteine (Hcy) levels in embryo culture media for estimating better invitro fertilization outcomes in endometriosis patients. Nineteen women with endometriosis who were admitted to Cerrahpaşa Medical Faculty, Department of Obstetrics and Gynecology, Infertility Outpatient Clinic with the diagnosis of infertility were included in the study. The results of intracytoplasmic sperm injection treatments were recorded and Hcy levels in the embryo culture were evaluated. The results were compared with those of the control patients without endometriosis, who had previously been admitted to our clinic for assisted reproductive technology. Mean Hcy levels in the culture media of the endometriosis group and non-endometriosis group were 4.31±0.48 µmol/L and 4.15±1.44 µmol/L, respectively (p>0.05). Pregnancy was achieved in 3 patients in the endometriosis group, while 13 pregnancies were obtained in the non-endometriosis group (p>0.05). When all cases were evaluated, the mean value of Hcy in the culture medium was found to be 3.60±0.84 µmol/L in the patients with a pregnancy and 4.21±0.84 µmol/L in the group that failed to achieve a pregnancy, and this difference was statistically significant (p<0.05). Difference between mean Hcy levels in the culture media of the endometriosis group and non-endometriosis group was statistically non-significant. Further studies with larger groups are needed for evaluating the association of Hcy with infertility in endometriosis patients. Mean Hcy levels in the group of patients who succeeded in conceiving were statistically higher than the group of patients who failed to conceive. It may be suggested that Hcy levels in the embryo culture media can predict the achievement of a pregnancy independently from some conditions which may adversely affect the embryo quality, such as endometriosis.

Effects of gonadotropin releasing hormone antagonist (GNRHant) and oral progestin-primed protocol on oocyte count over the punctured follicle number in consecutive two cycles: A comparative study.

Controlled ovarian hyperstimulation plays a critical role in in vitro fertilization (IVF) success. However, premature luteinization and variations in oocyte yield can impact IVF outcomes. This comparative study aims to investigate the effects of gonadotropin releasing hormone antagonist (GNRHant) and oral progestin-primed protocol on the oocyte count over the punctured follicle number in the same patient group undergoing consecutive IVF cycles. Forty-nine patients undergoing IVF were enrolled in this comparative study. Each participant underwent two consecutive IVF cycles. In the first cycle, GNRHant protocol was used. In the second cycle, the OPP protocol was used. The number of punctured follicles and oocytes retrieved was recorded and compared between the two cycles for each patient. The ratio of oocyte count per punctured follicle number was higher in the OPP group compared to the GNRHant group, without clinical significance (p>0.05). In the OPP, the ratio of oocytes retrieved over the punctured follicle number was 0.90±0.28; in the GNRHant group, it was recorded as 0.94±0.36, and the differences between the ratios were statistically insignificant. Oocyte yield is a critical determinant of IVF success, and it can be influenced by various factors, including premature luteinization and follicular development. The use of GNRHant and OPP is known to prevent premature luteinization and improve follicular synchronization. This study demonstrates that neither of the protocols is superior in the success of oocyte retrieval over the punctured follicle count. Further research with larger sample sizes and randomized controlled trials is warranted to validate these results, and optimize clinical application of this combined protocol in IVF treatments.

Impact of Polycystic Ovary Syndrome Hyperandrogenic Phenotypes A and Non-Hyperandrogenic D on Pregnancy Outcomes After in vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI).

This study aims to evaluate the association between polycystic ovary syndrome (PCOS) phenotypes A and D with primary and secondary pregnancy outcomes among PCOS vs non-PCOS patients after in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). A retrospective cohort design using data of eligible women aged 20-40 years who had their first IVF treatment. The data were obtained from medical records. The women were either diagnosed with PCOS according to Rotterdam Criteria, namely phenotypes A and D or non-PCOS. Pregnancy outcome including (1) the rate of biochemical pregnancy and (2) ongoing clinical pregnancy and (3) the rate of miscarriage were measured. Furthermore, secondary outcome data were collected on (1) the number of oocytes retrieved, (2) the number and percentage of mature oocytes, (3) fertilization rate, (4) the percentage of grade 1 embryos on day 3 and (5) the percentage of grade 1 embryos on day 5. A sample of 149 women was analyzed. For secondary pregnancy outcomes, PCOS women in groups A and D have lower oocyte maturity rate and lower fertilization oocyte ratio, as well as fewer grade 1 oocytes on day 3 in comparison to the control. Primary pregnancy outcomes have significantly lower values among PCOS women in group A with respect to biochemical pregnancy and ongoing clinical pregnancy and higher miscarriage rates in comparison to group D and the control group. Finally, group D and control did not differ significantly in the primary pregnancy outcomes. Patients with phenotype D have better IVF outcomes in comparison to phenotype A. Phenotype A, affects the IVF outcomes negatively possibly due to hyperandrogenism.

Association of anti-phosphatidylserine/prothrombin antibodies with adverse in vitro fertilization outcomes.

Association of anti-phosphatidylserine/prothrombin antibodies with adverse in vitro fertilization outcomes.