Infertility Issues Research Articles

Maternal stress and the early embryonic microenvironment: investigating long-term cortisol effects on bovine oviductal epithelial cells using air–liquid interface culture

The oviduct epithelium is the initial maternal contact site for embryos after fertilization, offering the microenvironment before implantation. This early gestation period is particularly sensitive to stress, which can cause reduced fertility and reproductive disorders in mammals. Nevertheless, the local impact of elevated stress hormones on the oviduct epithelium has received limited attention to date, except for a few reports on polyovulatory species like mice and pigs. In this study, we focused on the effects of chronic maternal stress on cattle, given its association with infertility issues in this monoovulatory species. Bovine oviduct epithelial cells (BOEC) differentiated at the air–liquid interface (ALI) were stimulated with 250 nmol/L cortisol for 1 or 3 weeks. Subsequently, they were assessed for morphology, bioelectrical properties, and gene expression related to oviduct function, glucocorticoid pathway, cortisol metabolism, inflammation, and apoptosis. Results revealed adverse effects of cortisol on epithelium structure, featured by deciliation, vacuole formation, and multilayering. Additionally, cortisol exposure led to an increase in transepithelial potential difference, downregulated mRNA expression of the major glucocorticoid receptor (NR3C1), upregulated the expression of cortisol-responsive genes (FKBP5, TSC22D3), and significant downregulation of oviductal glycoprotein 1 (OVGP1) and steroid receptors PGR and ESR1. The systematic comparison to a similar experiment previously performed by us in porcine oviduct epithelial cells, indicated that bovine cultures were more susceptible to elevated cortisol levels than porcine. The distinct responses between both species are likely linked to their divergence in the cortisol-induced expression changes of HSD11B2, an enzyme controlling the cellular capacity to metabolise cortisol. These findings provide insights into the species-specific reactions and reproductive consequences triggered by maternal stress.

General practice preconception care invitations: a qualitative study of women’s acceptability and preferences

BackgroundIn general practice, primary care providers can potentially use electronic medical records (EMRs) to identify and invite reproductive-aged women with preconception health risk factors to increase their engagement in preconception...

Effect of Clomiphene Citrate on Fertility Hormones in Women with Polycystic Ovarian Syndrome

This study aims to investigate the positive effect of Clomiphene Citrate (CC) in inducing ovulation in women with PCOS. Clomiphene Citrate is a non-steroidal drug that primarily affects estrogen production. CC also has pronounced effects on balancing of the female hormones, normal ovulation process, and overcoming the PCOS-based infertility issues. Hormonal profile evaluation including follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and estrogen was performed at Clinical Laboratory, Services Hospital, Lahore. Serum volume of the aforementioned hormones were determined in PCOS-suffering infertile women (n=50) and healthy fertile women (n=50) by using a commercially available ELISA kit manufactured by Calbotech lnc. Serum luteinizing hormone (LH), follicle stimulating hormone (FSH), progesterone, and estrogen mean values in PCOS patients before the use of CC were evaluated as 5.74±0.939 (IU/L), 3.804±1.163 (IU/L), 2.098±1.233 (ng/ml), and (51.458±7.091 pg/ml respectively, while after management with CC the mean value of serum LH, FSH, Progesterone, and Estrogen were 3.716±0.513 (IU/L), 5.644±1.130 (IU/L), 10.704±2.313 ng/ml and 37.72±4.969 pg/ml respectively, which indicated a significant differences in hormonal pattern . The current study demonstrates that Clomiphene Citrate (CC) has positive effects in ovulation process in females with polycystic ovarian syndrome (PCOS), within the local population.

The Effectiveness of Bariatric Surgery on Treating Infertility in Women-A Systematic Review and Meta-Analysis.

Background/Objectives: Obesity is a growing global health concern, which increases the risk of various diseases and has seen a rising prevalence over time. The global prevalence of obesity among adults has doubled over time. Obesity significantly impacts health by increasing the risk of a range of severe medical conditions. Cardiovascular diseases, such as heart attacks and strokes, are more prevalent in individuals with obesity due to factors like high blood pressure and abnormal cholesterol levels. This systematic review and meta-analysis sought to establish the effectiveness of bariatric surgery in treating infertility in women. Methods: This systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A broad electronic search was conducted through PubMed, Web Science, and Medline databases for studies published between April 2017 and October 2023. The search strategy used the following terms: bariatric surgery, metabolic surgery, bariatric surgical procedures, stomach stapling, infertility, and fertility issues. The data were analyzed using the Revman version 5.1.2 software. Results: The results of the study show that despite the heterogeneity found in the studies, irregular menstrual cycles were found to reduce significantly in patients who underwent bariatric surgery (p = 0.01), with an RR of 0.22, at a 95% CI (0.06, 0.74). With regards to infertility, the results indicate that bariatric surgery reduced the level of infertility among the patients significantly (p = 0.00001), with an RR of 0.55, at a 95% CI (0.45, 0.68). Further, the results show bariatric surgery reduced rate of miscarriages among patients (p = 0.01), with an RR of 0.51, at a 95% CI (0.30, 0.86). Moreover, bariatric surgery reduced the level of congenital malfunction, but the effect was not statistically significant (p = 0.16), with an RR of 0.39, at a 95% CI (0.10, 1.45). However, the overall effect of bariatric surgery on treating infertility was found to be significantly effective (p = 0.0001), with an RR of 0.54, at a 95% CI (0.43, 0.68). This implies that bariatric surgery helps in weight loss, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. Conclusions: This study found that bariatric surgery helps infertile women of a reproductive age to lose weight, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. On the other hand, the study noted that after bariatric surgery, spontaneous conception can occur because of a decreased rate of miscarriage, increased fertility, reduced levels of congenital malfunction, and the restoration of regular menstrual cycles. Therefore, this study highlights the need to offer adequate preconception care and counselling to women who are about to be pregnant, both before and after bariatric surgery. Further, based on the fact that this study focused on general bariatric surgery, future research should focus on specific types of bariatric surgery to establish the most effective type of bariatric surgery in treating infertility in women.

Permanently infertile couples and family building-a cross-sectional survey in Denmark.

Which decision-making factors influence family building among permanently infertile couples? Ethical, legal, and financial considerations outweigh genetic relatedness in decision-making, favouring domestic gestational surrogacy, if this were possible, over international options. Permanent infertility affects 4-5% of people in the fertile age. Their family-building options include adoption, surrogacy, uterus transplantation, foster care, and intentional multiple parenthood. However, in most countries, including Denmark, legal barriers constrain these methods due to surrogacy restrictions, suspended international adoptions, and the experimental status of uterus transplantation. Despite existing research on surrogacy, adoption, and specific causes of permanent infertility, a significant gap remains in our understanding of how couples with permanent infertility make family-building decisions within these limited frameworks. This cross-sectional study with 150 permanently infertile Danish participants was conducted from June to November 2023 using an online questionnaire. Multiple strategies, such as online forums, fertility clinics, hospital departments, and snowballing, were used to recruit a diverse sample. The study included couples aged 26-50 years facing permanent infertility due to the following primary causes: women without a uterus (15%), women with a non-functional uterus (47%) or women for whom pregnancy would be life-threatening (9%), male couples (16%), transgender partner couples (2%), and other causes (11%). The survey collected data on demographics, reproductive history, family-building choices, and communication strategies. Closed questions were analysed using descriptive statistics. Among 150 respondents, 41% had used transnational surrogacy, 27% adoption, 14% chose to remain childless, and 19% were undecided. Critical factors on family-building decisions were ethical, legal, and financial concerns which ranked higher than genetic relatedness. Despite the complexity of family building, most participants were open about their child's origin and received social support. If all family-building methods were legal and available in Denmark, domestic gestational surrogacy would be the preferred method, with uterus transplantation and remaining childless being least popular. The sample size is relatively small, despite the use of a variety of recruitment strategies. Nevertheless, this has ensured a diverse cohort representing the different reasons for infertility and family-building choices. It is important to note that the strategies may have favoured individuals achieving parenthood. The finding of our study reveals a notable gap between available family-building options in Denmark and the preferences of couples facing permanent infertility. These insights could be instrumental for organizations reviewing and developing family-building frameworks. Furthermore, for healthcare professionals guiding couples experiencing infertility issues in their attempts to build a family, an understanding of these preferences is essential to facilitate informed decisions about their future family plans. The project was financed by the Independent Research Fund Denmark. The authors have no conflict of interest to declare. N/A.

Correlation of sibling couple infertility history with semen parameters of infertile men, a cohort study.

Infertility is a growing issue globally, particularly in industrialized cultures, affecting 13%-18% of couples of reproductive ages. In recent years, numerous studies have aimed to identify prognostic factors for infertility and abnormal semen analysis. To date, no study has examined the relationship between the number of infertile siblings and abnormal sperm parameters. This study aims to investigate whether the number of infertile siblings can be considered a prognostic factor for abnormal sperm parameters. Semen samples were collected from the male partners of couples experiencing infertility issues. Study participants completed a questionnaire detailing demographic information including age and family history of infertility. Each participant provided two semen samples, with a minimum 15-day interval between collections. Sperm concentration, motility, and morphology were assessed for each sample. Clinical investigators conducted physical examinations, using an orchidometer to measure testicular size. The number of infertile brothers and testis volume were prognostic factors for abnormal sperm count (OR = 1.374, p-value = 0.03; OR = 0.786, p-value < 0.001; respectively) and abnormal motility (OR = 1.514, p-value = 0.018; OR = 26.74, p-value < 0.001, respectively). There was no significant association between the percentage of abnormal morphology of sperm cells and the mentioned prognostic factors. The optimal cut-off point of the number of infertile brothers for both abnormal sperm count and abnormal sperm motility was one. It is recommended that males with at least one infertile brother, undergo sperm analysis to identify individuals at risk of infertility.

Physician infertility: a structured literature review.

Physician infertility has become a growing concern because of the increasingly high rates of infertility physicians experience associated with their strenuous work schedules, environmental exposures, and delayed family planning due to their necessitated years of training. Fortunately, there has been an increase in awareness, advocacy, and urgency for institutional support alongside this suboptimal association. This awareness is reflected in the vast existing literature regarding physician infertility; in this scoping review, we aggregated and assessed the current data as well as identified gaps in the available research. Including 56 articles regarding various aspects of the current state of physician infertility, we compiled and synthesized the available data to understand the role of infertility in physician family planning, including specific analyses for surgeons and comparisons of male and female physicians. We discussed the utilization and downsides of artificial reproductive technologies for this population in terms of finances and logistics, contributing to this complex and, until recently, neglected issue. Lastly, we reported on a multitude of suggestions aimed at medical training programs to help combat the complex issue of physician infertility.

The Synergic Effect of Tubal Endometriosis and Women's Aging on Fallopian Tube Function: Insights from a 3D Mechanical Model.

The fallopian tubes are essential for human fertility, facilitating the movement of sperm and oocytes to the fertilization site and transporting fertilized oocytes to the uterus. Infertility can result from changes in the fallopian tubes due to tubal endometriosis and women's aging. In this study, we modeled human fallopian tubes with and without endometriosis for different women's age groups to evaluate the chances of normal sperm cells reaching the fertilization site and oocytes arriving at the uterine cavity. For this purpose, we employed a distinctive combination of simulation tools to develop a dynamic three-dimensional (3D) model of normal human sperm cells and oocytes swimming inside normal and endometriosis-affected human fallopian tubes for different women's group ages. We observed that in tubal endometriosis cases, fewer sperm cells reach the fertilization site and more oocytes become trapped in the tube walls compared to normal tubes. Additionally, aging decreases the number of sperm cells and oocytes reaching the fertilization site in normal and endometriosis-affected tubes. Our model evaluates the mechanisms of sperm and oocyte behaviors due to women's aging and fallopian tube issues caused by endometriosis, presenting new avenues for developing diagnostic and treatment tools for tubal endometriosis and age-related infertility issues.

Impact of daily breakfast intake on the outcomes of assisted reproductive technology procedures

ObjectiveTo assess the relationship between meal consumption frequency and assisted reproductive technology (ART) outcomes among female patients with infertility. Research Methods & ProceduresThis cohort study was conducted from February 2022 to January 2024 at Tokyo Medical University Hospital. Overall, 101 female patients with infertility issues and without a history of stroke, heart disease, cancer, or type 1 or type 2 diabetes were enrolled in this study. The factors extracted from the questionnaire included demographic information, meal consumption frequency before ART and at 20 years of age, smoking status, and alcohol consumption status. Data on other factors, including age, body mass index, anti-Müllerian hormone level, and parity history, were collected from medical records. The assessed clinical outcomes included number of transplanted embryos, clinical pregnancies, ongoing pregnancies, live births, and miscarriages. ResultsAfter adjusting for potential confounding factors, including age, smoking status, alcohol consumption status, body mass index, anti-Müllerian hormone level, and parity history, a multivariate analysis of ART outcomes was performed. Patients were categorized into groups based on the frequency of weekly consumption of breakfast, lunch, and dinner. Patients who consumed breakfast 6–7 times a week were significantly more likely to have higher rates of live birth and lower rates of miscarriage in pregnancies conceived through ART. ConclusionsConsumption of breakfast 6–7 times a week before ART was associated with increased success rates following ART. This highlights the potential importance of regular breakfast consumption for optimizing ART outcomes.

Reproductive Tract Microbiota of Mares.

The female reproductive tract microbiota is a complex community of microorganisms that might be crucial in maintaining a healthy reproductive environment. Imbalances in the bacterial community (dysbiosis) and the reduction of beneficial organisms and pathogen proliferation are associated with disease. Endometritis is a common cause of fertility problems in mares, and it is still challenging to diagnose and treat based on routine culture results of certain microorganisms. Although high-throughput sequencing studies provide helpful information regarding the composition of the reproductive tract microbiota in mares, there are still challenges in defining a "normal" microbiota. The primary objective of this literature review is to summarize the current knowledge regarding the microbiota present in the reproductive tract of mares, including the vagina, cervix, and uterus. The second objective is to describe the relevant factors that can impact the reproductive microbiota of mares, including the estrous cycle stage, the type of species (genera) investigated, season, and geographic location. The rationality of identifying the normal microbiota in the reproductive tract of a mare will likely aid in understanding the impact of the microbiota on the host's reproductive health and contribute to the treatment and prevention of equine sub and infertility issues.

Enhancing Endometrial Health in Assisted Reproductive Technology (ART): Evaluating Autologous Endometrial Cells and Platelets-Rich Plasma (PRP) via Hysteroscopic Injections.

This review article examines the effectiveness of incorporating autologous endometrial cells and platelet-rich plasma (PRP) through hysteroscopic injections within the field of assisted reproductive technology (ART). This study assesses the outcomes of these injections on the susceptibility of the endometrium, the dynamics of the uterus, and the frequencies of pregnancy in individuals with refractory thin endometrium. Based on a complete examination of several trials, it becomes apparent that autologous PRP injections provide encouraging turnouts in augmenting endometrial thickness, raising endometrial receptivity, and, in the end, raising chances of being pregnant and successful delivery. The research highlights the promise of autologous PRP and minimally changed endometrial cellular treatments in enhancing outcomes in ART, especially for people who have had problems with implantation. This article gives a whole evaluation of the medical use of and upgrades regarding the utilization of infusions of PRP and autologous endometrial cells under hysteroscopic control to deal with infertility issues related to endometrial health through the synthesis of contemporary studies.

P-341 From cross-border reproduction to embryos and gametes transit: the peculiar italian case examined from ethical, legal, and comparative standpoint

Abstract Study question Is the transportation of gametes and embryos by land or air from a foreign country the solution for the lack of donors supply in Italy? Summary answer In Italy, post-2014 Court ruling made heterologous fertilization legal. Yet, gamete acquisition is tough, pushing clinics to foreign banks, facing transport risks. What is known already The international flow of human gametes, expanding due to the growth in reproductive medicine, is regulated by European Directives aiming for uniform EU regulations to maximize health protection via standardized quality and safety. However, diverse national regulations, especially regarding gamete donation, create complex scenarios. In Italy, for instance, regulatory constraints and insufficient legislative support force ART centers to import gametes, mainly from Spain, leading to ongoing cross-border transport of biological material, a process fraught with challenges. Study design, size, duration This study reviews European and Italian regulations on human cell and tissue circulation, focusing particularly on Italy. Directive 2004/23/EC, initiated by the European Parliament and Council, aims to regulate the use of human reproductive biological material, promoting donorship and uniform quality and safety standards across EU member states. Later Directives, including (EU) 2015/566, specifically address gamete transfer within the EU, differentiating between intra-EU distribution and import from non-EU countries. Participants/materials, setting, methods We have meticulously analyzed the legislation applied by the European and non-European states included in the study, examined the role of the European legislator, and conducted a comparative analysis of the effects produced on society. Official data published on this topic by the Italian Ministry of Health have also been collected and analyzed. Main results and the role of chance Aligning with both national and European legal frameworks, as well as adhering to scientific guidelines, is crucial for the secure transport of gametes and embryos. The importance of effective risk management and minimizing liability cannot be overstated, requiring clear communication about consent, transport methods, data sharing, and managing unforeseen events. Despite efforts, European legislation struggles to harmonize effectively, ensuring uniform rights across the continent. In Italy, the demand for donated sperm and oocytes has surged following the invalidation of certain legal restrictions on the use of donated gametes. However, the availability of donated human gametes within Italy falls short of meeting this demand. According to the Italian Ministry of Health, in 2020, there were over 3,100 requests for donated oocytes, but only 60 instances of fresh oocyte donations were recorded in Italy, necessitating imports primarily from Spain. A key factor in the low donation rates is Italy’s ban on compensating donors for their inconvenience and lost work time. Similarly, semen donations in Italy are inadequate, with 75% of male gametes imported from abroad. The lack of financial incentives, coupled with the significant influence of the Catholic Church and limited public awareness about infertility issues, contributes to Italy’s shortage of donors. Limitations, reasons for caution Not applicable. Wider implications of the findings The absence of a decision by the Italian legislator regarding the issue of donors leads to various problems: we refer to the costs that affect the centers, inevitably impacting patients who opt for treatment in Italy; or, conversely, in the travel costs for those who decide to seek treatment abroad. Trial registration number not applicable

P-575 Application of biomarkers in obese infertile women: a genetic tool for a personalized treatment

Abstract Study question Investigate CART and Leptin gene expression, FSH Receptor Asn680Ser polymorphism, and reproductive hormones in patients suffering from obesity under 40, facing infertility, undergoing bariatric surgery. Summary answer The present study proposes that variations in CART, leptin expressions, and the Polymorphism Asn680Ser on the FSH Receptor, may influence the response to IVF treatment. What is known already Obesity, presents a multifaceted challenge with profound implications for fertility, particularly concerning hormonal disruptions in reproductive hormones. Research has shown that Asn680Ser polymorphism of FSH Receptor has a pivotal role in infertility. Notably identified as a singular factor sufficient for infertility, this polymorphism influences the response of the FSH receptor to follicle-stimulating hormone (FSH). Leptin activates the expression of CART neuropeptide, indicating a significant interplay between these two regulatory factors. In ovarian granulosa cells (GCs) of obese patients, elevated CART levels have been observed, with leptin stimulation increasing CART expression and subsequently inhibiting GC aromatase expression and steroidogenesis. Study design, size, duration A total of 29 women were included in the study. An hormonal profile along with a detection of CART and Leptin gene expression was evaluated before and after bariatric surgery. Additionally, the presence or absence of Asn680Ser of FSHR gene was studied. Participants/materials, setting, methods Participants had suffer from obesity and experiencing infertility, with a body mass index (BMI) equal to or greater than 40 kg/m². Only women below 40 were included. Blood samples were collected from all women before surgery and 6 months later. Total RNA was extracted from blood samples. To assess the gene expression of Leptin and CART, we utilized Real-time Polymerase Chain Reaction (RT-PCR). The FSHR polymorphism was detected by using the RFLP method. Main results and the role of chance Following bariatric surgery, a mean reduction in BMI (16.03 kg/m²) was observed in all women, reaching high statistical significance (p &amp;lt; 0.001). The intervention also yielded significant differences (p &amp;lt; 0.001) in hormone levels and gene expressions post-surgery, with FSH, LH, E2, and AMH displaying noteworthy variations. Further investigations explored associations between CART and leptin gene expression before and after the intervention, coupled with the detection of the Polymorphism Asn680Ser on the FSH Receptor. Elevated CART expression before treatment correlated with lower expression after treatment (rs = 0.51, p = 0.005), and a similar significant correlation was noted for leptin (rs = 0.75, p &amp;lt; 0.001). Genetic analysis revealed that 27.6% of patients were homozygous for the polymorphism, 44.8% were heterozygous, and it was absent in 27.6%. An ongoing statistical analysis is realized to establish a potential relationship between the presence/absence of the polymorphism and CART and Leptin expression. Limitations, reasons for caution The study’s limitations encompass a small patient cohort, exclusively pre- and post-bariatric surgery assessments. Expanding the sample to include diverse groups—infertile women with lower BMI and high BMI women without fertility issues—would enhance validity. Furthermore, examining gene expression in all participants one year post-surgery could provide valuable insights. Wider implications of the findings Our results underscores the positive impact of bariatric surgery on BMI decrease and possible link between surgical intervention, genetic markers, and hormonal alterations and consequently with infertility issues. These significant correlations may be applied for personalized therapeutic approaches, offering a valuable genetic tool for improved fertility outcomes in obese individuals. Trial registration number not applicable

O-058 Newly identified female mutations causing oocyte maturation defect and embryo developmental arrest

Abstract Female infertility is a complex issue affecting a significant number of women. In the United States, among married women aged 15–49 years with no prior births, approximately one in five (19%) were unable to get pregnant after one year of trying. In addition, approximately one in four (26%) women in this group had difficulty getting pregnant or carrying a pregnancy to term. For women under 35 years of age, infertility is defined as a lack of success within one year, while for women aged 35 and older, it is within six months. Various factors, such as genetic, endocrine, physiological, anatomical, and immunological irregularities within the reproductive system, can affect a woman's chances of achieving pregnancy and delivering a healthy child. Among these factors, oocyte maturation is an important prerequisite for successful fertilization and subsequent embryonic development. In Medically Assisted Reproduction (MAR), the meiotic maturation of oocytes is induced by human chorionic gonadotropin (hCG) injection, which mimics the natural endogenous luteinizing hormone (LH) surge during the menstrual cycle. Although it is common for a few oocytes to remain immature despite ovarian stimulation and hCG administration, generally, immature oocytes have the competency to spontaneously mature in vitro. However, oocyte maturation is a sophisticated process involving multiple genes or protein molecules. Therefore, pathogenic variations in the genomic sequence or functional defects in any molecule that affects meiosis may lead to impaired oocyte maturation. While complete failure of all oocytes to mature in vivo is extremely rare, understanding the molecular aetiology of oocyte maturation is crucial for addressing infertility issues related to this process and improving fertility outcomes. The transition from the cleavage to the blastocyst stage often represents a significant bottleneck, with nearly 10% of fertilized eggs arrested at the cleavage stages. Developmental arrest of the preimplantation embryo is characterized by the cessation of cellular division for at least 24 h. Various factors originating from both embryonic and parental sources contribute to arrest of early stage embryo development. The genetic roots of developmental arrest were examined by considering both the parental causes of infertility and factors within the embryo. Examination revealed shared elements, regardless of the source of origin. Chromosomal abnormalities, abnormal preimplantation development, and monogenic variations have been reported to cause embryonic developmental arrests. Recently, deficiencies in oocyte maturation and embryo development have been categorized as part of the oocyte/zygote/embryo arrest (OZEMA) phenotype in the Online Mendelian Inheritance in Man (OMIM) database. A latest extensive review of monogenic causes associated with female infertility identified 23 genes with a total of 27 gene disease relationships (GDRs) for the OZEMA phenotype. Seventeen GDRs were classified as having at least moderate evidence of involvement in OZEMA, in addition to ten GDRs with less substantial evidence. Several additional genes were subsequently identified. This presentation will provide an overview of gene defects linked to the OZEMA phenotype, discuss the current status and future prospects of pre-MAR screening of females with OZEMA, and assess a novel workflow for modern genetic diagnosis to maximize the benefit of the patient.

P-456 Sexual attitudes in men undergoing Infertility treatment:Turkish sample

Abstract Study question 1. What are the sexual attitudes in men undergoing Infertility treatment ? Summary answer When the infertility reason arises from their spouse, men tend to display a more self-centred sexual attitude. What is known already Men experiencing infertility often hesitate to seeking information or ask questions about sexuality due to prevailing societal norms.Health professionals predominantly focus on addressing women’s issues, leaving the male partner feeling like an outsider who observes the treatment process from a distance. Study design, size, duration This research was conducted in cross-sectional type.,September and December 2017. 141 participant. Participants/materials, setting, methods 141 men who applied to an infertility clinic in Istanbul on Tuesdays and Thursdays between September 2017 and December 2017. The participants’ inclusion criteria were as follows: being men between the ages of 18-49, literate, accepting to participate, and having no diagnosed psychiatric illness.. All men meeting the sampling criteria were invited to participate, and there were no refusals. This setting accepts couples who have been married for at least one year and infertility problems. Main results and the role of chance The mean score of Hendrick Sexual Attitude Scale (HSAS) was 69.78 ± 9.46. Among its subscales, Birth Control had the highest mean score (11.95 ± 2.81), while Instrumentality had the lowest mean score (10.43 ± 4.34). Men whose spouse was over 30, whose marriage age was over 27, and the cause of infertility was unexplained had higher HSAS mean scores. Additionally, men with male-factor infertility scored higher in HSAS than female-factor infertility. Healthcare professionals involved in infertility treatment must prioritise addressing the sexuality of both partners. Male partners may struggle in this aspect, leading to potential misunderstandings or incomplete understanding of sexual information. By addressing and dispelling erroneous cognitive schemas, false beliefs, and self-centred attitudes, healthcare professionals can play a significant role in supporting both partners in their sexual well-being throughout the infertility treatment process. Providing sexual counselling for couples, both jointly and individually, can have a positive impact. However, it is essential to recognise that male partners may be reluctant to engage in such counselling, resulting in suppressed problems and thoughts. Healthcare providers must actively involve male partners and encourage them to share their feelings and concerns professionally and openly. Limitations, reasons for caution The participants included from a single outpatient clinic and little sample size which may limit the generalizability of the findings. Due to the topic’s taboo in Turkish society, some men might not feel openly expressing their thoughts and feelings while answering the questions, potentially affecting the accuracy of the responses. Wider implications of the findings The findings of this research highlight the significance of further investigations into men facing infertility issues from various cultural backgrounds. Qualitative and quantitative research can offer valuable insights into the complexities of sexual attitudes in diverse cultural settings. Collobaration between infertility clinics and liaison psychiatry may be advantageous. Trial registration number not applicable

P-191 Pronuclear transfer overcomes embryonic developmental arrest in Padi6-deficient mice

Abstract Study question Can pronuclear transfer (PNT) overcome embryonic developmental arrest (EDA) observed in the created Padi6-/- mouse model? Summary answer Applying PNT significantly improved the blastocyst rate of Padi6-/- zygotes, indicating its potential in overcoming female-related infertility. What is known already Various components of the subcortical maternal complex (SCMC), including peptidyl arginine deiminase 6 (PADI6), play a crucial role in early embryonic development and female fertility. Recent studies have revealed that mutations in PADI6 can result in EDA and thus female infertility, which is hard to overcome by current available treatment methods. The PNT technique, designed to replace compromised cytoplasm with a healthy counterpart, has been proposed to overcome specific female-related infertility indications. The Padi6-/- mouse displaying EDA, offers a valuable model to investigate the efficacy of PNT to overcome female-related infertility. Study design, size, duration From April 2022 to December 2023, an experimental study was conducted with CRISPR/Cas9 created Padi6 knockout mice. For fertility evaluation, Padi6-/- and Padi6+/- females were paired with wildtype males. Next, 30 wildtype and 25 Padi6-/- oocytes were collected for parthenogenetic activation. A total of 81, 54 and 145 zygotes were collected from wildtype, Padi6+/- and Padi6-/- females, respectively, for evaluating embryonic development and the effectiveness of PNT in overcoming EDA. Participants/materials, setting, methods The C57BL/6J Padi6-/- mouse model was established by introducing Padi6 c.1577_1578insT with CRISPR/Cas9. Female mice aged 6-12 weeks underwent ovarian hyperstimulation and mated with wildtype males. Oocytes were parthenogenetically activated with SrCl2 in presence of Cytochalasin D, and checked for 2-cell and blastocyst rates. PNT treatment was applied by transferring the 2PN from Padi6-/- to wildtype enucleated zygotes using electrofusion, and the efficiency was evaluated in terms of embryonic developmental potential. Main results and the role of chance After mating Padi6-/- female mice with wild-type males, no offspring could be obtained. In contrast, Padi6+/- females exhibited normal fertility, yielding an average of 7.3 offspring per litter. In addition, Padi6-/- males are also fertile. Twenty-eight wildtype oocytes (n = 30) survived parthenogenetic activation, with 85.71% (24/28) reaching the 2-cell stage, and 75% (18/24) subsequently forming blastocysts. In contrast, all Padi6-/- oocytes (n = 25) survived after activation, but only 20% (5/25) reached the 2-cell stage (P &amp;lt; 0.0001), with none progressing to blastocyst (P = 0.0039). Regarding zygote development, 82.14% (46/56) of wildtype zygotes and 98.14% (53/54) of Padi6+/-embryos reached the 2-cell stage, showing blastocyst rates of 95.65% (44/46) and 100% (53/53) respectively. For zygotes obtained from Padi6-/- females, 72.50% (87/120) of them progressed to the 2-cell stage (P = 0.1908, vs wildtype), but only 4.60% (4/87) reached blastocysts (P&amp;lt; 0.0001, vs wildtype), exhibiting the EDA phenotype. Following PNT to wildtype cytoplasm (n = 25), 23 reconstructed PNT zygotes were obtained. Of these, 91.30% (21/23) reached the 2-cell stage (P = 0.4924, vs wildtype), and 85,71% (18/21) developed to the blastocyst stage (P = 0.3151, vs wildtype), which is equivalent to the wildtype zygotes. Limitations, reasons for caution This study is limited by the small sample size of the PNT, which will still be extended. Next to the blastocyst rate, additional assessment methods such as multi-omics analyses will be employed to assess the efficiency and safety of PNT treatment. Wider implications of the findings This study provides further insight into the potential of the nuclear transfer technology for female-related infertility issues due to cytoplasmic incompetence. For couples experiencing recurrent EDA after ICSI due to inferior oocyte quality, PNT still offers them the possibility of having genetically related children. Trial registration number Not applicable

Analysis of determinants of infertility among women at &lt;i&gt;in vitro&lt;/i&gt; fertilization clinic in Surabaya

In social life and global health, infertility is common. History of abdominal surgery, body mass index (BMI), endometriosis, menstrual history, and polycystic ovarian syndrome (PCOS) have not been fully explained as female infertility factors. This study examined infertility causes at ASHA in vitro fertilization Primasatya Husada Citra (PHC) Hospital Surabaya. This quantitative study was cross-sectional. In May-July 2023, 82 childbearing-age women with infertility issues visited the hospital and completed questionnaires. Description and analysis were performed using the Wilcoxon rank test to evaluate menstrual history, BMI, PCOS, endometriosis, and abdominal surgery history in relation to infertility. Infertility was statistically associated with abdominal surgery history (P=0.008), BMI (P=0.000), endometriosis diagnosis (P=0.000), and PCOS (P=0.000). Women with abdominal surgery, endometriosis, and PCOS had significant infertility. Women’s infertility can be caused by ovulation disorders, tubal and pelvic disorders, or uterine disorders, but one-third of cases are unexplained. Infertility treatment may benefit from addressing abdominal surgery history, BMI, endometriosis, and PCOS. Early intervention and targeted care based on these determinants may improve fertility outcomes and reduce unexplained infertility.

ROLE OF INTEGRINS IN HUMAN SPERM CELLS ON THE REPRODUCTION PROCESS

Ovum and spermatozoa cells, namely male and female reproductive cells that unite at the time of fertilization, are synchronized molecular events that occur sequentially. Apart from being present in the egg cell, adhesion molecules called integrins are also involved in this molecular process. However, recently, these integrins have also been found in spermatozoa cells, especially in the head and tail areas. Because this problem is intended as an introduction to the laboratory which is part of the thesis research, the method used in this research is a literature review whose publication age is not more than 10 years. Research findings indicate that integrins play a crucial role in egg-sperm recognition, their interaction, and fusion, potentially addressing infertility issues in couples of reproductive age.

Male Genetic Evaluation in Infertility, Recurrent Abortion and Recurrent in Vitro Fertilization Failure; A Clinical Approach.

This review presents a clinical approach to genetic issues in male infertility. Unlike other related reviews that discuss different types of genetic diseases (such as Klinefelter and Down syndrome), this review focuses on the clinical features that result from these genetic problems (such as azoospermia and oligospermia). A narrative review of the clinical literature in PubMed was conducted using keywords related to male infertility, recurrent pregnancy loss, recurrent in vitro fertilization failure, and genetics. The search included articles with English reviews published online after 2020. Headlines were defined based on the available literature, and after a critical review of each manuscript, clinical facts were classified under the corresponding headlines, and a primary draft was written. 29 relevant articles were selected from the search. According to the literature, there are clinical genetic approaches for azoospermia, severe oligospermia, severe teratospermia, severe asthenospermia, recurrent miscarriage, and recurrent in vitro fertilization failure. Although many mutations that can affect male fertility and spermogram have been identified, only a few have clinical predictive value.

The potential of radio programs in addressing infertility and other maternal health issues amongst married couples in Isiala-Ngwa North LGA of Abia State, Nigeria

The potential of radio programs in addressing infertility and other maternal health issues amongst married couples in Isiala-Ngwa North LGA of Abia State, Nigeria