Intracytoplasmic Sperm Injection Cycles Research Articles

Comparison of live birth rate and fetal outcomes between fresh embryo and frozen-thawed embryo transfers: a prospective study

BackgroundThe study aimed to compare the pregnancy, prenatal, and postnatal outcomes between fresh and frozen embryo transfer (ET) in intracytoplasmic sperm injection (ICSI) cycles at Al-Zahra Referral Women’s Hospital in northwest Iran.MethodsA prospective study was conducted among all infertile women (N = 469) who underwent embryo transfer between 2018 and 23 at Al-Zahra referral infertility center. Patients in cycles with fresh embryo transfer and patients for whom frozen embryos were transferred were compared in terms of live birth rate and fetal outcomes. Multiple logistic regression analysis was used to estimate adjusted odds ratios (AORs) with 95% confidence intervals (CIs).ResultsThe majority of the participants were primary infertility 83.3%. The rate of chemical and clinical pregnancy was (21.8% vs. 17.2%) and (19% vs. 13.4%) in the fresh embryo and the frozen embryo transfers, respectively. Likewise, the rate of live births was (14.1% vs. 9.1%), respectively. The number of retrieved oocytes was significantly higher in frozen ET compared to fresh ET (P = 0.001). In the final analysis, after adjusting for potential confounders, no significant associations were found for clinical pregnancy (AOR = 1.51; 95% CI: 0.90–2.5; P = 0.125) and chemical pregnancy (AOR = 1.31; 95% CI: 0.81–2.3; P = 0.238) rates between fresh and frozen ETs. Similarly, there were no significant differences in live birth rate (AOR = 1.6; 95% CI: 0.54–12.4), preterm birth (AOR = 0.62; 95% CI: 0.33–5.5), and primary infertility (AOR = 0.73; 95% CI: 0.34–1.6) between fresh and frozen ETs. The incidence of multiple pregnancies and spontaneous abortion was (5% vs. 13.8%) and (22.2% vs. 30.2%) in the fresh embryo and frozen embryo groups, respectively.ConclusionNo significant differences in perinatal and postnatal outcomes were found between fresh and frozen embryo transfers.

Evaluating the Effectiveness of Assisted Oocyte Activation in ICSI: Pairwise Meta-Analyses and Systematic Evidence Evaluation.

Artificial oocyte activation (AOA) is used to improve fertilisation rates in intracytoplasmic sperm injection (ICSI) cycles. To assess the effectiveness of AOA on fertilisation, embryo development, and clinical outcomes, including live birth. We searched PubMed, Cochrane, and Scopus from January 1990 to March 2024 using terms related to 'artificial oocyte activation' and 'ICSI.' Study designs included randomised trials (RCTs), quasi-experimental, cohort, and case-control studies that evaluated AOA's effects on ICSI outcomes, provided quantitative data and were published in English. Reviewers independently performed data extraction using a standardised form. Study quality was appraised using Joanna Briggs Institute (JBI) Checklists. Meta-analyses employed a random-effects model, and evidence was classified using a comprehensive numerical framework. We included 45 studies covering 56 787 mature oocytes, 7463 women for clinical pregnancies, and 7063 women for live births. AOA showed potential in increasing fertilisation rates in patients with a history of low or absent fertilisation but did not enhance embryo development or clinical outcomes. This effect diminished when excluding low-quality studies or focusing solely on RCTs. In other patient groups, AOA showed limited or nonsignificant benefits. Applying comprehensive evidence assessment, AOA showed potential in improving fertilisation rates in patients with fertilisation problems but no benefits for embryo development or live birth rates. This underscores the critical importance of rigorous evidence credibility in informing clinical practice in assisted conception.

Impact of blastocyst biopsy for preimplantation genetic testing on maternal and neonatal outcomes following single frozen embryo transfer cycles

BackgroundUp to now, a number of studies have explored the influence of blastocyst biopsy on maternal and neonatal outcomes, and the results have been somewhat inconsistent. Therefore, the aim of this study was to investigate whether blastocyst biopsy is associated with an elevated risk of hypertensive disorders of pregnancy (HDP) and other adverse perinatal outcomes during frozen embryo transfer (FET) cycles in singleton live births resulting from intracytoplasmic sperm injection (ICSI) in women aged ≤ 35 years.MethodsA total of 1,008 women were involved in this study from January 2020 to June 2022, who underwent ICSI cycles and received single FET, leading to the birth of a live singleton newborn. The study population were categorized into two groups: the preimplantation genetic testing (PGT) group, comprising 269 women whose blastocysts underwent trophectoderm biopsy, and the control group, consisting of 739 women whose blastocysts did not undergo biopsy. The primary outcome assessed in this study was HDP. Additionally, various relevant perinatal outcomes related to both maternal and neonatal health were also evaluated.ResultsIn comparison to the control group, notable disparities were observed between the groups in relation to infertility duration, EMT, infertility type, infertility cause and endometrial preparation protocol (P < 0.05, for all). The percentage of female gender significantly increased in the PGT group in comparison with the control group (P < 0.05). However, the risk of HDP, other maternal and neonatal outcomes exhibited comparable results between the two groups (P > 0.05, for all). Moreover, univariate regression analyses further revealed that PGT had no influence on maternal and neonatal outcomes, except for gender (aOR 1.44; 95% CI, 1.03–2.01; P = 0.031).ConclusionsIn the short-term perspective, it could be inferred that blastocyst biopsy may not increase the risks associated with HDP or other unfavorable maternal and neonatal outcomes. However, despite the limited sample size, our findings may not be applicable to those aged 35 or over; therefore, larger cohort studies are imperative for the validation of our results.

Superior Live Birth Rates, Reducing Sperm DNA Fragmentation (SDF), and Lowering Miscarriage Rates by Using Testicular Sperm Versus Ejaculates in Intracytoplasmic Sperm Injection (ICSI) Cycles from Couples with High SDF: A Systematic Review and Meta-Analysis

This study aimed to compare sperm DNA fragmentation (SDF) levels between ejaculate and testicular sperm and evaluate clinical outcomes of intracytoplasmic sperm injection (ICSI) cycles using testicular sperm (T-ICSI) versus ejaculate sperm (E-ICSI) in males with high ejaculate SDF, prior ICSI failures, or severe male infertility. A systematic review of major databases and a subsequent meta-analysis were performed to compare clinical outcomes in men with high SDF, oligozoospermia, or prior ICSI failures undergoing T-ICSI or E-ICSI. Thirteen studies met the inclusion criteria. Outcomes analyzed included SDF levels, fertilization rate (FR), clinical pregnancy rate (CPR), live birth rate (LBR) per embryo transfer (ET), and miscarriage rate (MR) per pregnancy. The mean difference (MD) and odds ratio (OR) were calculated for each outcome. Paired assessments of SDF showed significantly lower levels in testicular sperm compared to ejaculated sperm (MD = −25.42 [−31.47, −17.30], p &lt; 0.00001). While no significant difference in FR was observed in T-ICSI cycles overall (OR = 0.94 [0.74, 1.20]), a subgroup analysis revealed significantly higher FR with E-ICSI in men with oligozoospermia and no prior ICSI failures (OR = 0.61 [0.52, 0.71], p &lt; 0.00001). CPR was significantly higher in T-ICSI cycles (OR = 2.13 [1.35, 3.36], p &lt; 0.001; n = 540 ET), along with a significantly lower MR (OR = 0.31 [0.14, 0.70], p = 0.004; n = 35) and increased LBR (OR = 2.40 [1.32, 4.36], p = 0.004; n = 446 ET). In conclusion, using testicular sperm in cases of elevated ejaculate SDF, oligozoospermia, or prior failed ICSI cycles enhances the selection of sperm with lower DNA damage, leading to improved pregnancy rates, reduced miscarriage rates, and higher live birth rates. However, the studies included were rated as having a moderate to serious risk of bias. Further well-designed randomized controlled trials are necessary to confirm these findings with stronger evidence.

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

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

Effects of Intrauterine Human Chorionic Gonadotropin on Endometrial Receptivity in Intracytoplasmic Sperm Injection Cycle

Effects of Intrauterine Human Chorionic Gonadotropin on Endometrial Receptivity in Intracytoplasmic Sperm Injection Cycle

The Safety and Efficacy of inactivated COVID-19 vaccination in couples undergoing assisted reproductive technology: A prospective cohort study.

The safety of the COVID-19 inactivated vaccine on pregnancy outcomes in couples undergoing assisted reproductive technology remains uncertain due to limited and speculative evidence. Existing studies primarily focus on the vaccination status of females, with scant information available regarding the vaccination status of male partners. Moreover, there is minimal research tracking live birth outcomes. The objective of this study was to evaluate the impact of COVID-19 inactivated vaccine administration on the outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles in infertile couples in China. This prospective cohort study involved couples undergoing IVF treatment at Sichuan Jinxin Xinan Women & Children's Hospital from August 2021 to September 2022. Based on whether they received vaccination before ovarian stimulation, the couples were divided into the vaccination group and the non-vaccination group. We compared the laboratory parameters and pregnancy outcomes between the two groups. After performing propensity score matching (PSM), we observed similar live birth rates (41.23% vs. 44.08%, P=0.555), clinical pregnancy rates (52.61% vs. 54.98%, P=0.625), biochemical pregnancy (62.56% vs. 63.98%, P=0.762), and ongoing pregnancy rates (49.76% vs. 51.18%, P=0.770) between the vaccinated and unvaccinated women. Also, no significant disparities were found in terms of embryo development and laboratory parameters between the groups. Moreover, male vaccination had no impact on patients' pregnancy outcomes in assisted reproductive technology (ART) treatments (all P>0.05). Additionally, there were no observable effects of vaccination on embryo development and pregnancy outcomes among couples undergoing ART (all P>0.05). The findings suggest that COVID-19 vaccination did not have a significant effect on patients undergoing IVF/ICSI with fresh embryo transfer. Therefore, it is recommended that couples should receive COVID-19 vaccination as scheduled to help mitigate the COVID-19 pandemic.

Sperm retrieval, fertilization rates, and clinical outcomes of infertile men with Y chromosome microdeletion: A retrospective cohort study.

In this study, we aimed to explore whether a Y chromosome microdeletion (YCM) confers adverse effects on surgical sperm retrieval potential and intracytoplasmic sperm injection (ICSI) outcomes in men with azoospermia and severe oligospermia. This was a retrospective cohort study, which included infertile men with azoospermia or severe oligospermia who were evaluated for karyotype analysis and YCM testing at a university-affiliated hospital between 2010 and 2022. Outcomes of microdissection testicular sperm extraction (mTESE) for surgical sperm retrieval were compared between men diagnosed with YCM and the control group in which no YCM were found. Additionally, patients from each group who underwent in-vitro fertilization (IVF) - ICSI cycle using ejaculated sperm or surgically retrieved mature spermatozoa were compared regarding their IVF-ICSI cycle outcomes - fertilization rates, cleavage, and blastocyst formation and clinical pregnancy rates. A total of 116 azoospermic and oligospermic men who underwent Y chromosome microdeletion testing were included in the study: 19 men with YCM and 97 controls without YCM. Overall, nine mTESE procedures were performed for patients with YCM and 38 mTESE procedures were done on men from the control group. There were no significant differences between the YCM and control groups in mature sperm retrieval rates (11.1% vs. 26.3% p=0.663), though a trend towards higher rates of findings of elongated and round spermatids as the most mature germ cell was noted in the YCM group (66.7% vs. 28.9%, p=0.054). Out of the 13 men with mature sperm - either ejaculated or surgically retrieved (mTESE) - that had known ICSI cycle outcomes, three men had proven YCMs and 10 controls had no identified YCMs. Basic characteristics were similar between the groups, except for testosterone levels, which were higher in the YCM group (23.0±13.1 vs. 9.4±6.4 nmol/L, p=0.027). Fertilization rates and cleavage rates were similar between the YCM and control groups (42.3% vs. 49.7% and 42.3% vs. 39.3%, p=0.491 and 0.774, respectively). Blastocyst formation rates, and pregnancy rates, while not statistically significant, showed a trend for favorable outcomes in the control group compared to the YCM group (24.1% vs. 7.7%, 72.7% vs. 20.0%, p=0.078 and 0.106, respectively). Y chromosome microdeletion does not affect sperm retrieval rates. Fertilization and cleavage rates are not impaired by microdeletions, while blastocyst formation rates and clinical pregnancy rates per embryo transfer follow a non-significant trend for unfavorable outcomes in the YCM group. Clinical and embryonic development results should be interpreted with caution, as these groups are relatively small.

Stringent Regulations of Oocyte Donation Among Jewish Women in Israel: Characteristics and Outcomes of the National Oocyte Donation Program in One Central IVF Unit.

On September 5, 2010, the Israeli Parliament passed a law that allows Israeli female residents to donate their oocytes to infertile Israeli female residents. This law includes unique restrictions that do not exist in other countries. Our aim was to characterize Israeli oocyte donors and recipients and the outcomes of the oocyte donation program as regulated by national law. This retrospective study included 26 financially compensated volunteer donors (mean age 29 ± 3.52 years) and 69 recipients (mean age 44.6 ± 3.53 years) who underwent 30 intracytoplasmic sperm injection cycles and 166 embryo transfers (ETs) in our unit between March 2016 and November 2020. Stringent legal caveats unique to Israel (e.g., Jewish/Moslem donor only to Jewish/Moslem recipient, only unmarried donor, eggs in one cycle restricted to ≤ 3 recipients, donated sperm only from non-Jewish donors, and more) were meticulously applied. Sociodemographic characterizations of donors and recipients were reviewed, and pregnancy and obstetric outcomes were determined. Variables that were significant in achieving live births among the recipients were examined. Twenty-five donors and all 69 recipients were Jewish, and most were unmarried and childless. The main indication for seeking egg donation was age ≥ 40 years/perimenopause (80%). One-half of the recipients used donor sperm and one-half used partner sperm. The pregnancy, clinical pregnancy, live birth, and miscarriage rates were 28.6%, 19.2%, 18.2%, and 2.8%. The live birth rate was negatively associated with multiple ETs. Maternal complications included hypertensive disorders of pregnancy (18.2%), gestational diabetes mellitus (32.3%), and caesarean sections(78.8%). There were no adverse neonatal outcomes. In conclusion, few young women are interested in donating oocytes in Israel. Pregnancy and live birth rates are lower than published values in other egg donation programs.

The impact of age and number of oocytes retrieved on the cumulative live birth rate in women with poor ovarian response: A 15-year study

BackgroundApproximately 15 % of women undergoing assisted reproductive treatment (ART) fall in the category of poor ovarian reserve defined as the retrieval of three or fewer oocytes following conventional ovarian stimulation with a daily gonadotrophin dose of 150–450 international units, according to the Bologna criteria. Low number of oocytes collected is, therefore, likely to translate to low chance of successful ART treatment. ObjectivesThe objective of the study was to assess if age and number of oocytes retrieved influence the cumulative live birth rate (LBR) in women with poor ovarian response (POR) to controlled ovarian hyperstimulation. Study designWe have used anonymised, prospectively collected data spanning July 2004 until June 2019 on consecutive in vitro fertilisation (IVF) and intra-cytoplasmic sperm injection (ICSI) cycles performed at a tertiary fertility treatment unit. Women who underwent conventional ovarian stimulation with a starting daily gonadotrophin dose of 150–450 IU in their first or second IVF cycle where 1–3 oocytes were retrieved were included in the study, with women where four oocytes were retrieved formed a comparative control group. Only one cycle per patient was included. ResultsA total of 2,516 fresh IVF or ICSI cycles were analyzed. The overall clinical pregnancy and LBR in the cohort of included women were 16.4 % and 12.6 % respectively. The cumulative LBR per patient included was 13.1 %. When adjusting for age, treatment type, FSH at baseline, and daily gonadotrophin dose, a significant increase in cumulative LBR was observed for two (OR 2.63, 95 % CI 1.43–4.81), three (OR 3.74, 95 % CI 2.09–6.68) and four (OR 5.3, 95 %CI- 3.01–9.35) oocytes collected, compared to one oocyte only. A significantly lower chance of successful outcome was noted in women 43–45 years old versus younger age groups, irrespective of number of oocytes collected. ConclusionsIn this large cohort of women with POR, both age and number of oocytes retrieved are independent factors influencing the cumulative LBR after IVF treatment. Irrespective of age, retrieval of one additional oocyte is associated with an increase in the cumulative LBR per oocyte retrieval.

Effect of Paternal Body Mass Index on Cumulative Live Birth Rates: Retrospective Analysis of 3048 Embryo Transfers in Couples Using Autologous Gametes.

Obesity is a multifactorial disease present worldwide and correlated with hormonal alterations that may cause a decrease in reproductive outcomes and seminal quality. However, the specific mechanisms involved are unknown. This led us to examine the relationship between paternal body mass index (BMI) and clinical reproductive outcomes by evaluating the cumulative live birth rates (CLBRs) per number of embryo transfers (ETs), embryos replaced (EmbRs), and oocytes used (OUs) in consecutive treatments until achieving the first newborn. A retrospective study was performed, and Kaplan-Meier survival curves were created to observe CLBRs with regard to the paternal BMI, adjusted by relevant confounders through Cox regression models. The participants were couples undergoing intracytoplasmic sperm injection (ICSI) and ET in Spanish IVIRMA clinics using autologous gametes. The cohort was subdivided based on paternal BMI: normal (18.5-24.99 kg/m2) (N), overweight (25-29.99 kg/m2) (OV), or obese (≥30 kg/m2) (OB) patients. A total of 4750 ICSI cycles were included, encompassing 49,485 mature oocytes, 23,963 blastocysts, and 3048 ETs. When calculating CLBRs based on the number of ETs carried out until live birth was achieved, no statistically significant differences were found (p = 0.72). After adjusting for maternal age and BMI, female infertility diagnosis, the use of preimplantation genetic testing, and the number of ETs, Cox regression showed that there were no statistically significant differences between the BMI groups (HR: 0.94 [95% CI: 0.7-1.2]; p = 0.59). When calculating CLBRs considering EmbRs, there was a similarity between the BMI groups (p = 0.57). However, there were no statistically significant differences in the adjusted Cox regression (HR: 0.93 [95% CI: 0.7-1.2]; p = 0.51). Finally, when calculating CLBRs considering OUs, the results were comparable among BMI subgroups (p = 0.75), and there were no statistically significant differences with adjusted Cox regression (HR: 0.95 [95% CI: 0.8-1.2]; p = 0.66). In conclusion, paternal BMI was not associated with clinical reproductive outcomes when considering the ETs, EmbRs, or OUs needed to reach the first liveborn (LB).

Progesterone peak influences embryonic developmental morphokinetics on trigger day? A retrospective study

ObjectivePremature Progesterone Rise (PPR) is characterized by elevated serum progesterone concentrations either towards the end of the follicular phase or on the trigger day, surpassing a pre-defined threshold value. Aim of the study is to evaluate the impact of PPR exceeding 1.5 ng/ml at the time of hCG-trigger on embryo morphokinetic parameters and to identify predictive biomarkers of in IntraCytoplasmic Sperm Injection (ICSI) cycles outcomes.MethodsIt is a retrospective study including patients underwent ICSI cycles in the period 2020–2023. 58 patients were recruited in the study group showing P levels in the trigger day greater than or equal to 1.5 ng/ml. A matching control group of 58 patients with P levels below 1.5 ng/ml was after selected. The general characteristics of these patients, including age, Body Mass Index (BMI), antral follicle count (AFC), anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) levels, the type of infertility and smoking/non-smoking patients, were recorded on the day of their initial visit. Subsequently, data were collected regarding the number of eggs retrieved, mature eggs, successfully fertilized eggs, and embryos reaching the blastocyst stage. Additionally, the timing of embryonic development and the quality of obtained blastocysts, as assessed by the degree of expansion and the characteristics of the inner cell mass (ICM) and trophectoderm (TE), were evaluated using Time-Lapse technology.ResultsElevated P levels exceeding 1.5 ng/ml on the trigger day were directly associated with a significantly larger number of antral follicles, consequently leading to a higher count of retrieved eggs, mature eggs, successfully fertilized eggs and embryos reaching the blastocyst stage. Furthermore, the analysis of morphokinetic parameters indicated faster division times and a notably greater number of high-grade blastocysts in the study group compared to the control group.ConclusionsP levels ≥ 1.5 ng/ml on the trigger day did not negatively impact embryonic morphokinetic parameters, instead resulting in faster embryo development in the initial stages.

IVF with frozen-thawed sperm after prolonged capacitation yields comparable results to ICSI in horses: A morphokinetics study

Intracytoplasmic sperm injection (ICSI) is the current clinical practice for the in vitro production of equine embryos. The use of conventional fertilization methods such as in vitro fertilization (IVF), has historically been associated with poor success in horses. However, recent improvements have led to better outcomes with IVF, though only when using fresh semen, which limits its use in clinical practice. IVF remains in its infancy in equine reproduction, and several unknowns remain about the technique. One significant gap in knowledge concerns the morphokinetics of IVF embryos and how they differ from their ICSI counterparts. To address this, we performed IVF using frozen-thawed sperm from five different stallions following sperm selection and a prolonged capacitation period of 10 h, on a total of 109 oocytes. We then analyzed the cleavage rate (cleaved/initial oocytes), blastocyst rate (blastocyst/initial zygotes), and blastocyst development (blastocyst/cleaved zygotes) of the IVF cycles, and compared them with those of the clinical ICSI cycles during the same period. We also evaluated time-lapse images of the developed embryos to assess developmental time points such as time to morula compaction and blastocyst expansion, as well as morula and blastocyst sizes. Overall, developmental rates were not different between IVF and ICSI cycles (blastocyst rate 41.1 % IVF and 41.8 % ICSI, p > 0.05). However, development proceeded faster in IVF cycles (blastocyst expansion IVF 155.5 ± 18.5 h; ICSI 167.2 ± 19.6 h; p < 0.05) and IVF embryos were also larger (blastocyst area IVF 22608 ± 2857 μm2; ICSI 20806 ± 1505 μm2; p < 0.05). The faster development and larger size might suggest a more advanced developmental stage. The implications of these findings need to be further evaluated to assess their association with pregnancy potential. The successful developmental rates achieved in IVF cycles demonstrate the potential of this technique for clinical application, although the amount of frozen-thawed semen required is significantly higher in IVF than in ICSI, which is an important consideration for mare and stallion owners. Nonetheless, the use of frozen-thawed semen in equine IVF, coupled with comparable blastocyst rate, presents promising potential for broader clinical adoption of the IVF technique.

Impact of Microfluidic Sperm Sorting on Embryonic Euploidy in Infertile Patients with Sperm DNA Damage: A Retrospective Study.

Sperm DNA fragmentation is an important factor that affects male fertility. This study intends to evaluate the impact of sperm DNA damage [single-strand breaks (SSB) and double-strand breaks (DSB)] on fertilisation and embryonic euploidy after intracytoplasmic sperm injection (ICSI). Of the different sperm selection techniques, the novel microfluidic sperm sorting (MSS) ZyMōt™ ICSI device reduces both SSB and DSB in semen samples. The second objective is to study the impact of this MSS device on fertilisation and embryonic euploidy. This retrospective study included data from 167 ICSI treatments. The alkaline and neutral Comet assays were used to analyse SSB and DSB, respectively. Analysis of fertilisation and embryo euploidy rates was performed in four groups of patients with normal/altered SSB or DSB values. Density gradient centrifugation (DGC) and the ZyMōt™ ICSI MSS device were used for semen preparation. Fertilisation rates in 167 ICSI cycles were higher when using sperm from patients with normal SSB values (70.84%) and patients with abnormal SSB whose samples were processed using the MSS device (69.71%) compared to patients with abnormal SSB values using DGC (58.49%). Preimplantation genetic testing for aneuploidies (PGTA) revealed a higher embryo euploidy rate in patients with normal DSB values (60.00%) and patients with abnormal DSB whose samples were processed using the MSS device (44.59%) compared to patients with abnormal DSB values using DGC (36.84%). When female age was considered, there were fewer euploid embryos in women ≥35 years of age compared to younger women, independently of SSB and DSB. The number of euploid embryos increased when the MSS device was used. High SSB and DSB values in semen samples decreased fertilisation rates and embryonic euploidy, respectively. The ZyMōt™ ICSI device for semen preparation increased both rates, especially in couples that included women <35 years old.

Effect of refreezing extender on stallion sperm quality and embryo production after intracytoplasmic sperm injection

Intracytoplasmic sperm injection (ICSI) is a valuable assisted reproduction technology in clinical practice, especially when semen availability is limited. Since the number of sperm required per ICSI cycle is much less than the number of sperm available in a standard straw of frozen semen, refreezing semen at lower sperm concentrations could yield multiple straws for ICSI use. However, there is little data on the effect of sperm refreezing on ICSI outcomes, especially on the effect of extender used for refreezing. The objective of the present study was to evaluate the effect of refreezing extender on stallion sperm quality and embryo production after ICSI. Semen was frozen in a low egg yolk/glycerol/amide extender (Extender 1), then thawed, re-extended, and refrozen in each of three extenders. When sperm were refrozen in Extender 1, the cleavage rate was lower (P < 0.05) and the blastocyst development rate tended to be lower (P = 0.06) than for the once-frozen sperm. In contrast, when sperm were refrozen in high egg yolk/glycerol (Extender 2) or low egg yolk/milk/glycerol (Extender 3) extenders, cleavage and blastocyst development rates did not differ significantly from those for the once-frozen semen. Notably, sperm refrozen in Extender 1, which yielded the lowest ICSI outcomes, showed the highest sperm motility and viability, demonstrating that traditional measures of sperm quality were inadequate to assess the suitability of refrozen sperm for ICSI. In a follow-up experiment conducted to evaluate the effects of Extenders 1 and 3 when used for once-frozen semen, cleavage and blastocyst rates did not differ between extenders. In conclusion, the extender used to initially freeze stallion sperm may not significantly affect ICSI outcomes; however, the extender used for refreezing can significantly affect embryo production. Refrozen stallion semen can be effectively used for ICSI when low egg yolk/milk/glycerol extender is used for refreezing. Until further research is available, use of extenders without amides is recommended when refreezing stallion semen for ICSI.

Increased miscarriage rate is associated with at least four components of metabolic syndrome in women with polycystic ovary syndrome undergoing in vitro fertilization or intracytoplasmic sperm injection embryo transfer cycle.

This study aimed to investigate the association between the components of metabolic syndrome (MetS) and reproductive outcomes in women with polycystic ovary syndrome (PCOS) undergoing their first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) embryo transfer cycle. This is a retrospective study that included 720 women with PCOS from January 2018 to December 2021. Anthropometric, biochemical, and reproductive data of the study subjects were collected from electronic medical record. Women with PCOS met <3, 3, and >3 criteria of MetS were classified in group 1, 2, and 3, respectively. The miscarriage rate in women with MetS was significantly higher than that in non-MetS group (23.2% vs. 14.2%, p = 0.03). There was a significant increasing trend in miscarriage rate from group 1 to group 3 (p for trend <0.05). The miscarriage rate in group 3 was significantly higher than that in group 1 (29.3% vs. 14.2%, p < 0.05). Logistic regression analyses showed that women with at least four components of MetS (group 3) were independently associated with a high risk of miscarriage, with the odds ratios and 95% confidence intervals for group 2 and 3 versus group 1 were 1.38 (0.67-2.82) and 2.46 (1.06-5.74), respectively (p for trend = 0.04). PCOS women accompanied with at least four diagnostic criteria of MetS is independently associated with increased miscarriage rate when undergoing their first IVF or ICSI cycle.

Clinical validation of the early embryo viability assessment system: Analysis for the blastocyst morphology and pregnancy outcomes

Objective: To determine the relationship between the early embryo viability assessment (EEVA) and blastocyst morphological parameters and pregnancy outcomes. Methods: This retrospective cohort study was conducted on 291 intracytoplasmic sperm injection cycles including 2 522 embryos with indications of prolonging embryo culture to the blastocyst stage in the Genea embryo review incubator, and 511 single vitrified- warmed blastocyst transfer cycles from January 2020 to June 2023. The EEVA system produced an EEVA score from E1 (best) to E5 (worse) for the potential of blastocyst formation. Blastocyst morphology was evaluated. The association between the EEVA score and each type of blastocyst morphology, implantation rate, clinical pregnancy, and ongoing pregnancy were assessed using generalized estimating equations. Results: The inner cell mass A (ICM A), trophectoderm A (TE A), blastocoele expansion degree of 3, 4, 5, 6, 7 rates were higher with lower the EEVA score. The adjusted odd ratio (aOR) (E5 vs E1) was 0.3 for ICM A, 0.174 for TE A and 0.210 for BL3, 4, 5, 6, 7 (all P&lt;0.001), suggesting a significant association between lower EEVA scores and improved embryo quality. The implantation, clinical pregnancy, and ongoing pregnancy rate were also higher with lower the EEVA score. The aOR of E5 vs E1 was 0.245 for implantation, 0.185 for clinical pregnancy and 0.200 for ongoing pregnancy rate (P&lt;0.001). Conclusions: There were associations between blastocyst morphology, pregnancy outcome and EEVA scores. The good blastocyst morphology and pregnancy outcomes are higher with lower the EEVA score.

Assisted oocyte activation significantly improves zygote formation, cleavage, and implantation rates in patients with a history of fertilization failures.

Fertilization check performed at the 18th hour following classic in vitro fertilization procedure (IVF) or intracytoplasmic sperm injection (ICSI) is a critical stage in assisted reproduction. The success of the treatment is significantly reliant on the quantity of zygotes exhibiting two pronuclei. Consequently, low fertilization rates or complete fertilization failure are highly undesirable outcomes for both patients and reproductive specialists. Applying additional calcium ionophore for oocyte activation subsequent to ICSI may offer benefits and potentially enhance treatment outcomes, particularly for patients who have experienced low or absent fertilization rates (FR) in previous treatment cycles. The aim of the study is to evaluate the efficacy of Ca2+ ionophore application for oocyte activation. A retrospective analysis of 924 oocytes obtained from 120 patients who underwent ICSI cycles with a history of low or no fertilization as a result of previous unsuccessful treatment rounds. The next ART cycle followed with additional oocyte Ca2+ ionophore activation applied in 57 of the cases in order to optimize the treatment process (Group 1), and 63 patients were included and their outcomes followed as a control group (Group 2).We conducted a comparative analysis of results in both groups. The study's primary outcomes encompassed fertilization, cleavage embryo quality, blastocyst rate, and established clinical pregnancies. At day 1fertilization check we had 274/386 zygotes (71%FR) in group 1 and 132/410 in group 2 (32.2%FR), (P<0.0001). Twenty-two (34.9%) cycles in group 2 resulted in total fertilization failure (TFF). At the cleavage stage top-quality embryos from group 1 were significantly higher (P = 0.0021) in comparison to group 2. Forty-eight embryo transfers (ET) were performed in group 1 resulting in 41.67% clinical pregnancies versus 33 ET and only 4 pregnancies (12.12%) for group 2 (P = 0.0044). The results confirm the appropriateness of assisted oocyte activation as an additional method in cases of previous fertilization failure cycles.

Comparative motility assessment of sperm retrieved from micro-testicular sperm extraction: A single-centre study comparing fresh and frozen-thawed sperm.

Microsurgical testicular sperm extraction (microTESE) is crucial for treating non-obstructive azoospermia (NOA), offering both 'fresh' and 'frozen' options. This study evaluates the impact of fresh versus frozen microTESE on the progression to intra-cytoplasmic sperm injection (ICSI) cycles, focusing on sperm motility. We conducted a retrospective analysis of microTESE procedures at a major medical centre from 2007 to 2021, excluding cases of obstructive azoospermia and cryptozoospermia. Patients were divided into two groups: fresh microTESE (Group FR) and frozen microTESE (Group FZ). Sperm motility was assessed, and ICSI outcomes were compared between groups. Out of 128 microTESE procedures on 113 NOA patients, 31 were fresh and 97 were frozen. Sperm was found in 67.7% of fresh cases and 45.3% of frozen cases. In fresh cases, 85.7% had motile sperm for ICSI, whereas in frozen cases, 81.8% had motile sperm initially, but only 52.7% retained motility post-thaw. Our findings indicate a significant drop in motile sperm availability for ICSI in frozen microTESE cases compared to fresh ones. This suggests a potential advantage of fresh microTESE for certain couples, despite the logistical challenges, highlighting the need for careful patient selection and counselling.

Factor Influencing Psychological Aspect among Women Undergoing in Vitro Fertilization or Intra Cytoplasmic Sperm Injection Cycles

Background: Physical and psychological stresses that suppress the immune system and damage the endocrine system can have an impact on in vitro fertilization. Any civilization thinks that taking care of one's physical and mental health now will assure the community's health in the future. Infertility is one of the issues that some people face with their mental health. The study aims to identify the psychological aspects that influence the results of women undergoing IVF. The current study used a descriptive (cross-sectional) quantitative approach to achieve the stated objectives. During the period of October 18, 2023 to April 9, 2024 at Al-Najaf City. The study was done on women who underwent vitro fertilization or intracytoplasmic sperm injection cycles at the Fertility Center is located in Al-Sadder Medical City in Al-Najaf. The study sample of (100) women was recruited using a non-probability selection approach (convenience sampling) from the Fertility Center at Al-Sadder Medical. The participants filled out the demographic characteristics questionnaire and the General Health Questionnaire-28 to measure psychological variables influencing IVF results for women. The findings of the present study indicate to the General Health Questionnaire-28 indicated that 38.4% of people had moderate anxiety. There was a significant relationship between psychological traits, age (P=0.001), and type of infertility (P=0.046). The study concluded that psychological stresses like as depression and anxiety are critical to the effectiveness of IVF results. The study recommends that educating women about the effects of physical and psychological aspects that might affect treatment from the outset is a good way for nurses and doctors to have an active role in infertility care, but more research is still needed.