Number Of Mature Oocytes Research Articles

Development of a novel calculator to predict gonadotropin dose and oocyte yield in oocyte cryopreservation cycles.

To develop a predictive model for estimating the total dose of gonadotropins and the number mature oocytes in planned oocyte cryopreservation cycles. In this retrospective study, oocyte cryopreservation cycles recorded in the Society for Assisted Reproductive Technology Clinic Outcome Reporting System Database from 2013 to 2018 were analyzed. Bivariate copula additive models for location, scale, and shape were performed to create a predictive model for estimating total dose of gonadotropins and number of mature oocytes. A total of 15,806 oocyte cryopreservation cycles between 2013 and 2018 were included in the analysis. The average age of participants was 35.4years, the mean duration of stimulation was 11.8days, and the average number of mature oocytes retrieved was 11.8. The treatment dose increased with age, FSH levels, BMI ≥ 35kg/m2, smoking, and history of diminished ovarian reserve, while it decreased with increasing AMH, ovulatory disorder, and BMI < 25kg/m2. The number of mature oocytes retrieved was positively correlated with AMH and negatively correlated with age, FSH levels, Asian race, and diminished ovarian reserve. With a maximum gonadotropin dosage of 450IU per day for 12 ± 3days of stimulation and a tolerance level of six mature oocytes, the predictive model achieved 70% accuracy. An interactive version of the equation was created as an online tool. We developed a predictive model to estimate the total treatment dosage and the number of mature oocytes. This calculator, utilizing objective patient variables, can assist in patient counseling prior to planned oocyte cryopreservation cycles.

Ovarian response in preimplantation genetic testing for myotonic dystrophy type 1.

To evaluate ovarian stimulation response in couples undergoing preimplantation genetic testing (PGT-M) for myotonic dystrophy type 1 (DM1) METHODS: Retrospective, observational, multicentric study. Parameters of ovarian response and PGT-M outcomes were compared according to the DM1-affected patient (female or male). A total of 229 couples underwent at least one controlled ovarian hyperstimulation cycle for the PGT-M procedure. Overall, 678 COS cycles were started, leading to 560 cycles with oocyte retrievals and subsequent PGT-M analysis. At the time of the first PGT-M attempt, affected DM1 females were 1 year older and their serum AMH level was significantly lower than that of the healthy partner of affected DM1 males. After higher starting and total doses of exogenous gonadotropins, the number of mature oocytes was not statistically different between both groups (9 [6-13] vs 9 [6-13] mature oocytes, p=0.73). The FORT index was similar in both groups (35.2% [19.2-52.8] vs 33.3% [19.6-50.0], p=0.09), suggesting that antral follicle responsiveness to FSH is not altered. The live birth rate per fresh embryo transfer was 23.8% in the affected females group and 27.6% for the affected males. After adapted controlled ovarian stimulation protocol and starting dose, a similar response (number of mature oocytes) and sensitivity (FORT index) was observed in DM1 females when compared to healthy partners of DM1 males undergoing PGT-M.

In Vitro Maturation of Oocytes Obtained from Ovarian Cortex Among Postpubertal Hematological Cancer Patients Undergoing Fertility Preservation.

Purpose: In vitro maturation (IVM) of oocytes obtained from ovarian tissue during ovarian tissue cryopreservation (OTC) is a technique for fertility preservation in patients with cancer obviating the need to postpone chemotherapy initiation. Little is known about IVM outcomes in hematological malignancies, especially post-chemotherapy. The purpose of this study was to evaluate the effect of cytotoxic treatment on the potential to retrieve immature oocytes and mature them in vitro and examine the association between serum inflammatory markers and these results. Methods: In this retrospective study, we evaluated inflammation markers, including B symptoms and IVM outcomes of 78 chemotherapy-naive and exposed patients diagnosed with Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), or acute myeloid leukemia (AML). Results: The mean number of oocytes found was 7.2 ± 7.2. The average number of oocytes matured by IVM was 2.8 ± 3.5, and a mean IVM rate was 32.1 ± 27.7%. All patients in the ALL and AML groups had previous exposure to chemotherapy before OTC, compared with 50.0% (7/14) and 31.9% (15/47) in the NHL and HL groups, respectively. Among patients with lymphoma, chemotherapy exposure was associated with the reduced number of retrieved oocytes (9.8 ± 7.7 vs. 5.3 ± 5.7 oocytes, p = 0.049) in the HL group but not with the number of mature oocytes or IVM rate. B symptoms were not associated with IVM outcomes. Lymphocyte count (ß = 1.584; p = 0.038) and lactate dehydrogenase (ß = 0.009; p = 0.043) were the only significant parameters associated with the number of matured oocytes in a linear regression model. Conclusion: IVM is a promising assisted reproductive technology, which holds great potential for patients in need of urgent fertility preservation or those who cannot receive hormonal stimulation. Our results demonstrate the feasibility of the technique even in the presence of B symptoms and elevated inflammation markers and in patients with previous exposure to chemotherapy.

Oocyte Cryopreservation in Transgender and Gender-Diverse Individuals With or Without Prior Testosterone Use.

To evaluate oocyte cryopreservation among transgender and gender-diverse adolescents and young adults with or without prior testosterone exposure, we performed a retrospective cohort study of all patients younger than age 35 years referred for oocyte cryopreservation through our formal fertility-preservation program from 2014 to 2023. The number of patients referred and pursuing fertility preservation increased over time. Among the 93 patients referred, 37 pursued oocyte cryopreservation (31 testosterone-naïve and six testosterone-exposed). Among the latter, neither length of time on testosterone before presentation nor duration off testosterone before retrieval (minimum 2 months) were associated with the number of mature oocytes frozen. When comparing testosterone-naïve with testosterone-exposed individuals, there was no difference in number of oocytes retrieved (median 28 vs 32, P =0.43) or mature oocytes frozen (21 vs 21, P =0.95).

Ultrasound in in vitro fertilization programs

Ultrasound examination is an integral part of in vitro fertilization programs. This work shows that the antral follicle count compared to the level of antimüllerian hormone is a preferred marker for assessing the ovarian reserve, response to ovarian stimulation and the results of in vitro fertilization programs, while counting the antral follicle count can be carried out on any day of the menstrual cycle without reducing the informativeness of the study of the ovarian reserve, which is convenient for both patients and doctors. 3D transvaginal ultrasound allows automated assessment of the number of antral follicles with high accuracy and efficiency in less time than 2D transvaginal ultrasound. Using 3D transvaginal ultrasound and artificial intelligence, a threshold value of dominant follicle volume of 0.5 cm3 or greater was determined as a marker for predicting the number of mature oocytes in in vitro fertilization programs. The measurement of endometrial thickness and volume in combination with the determination of vascularization index, flow index, vascularization-flow index and systole-diastolic ratio in the uterine artery at transvaginal ultrasound allows predicting the results of in vitro fertilization programs. Modern possibilities of transabdominal oocyte aspiration using vaginal probe are presented.

Effect of abamectin on haemolymph and ovarian proteins during the reproductive cycle of female Argas (Persicargas) arboreus (Acari: Argasidae)

AbstractThe avian tick Argas (Persicargas) arboreus is a vector of pathogens infecting the nestlings of the agriculturally beneficial bird, the buff-backed heron in Egypt. The topical treatment of the fed-mated (engorged) female A. (P.) arboreus with a sublethal dose of abamectin (10 µl 10 ppm/female) on the 3rd day after feeding (daf), reduced the concentration of total protein in the haemolymph (HL) by 13–66%, in the ovary by 30–54%, and in freshly deposited eggs by 11–16%, compared to untreated females during vitellogenesis and oviposition. However, the treatment did not prevent vitellogenesis and oviposition but reduced the number of mature oocytes (stages III–V) and deposited eggs. Additionally, it delayed the onset and slowed the progress of each process in the treated females. The application of abamectin at the onset of vitellogenesis (on the 3rd daf) in normal female and the prominent decrease inHL total protein concentration in treated female on the 4th daf pointed to a probable interference of abamectin with the release of the vitellogenesis-inducing factor (VIF) and/or other subsequent hormone(s) known to regulate vitellogenesis in this argasid tick species. Graphical abstract

Triggering oocyte maturation in invitro fertilization treatment in healthy responders: a systematic review and network meta-analysis.

To compare efficacy and safety of human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) agonist, dual, and double triggers in predicted healthy responders undergoing ovarian stimulation and invitro fertilization. A systematic review and network meta-analysis of randomized controlled trials (RCTs). Randomized controlled trials indexed in PubMed, MEDLINE, EMBASE, clinical trial registries, and Cochrane Database of Systematic Reviews up to December2023. Twelve high-integrity RCTs comprising 1,931 women were included, which compared hCG trigger with GnRH agonist trigger, dual trigger, and double trigger. Statistical analysis was performed using STATA version16. Key outcomes included clinical pregnancy rates (CPR), live birth rates (LBR), number of oocytes, number of mature oocytes, miscarriage rates, and rates of ovarian hyperstimulation syndrome. The network meta-analysis for CPR were risk ratio (RR), 1.13; (95% confidence interval [CI], 0.80-1.60) for hCG vs. GnRH agonist trigger, RR, 1.23 (95% CI, 0.92-1.65) for hCG vs. dual trigger, RR, 0.38 (95% CI, 0.21-0.69) for hCG vs. double trigger, RR, 1.09 (95% CI, 0.70-1.70) for GnRH agonist vs. dual trigger and 0.34 (95% CI, 0.17-0.67) for GnRH agonist vs. double trigger, and RR, 0.31 (95% CI, 0.16-0.60) for double vs. dual trigger. Dual trigger demonstrated the highest Surface Under the Cumulative Ranking (85.1%), indicating superior efficacy for CPR. For LBR, although connectivity was limited, the RR was 1.31 (95% CI, 1.00-1.70) for dual vs. hCG trigger, and RR, 1.60 (95% CI, 1.05-2.43) for dual vs. GnRH agonist trigger. Ovarian hyperstimulation syndrome rates were significantly lower with the GnRH agonist compared with hCG trigger (RR, 0.56; 95% CI, 0.19-1.75). There were no RCTs reporting ovarian hyperstimulation syndrome rates with the use of dual or double trigger. No significant differences were observed in the number of oocytes retrieved, mature oocytes, or miscarriage rates among the trigger protocols. The findings indicate that there is no evidence to suggest that using GnRH agonist, dual, or double protocols is superior to hCG trigger in improving CPR. Although LBR may benefit from dual trigger, results are limited by available RCTs. Larger, multicenter trials are needed for further evaluation of LBR and understanding of long-term outcomes.

The progesterone prime protocol: an affordable option for ICSI in Egypt

BackgroundThe two main input indicators needed to assess the success of assisted reproductive technology (ART) strategies are cost-effectiveness and clinical outcome. Therefore, we focused in our study on the direct cost associated with the Progesterone Prime Ovulation Induction Protocol (P-P-OP protocol) compared to other protocols, and the clinical outcomes of this strategy were measured in their effect on implantation and pregnancy rates.MethodsA pilot single-armed study was conducted on 47 infertile women coming for an ICSI cycle. Progesterone priming was started with 10 mg dydrogesterone along with HMG 150–300 IU from the second day of the menstrual cycle and was maintained until the day of ovulation trigger. The primary outcome was the cost per cycle, while the secondary outcome was the clinical pregnancy rate. The cost per cycle, including the cryopreservation cost, was calculated for economic evaluation.ResultsPer each cycle, the number of retrieved oocytes was 14.87 ± 8.09, the number of mature oocytes was 9.81 ± 4.67, the number of total embryos was 8.74 ± 4.28 (grade A = 67.40%, grade B = 11.92%, grade C = 20.68%), and the number of transferred embryos was 2.43 ± 0.68. The clinical pregnancy rate in our study was 42.5%. Economically, the cost of the P-P-OP protocol for each patient was only 56 USD.ConclusionThe P-P-OP protocol is a simplified approach suitable for freeze-only strategies, offering the benefits of positive results, fewer injections, lower costs, and increased patient convenience.

Impact of GnRH antagonist pretreatment on oocyte yield after ovarian stimulation: A retrospective analysis.

The study investigates whether a 3-day pretreatment course with a GnRH antagonist in the early follicular phase has an impact on the number of retrieved COCs in a GnRH antagonist stimulation protocol. This is a retrospective single center crossover study involving women who did not conceive after one GnRH antagonist stimulation cycle ("standard cycle") and proceeded with another GnRH antagonist stimulation cycle preceded by early administration of GnRH antagonist for 3 days ("pretreatment cycle") with fresh embryo transfer or frozen embryo transfer. 430 patients undergoing 860 cycles were included. The mean female age was 34.4 ± 4.8 years. Indications for fertility treatment included unexplained infertility (34.3%), male-factor infertility (33.3%), age (16.9%), PCOS (8.2%), tubal (4.7) and endometriosis (2.6%). All cycles were divided into two groups: group 1 (standard, 430 cycles) and group 2 (pretreatment, 430 cycles). The mean duration of stimulation was similar in both groups (10.3 vs 10.3 days, p = 0.28). The starting dose of gonadotropin (234.9 vs 196.8 IU, p<0.001), total amount of gonadotropin used (2419 vs 2020 IU, p<0.001), the total number of retrieved COCs (10 vs 7.8 p<0.001) and the number of mature oocytes (8 vs 5.8 p<0.001) were significantly higher in group 2 than in group 1. The Generalized estimating equation (GEE) regression analysis showed that the pretreatment strategy had a significant positive effect on the number of COCs (coefficient 2.4, p <0.001 after adjusting for known confounders (age, indication, stimulation dose, type, and duration of stimulation). In conclusion, A 3-day course of GnRH antagonist pretreatment increases the number of COCs obtained after ovarian stimulation.

Short-Term Metformin Therapy in Clomiphene Citrate Resistant PCOS Patients Improves Fertility Outcome by Regulating Follicular Fluid Redox Balance: A Case-Controlled Study.

To determine the effect of short-term metformin administration on follicular fluid (FF) total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) and nuclear factor kappa B (NF-kB) in women with clomiphene citrate-resistant polycystic ovary syndrome (PCOS). Fifty-eight patients aged 23-34 who were planned to have intracytoplasmic sperm injection due to clomiphene citrate-resistant PCOS were included in the study. Participants were divided into two groups according to whether they used metformin or not. While 30 of 58 PCOS patients were using short-term metformin in combination with controlled ovarian stimulation, 28 PCOS patients were not using metformin. Metformin was started in the mid-luteal period and continued until the day before oocyte retrieval at 850 mg twice daily. To determine FF-NF-kB, TAS, TOS and OSI values, a dominant follicle ≥17-18 mm in diameter was selected for aspiration. The number of mature follicles and fertilization rates of the metformin group were significantly higher than those not taking metformin. FF-TOS and OSI of the metformin group were significantly lower than those of the group not receiving metformin. Patients receiving metformin had higher FF-TAS than the group not receiving metformin. FF-NF-kB levels of the metformin group were significantly lower than the group not receiving metformin. Insulin resistance, FF-NF-kB and FF-TOS were negatively correlated with the number of mature oocytes. FF-TAS was positively correlated with the number of oocytes. Short-term metformin treatment in clomiphene-resistant PCOS improves the number of mature follicles and fertilization rates by regulating the intra-follicle redox balance.

Comparison of highly purified human menopausal gonadotropin and recombinant follicle stimulating hormone use in patients undergoing in vitro fertilization with progestin-primed ovarian stimulation protocol: a single center retrospective analysis.

Recently, progesterone has been used to prevent LH surge instead of GnRH analogues during ART treatments, which is known as progesterone-primed ovarian stimulation (PPOS) protocol. During ART treatment, highly purified human menopausal gonadotropin (HP-hMG) and recombinant follicle stimulating hormone (rFSH) are two of the agents used for stimulation of antral follicles. The aim of this study is to compare the efficacy and success of HP-hMG and rFSH agents in the ovarian stimulation step of the PPOS protocol, which has not been previously reported in the literature. This retrospective study was conducted at a university hospital with patients who underwent IVF treatment using PPOS protocols in between January 2019 and July 2021. For ovarian stimulation, rFSH was used in group I and HP-hMG was used in group II. Mature oocyte ratio was the primary outcome, and live birth rate was the secondary outcome. Mann-Whitney and Chi-square tests were used for statistical analysis. All p values below 0.05 were considered significant. Total numbers of follicles, oocytes, MII, and 2PN numbers obtained were similar between the two groups. The fertilization rates were 66.7% in the rFSH group and 64.3% in the HP-hMG group (p > 0.05). The pregnancy rates were 53.5% and 46.7% in the rFSH and HP-hMG groups, respectively. There was no statistically significant difference between pregnancy, abortus, and live birth rates. In this study, it is demonstrated that stimulation of oocytes with either rFSH or hMG in the PPOS protocol, which has been added to IVF treatment protocols in recent years, had no statistical difference regarding mature oocyte numbers and live birth rates between the two groups. These results are consistent with the previous literature which compared rFSH and hMG in GnRH agonist and antagonist protocols.

Developmental Competence of Somatic Cell Nuclear Transfer Embryos and Interspecies ICSI Zygotes From Bovine Small Antral Follicles.

Assisted reproductive technologies (ART) play a crucial role in conserving threatened wildlife species such as Bos gaurus. ART requires a large number of mature oocytes, and small antral follicles (SAFs) in the ovary are often used to obtain abundant sources of bovine oocytes. However, oocytes from SAFs often experience difficulty completing maturation and obtaining high quality and quantity of blastocyst formation compared to fully grown oocytes. This study aimed to increase the number of high-quality mature oocytes and improve their potential for ART applications in cloned and interspecies intracytoplasmic sperm injection (ICSI) embryos by utilising L-ascorbic acid (LAA) in pre invitro maturation (pre-IVM) culture. First, oocytes isolated from SAFs were cultured with the duration of pre-IVM 0, 6, 8, 10 h and different concentrations of LAA to determine good conditions for oocyte maturation. Then, mature oocytes were assessed for their developmental competence through parthenogenesis, cloned and interspecies ICSI embryos. The results showed that 8-h pre-IVM with 50 μg/mL LAA improved the maturation rate and developmental competence of parthenogenetic and clone embryos, especially, improving the high blastocyst quality by increasing cell number and expression of histone acetylation at lysine 9 (H3K9ac). In addition, the culture process improved the nuclear reprogramming of somatic cells after nuclear transfer into mature oocytes, resulting in an increased hatching rate of cloned embryos. It also enhanced the activation and the pronuclear formation rate of Gaurus-Taurus zygotes. Overall, the established pre-IVM culture method enhanced the meiotic and developmental competence of embryos. This procedure opened hope for the preservation of endangered species and other applications.

Vaginal Progesterone Gel versus Intramuscular Progesterone for Luteal Phase Support in Suboptimal Responders Undergoing Assisted Reproductive Cycles

Background: The purpose of this research is to compare the efficacy of 8% micronized vaginal progesterone gel (VAG) at 180 mg daily versus intramuscular progesterone (IMP) in oil at 100 mg daily for luteal phase support (LPS) after fresh single embryo transfer (SET) in Patient-Oriented Strategies Encompassing Individualized Oocyte Number (POSEIDON) Group 1b patients, and to ascertain whether the type of LPS predicts live birth in these patients. Methods: A total of 2420 assisted reproductive technology (ART) cycles performed in Ondokuz Mayıs University IVF Unit were analysed retrospectively. The data of POSEIDON Group 1b (unexpected suboptimal responders) who underwent antagonist in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles were included. All patients were categorized into groups according to the form of LPS, specifically VAG and IMP. Pregnancy, clinical pregnancy rate (CPR), live birth rate (LBR), spontaneous abortion rate and predictors of live birth (age, infertility duration, body mass index (BMI), type of progesterone used for luteal support, serum day 3 estradiol, serum progesterone on the day of human coryonic gonadotrophin (HCG), total duration of induction, serum estradiol on the day of HCG, the total number of oocytes retrieved, number of mature oocytes obtained, average gonadotropin dose per day, total gonadotropin dose administered and total number of embryos retrieved) were analyzed. Results: There was no statistically significant difference between the micronized VAG and IMP groups in terms of age (31 (23–35) vs. 27 (23–35), p = 0.319). There were no statistically significant differences in pregnancy outcomes between the two groups concerning CPR per transfer (70.6% vs. 75.6%; p = 0.364), ongoing pregnancy per cycle (36.2% vs. 39.5%; p = 0.577), and LBR per cycle (34.4% vs. 36.1%; p = 0.785). The spontaneous abortion rates (36.2% vs. 36.8%; p = 0.921) were similar between VAG and IMP groups. The type of LPS did not emerge as a parameter predicting pregnancy (odds ratio (OR): 0.718, 95% confidence interval (95% CI): 0.652–1.313, p = 0.451), clinical pregnancy (OR: 0.598, 95% CI: 0.592–1.289, p = 0.562) and live birth (OR: 0.802, 95% CI: 0.661–1.202, p = 0.580). The logistic regression analysis aimed at assessing the influence of confounding factors, namely age, BMI, and duration of infertility on pregnancy rate, CPR and LBR, did not reveal statistically significant results (p &gt; 0.05). Conclusions: VAG 180 mg daily provide similar pregnancy outcomes compared to 100 mg daily IMP in POSEIDON Group 1b patients undergoing antagonist fresh IVF/ICSI cycles.

Preliminary Report of the Effects of Platelet-Rich Plasma on the Ovarian Function and Oocyte Quality in Women with Ovarian Failure

This study investigated the effects of platelet-rich plasma (PRP) treatment on ovarian function and pregnancy outcomes in three patients with severe reduction of ovarian reserve. The patients had previously undergone multiple cycles of assisted reproductive technology (ART) without favorable results. Prior to PRP treatment, follicle-stimulating hormone (FSH), estradiol (E2), and anti-Mullerian hormone (AMH) levels were assessed. PRP was administered through intraovarian injection. Hormonal assessments were performed at 6–7 months after the first PRP injection. The results showed major improvements in ovarian function, as evidenced by decreased FSH levels and increased AMH levels in all three patients. The number of mature oocytes retrieved per cycle and the ovum-to-blastocyst rate were also improved. All the patients achieved successful pregnancies and gave birth to healthy infants. These findings suggest that PRP may enhance ovarian function, oocyte quality, and pregnancy outcomes in patients with severely reduced ovarian reserve. Further research is necessary to validate these results and explore the underlying mechanisms.

Ovarian stimulation response and fertility outcomes in patients with breast cancer across different stages, grades, and hormone receptor status for fertility preservation

BackgroundThis study aimed to explore the potential impact of stage, grade, and hormone receptor profile on ovarian stimulation response and fertility preservation outcomes. MethodsThis retrospective cohort study evaluated data from breast cancer patients who underwent fertility preservation at a tertiary medical center between 2014 and 2022. The outcomes of women with low-stage cancer (stages I and II) were compared with those of women with high-stage disease (stages III and IV or lymph node metastasis). Similarly, we compared those with low-grade (grades 1 and 2) and high-grade (grade 3) malignancies. In addition, we compared different hormone statuses of breast cancer (1) estrogen receptor (ER) positive vs. ER-negative and (2) triple-negative breast cancer (TNBC) vs. non-TNBC. The primary outcome measured was the number of mature oocytes, while the secondary outcomes included the numbers of total oocytes retrieved, peak estradiol levels, and subsequent fertility preservation outcomes. ResultsA total of 47 patients were included. Patients with high-grade tumors had a comparable number of mature oocytes (8 vs. 10, p = 0.08) compared to patients with low grade cancers. The stage-based analysis revealed a similar number of mature oocytes (8 vs. 10, p = 0.33) between high/low stage patients. In the hormone receptor-based analysis, no differences were seen in mature oocytes collected between the ER-positive/ER-negative group (9 vs. 9, p = 0.87) and the TNBC/non-TNBC group (11 vs. 9, p = 0.13). The utilization rate was 27.6% (13/47). ConclusionOur study showed similar ovarian stimulation response and fertility preservation outcomes among breast cancer patients with different prognostic factors.

Ethanol sclerotherapy of endometriomas prior to IVF/ICSI improves progressive pregnancy and live birth rate

Research QuestionWhat is the impact of ethanol sclerotherapy of endometriomas prior to IVF/ICSI on pregnancy rates? DesignWe reviewed women with endometrioma(s) larger than 25 mm having IVF/ICSI cycles. All patients with a history of ovarian cystectomy were excluded. Two groups were compared: patients who had transvaginal ethanol sclerotherapy of their endometrioma(s) before ovarian stimulation and patients whose endometrioma(s) were left in situ (untreated) at the time of IVF/ICSI (control group). Analyses were adjusted for confounding factors by inverse probability of treatment weighting. The primary endpoint was progressive pregnancy rates per IVF/ICSI cycle including fresh and frozen embryo transfers. Secondary endpoints were live birth rates, the number of mature oocytes retrieved, pregnancy loss. Endometriomas recurrence rates after sclerotherapy and procedural complications were also analyzed. ResultsA total of 96 cycles (67 patients) were included: 46 cycles (34 patients) in the ethanol sclerotherapy group and 50 cycles (33 patients) in the control group. After propensity score weighting, the pregnancy and live-birth rates were significantly higher in the ethanol sclerotherapy group compared to the control group (weighted OR, 2.9 ; 95 CI, 1.4 – 6.6 and weighted OR 2.4 ; 95 CI, 1.1 – 5.4 respectively), with a lower rate of pregnancy loss (weighted OR 0.3 ; 95 CI, 0.1 – 0.9). Ovarian response was similar in the two groups. The recurrence rate of endometrioma at 6 months after sclerotherapy was 20 %. ConclusionSclerotherapy of endometrioma before ovarian stimulation may increase pregnancy rate, with a low rate of recurrence and a minimal risk of complication.

Improper dietary protein to carbohydrate ratio causes abnormal visceral fat deposition, hampering gonadal development and breeding performance in Labeo Catla female

The availability of balanced diet is critical for reproductive success in fish. A feeding trial on Labeo catla females was carried out in earthen pond to assess the effect of different dietary protein to carbohydrate ratio on gonad maturation and breeding performance. Three feed D-I (Feed-I), D-II (Feed-II) and D-III (Feed-III) were formulated with varying ratio of Ground Nut Oil Cake (GNOC) and rice bran (2:1, 1:1 and 1:2) and fed for 120 days. To assess the gonad maturation events, GSI VSI, breeding, fatty acid analysis, sex hormone profiling, cholesterol, triglyceride and histological examinations were conducted. Fish groups fed with D-III exhibited the highest VSI and visceral fat (VF) deposition, followed by those fed with D-I, whereas groups fed with D-II showed significantly lower levels (P<0.05). The result of GSI was completely opposite to values of VSI. Ovarian histology showed less number of mature oocytes in D-I & D-III treatments and more mature oocytes in D-II. Breeding results showed that fishes fed with D-I and D-III hampered gonad maturation whereas fish fed with D-II responded towards spawning, fertilization, and hatching. Increased levels of testosterone, estradiol, and vitellogenin (Vtg) were observed in the D-II fed group whereas increased level of progesterone was observed in D-I fed group followed by D-II and D-III. Serum cholesterol was higher in the D-III and D-I group. Visceral fat accumulation prior to ovarian maturation is a normal phenomenon in this species which serves as a lipid reservoir required for the later transfer to the gonad as yolk or is utilized as an energy source for gonad maturation. However higher level of protein or carbohydrate in the diet disrupted normal gonad maturation and lead to abnormal visceral fat accumulation, sex steroid level, failure in spawning response and seed production.

The efficacy of evening primrose seed oil supplements on ART outcomes: A triple-blinded randomized placebo-controlled clinical trial

BackgroundEvening primrose oil (EPO) has been extensively documented for its potential benefits in various medical conditions, including gestational diabetes, inflammatory diseases, cyclic breast pain, cancer, premenstrual syndrome, menopausal syndrome, and female reproductive disorders. ObjectivesThe aim of this study was to investigate the impact of evening primrose oil (EPO) supplementation on the outcomes of assisted reproductive technology (ART). MethodsA randomized, triple-blinded, placebo-controlled clinical trial was conducted. A total of 84 infertile women who were candidates for intracytoplasmic sperm injection (ICSI) were randomly assigned to either the EPO supplementation group or the placebo (p) group with a 1:1 ratio. The EPO capsule was given from day 1–2 of the ART cycle at a dosage of 1000 mg every eight hours for two weeks. Finally, the ART outcomes parameters as well as the treatment side effects were evaluated. ResultsThe results illustrated no statistically significant disparities between the groups in terms of the number of oocytes retrieved, ovarian sensitivity index (OSI), rate of fertilization, and number and quality of embryos (p>0.05). However, a notably enhanced incidence of pregnancy and implantation rates in the EPO group was observed when compared to the P group (42.9 % vs. 17.4 % and 23±30.5 % vs. 10.87±26 %, respectively). Moreover, none of the patients experienced side effects from the intervention. ConclusionsEPO consumption for two weeks could improve ART outcomes by increasing implantation and pregnancy rates without significantly affecting the number of mature oocytes, rate of fertilization, and the quantity and quality of embryos. These findings highlight the significance of a maternal preconception diet.

Effect on growth, gonad development, health and disease resistance against Aeromonas hydrophila of Origanum minutiflorum essential oil in Cyprinus carpio

This study investigated the effects on growth performance, histopathology, intestinal histomorphology, antioxidant activity, serum biochemical parameters, and disease resistance against A. hydrophila of carp fed with oregano essential oil (EO). Fish (13.54±0.24 g) were fed with experimental diets containing 1.0 and 3.0 mL kg−1 oregano EO for 60 days. At the end of the experiment, no significant difference was found among the growth performances of fish fed with oregano EO supplemented diets (p>0.05). However, dietary administration of 3.0 mL kg−1 oregano EO had significantly increased survival rates of common carp post-challenged with A. hydrophila (p < 0.05). In addition, goblet cells number and villi length in the intestine were increased in fish fed with oregano EO diets (p < 0.001). Also, no pathological findings were observed in hepatopancreas, gonads and intestines in fish fed with oregano EO. Fish fed with a diet containing 3.0 mL kg−1 oregano EO showed higher catalase activity (CAT) than the other experimental groups (p < 0.05). Superoxide dismutase (SOD), melondialdehyde (MDA), total protein, albumin, AST, ALT and ALP levels were similar in oregano EO supplemented groups compared to the control (p > 0.05). Number of mature oocytes in female ovaries caused a slight increase in fish fed with oregano EO. Adding oregano EO to common carp diet showed improved intestinal histomorphology and increased the survival against the A. hydrophila. Therefore, O. minutiflorum EO can be used as a health promoter for carp.

Spironolactone use and oocyte maturation in patients undergoing controlled ovarian hyperstimulation.

To evaluate the association between spironolactone use and controlled ovarian hyperstimulation (COH) outcomes. Retrospective study, including patients who underwent COH. Oocyte yield and maturation rates were compared by categories of spironolactone use at the start of their cycle. 402 patients were included. 83 patients continued spironolactone, 44 patients discontinued spironolactone, and 275 matched control patients were spironolactone-naïve. No difference was observed in the number of oocytes retrieved (17 ± 14 vs. 15 ± 13, p = 0.4) or mature oocytes vitrified (15 ± 9.5 vs. 12 ± 11, p = 0.4) in patients who continued spironolactone use and spironolactone naïve patients, respectively. When comparing patients who continued spironolactone use and patients who discontinued spironolactone use, no difference was seen in the number of oocytes retrieved (17 ± 14 vs. 17.5 ± 7.8, p = 0.9) or mature oocytes vitrified (15 ± 9.5 vs. 13.5 ± 6.5, p = 0.5), respectively. There was no observed relationship between total daily spironolactone dose (< 100mg/day, 100mg/day, 150mg/day and > 200 mg/day) and the total number of mature oocytes vitrified (respectively, 14.0 ± 13.0, 16.0 ± 7.8, 14.0 ± 4.5, 11.0 ± 7.0 oocytes, p = 0.4). This is the first study to evaluate the association between spironolactone and oocyte yield and maturation rates during COH cycles. These findings can assist in counseling patients on the implications of continuing spironolactone during COH cycle.