Fertility Outcomes Research Articles

Comparison of hysteroscopic adhesiolysis with electrosurgery instrument or hysteroscopic scissors in the treatment of intrauterine adhesions of infertile or recurrent pregnancy loss women.

To investigate pregnancy outcomes following hysteroscopic adhesiolysis (HA) in patients with recurrent pregnancy loss (RPL) or infertility. Retrospective cohort study. University-affiliated hospital. According to the inclusion and exclusion criteria of this study, finally, a total of 461 subjects were included. HA performed using either an electrosurgical instrument or hysteroscopic scissors. Pregnancy outcomes post-HA. A total of 461 patients were included in the study, with follow-up periods ranging from 1 to 6years. The mean age was 29.48 ± 3.25years. Hysteroscopic scissors demonstrated greater efficiency in restoring the uterine cavity compared to electrosurgical instruments (88.1% vs. 80.0%, p = 0.025). Post-HA, the pregnancy rate was approximately 75.3% (347/461), with a live birth rate of 55.9% (251/449). No significant differences were found between the electrosurgical instrument and hysteroscopic scissors groups regarding improvements in menstrual flow or fertility outcomes (all p > 0.05). Kaplan-Meier time-dependent cumulative curves for pregnancy and live birth rates after HA indicated that over 50% of patients achieved pregnancy within one year, with the pregnancy rate plateauing at 2years and the live birth rate at 3years. Our findings suggest that HA can improve fertility outcomes for patients with RPL or infertility within 2 to 3years following surgery. Hysteroscopic scissors proved more effective than electrosurgical instruments in restoring the uterine cavity, although no differences were observed between the techniques in terms of menstrual flow or fertility improvements. All in all, our study suggests that standardized HA procedures, the implementation of proactive intraoperative and postoperative measures to prevent the recurrence of intrauterine adhesions (IUA), and an active conception plan following HA are key factors in improving reproductive outcomes for these patients with RPL or infertility.

Adenomyosis, especially in its focal nature, hampers implantation and live birth rate after single euploid embryo transfer.

The primary objective of this study was to assess if uterine adenomyosis impacts live birth rate per euploid embryo transfer. The secondary objectives included addressing obstetric and perinatal outcomes in the study group. This was a multicenter and retrospective cohort study in which 228 patients diagnosed with adenomyosis undergoing single euploid embryo transfer between 2016 and June 2023 were included and matched on 1:1 ratio to control patients without ultrasonographic diagnostic criteria for adenomyosis. A significant higher live birth rate per embryo transfer was observed in controls compared to women with adenomyosis: 107/228 (46.9%) versus 56/228 (24.6%), respectively (odds ratio (OR) = 2.71, 95% confidence interval [CI]: 1.73-4.13, p < 0.001). When dividing adenomyotic patients regarding the nature of the disease, a higher live birth rate per transfer was described in diffuse adenomyosis compared to focal adenomyosis: 47/166 (28.3%) versus 9/62 (15%), respectively (OR = 2.32, 95% CI: 1.03-5.78, p = 0.034). Described differences were constant even when correcting for multiple variables. There was no statistically significant difference in childbirth delivery method (vaginal vs. cesarean section) between the adenomyosis and control groups. Mean gestational age at the time of delivery, newborn size and weight, and incidences of low birth weight, preterm birth, and admission to the neonatal intensive care unit did not differ between the two groups. In addition, invitro fertilization (IVF) and perinatal outcomes were similar in patients with diffuse compared with focal adenomyosis. Adenomyosis, especially focal adenomyosis, affects clinical but may not affect perinatal outcomes after single euploid embryo transfer.

Ethanol Sclerotherapy for Endometriomas in Infertile Women: A Narrative Review.

Ethanol sclerotherapy (EST) has gained attention as a minimally invasive treatment option for ovarian endometriomas, particularly in infertile women with endometrioma undergoing in vitro fertilization (IVF). Endometriomas are associated with decreased ovarian reserve and impaired fertility outcomes, and traditional surgical approaches, such as cystectomy, often lead to further reductions in ovarian reserve. Ethanol sclerotherapy offers a potential alternative that preserves ovarian function while effectively managing endometriomas. This review examines the safety, efficacy, and impact of EST on ovarian reserve, IVF outcomes, and recurrence rates. Comparative studies suggest that pregnancy rates following EST are similar to or better than those after cystectomy, with the added benefit of more oocytes retrieved, which may lead to higher cumulative live birth rates. Despite these promising results, challenges such as recurrence and complications, particularly with prolonged ethanol exposure, remain. The use of transvaginal versus laparoscopic approaches and optimal ethanol exposure protocols are areas of ongoing research. The need for further large-scale, prospective studies is highlighted to refine the EST protocol and better understand the long-term outcomes. Sclerotherapy presents a feasible option for preserving fertility in women with endometriomas, with positive implications for IVF success and ovarian reserve preservation.

Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis

Adenomyosis is a commonly encountered pathology in women of reproductive age and frequently coexists with infertility. The effect of adenomyosis on fertility, particularly on in vitro fertilisation and intracytoplasmic sperm injection outcomes, is not well understood. Various pretreatment modalities have been used to improve pregnancy rates and live birth outcomes; however, because of a lack of high-quality evidence, there is no clear consensus on the best pretreatment option. This review was conducted through a PubMed search aiming to highlight the relationship between pretreatment and fertility in women with adenomyosis. Medical, ablative surgical, and non-surgical therapies were reviewed. According to the current literature, gonadotropin-releasing hormone agonist therapy and placement of a levonorgestrel intrauterine system are two suitable medical pretreatment strategies that can improve the clinical pregnancy rates of patients with adenomyosis. Surgical ablation of adenomyosis can also be beneficial, although surgical management can be challenging. Non-surgical thermal techniques, including high-intensity focused ultrasound ablation, percutaneous microwave ablation, and radiofrequency ablation, are much less invasive techniques that have shown effectiveness in improving fertility. Although evidence remains limited, all these procedures have demonstrated a favourable safety profile. Further studies are needed to better develop these techniques and demonstrate their effectiveness.

The Role of the Vaginal and Endometrial Microbiomes in Infertility and Their Impact on Pregnancy Outcomes in Light of Recent Literature.

The Human Microbiome Project (HMP), initiated in 2007, aimed to gather comprehensive knowledge to create a genetic and metabolic map of human-associated microorganisms and their contribution to physiological states and predisposition to certain diseases. Research has revealed that the human microbiome is highly diverse and exhibits significant interpersonal variability; consequently, its exact impact on health remains unclear. With the development of next-generation sequencing (NGS) technologies, the broad spectrum of microbial communities has been better characterized. The lower female genital tract, particularly the vagina, is colonized by various bacterial species, with Lactobacillus spp. predominating. The upper female genital tract, especially the uterus, was long considered sterile. However, recent studies have identified a distinct endometrial microbiome. A Lactobacillus-dominated microbiome of the female genital tract is associated with favorable reproductive outcomes, including higher success rates in natural conception and assisted reproductive technologies (ART). Conversely, microbial imbalances, or dysbiosis, marked by reduced Lactobacilli as well as an increased diversity and abundance of pathogenic species (e.g., Gardnerella vaginalis or Prevotella spp.), are linked to infertility, implantation failure, and pregnancy complications such as miscarriage and preterm birth. Dysbiosis can impair the vaginal or endometrial mucosal barrier and also trigger pro-inflammatory responses, disrupting essential reproductive processes like implantation. Despite growing evidence supporting the associations between the microbiome of the female genital tract and certain gynecological and obstetric conditions, clear microbial biomarkers have yet to be identified, and there is no consensus on the precise composition of a normal or healthy microbiome. The lack of standardized protocols and biomarkers limits the routine use of microbiome screening tests. Therefore, larger patient cohorts are needed to facilitate comparative studies and improve our understanding of the physiological microbiome profiles of the uterus and vagina, as well as how dysbiosis may influence clinical outcomes. Further research is required to refine diagnostic tools and develop personalized therapeutic strategies to improve fertility and pregnancy outcomes.

Cryptorchidism: A 20-Year Journey of Patient Outcomes and Family Concerns – A Cohort Study at a Single Center

Background: Undescended testis (UDT), or cryptorchidism, is a prevalent pediatric condition with significant implications for fertility and malignancy risk if untreated. Affecting 1–5% of male infants, UDT is influenced by genetic, hormonal, and environmental factors. Methods: This retrospective cohort study examines 470 pediatric UDT cases treated at a single center over two decades (2004–2024) at a single pediatric surgery center - The Maternity and Child Teaching Hospital, Al Qadisiya, Iraq, focusing on surgical outcomes, fertility, long-term testicular health, and family concerns. Inclusion criteria; Patients were identified from hospital records and outpatient clinic registries confirmed diagnosis of UDT (unilateral or bilateral), availability of complete medical records, patients who underwent chromosomal analysis as part of their diagnostic workup, and underwent surgical intervention within the study timeframe at our center with at least three years of follow-up. Results: The mean age at diagnosis was 18 months, with 45% diagnosed within the first year. Unilateral UDT predominated (60%), and testicular position influenced size and outcomes. Surgical success was achieved in 90% of cases, with minor complications including wound infections (5%) and reoperations (5%). Earlier diagnosis correlated with improved fertility outcomes, with normal spermatogenesis observed in 75% of early cases but declining significantly with delayed treatment (P &lt; 0.05). Chromosomal abnormalities, present in 9% of patients, heightened family concerns, particularly regarding fertility and psychosocial impacts. Conclusion: Family concerns evolved through stages of care, initially focusing on fertility and malignancy risks, then shifting to surgical safety and postoperative recovery. Tailored counseling and psychosocial support were integral to family satisfaction. This study underscores the importance of early diagnosis, multidisciplinary care, and culturally sensitive family engagement to optimize outcomes and enhance the quality of life for patients with UDT. Future recommendations include routine genetic screening and targeted educational initiatives to address community-specific challenges.

Luteinizing hormone profiles during ovarian stimulation in assisted reproductive treatment.

Few data is available on the natural course of luteinizing hormone (LH) during ovarian stimulation, but it has been suggested that 'oversuppressed' LH could decrease fertility outcomes. Our aim with this study is to evaluate the changes in LH depending on the used stimulation protocol to better define LH oversuppressioin. Patients undergoing oocyte retrieval in a tertiary fertility center between 01-01-2015 and 30-09-2020 after stimulation with a short-agonist (SA) or antagonist (A) protocol were included. Data were retrospectively retrieved from 858 electronic patient records, of which 338 SA cycles and 783 A cycles. A continuous profile was set out to evaluate the pooled measurements of the mean LH in time during ovarian stimulation and linear mixed modeling was used to compare the change of LH between 4 time points: the day prior to start of gonadotrophins (T1), stimulation day 5 (T2), stimulation day 6 (T3) and on the day of oocyte maturation trigger (T4). Oversuppression of LH was defined as a decrease of LH > 50% after initiation of GnRH antagonist and LH levels < 1.2 IU/l after GnRH antagonist. A subanalysis was performed for type of gonadotrophin (recFSH vs hp-hMG). In the SA protocol, an initial LH peak was followed by a slow decrease of LH until triggering. In the A protocol, LH decreased after gonadotrophin initiation with a further rapid decrease after initiation of the antagonist and remained low until trigger. LH levels dropped > 50% in 26.2% of the antagonist cycles and LH levels were < 1.2 IU/l in 45.3% of cycles after initiation of GnRH-antagonist. The course of LH in the SA protocol differs from the A protocol where low mean LH levels are seen. Oversuppression of LH, or iatrogenic LH deficiency as described in earlier studies, may be a rather pervasive phenomenon during stimulation with an antagonist protocol and warrants further investigation to elucidate the clinical relevance of low LH levels during ovarian stimulation.

The Effect of Endometriosis on In Vitro Fertilization Outcomes: A Systematic Review and Meta-Analysis.

The purpose of this study was to evaluate the impact of endometriosis on various outcomes of in vitro fertilization (IVF), including live birth rates, clinical pregnancy rates, fertilization rates, and implantation rates, through a systematic review and meta-analysis. Systematic searches were carried out using PubMed, MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, EMBASE, and Web of Science from January 2010 to November 2023. Studies comparing IVF outcomes in women with and without endometriosis were included. The primary outcome was live birth rate; secondary outcomes included clinical pregnancy, fertilization, and implantation rates. Data were extracted and analyzed using odds ratio (OR) and 95% confidence interval (CI) with fixed or random-effects models, depending on heterogeneity. From 1340 studies initially identified, 40 studies met the inclusion criteria, encompassing 8970 women with endometriosis and 42,946 control participants. There were no significant differences between the endometriosis and control groups in terms of live birth rate (OR 1.03, 95% CI 0.75-1.41, p = 0.84), clinical pregnancy rate (OR 0.86, 95% CI 0.72-1.02, p = 0.1), or fertilization rate (OR 0.96, 95% CI 0.79-1.15, p = 0.64). However, endometriosis was associated with a significantly lower implantation rate (OR 0.85, 95% CI 0.74-0.97, p = 0.02). Endometriosis significantly negatively affects implantation rates in women undergoing IVF, despite the absence of significant differences in live birth, clinical pregnancy, and fertilization rates. Further research is needed to evaluate the impact of different stages of endometriosis on IVF outcomes and to develop optimized management protocols for these patients.

Genetic Abnormalities of Oocyte Maturation: Mechanisms and Clinical Implications.

Genetic anomalies in oocyte maturation present significant fertility and embryonic development challenges. This review explores the intricate mechanisms of nuclear and cytoplasmic maturation, emphasizing the genetic and molecular factors contributing to oocyte quality and competence. Chromosomal mutations, errors in segregation, genetic mutations in signaling pathways and meiosis-related genes, and epigenetic alterations are discussed as critical contributors to oocyte maturation defects. The role of mitochondrial defects, maternal mRNA dysregulation, and critical proteins such as NLRP14 and BMP6 are highlighted. Understanding these genetic factors is crucial for improving diagnostic approaches and therapeutic interventions in reproductive medicine, particularly for couples encountering recurrent in vitro fertilization failures. This review will explore how specific genetic mutations impact fertility treatments and reproductive success by examining the intricate oocyte maturation process. We will focus on genetic abnormalities that may disrupt the oocyte maturation pathway, discussing the underlying mechanisms involved and considering their potential clinical implications for enhancing fertility outcomes.

Fertility and abortion: A population-based comparison between women with cancer and those in childbearing age.

Concurrence of pregnancy and cancer diagnosis is increasingly frequent in Italy. The study aimed to compare women with pregnancy-associated cancers (PACs) to those of childbearing age, focusing on fertility, induced abortion, and miscarriage. The population-based study included women aged 15-49 years, both with and without PAC, who were residents in the area covered by the 19 participating Cancer Registries between 2003 and 2015 and identified by individual deterministic linkage with the Hospital Discharge Database. Overall, 2,218,139 obstetrics hospitalizations occurred, covering delivery (75%), induced abortion (14%), and miscarriage (11%). Among 2409 women with PAC, 69% gave birth, 16% had an induced abortion and 15% a miscarriage. Compared with the reference population, the fertility rate in women with PACs was steadily lower (mean values 25.7/1000 vs 37.7/1000), while induced abortion (from 359/1000 - SRR 1.99, 95%CI 1.32-3.00 - in 2003 to 147/1000 - SRR 1.11, 95%CI 0.59-2.09 - in 2015) and miscarriage ratios exhibited a decreasing trend. These results are consistent with international literature and are probably due to advancements in diagnostic and therapeutic opportunities. This is the first Italian population-based study analysing fertility and pregnancy outcomes among women with PAC based on a reliable information on cancer diagnosis.

Testicular mapping-guided sperm retrieval vs. upfront microTESE in non-obstructive azoospermia: a comparison of sperm retrieval, pregnancy and live-birth rates.

Sperm extraction by Microscopic Testicular Sperm Extraction (microTESE) has become the standard of care for sperm retrieval (SR) in men with non-obstructive azoospermia (NOA) but is costly and has a 40-50% chance of failure. Fine needle aspiration mapping (FNAM) can be performed prior to microTESE as a predictor of success to reduce the likelihood of failure to retrieve sperm but there is limited evidence that directly compares these methods. The objective of this study was to compare success rate of SR, pregnancy, and live birth rates in men who underwent upfront microTESE versus FNAM. We performed a retrospective cohort study of men with NOA over a 10-year period from 2010 to 2019. The primary outcome was success of SR with secondary outcomes of pregnancy, and live-birth rates. Ninety men were included in the analysis. 60 in the FNAM group in 30 having upfront microTESE. In the FNAM group, 34/60 (56.7%) patients had positive fine needle aspiration (FNA) map for spermatogenesis. Of these 20/31 (64.5%) had FNAM-guided TESA/E, and 11/31 (35.5%) had microTESE. SR was successful in 30 of 31 men (96.8%). Overall SR rate was 54.4% and 56.7% in the FNAM group and upfront microTESE, respectively. There was no statistical difference in SR (P=0.65). The FNAM group had pregnancy and live-birth rates of 42.1% and 36.8%, respectively. The upfront microTESE group had pregnancy and live-birth rates of 36.7% each. χ2 analysis revealed no statistical difference for both pregnancy (P=0.76) and live-birth rates (P=0.75). FNAM carries high predictability and reliability in SR and can be performed prior to microTESE in NOA patients without change in fertility outcomes.

Impact of caesarean scar defects on the success of assisted human reproduction: the NICHE-ART prospective French cohort study protocol

BackgroundThe global increase in caesarean sections (CS), currently at 21.1% of all deliveries, has led to a rise in uterine scar defects, or ‘niches’, at the hysterotomy site. These niches,...

Intramural myomas and fertility: To operate or not?

Intramural uterine myomas are very common among women of reproductive age, but their impact on natural and assisted fertility remains controversial. Although international federation of gynecology and obstretrics type 3 myomas may have the most negative impact on receptivity, available data are still not convincing. Surgical removal of these myomas is encouraged when they are symptomatic, but myomectomy for fertility-only reasons cannot be offered in daily clinical practice before in vitro fertilization treatment, as data are still inconclusive. Moreover, myomectomy is strongly associated with short and long-term complications, some of which may also affect the fertility outcome. A better understanding of the association between intramural myomas and fertility may open up new perspectives for the individualized management of infertile women with uterine myomatous masses.

Prevalence of Polycystic Ovary Syndrome among infertile women in the Gulf Cooperation Council (GCC) countries: a systematic review and meta-analysis

BackgroundPolycystic ovary syndrome (PCOS) is a significant contributor to female infertility and other various metabolic disorders. This systematic review estimates the prevalence of PCOS among infertile women in the Gulf Cooperation Council (GCC) countries. MethodsThe study searched five databases (PubMed, Embase, CINAHL, Web of Science, and SCOPUS), from their inception to 2022 for observational studies conducted in GCC countries. Eligible studies included data on PCOS prevalence among infertile women. A random-effects model assessed the pooled prevalence, stratified by age, BMI, and infertility type. ResultsOut of 855 records screened, seven studies were deemed eligible. Four (57.1%) studies were conducted in Saudi Arabia, while the remaining three studies were carried out in Qatar, Kuwait, and Oman, respectively. The pooled prevalence of PCOS was 30.0% (95% CI: 29.0–38.0%, I-squared: 91.98%). PCOS prevalence was higher in obese (BMI: ≥30 Kg/m2) women (27.0%, 95% CI: 22.0–32.0%) than those with normal (18.5–24.9 Kg/m2) BMI (18.0%, 95% CI: 11.0–26.0%). Women aged 35 or older had a PCOS prevalence of 59.0% (95% CI: 45.0–72.0%), compared to 30.0% (95% CI: 29.0–36.0%) in age group 15–24 years old. Primary infertility was associated with higher PCOS prevalence (37.0%, 95% CI: 29.5–46.0%) than secondary infertility (17.0%, 95% CI: 13.0–21.0%). ConclusionIn four out of six GCC countries, PCOS was diagnosed in three out of every ten infertile women. Older age, obesity, and primary infertility were linked to higher PCOS prevalence. Screening for PCOS in these high-risk groups could improve fertility outcomes.

Association of leukocyte elastase in semen and seminal plasma with sperm parameters and pregnancy outcomes in male fertility.

Semen analysis is the standard test for evaluating male fertility. However, it may not address all aspects of male infertility. This review explores the role of leukocyte elastase (LE) as a possible biomarker for male fertility by evaluating 28 corresponding studies. We aimed to explore how leukocyte elastase levels in semen relate to sperm quality and pregnancy outcomes. This systematic review followed PRISMA guidelines and included studies from PubMed, Medline, EMBASE, and Scopus (March 22-25, 2024) using the keywords "Elastase," "Sperm," and "Semen." Out of 897 identified articles, 334 were screened, leading to 90 full-text reviews. We included 28 studies reporting sperm parameters linked to LE and excluded non-English articles, reviews, and animal studies. Data collected included study details, methods, population, LE levels, sperm characteristics, and pregnancy outcomes. A narrative synthesis was used due to differing study designs. Quality assessment, using the National Heart, Lung, and Blood Institute tool, rated 21 studies medium quality, 6 high, and 1 low. Only a limited number of studies reported a correlation between leukocyte elastase levels and sperm parameters, with no significant link to sperm concentration. Overall, we did not identify a strong association between LE levels and pregnancy or fertilization rates. While LE serves as a marker for seminal leukocyte concentration, its link to sperm quality and fertility outcomes remains weak and inconsistent. Based on current evidence, LE does not appear to be a reliable diagnostic marker for male infertility. Future studies should focus on standardizing LE measurement techniques and exploring its interaction with other semen parameters to clarify its role in male fertility.

NSAID exposure delays time-to-pregnancy in patients with spondyloarthritis: an analysis of the GR2 prospective cohort

BackgroundThe impact of disease activity and treatment on fertility outcomes in patients with spondyloarthritis (SpA) has been little explored. This study aimed to describe median time to pregnancy (TTP) in...

The Relationship Between Body Composition Parameters and the Intake of Selected Nutrients, and Serum Anti-Müllerian Hormone (AMH) Levels in the Context of Ovulatory Infertility.

Background/Objective: The aim of this study was to outline the relationships between selected parameters connected with lifestyle and serum anti-Müllerian hormone (AMH) levels, i.e., a marker of ovarian reserve. By examining AMH levels in connection with nutrient intake and body composition parameters, this study aimed to provide a preliminary background for further studies focused on establishing dietary and lifestyle recommendations that could lead to improvements in fertility outcomes. Methods: The research involved 28 women, aged 26 to 42-both with and without ovulatory infertility-who were patients of the Reproductive Health Clinic at the Medical University of Białystok. The participants underwent a number of tests consisting of hormonal profiling, including AMH measurements, body composition analyses, and dietary assessments based on a 3-day food diary. Results: The findings of the study indicate that certain lifestyle factors are associated with changes in AMH levels. Most importantly, the multivariate linear regression model designed in the study shows that age, waist-to-hip ratio (WHR), as well as the intake of sucrose, iodine, and erucic acid explain variations in serum AMH levels. These results support the hypothesis that modifiable lifestyle factors can influence AMH levels, and thus ovarian reserve. Conclusions: The study underscores the potential for targeted lifestyle interventions to support fertility and calls for further research in the form of prospective studies performed in larger groups of patients to substantiate these associations and inform fertility care strategies. Based on the preliminary results of this study, certain dietary ideas that could positively influence fertility have been proposed, focused on the normalization of body weight and the reduction in excess fat tissue.

Abnormal Menstrual Chart Patterns, Their Treatment and Fertility Outcome Among Women with Hormonal Infertility at Bugando Medical Centre, Mwanza, Tanzania

&amp;lt;i&amp;gt;Background:&amp;lt;/i&amp;gt; Infertility is a global public health issue, affecting one in six individuals at some point in their lives. Menstrual cycle patterns serve as indicators of reproductive health, and tracking these patterns is a simple, noninvasive, and cost-effective method that all women should consider. This study aimed to analyze menstrual chart patterns, associated clinical profiles, interventions and fertility changes among women with hormone-related infertility at Bugando Medical Centre. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: A prospective longitudinal study that involved 230 women with hormonal infertility aged 18-44 years, was carried out at Bugando Medical Centre from March 2023 to March 2024. A pretested data collection tool was used. Mothers were instructed to chart their menstrual cycle biomarkers. Basic hormonal profiles were investigated. Data analysis was done according to the objectives using STATA version 15 and Pearson’s Chi2 test or Fisher’s Exact test was used to measure the association between menstrual patterns and clinical profiles. The significance level was determined at p-value &amp;lt;0.05. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; The mean age of the participants was 32.2 ± 5.7 years. The years of infertility ranged from 1 to 20 with a median age of 4 [IQR=2–7] years. Participants with normal HbA1c conceived more than those with abnormal HbA1c; 34.7 % (41/118) versus 22.3 % (25/112), (p-value 0.037), while those with normal thyroid function 31.1% (61/196) conceived more compared to those with thyroid dysfunction 14.7% (5/34) (p-value 0.035). At the end of three months, most of them were ovulating. Among those who ovulated 28.7% conceived within three months. &amp;lt;i&amp;gt;Conclusion:&amp;lt;/i&amp;gt; Answers to infertility are hidden within the menstrual cycle patterns. Menstrual cycle charting and lifestyle changes should be incorporated as tools in managing women with infertility.

Body Composition and Dietary Intake of Women Attending an Infertility Clinic-Polish Observational Study.

We aimed to assess the body composition and dietary intake of female patients attending one of the Polish infertility clinics. Additionally, we evaluated if there were any relationships between dietary intake and body composition parameters. The study involved 51 women who met the inclusion criteria. For the nutritional assessment, we used 3-day dietary records. Weight, height, waist and hip circumferences, and body composition were assessed. The participants were divided into three groups, with low (I, n = 12), normal (II, n = 27), and high (III, n = 12) fat tissue content, and then compared in terms of dietary intake. The lowest protein intake per kilogram of body weight was observed in group III (p < 0.001). In group I, we reported the highest consumption of plant protein in general (p = 0.03) and per kg of body weight (p < 0.001). Higher protein intake per kg body mass was associated with lower values of BMI (r = -0.681; p < 0.001), fat mass (r = -0.641; p < 0.001), waist-hip ratio (r = -0.391; p = 0.005), and abdominal fat index (r = -0.653; p < 0.001). Our findings suggest that targeted nutritional counseling focused on optimizing protein intake and emphasizing plant-based sources may improve body composition and potentially support fertility outcomes in women undergoing infertility treatment.

Oocytes Quality Assessment-The Current Insight: A Systematic Review.

An overall in vitro fertilization (IVF) outcome is dynamic. Good oocyte quality is important for achieving a better IVF pregnancy. Various methods have been used for OQ assessment (OQA). However, due to inconclusive evidence, one method's superiority has not been proposed over others. Thus, OQA should be consolidated based on the current evidence for this matter. Our study aims to summarize the current OQA used and compare their recommended methods. Our results revealed that the optimal OQA for cost-effectiveness and clinical implementation is still via morphological assessment. The current method most opted for is total oocyte scoring. Although other methods-follicular fluid evaluation, mitochondria spindle assessment, or live zona imaging-can be applied with better precision, due to cost, additional tools, and expertise, and they should cater to research purposes and selected centers. Our results added value as a current strategy for optimizing OQA in IVF practice, aiming at cost-effectiveness and reproducibility for better clinical implementation.