Oocyte Retrieval Research Articles

Immune imbalance in the pre-ovulatory follicular microenvironment of overweight and obese women during IVF

BackgroundOverweight and obesity can induce an inflammatory milieu in the oocyte microenvironment and are closely associated with reduced assisted reproductive outcomes.ObjectiveHow are immune cells, cytokines and lipid profiles altered in the pre-ovulatory microenvironment of overweight and obese women?Methods32 women undergoing in vitro fertilization (IVF) were included, with 14 overweight or obese (OW) and 18 normal weight (NW) participants. Serum was collected before ovulation induction, follicular fluid (FF) and aspirates were obtained during oocyte retrieval for flow cytometry, cytokines, hormone, and lipid profiles measurement. Clinical outcomes were recorded through a one-year follow-up.ResultsThe percentage of T cells in the pre-ovulatory follicular microenvironment, especially CD4+ T cells, increased significantly in the OW group, which positively related with BMI. Notably, type 2 cytokine IL4 and IL13 transcription level in OW group had significantly increased, while the type 1 cytokine IFNG only showed a non-statistically significant upward trend. Lipid profiles were screened, revealing no difference between the two groups, however, levels were higher in serum compared to FF. Additionally, the concentration gradient of TG between serum and FF was 22-fold in OW group (2.92 ± 3.66 vs. 0.13 ± 0.03), which was significantly higher than the 12-fold gradient observed in NW group (1.72 ± 0.95 vs. 0.14 ± 0.08). Furthermore, day 3 high quality embryos rate is negatively associated with BMI and exhibits a decreasing trend in OW group.ConclusionOverweight and obesity can disrupt immune hemostasis in the pre-ovulatory follicular microenvironment, potentially leading to adverse effects on assisted reproductive outcomes.

Asymptomatic or mild COVID-19 infection in women prior to oocyte retrieval has no impact on embryo laboratory outcomes: a retrospective study

BackgroundFew previous studies have addressed the impact of COVID-19 infection status on assisted reproductive technology outcomes. The purpose of this study was to assess whether COVID-19 infection affects ovulation induction outcomes and the laboratory outcomes of women undergoing assisted reproductive technology treatment.MethodsIn total, 363 patients were divided into three groups: the COVID-19 infection group (group A, n = 49), the COVID-19 recovery group (group B, n = 119) and the COVID-19 non-infection group (group C, n = 195). Intergroup comparisons of baseline characteristics, stimulation characteristics and laboratory outcomes were performed.ResultsThe Gn dosage in group A was significantly higher than those in groups B and C. The duration of Gn treatment was longer in group A than in group B. In group B, the number of high-quality blastocysts was lower than that in group C. The rates of blastocyst formation (42.56%) and high-quality blastocyst formation (12.05%) in group B were significantly lower than those in group A (51.51%; P = 0.003, 16.58%; P = 0.026) and C (48.20%; P = 0.005, 16.49%; P = 0.002). The high-quality blastocyst rate in group C (34.20%) was the highest and was different from that in group B (28.33%). The main risk factor for high-quality blastocyst formation according to multivariate logistic regression analysis was recovery from COVID-19 (0.599, 95% CI: 0.360–0.996; P = 0.048).ConclusionAsymptomatic or mild COVID-19 infection prior to oocyte retrieval may not has a significant negative effect on ovulation induction outcomes or laboratory outcomes, although the number of Gn days and dose of Gn may increase. In addition, we should pay attention to infertile women recovering from COVID-19 infection and be aware of the significant reduction in the number of high-quality blastocysts in this population.

Egg Retrieval as a Cognitive Indicator in Cuckoo Hosts.

Egg retrieval behavior in hosts within avian brood parasitism systems was found to be regulated by the motivation to reject parasitic eggs. However, due to the limitations in the research systems, there is a lack of effective validation regarding the adaptation mechanisms of cuckoo hosts to the conflict between retrieving their own eggs outside the nest and rejecting parasitic eggs. This study uses Daurian redstarts (Phoenicurus auroreus), a secondary cavity-nesting host parasitized by common cuckoos (Cuculus canorus), to verify the adaptive decision-making of the host between egg retrieval and egg rejection by simulating the occurrence of eggs outside the nest. The results showed that Daurian redstarts ignored 60.6% of highly mimetic conspecific eggs, with a retrieval rate of only 18.2%. Additionally, Daurian redstarts rejected 21.2% of conspecific eggs. However, non-mimetic budgerigar (Melopsittacus undulatus) and white model eggs were more likely to be directly rejected (75% and 86.4%, respectively) with no retrieval events. Our findings suggest that egg retrieval behavior in Daurian redstarts is likely influenced by the cognitive process of rejecting parasitic eggs, leading to occasional over-identification and difficulty in decision-making between egg retrieval and egg rejection, especially in the context of conflicting motivations.

Impact of Rearing Substrates on Black Soldier Fly Growth and Fertility: A Semi-Industrial Scale Study to Optimize Egg Collection

Juvenile environments can influence adult phenotypes in holometabolous insects. This study examines the effects of larval rearing substrates on the reproductive outcomes of Black Soldier Flies (BSFs) at a semi-industrial scale. Larvae were reared on five substrates. Larval growth, adult size, and reproductive performance were monitored, with a specific focus on egg production and hatching rates across 17 continuous egg collection days. Egg production was positively correlated with female body weight, while male body weight appeared to influence the egg production peak. Extended larval feeding stages and shorter non-feeding periods were associated with an earlier onset of egg-laying, suggesting life-history traits as predictors for reproductive timing. Diets high in carbohydrates but low in protein and fat positively influenced larval growth, egg production, and female body weight, while diets rich in both protein and carbohydrates negatively affected all measured parameters. Notably, higher fecundity did not necessarily correlate with fertility (i.e., more viable larvae for bioconversion), highlighting the need to optimize diets for both egg quantity and hatchability to maximize productivity. These findings provide valuable insights for optimizing larval nutrition and egg collection practices, enhancing reproductive efficiency and overall productivity in industrial BSF farming.

Frozen versus fresh embryo transfer in women with low prognosis for in vitro fertilisation treatment: pragmatic, multicentre, randomised controlled trial

ObjectiveTo test the hypothesis that a freeze-all strategy would increase the chance of live birth compared with fresh embryo transfer in women with low prognosis for in vitro fertilisation (IVF)...

A Decade of Oocyte Cryopreservation: New Horizons in Patients Accessing Care.

Objective: Utilization of fertility preservation treatments has increased since the American Society for Reproductive Medicine lifted the "experimental" label for oocyte cryopreservation in 2012. This study characterizes changes in insurance coverage, clinical outcomes, and live birth probabilities over a span of a decade (2012-2022) in patients who underwent planned oocyte cryopreservation. Methods: Retrospective analysis of planned oocyte cryopreservation cycles using vitrification from 2012 to 2022. Medically indicated cycles were excluded. Age, anti-mullerian hormone (AMH), number of mature oocytes vitrified, and insurance coverage were evaluated by year of procedure. Comparative statistics were performed using Kruskal-Wallis and chi-square analysis. Linear regression models and Cochran-Armitage trend test were performed to determine the relationships between each variable and time. Result(s): A total of 4,544 planned oocyte cryopreservation cycles were included. Mean age at egg retrieval decreased significantly over time (37.9 ± 2.9 years versus 34.9 ± 3.3, p < 0.0001). Mature oocytes frozen per cycle rose significantly over time (10.7 ± 7.4 in 2012 versus 13.3 ± 8.6 in 2022, p ≤ 0.0001). Cycles with insurance coverage significantly increased, 0% covered in 2012 versus 46.9% covered in 2022 (p ≤ 0.0001). Conclusions: Since 2012, patient age at time of egg freezing has decreased, coinciding with a mean increase in AMH and number of mature oocytes frozen per cycle. Younger participation in extending fertility is likely driven by a boost in social awareness regarding reproductive aging, cryopreservation technologies, and improved access to treatment. Modern oocyte cryopreservation includes more access to insurance coverage, shown by nearly half of current cycles benefiting from plan support. Shifts in patient demographics and insurance coverage, paired with updates to stimulation protocols that optimize oocyte yield, are expected to improve the overall prognosis and future fertility of patients who utilize thawed oocytes.

Optimal aspiration pressure of suction pump for oocyte retrieval in infertile patients undergoing in vitro fertilization.

The oocyte retrieval is a critical step in assisted reproductive technologies, including in vitro fertilization and fertility preservation. Despite evolving techniques, the optimal aspiration pressure during retrieval remains debatable, with limited in vivo human studies. Existing studies, primarily in vitro and on animals, suggest that inappropriate aspiration pressures can impair oocyte quality. This study aims to compares the effects of two different aspiration pressures, 120mmHg and 150mmHg, on oocyte recovery, damage, and subsequent embryo development and pregnancy outcomes in infertile women undergoing transvaginal ultrasound-guided oocyte retrieval. This retrospective study analyzed data from 891 women at Seoul National University Hospital between May 2018 and August 2023. A total of 400 cycles were included, with 202 at 120 mmHg and 198 at 150 mmHg aspiration pressures. The primary outcomes were the number of retrieved, matured, fractured oocytes, embryos, and good-grade embryos. Pregnancy outcomes were evaluated by comparing the clinical pregnancy rates and live birth rates. Univariate and multivariate logistic regression analyses were conducted to evaluate the relationship between aspiration pressure, clinical pregnancy, and live birth rates. There was statistically significant difference in the number of retrieved oocytes and mature oocytes between the 120 mmHg group and the 150 mmHg group (6.3±5.2 vs. 7.7±6.7, p = 0.018; 4.4±3.7 vs. 5.6±5.3, p = 0.011). The number of embryos and good grade embryos also differed significantly (3.3±3.1 vs. 4.2±3.9, p = 0.011; 1.0±1.6 vs. 1.5±2.6, p = 0.031). However, there were no significant differences in clinical pregnancy and live birth rates between the two groups in multivariate logistic regression analysis (adjusted OR = 0.725, p = 0.519; adjusted OR = 0.370, p = 0.170). Increasing the aspiration pressure to 150mmHg led to a higher yield of oocytes and embryos than 120mmHg, without any negative impact on oocyte quality or live birth rates. These findings provide valuable insights for clinical decision-making in infertility treatments, suggesting that 150mmHg may be a more effective pressure for oocyte retrieval in in vitro fertilization and embryo transfer.

Cyclical, multi-trophic-level responses to a volatile, introduced forage fish: Learning from four decades of food web observation to inform management

Abstract Species introductions can have significant effects on recipient ecosystems. Anticipating potential ecosystem change in response to introduced species based on historical information can help managers prepare for future conditions. Rainbow Smelt Osmerus mordax have been introduced widely to improve sport fish growth. As intended, Walleye Sander vitreus growth in Horsetooth Reservoir, Colorado increased after Rainbow Smelt introduction, but poor Walleye recruitment occurred as well. Additionally, opossum shrimp Mysis diluviana became absent from both predator diets and intermittent surveys, the dominant Daphnia species in Horsetooth Reservoir shifted and Daphnia densities declined significantly. These patterns were repeated during two different time periods of increased Rainbow Smelt abundance, suggesting that Rainbow Smelt have a strong influence on multiple components of the ecosystem. The repetition of responses to Rainbow Smelt offered the opportunity to evaluate indicators to anticipate potential ecosystem regime shifts that restructure predator–prey dynamics across trophic levels. Three predictors (i.e., high estimated Rainbow Smelt abundance, high catch rates of large Walleye, and low Daphnia densities) were associated with poor Walleye recruitment. Simple indicators like these could inform timely management decisions to take advantage of the benefits Rainbow Smelt offer, while lessening their undesirable effects. For example, management decisions could be made, such as preparing for Walleye egg collections, rearing and stocking of Walleye, increasing availability or quality of Walleye spawning habitat, allowing more protective or liberalized adult Walleye harvest to promote natural recruitment, and limiting Rainbow Smelt access to their spawning habitat.

Factors Affecting the Success of Ovum Pick-Up, In Vitro Production and Cryopreservation of Embryos in Cattle

Increasing global demand for animal proteins warrants improved productivity by genetic selection of superior cattle and faster dissemination of genetics. Availability of more progeny for genomic selection should maximize chances of identifying animals with desirable traits and increase selection pressure. OPU and IVP of embryos using these oocytes will substantially increase calves produced compared to conventional embryo transfer (ET). The OPU-IVP technology not only supports genetic improvement but also contributes to reducing environmental impacts of livestock production systems by improving efficiency and optimizing resources, aligning with the Sustainable Development Goals of the United Nations. However, there are several factors influencing the success of OPU-IVP. This review is focused on these factors and the impacts of in vitro culture conditions on the lipid content of embryos and potential role of L-carnitine, a lipolytic agent, on developmental competence of IVP embryos. The documented effects of L-carnitine and current knowledge regarding regulation of the Hippo signaling pathway suggest that supplementation of embryo culture media with L-carnitine will increase post-thaw survival of IVP embryos and their subsequent developmental competence by regulating lipid metabolism, production of reactive oxygen species, and Hippo signaling. Therefore, this review highlights current advancements in the field of OPU-IVP and potential areas for refining culture conditions to yield developmentally competent embryos that survive cryopreservation procedures.

B cell translocation gene 2 expression levels in human granulosa cells is negatively associated with in vitro fertilization/intracytoplasmic sperm injection outcomes: a pilot study.

This study aimed to monitor the expression of B-cell translocation gene 2 (BTG2) in granulosa cells of patients undergoing IVF/ICSI with respect blastocyst qualityoutcomes. We recruited 181 women undergoing IVF/ICSI cycles for infertility. Granulosa cells were extracted from follicular fluid. BTG2 expression level of granulosa cells were stratified into tertiles (low, middle, and high), and the patients of each tertile were compared for outcome indicators by Kruskal-Wallis analysis. Spearman's correlation analyses were used to evaluate the correlation between BTG2 mRNA levels and outcome indicators. Generalized linear models and generalized additive models with smoothing splines were used to adjust for potential confounders. Patients in the low BTG2 tertile had higher oocyte retrieval, fertilization, blastocyst formation, and high-quality blastocyst rates than those in the high BTG2 tertile. Patients in the high BTG2 tertile exhibited a downward trend in implantation and clinical pregnancy rates compared to those in the low or middle BTG2 tertiles, whereas the early pregnancy loss rate showed an upward trend, although the difference was not significant. After adjusting for confounding factors, the expression level of BTG2 was negatively correlated with oocyte retrieval, blastocyst formation, and high-quality blastocyst rates. Stratified analysis of AMH > 4ng/ml showed elevated BTG2 expression was associated with reduced oocyte retrieval, fertilization, cleavage, blastocyst formation, and high-quality blastocyst rates. No differences in these outcomes were observed in patients with AMH ≤ 4ng/ml. In women with high AMH levels (> 4ng/ml) elevated BTG2 expression in granulosa cells was associated with poor quality blastocyst outcomes.

Clinical and ethical perspectives of ovarian stimulation and oocyte cryopreservation in adolescents: 6 years experience from a tertiary Centre

Abstract STUDY QUESTION What are the clinical and ethical challenges of performing ovarian stimulation and oocyte cryopreservation in adolescents and the barriers to providing treatment? SUMMARY ANSWER Our study shows that, in one of the largest case series to date in this population, post-pubertal adolescents as young as age 13 years can undergo ovarian stimulation and oocyte cryopreservation with a response comparable to adults. WHAT IS KNOWN ALREADY Fertility preservation in adolescents has not been well studied, with little data available in the existing literature. Referrals for fertility preservation in adolescents are increasing due to developments in childhood cancer treatments, which have led to a growing population of children at risk of developing premature ovarian insufficiency. Those with certain benign conditions or gender incongruence also face this challenge. All established fertility preservation guidelines state that where there is a risk to fertility, oocyte cryopreservation should be offered to post-pubertal females. However, counselling and consenting young people about fertility decisions is an ethically complex area and assessing capacity to consent in this age group is not straightforward. STUDY DESIGN, SIZE, DURATION This was a retrospective observational cohort study of 182 referrals for fertility preservation counselling to a specialist unit and we present outcomes for the 33 adolescents who underwent 36 cycles of ovarian stimulation and oocyte cryopreservation between January 2018 and January 2024. PARTICIPANTS/MATERIALS, SETTING, METHODS We included patients aged 13 to 18 years who underwent ovarian stimulation and oocyte cryopreservation for fertility preservation due to high or intermediate risk of gonadotoxicity from medical or surgical treatment at a public-funded specialist unit. The primary outcome was oocyte yield; secondary outcomes included oocyte maturity rate, complications and dropout rate. Data were retrieved from a prospectively managed database. MAIN RESULTS AND THE ROLE OF CHANCE There was a total of 182 referrals received and of these 33 patients underwent 36 cycles of ovarian stimulation and oocyte cryopreservation. Indications for fertility preservation included malignancy n = 19/36 (54%), ovarian cyst surgery n = 7/36 (19%), immunological disorders n = 4/36 (11%), benign haematological disease n = 2/36 (6%), gender reassignment treatment 3/36 (8%) and genetic conditions n = 1/36 (3%). The youngest child who underwent ovarian stimulation was aged 13 years and 10 months at the time of egg collection, minimum time from menarche to ovarian stimulation was 4 months, median AMH (anti-Müllerian hormone) was 16.7 pmol/L (range 2.8–36.9 pmol/L) and antral follicle count (AFC) 11 (3-36). The median number of cryopreserved oocytes was 14 (range 4-39) and oocyte maturity rate 85% (35-100%). Ultrasound monitoring was performed transabdominally in 5/33 (15%) and transvaginally in 28/33 (85%). Egg collection was performed transvaginally in all cases in this cohort. All cycles proceeded to completion. All adolescents were counselled in association with a family member to obtain informed consent and all were assessed as able to comprehend discussions. LIMITATIONS, REASONS FOR CAUTION In view of concerns regarding increased aneuploidy rates in this age group compared to women in their 20 s, there is a need for long-term outcome studies expanding on our findings with data on livebirths, to support clinicians needing to counsel patients and perform oocyte cryopreservation in adolescents. WIDER IMPLICATIONS OF THE FINDINGS Clinician experience, correct setting and availability of funding will enable a permissive environment for oocyte cryopreservation in adolescents. In our experience transvaginal egg collection is an accepted procedure when counselled appropriately. STUDY FUNDING/COMPETING INTEREST(S) No funding was received for this work. No competing interests are declared. TRIAL REGISTRATION NUMBER Not applicable

Fertility in transgender and gender diverse people: systematic review of the effects of gender-affirming hormones on reproductive organs and fertility.

Transgender and gender diverse (TGD) people seek gender-affirming care at any age to manage gender identities or expressions that differ from their birth gender. Gender-affirming hormone treatment (GAHT) and gender-affirming surgery may alter reproductive function and/or anatomy, limiting future reproductive options to varying degrees, if individuals desire to either give birth or become a biological parent. TGD people increasingly pursue help for their reproductive questions, including fertility, fertility preservation, active desire for children, and future options. Their specific needs certainly require more insight into the effects of GAHT on gonads, gametes, and fertility. This systematic review aims to provide an overview of the current knowledge on the impact of GAHT on gonads, gametes, fertility, fertility preservation techniques, and outcomes. This review was registered in the PROSPERO registry under number CRD42024516133. A literature search (in PubMed, Embase, and Web of Science) was performed with a medical information specialist until 15 November 2024. In all TGD people using GAHT, histological changes have been reported.Using testosterone GAHT, ovarian cortical and stromal changes were reported by various studies. In most studies, persistent activity in folliculogenesis can be concluded based on the descriptions of the follicle count, distribution, and oocyte retrieval yield. However, there may be a negative effect on the fertilization rate in the presence of testosterone. Reports of successful ovarian stimulation, fertilization, pregnancies, and live births have been published, describing cases with and without testosterone discontinuation.After using oestrogen GAHT, testes are reported to be more atrophic, including smaller seminiferous tubules with heavy hyalinization and fibrosis. Spermatogenic levels varied widely from complete spermatogenesis to meiotic arrest with spermatids, to spermatogonial arrest, Sertoli cells only, or even tubular shadows. Oestrogen and anti-androgen treatment causes higher proportions of sperm abnormalities (i.e. low total sperm count, low sperm concentration, poor sperm motility) or azoospermia. However, after cessation, this may be restored. Although knowledge of the effect of GAHT is growing, blind spots remain to be uncovered. Therefore, additional research in this specific population is needed, preferably comparing outcomes before and after the start of GAHT. This may help to reveal the pure impact of GAHT on reproductive functioning. Research suggestions also include investigations into the reversibility of the GAHT effect, especially for those who start transition at a young age. Looking carefully at the presented data on GAHT effects on gonads and gametes, the correct advice is to assess and reassess reproductive wishes and preferences repeatedly, and also to explore individual fertility preservation needs during gender-affirming treatment, given the expanding knowledge and therapy opportunities. Finally, concerns regarding long-term health outcomes and quality of life of children born by the use of gametes preserved after exposure to GAHT require prospective follow-up studies.

ИСПОЛЬЗОВАНИЕ ДОБАВКИ НА ОСНОВЕ ПЕРЕРАБОТАННОЙ ПИВНОЙ ДРОБИНЫ В КОРМЛЕНИИ СЕЛЬСКОХОЗЯЙСТВЕННОЙ ПТИЦЫ

Brewer's grain is a by-product of beer production, has a high biological potential due to dietary fiber and beta-glucan, which help animals to modulate the balance and activity of microbial populations in the intestine, so its use in combination with a mineral complex can increase the productivity of poultry. The paper discusses the effect of feeding complex feed additives based on processed brewer's grains as part of complete feed on the productivity, safety and control slaughter of quail-laying quails of the Texas white breed. The experiment was carried out in the vivarium of the Federal State Budgetary Scientific Institution Krasnodar Scientific Center for Animal Science and Veterinary Medicine on Texas white laying quails from 42 days of age to the 222nd day of rearing. The content of the bird was cellular in one tier. The conditions of detention corresponded to generally accepted zootechnical standards, the groups were formed by the method of pairs-analogues of 20 animals each. The first group was the control group and received a balanced complete feed (CF). For feeding the second group, CF was used with the addition of 1.5 % of the developed complex feed additive № 1 by weight of the feed. The third group received a complete mixed feed with the addition of 1.5 % complex additive № 2 by weight of the feed. It has been established that the use of the studied additives has a positive effect on the egg production of birds, increasing the gross collection of eggs by 3.17 and 3.82 % in the groups that received the studied additives. In the experimental groups, the slaughter qualities of laying quails improved. Thus, the weight of the gutted carcass increased by 8.30 % (P≤0.01) in the second group, and by 9.08 % (P≤0.001) in the third experimental group in relation to the control one. The use of complex additives based on processed brewer's grains contributed to an increase in production profitability by 3.22 and 3.24 % and additional profit per head by 11.9 and 12.6 % in the second and third groups, respectively, compared with the control group.

A cycle-based model to predict no usable blastocyst formation following cycles of in vitro fertilization in patients with normal ovarian reserve

ObjectiveThis study aimed to develop a predictive model for the risk of no usable blastocyst formation in patients with normal ovarian reserve undergoing IVF.MethodsThe model was derived from 7,901 patients who underwent their first oocyte retrieval and subsequent blastocyst culture, of which 446 cases have no usable blastocysts formed. Univariate regression analyses, least absolute shrinkage and selection operator regression analysis were used to identify the association of patient and cycle characteristics with the presence of no available blastocyst and to create a nomogram. The performance of the nomogram was assessed using the receiver operating characteristic (ROC) curve and calibration curve, the net benefit threshold of prediction was determined using decision curve analysis (DCA).ResultsMultivariate analysis identified three independent predictors: the number of day 3 (D3) embryos, the number of high-quality D3 embryos, and the number of embryos used for blastocyst culture. A nomogram model was developed and internally validated using bootstrapping, demonstrating good discriminative ability with an area under the receiver operating characteristic curve (AUC) of 0.879(95%CI: 0.861–0.890).ConclusionsThe cycle-based nomogram can anticipate the probability of no available blastocyst formation in IVF/ICSI treatment. This can help doctors make appropriate clinical judgments and assist patients in managing their expectations effectively.

Controlled ovarian hyperstimulation with or without letrozole for fertility preservation in breast cancer patients: study protocol for a randomised controlled trial

IntroductionMultimodal anticancer therapies greatly damage the fertility of breast cancer patients, which raises urgent demand for fertility preservation. The standard options for fertility preservation are oocyte and embryo cryopreservation; both...

Endometrial scratching before euploid embryo transfer: a case-control study.

To evaluate the effect of endometrial scratching on in vitro fertilization (IVF) success rates in women undergoing frozen embryo transfer with preimplantation genetic testing for aneuploidy (PGT-A). Biopsy was performed at oocyte retrieval in cases and compared to those who did not undergo scratching (controls). Endpoints included pregnancy loss, total pregnancy, clinical pregnancy rate (CPR), ongoing pregnancy rate/live birth rate (OPR), and the incidence of chronic endometritis (CE). Women in case and control groups had similar characteristics, such as age, body mass index, and parity. Overall total pregnancy rate was 82.43% following single euploid embryo transfer in cases compared to 85.7% in controls (p = 0.57; OR = 1.27; 95% CI = 0.565 to 2.78). CPR was 73.3% and 76.2% (p = 0.62; OR = 1.18; 95% CI = 0.594 to 2.29), and OPR between groups was 64.8% and 72.3% (p = 0.28; OR = 1.42; 95% CI = 0.74 to 2.7). First trimester loss rate was similar at 16.9%% and 15.5%%, respectively (p = 0.82). Subjects who underwent scratching closer to their frozen embryo transfer (≤ 3months) had a similar overall pregnancy rate to those with a longer delay between retrieval and frozen embryo transfer (> 3months 81.4% vs.87.5%; p = 0.56). CE incidence was 10.8% (8 out of 74; 95% CI = 5.5% to 19.9%). The odds of having a second trimester loss were significantly higher in the scratch group compared to controls (p = 0.03; OR = infinity; 95% CI = 1.3 to infinity). Endometrial scratching before frozen euploid embryo transfer did not influence pregnancy outcome but increased the chances of second trimester loss. CE was a frequent finding in those undergoing endometrial scratching at the time of retrieval.

The effects of growth hormone on the outcomes of in vitro fertilization and embryo transfer in age-grouped patients with decreased ovarian reserve: a prospective cohort study.

Growth hormone (GH) could improve the outcomes of in vitro fertilization and embryo transfer (IVF-ET) in patients with decreased ovarian reserve (DOR), but which age group will benefit the most has remained controversial. This study aims to explore the outcome of IVF-ET among differently aged patients with DOR treated with GH. A total of 846 patients with DOR undergoing IVF-ET from May 2018 to June 2023 at the Reproductive Medicine Center of Sichuan Provincial Women's and Children's Hospital were prospectively enrolled. The patients were divided into group A (< 35 year old, n = 399), group B (35 ~ 40 year old, n = 286), and group C (> 40 year old, n = 161). Each group was sub-divided into the GH part and the control part, with the former receiving pretreatment with GH 4 IU/day on day 2 of the previous menstrual cycle before the injection of gonadotrophin (Gn) until the trigger day. The ovarian stimulation protocol was gonadotrophin-releasing hormone antagonist (GnRH-A) or long-acting GnRH agonist protocol. The quality of oocytes and embryos and the outcome of pregnancy were compared. In group B, the number (1.16 ± 0.12 vs. 0.74 ± 0.09) and rate (34.27% vs. 23.90%) of high-quality cleavage embryos, rate of implantation (32.37% vs. 22.35%), clinical pregnancy (48.98% vs. 33.67%), and live birth (44.90% vs. 29.59%) were significantly higher, whereas the canceled oocyte retrieval rate was significantly lower (1.49% vs. 6.58%) in the GH part than those of the control part (P < 0.05). In group B, the duration and dose of Gn, number of oocyte retrieved, and rates of normal fertilization, cleavage embryo, blastocyst, high-quality blastocyst, and early miscarriage were not significantly different between the GH and control parts (P > 0.05). In groups A and C, no significant difference was detected in the quality of embryos and outcomes of embryo transfer with or without pretreatment (P > 0.05). GH could improve the quality of embryos and live birth rate for patients with DOR aged 35-40 years old.

Is the Beck Depression Inventory (BDI) a Useful Tool for Predicting IVF Success?

Background and Objectives: Infertility is a global problem. The interaction between depression and infertility seems bidirectional, and depression may negatively influence IVF outcomes. The Beck Depression Inventory (BDI) is one of the most extensively used instruments for diagnosing depression. The aim of this study was to assess the dynamics of depression in patients undergoing IVF utilizing the BDI. Materials and Methods: This prospective cohort study was conducted at the Clinic for Gynecology and Obstetrics of the University Clinical Center of Serbia in Belgrade, Serbia during the year 2019. Both partners in the IVF program were required to complete the paper-based BDI 5 to 10 days before starting ovarian stimulation, within the 48 h preceding oocyte aspiration and four weeks after embryo transfer. We sought to identify potential predictors of a favorable IVF outcome by using logistic regression modeling. Results: Our study enrolled 86 couples. The overall IVF efficacy in our cohort was 18.6%. A statistically significant logistic regression model (p = 0.001) managed to explain 47.6% of the variability. Increasing patient age, the presence of depression (BDI > 16) and the number of failed IVF cycles were found to be significant negative predictors of ongoing IVF success. Conclusions: Depression is more common in patients undergoing IVF than in the general population. Depression might increase the odds of IVF failure, lending credence to the idea that depression screening using BDI should be a routine part of the IVF process.

The Effects of Three Methods of Luteal Phase Support on Pregnancy Outcomes in Poor Ovarian Responders: A Randomized Clinical Trial.

The effectiveness of changing the type of luteal phase support in patients with poor ovarian response (POR) remains unclear based on the available evidence. This study aimed to compare the effectiveness of various luteal phase support (LPS) methods, including progesterone alone, human chorionic gonadotropin (hCG) alone, and the combination of progesterone with hCG, in these patients. In this randomized clinical trial, 375 patients diagnosed with POR based on the Bologna criteria underwent intracytoplasmic sperm injection-embryo transfer (ET) cycles at the Royan Institute between November 2015 and June 2019. The patients were allocated randomly into three different LPS groups on the day of oocyte pickup. In the first group, 1500 IU of hCG on the ET day, as well as 4 days after that were administrated intramuscularly. In the second group, the patients received 1500 IU of hCG IM on the ET day, as well as 3 and 6 days after the ET along with vaginal progesterone suppositories of 400 mg twice daily. For the third group, only vaginal suppositories twice daily were administrated from the day of oocyte pick up until the pregnancy test day. The clinical pregnancy, miscarriage and live birth rates were compared among groups using appropriate statistical tests. The data analysis indicated that the three groups were comparable, and there were no significant differences among the groups in terms of implantation, clinical pregnancy, miscarriage, and live birth rates. The twin pregnancy rate in the hCG-only group was higher than in the other two groups, although this difference did not reach statistical significance (P=0.060). Similar pregnancy and live birth rates were observed among different LPS regimens. Interestingly, the use of two boluses of low-dose hCG (1500) was associated with a slight increase in multiple pregnancies. We suggest this effective method, which is easier and more patient-friendly (registration number: NCT02798653).

Anti-Adhesive Podocalyxin Expression Is Disrupted in Recurrent Implantation Failure.

Objectives: The downregulation of anti-adhesive regulatory proteins and upregulation of adhesive genes are critical for the receptive endometrium. This study was designed to determine whether switching between the anti-adhesive podocalyxin (PDX) and adhesive HOXA10 receptivity modulator occurs in the endometrium of women with recurrent implantation failure (RIF). Methods: Twenty-four patients with RIF who could not conceive for three or more cycles despite good-quality embryo transfer constituted the study group. Twenty-four patients with unexplained infertility (UEI) matched for age, BMI, and infertility duration were included in the control group. Twenty women scheduled to undergo intrauterine device (IUD) placement for birth control were included in the comparative group. Endometrial tissue was collected from patients with RIF and UEI during egg retrieval after ovarian stimulation using the GnRH antagonist protocol. In the fertile group, endometrial tissues were collected during IUD insertion. HOXA10 mRNA expression was analyzed by qRT-PCR and PDX protein expression was analyzed by ELISA. The relative expression of endometrial HOXA10 mRNA was calculated using the 2-ΔΔCt equation. Results: The relative expression of HOXA10 mRNA in the RIF group was significantly lower than that in the UEI group (p < 0.001). HOXA10 mRNA expression in the fertile group was significantly higher than that in the RIF group and was similar to that in the UEI group. PDX expression in the RIF group was significantly higher than that in the UEI group (p < 0.001). PDX expression in the fertile group was significantly lower than in the RIF and UEI groups. A negative correlation was detected between the anti-adhesive PDX protein and adhesive HOXA10 (r = -0.797, p < 0.001). Although there was a positive correlation between endometrial thickness recorded on the day of hCG administration and HOXA10 (r = 0.590, p < 0.01), endometrial thickness was negatively correlated with PDX (r = -0.529, p < 0.01). Conclusions: The failed physiological downregulation of the anti-adhesive PDX protein in patients with RIF prevented the upregulation of adhesive HOXA10 mRNA.