Types Of Infertility Research Articles

Analysis of pregnancy outcomes in patients with recurrent implantation failure complicated with chronic endometritis.

Chronic endometritis (CE) has been considered to reduce uterine receptivity and negatively affect reproductive outcomes for in vitro fertilization-embryo transfer (IVF-ET) patients, especially for people undergoing recurrent implantation failure (RIF). To investigate the effects of antibiotic and platelet-rich plasma (PRP) therapy on pregnancy outcomes following frozen-thawed embryo transfer (FET) in RIF patients with CE, endometrial specimens of 327 patients with RIF obtained by endometrial scratching during mid-luteal phase were immunostained by multiple myeloma oncogene-1 (Mum-1)/syndecan-1 (CD138). RIF patients with CE were given antibiotics and PRP treatment. According to the Mum-1+/CD138+ plasmacytes after treatment, patients were divided into persistent weak positive CE (+) group, CE (-) group and non-CE group. FET was performed and the basic characteristics and pregnancy outcomes of patients in three groups were compared. Among 327 RIF patients, 117 patients were complicated with CE, the prevalence was 35.78%. The prevalence of strong positive was 27.22% and that of weak positive was 8.56%. 70.94% patients with CE converted to negative after treatment. There was no significant difference in the basic characteristics, including age, BMI, AMH, AFC, infertility years, infertility types, number of previous transplant cycles, endometrial thickness on transplantation day and number of transplanted embryos (p > 0.05); The positive rate of hCG, clinical pregnancy rate and implantation rate in CE (-) group were significantly increased compared with the weak CE (+) group and non-CE group (p < .01), and the live birth rate also improved (p < .05). Whereas, the rate of early abortion in CE (-) group was 12.70%, which was higher than that in weak CE (+) group and non-CE group (p < .05). After multivariate analysis, number of previous failed cycles and CE remained independent factors associated with live birth rate, while only CE remained to be the independent factor of clinical pregnancy rate. It is recommended to perform CE-related examination for patients with RIF. Antibiotic and PRP treatment can significantly improve pregnancy outcomes of patients with CE negative conversion in FET cycle.

The Concept of Infertility in Women: A Narrative Literature Review

Infertility can be defined as a married couple who have not experienced pregnancy for one year, after having regular intercourse 2-3 times a week and without using any preventive methods. There are two types of infertility, namely primary infertility and secondary infertility. Primary infertility is when the wife has never been pregnant even though she has had intercourse without contraception and is faced with the possibility of pregnancy for twelve months. Secondary infertility is when the wife has been pregnant before, but then there is no further pregnancy even though she has had intercourse without contraception and is faced with the possibility of pregnancy for twelve months. Causes of infertility can be divided into three groups. One-third of related problems in women, one-third in men, and one-third are caused by a combination of factors. Infertility in women can be caused by problems with the vagina, cervix uteri, fallopian tubes, uterus, or ovaries. This literature review aimed to describe the definitions, types, and current management of infertility in women.

Factors Affecting Infertility in Women of Reproductive Age in the IVF Programme

Approximately 8-10% of couples are facing some kind of infertility problem. Infertility is defined as a couple's inability to achieve pregnancy over an average of one year without using birth control methods and while engaging in normal sexual intercourse. Primary and secondary infertility are the two types of infertility. The high percentage of female reproductive age factors influencing infertility, as well as existing studies on infertility-related factors in women, piques the researcher's interest in studying the factors that influence infertility in women. This study is an observational descriptive-analytic with a chi-square design based on secondary data collected from medical records. The majority (37,6%) of infertile women in this study were within the 31-35 age group. Most of the infertile women are primary infertile type women (81%). Indications that cause infertility include an indication of tubal damage, uterine disorders of the endometrium, and ovulation problems. In this case, researchers used these three indications to examine infertility factors in women of reproductive age. Based on the study results, 25% of indications of tubes, 21.7% of endometrial indications, and indications of ovarian problems were calculated by looking at AMH (Anti Müllerian Hormone) and AFC (Antral Follicle Count) values. In this study, the researchers looked for a correlation between increasing age in reproductive women with increasing AMH and AFC levels. Based on random sampling, there was a significant correlation between the increasing reproductive age of women and decreasing AMH and AFC values in women of reproductive age who underwent therapy at Bunda International Clinic, Morula IVF Jakarta.

Introduction: The Why's and How's for Studying Spermatogenesis and Spermatogonial Stem Cells.

Spermatogenesis is maintained throughout adulthood by a pool of adult stem cells termed spermatogonial stem cells (SSCs). Research investigations into spermatogenesis can provide insight into the etiology of certain types of male infertility (e.g., Sertoli cell only syndrome), elucidate means of improving food animal production, reveal new therapeutic avenues to address naturally occurring defects in sperm production, mitigate iatrogenic male infertility (e.g., arising from cancer therapy), and potentially intervene for male contraception. This chapter will serve as a commentary about why studying spermatogenesis is important, including a high-level overview of spermatogonia and SSCs, and make the case for a critical need for use of stringent definitions for SSCs and experimental platforms that allow for clear distinction of the multiple types of spermatogonia that exist in testes of mammals.

Features of gynecological pathology in women with infertility and pathology of the thyroid gland

The objective: to study the structure of gynecological pathology and the hormonal background in women with infertility and various types of thyroid pathology. Materials and methods. The anamnesis of infertile patients was studied. The women, depending on the pathology of the thyroid gland and the method of fertilization were divided into the following groups: the 1st group included 119 women with infertility without thyroid pathology who became pregnant after the use of assisted reproductive technologies (ART); the 2nd group – 47 patients who became pregnant with the help of ART and in whom antibodies to thyroid peroxidase (anti-TPO antibodies) were detected; the 3rd group – 30 women with compensated hypothyroidism, whose pregnancy occurred with ART; the 4th group – 39 women without thyroid pathology and with spontaneous pregnancy; the 5th group – 128 patients with compensated hypothyroidism and spontaneous pregnancy. The concentrations of the following hormones in the blood plasma in the early follicular phase were determined in all the patients: luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, testosterone, cortisol, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate.Results. There were no significant differences between the women with infertility and thyroid pathology and the patients with spontaneous pregnancy without thyroid pathology regarding the age of menarche onset, the period of regularity onset of the menstrual cycle after menarche. The most frequent disorder of the menstrual cycle in patients of the 1st (26.9 %), 2nd (25.5 %) and 3rd (26.6 %) groups was dysmenorrhea. Oligomenorrhea was more often detected in women with infertility and thyroid pathology who became pregnant with the help of ART (25.5 % of patients in the 2nd group and 23.3% – in the 3rd group), compared to women with spontaneous pregnancy. The endocrine factor of infertility was most often determined in women with infertility who became pregnant after ART and had thyroid pathology: in the presence of anti-TPO antibodies, this factor was found in 29.8 % of women, hypothyroidism – 23.3 %. External genital endometriosis as a cause of infertility prevailed among patients with infertility without thyroid pathology, who became pregnant after ART (34.4 %), and women with compensated hypothyroidism, whose pregnancy occurred with the help of ART (26.6 %). In patients with infertility and anti-TPO antibodies, who became pregnant after ART, a significant increase of LH concentration was found compared to the patients with spontaneous pregnancy without thyroid diseases. A significant increase of FSH level was also determined in women of the 1st group compared to healthy patients with spontaneous pregnancy. Conclusions. In women with infertility and various types of thyroid pathology the disorders of the ovarian-menstrual cycle such as dysmenorrhea and oligomenorrhea are typical. The main factor of infertility in patients without thyroid diseases is external genital endometriosis, in persons with thyroid pathology – an endocrine factor. In women with infertility and various types of thyroid pathology, a significant increase of luteinizing hormone concentration in the blood plasma in the follicular phase of the menstrual cycle was established.

The longer-term effects of IVF on offspring from childhood to adolescence.

It is well established that there are increased pregnancy-related complications for a woman who conceives through assisted reproductive treatment (ART). Furthermore, it is known that the risk to the child born is greater, believed to be related to prematurity and growth restriction. Studies have also reported epigenetic changes in the DNA of offspring conceived through ART. In addition, it is believed that they have a greater risk of congenital malformations, although some of these risks may relate to underlying infertility, rather than the ART treatment per se. As a result, it may be expected that there is a greater risk to the longer-term health of the child who is born from ART; however, evidence about the long-term health of children conceived through ART is reassuring. Even though, it is recognised that many of the studies in this field come with limitations. Low numbers of participants is one of the major limitations, which makes subgroup analyses for diverse types of ART, or diverse types of infertility, not feasible. Furthermore, studies are often limited by short follow-up periods because of the difficulty and costs involved in longitudinal study designs. In addition, the rapid changes over time in ART limit the generalisability and significance of long-term findings. Well-designed studies investigating the long-term health outcomes of ART-conceived offspring and the potential influences of various aspects of the ART procedure, as well as studies of the potential underlying epigenetic mechanisms, are imperative. Furthermore, conclusions from childhood hospitalisation data from the United Kingdom, the long-term follow-up and quality of life study from researchers in Melbourne, and the data published from the Western Australian Growing Up Healthy Study will go a long way to help reassure current and prospective parents who may require ART to conceive.

Nutrients against adipogenesis : aim to cheating age or weight reduction

Obesity is associated with increased risk of conditions such as type 2 diabetes, CHD, hypertension, dyslipidaemia (which are often included in the so-called metabolic syndrome), gall stones, certain types of cancer (breast and colon), osteoarthritis, non-alcoholic steatohepatitis, sleep apnoea, infertility, and many psychological conditions. Moreover, there is a marked reduction in life expectancy of the order of several years.

Role of Serum Leptin Levels in Women with Primary Subfertility.

Subfertility significantly affects couples and their families and challenges obstetrics and gynecologists with long-term treatment. Leptin has been widely studied in different types of infertility. However, the results of previous studies are contradictory and the role of leptin is still debated in the reproductive process. The present study aimed to investigate the relationship between serum leptin concentration and some reproductive hormones and endometrial thickness in women with primary subfertility. The present case-control study was conducted from December 2020 to July 2021. A total of 100 women with primary subfertility and 100 fertile women participated in this study as a control group. Blood samples were collected and ultrasonography examinations were performed on all patients. The recorded data indicated that the mean leptin level was higher in women with subfertility compared to that of the control group, 26.8±15.2 ng/mL and 6.4±2.3 ng/mL, respectively (P<0.001). Leptin level significantly increased with a higher body mass index (P<0.001). Leptin at a level of 11 ng/ml or higher is a significant predictor of infertility (odds ratio=2.793). Leptin levels showed high sensitivity, specificity, and accuracy of 96%, 98%, and 96.9%, respectively as predictors of subfertility. As a result, a high leptin level was a strong and valid predictor of subfertility.

Comparison of intrahepatic cholestasis incidence and maternal perinatal outcomes in fresh and frozen embryo transfers

Objective: To compare the perinatal and maternal results of intrahepatic cholestasis (ICP) in fresh and frozen-thawed embryo transfer (ET) pregnancies.&#x0D; Material and Method: This research was performed retrospectively, including fourty-five pregnant women applied to our hospital between October 2010 and January 2021. Two groups have been determined, group:1 (Frozen thawed; n:21) and group:2 (Fresh; n:24). Common pruritus in the body and high fasting bile acids (FBA) levels (greater than 10 mmol/L) were accepted as diagnostic criteria. The exclusion criteria were spontaneous pregnancies, multiple pregnancies, chronic liver disease history. SPSS, version 26 was used for statistical analysis.&#x0D; Results: Statistically significant difference could not be associated between the two groups regarding age, maternal body mass index (BMI), smoking status, number of trials, gestational diabetes mellitus (GDM), types of infertility and polycystic ovary syndrome (PCOS) incidence (p-value &gt;0.05). The way of birth, gender, congenital anomaly, need for meconium aspiration syndrome (MAS), weight of newborn at birth, neonatal intensive care unit (NICU), gestational age at birth and 5 min Apgar score also compared and significantly difference could not be associated between two groups (p-value &gt; 0.05).&#x0D; Conclusion: This study supports the fact that frozen-thawed and fresh in vitro fertilization (IVF) pregnancies in terms of maternal characteristics and perinatal results have no difference.

The Effect of Autologous Platelet-Rich Plasma Treatment on In Vitro Fertilization/Intracytoplasmic Sperm Injection and Its Impact on the Endometrium and Clinical Pregnancy Rate.

BackgroundEndometrial thickness has been identified as a prognostic factor for improving the pregnancy rate for patients with female infertility.Study questionDoes platelet-rich plasma (PRP) treatment affect the endometrial thickness and pregnancy rate after an in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle?AimThis study aims to evaluate the effects of autologous PRP treatment on IVF/ICSI, endometrium, and clinical pregnancy rate.Materials, setting, and methodsThis is a prospective, non-blind, randomized controlled study. The ethical committee of the Jeddah IVF Center approved the study, and informed written consent was obtained from all patients. We recruited patients who consulted at the Jeddah IVF Center from September 2020 to May 2021.ResultsA total of 70 patients undergoing IVF/ICSI and embryo transfer (ET) were randomly divided by simple randomization into two groups: those who received PRP treatment after oocyte pickup (OPU) (group A) and those who did not receive PRP treatment (control, group B). The endometrial thickness was measured after OPU and before ET. The mean ages of patients in groups A and B were 35.91 ± 4.09 (range: 24-43) and 34.63 ± 4.26 (range: 25-43), respectively, which were not statistically significant (P < 0.223). In the PRP cases, the types of infertility were primary in 16 (45.7%) and secondary in 19 (54.3%), and the causes of infertility were male factors in 24 (68.6%), unexplained in five (14.3%), ovulatory factor in two (5.6%), endometriosis in two (5.6%), tubal factor in one (2.9%), and preimplantation genetic diagnosis (PGD) in one (2.9%). In the control group, the types of infertility were primary in 14 (40%) and secondary in 21 (60%), and the causes of infertility were male factors in 21 (60%), unexplained in three (8.6%), ovulatory factor in eight (22.9%), endometriosis in one (2.8), and PGD in two (5.6%). In our study, we found that the mean endometrial thicknesses after OPU were 0.594 ± 0.089 (range: 0.4-0.7) and 0.589 ± 0.090 (range: 0.6-0.9) in the treatment and control groups, respectively (odds ratio (OR): 0.005; 95% confidence interval (CI): 0.376-0.047; P < 0.791). Before ET, the mean endometrial thicknesses were 0.86 ± 0.090 (range: 0.7-0.9) and 0.7464 ± 0.06 (range: 0.7-1) in groups A and B, respectively, (OR: 0.114; 95% CI: 0.763-0.151; P < 0.001). Of the 35 patients in each group, 12 (34.3%) and five (14.3%) had confirmed pregnancies in groups A and B, respectively (OR: 0.319; 95% CI: 0.099-1.036; P < 0.05), which is statistically significant.ConclusionAutologous PRP treatment in IVF/ICSI improves the endometrial thickness and clinical pregnancy rate.

Conception and pregnancy outcome after laparoscopic treatment of subtle distal fallopian tube abnormalities in infertile women: a prospective cohort study

Research questionWhat are conception rates and pregnancy outcomes after laparoscopic treatment of subtle distal tubal abnormalities among infertile women, and which factors relate to natural conception? DesignProspective cohort study (n = 234) conducted in a single fertility referral centre between January 2017 and December 2018. Subtle abnormalities included fimbrial agglutination, tubal diverticula, accessory ostium, fimbrial phimosis and accessory fallopian tube. Pregnancy outcomes were followed-up annually until 36 months. ResultsOne hundred and nine patients conceived naturally (natural conception rate 46.6%), and 59 patients conceived after IVF. Term live birth rate of the natural conception group was significantly higher than the IVF conception group (86.2% versus 71.2%, chi-squared = 5.625, P = 0.018). Preterm birth (11.9% versus 0%, P = 0.001) and multiple pregnancy rates (27.1% versus 0%, P < 0.001) of the IVF conception group were significantly higher than the natural conception group. Patient age (hazard ratio = 0.917, 95% CI 0.870 to 0.967, P = 0.001), duration of infertility (hazard ratio = 0.846, 95% CI 0.740 to 0.966, P = 0.014) and concurrent types of subtle abnormalities (hazard ratio = 0.636, 95% CI 0.416 to 0.970, P = 0.036) were factors associated with natural conception. ConclusionsLaparoscopy is an effective treatment for infertile patients with subtle abnormalities, especially for young patients with a short infertile period and at most two types of subtle abnormalities. For older women, a long infertile period and more than two types of subtle abnormalities, IVF may be more suitable after laparoscopic diagnosis.

Association Between Type of Infertility and Live Birth in Couples With a Single Intrauterine Insemination Resulting in Pregnancy: A Propensity Score Matching Cohort Study.

BackgroundFew studies have described the relationship between the type of infertility and live birth in patients treated with intrauterine insemination (IUI). We focused on this issue and attempted to explore it.MethodsThis retrospective study enrolled 2,256 infertile patients who underwent their first IUI cycle and were subsequently diagnosed with a clinical pregnancy at Ji’an Women and Child Health Care Hospital between 2007 and 2018. Inductees were divided into primary infertility (1,680 patients) and secondary infertility groups (876 patients). Following 1:1 propensity score matching to obtain balanced data, the COX proportional hazards model, landmark analysis, and subgroup analysis were used to assess the association between infertility types and live birth rates. Subsequently, a sensitivity analysis was employed to evaluate the potential effect of unmeasured confounding on outcomes.ResultsOf the 1,486 patients who were identified as a matched cohort, 743 were in the primary infertility group and the remaining patients were in another group. A total of 1,143 patients had live births during 431,009 person-days of follow-up (average 290.0 days). Throughout the follow-up period, patients with secondary infertility demonstrated more live births than patients with primary infertility (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.04 to 1.30; P = .007). More details were observed in the landmark analysis. Live birth rates were similar in both groups within 316 days of follow-up (HR, 0.84; 95% CI, 0.62 to 1.14; P = .269), whereas the opposite was found between 316 days of follow-up and delivery day (HR, 1.19; 95% CI, 1.06 to 1.34; P = .004). This was also obtained in a subgroup analysis of patients younger than 35 years old and patients treated with natural cycles (NCs) and IUIs.ConclusionAmong the infertile patients who underwent a single natural or stimulated cycle followed by IUI and had later pregnancies, full-term young secondary infertility mothers (<35 years of age) had a greater chance of having viable babies than the primary infertility ones. The latter may get more benefits when undergoing ovarian stimulation and IUI rather than NC-IUI.

Clinical and economic analysis of the effectiveness of pre-implantation genetic testing in patients with various types of infertility in assisted reproductive technology programs

Introduction. A clinical and economic study was carried out to assess the effectiveness of infertility treatment using assisted reproductive technology programs with preimplantation genetic testing (PGT) in patients with various reproductive disorders.&#x0D; Materials and methods. Twenty models representing discrete-time Markov processes are developed. A total of 10 possible paired scenarios for couples undergoing infertility treatment using assisted reproductive technology, depending on reproductive disorders and the use of PGT, were considered in the study.&#x0D; Results. The most cost-effective scenarios from the simulation results should be the use of PGT in the group of females aged 3742 years and in the group of females under 35 years with missed abortion. These scenarios are not only resource-efficient in terms of the willingness-to-pay threshold, but they also preserve compulsory health insurance funds still with meaningful clinical efficiency. The remaining scenarios are characterized by significant clinical efficacy and low cost per added live birth, except for the PGT use in the group of males with teratozoospermia, which is characterized by a minimum of added live births and a maximum cost per added live birth.&#x0D; Conclusion. The study results indicate the most optimal and economically feasible scenarios of PGT in patients depending on the infertility factor for implementation in the practical healthcare system of the Russian Federation.

Detection of Sperm DNA Integrity and Some Immunological Aspects in Infertile Males

Immunoinfertility caused by anti-sperm antibodies (ASAs) represents about 10–20% of infertility among couples, which interfere with sperm motility and ability to penetrate cervical mucus, sperm-oocyte binding, fertilization, and embryo development. In addition, deoxyribonucleic acid (DNA) damages are increasingly found with infertile cases affecting male reproduction potency and progeny. This study aims to assess the semen, presence of ASAs, and DNA fragmentation index in normozoospermic patients. A total number of 116 cases with an average age of 20–51 years old, and duration of infertility at 4.70 ± 2.77 are classified into 77 and 39 primary and secondary types of infertility, respectively. Mixed agglutination reaction test was used to estimate the ASAs in semen (direct method) and in seminal plasma and blood serum (indirect method), for both immunoglobulins IgG and IgA. Acridine orange test was used to detect DNA fragmentation index. The results showed a significant difference (P &gt; 0.05) for those with a secondary type of infertility at means 24.37 and 31.48 for IgG, and 14.46 ± 1.76 and 6.86 ± 0.39 for IgA by both direct and indirect methods, respectively. The direct method showed a significant difference only for the sperm tail, while that for indirect method was in sperm mid-piece. The mean of DFI for all cases was 38.25 ± 2.08, at 41.61 ± 2.19 and 31.63 ± 4.29, for both primary and secondary cases, respectively. The percentage of ASAs revealed no significant difference with DFI, except in some parts of sperm.

P-743 Is the use of IVF in Australia appropriate?

Abstract Study question How often is ART treatment necessary and what is the true demand of ART treatment in Australia, as opposed to the published ART use? Summary answer The use of ART in Australia, as reported by ANZARD, exceeds the estimated demand of couples requiring ART treatment by 59%. What is known already ART has gained increasing attention over the years in high resourced settings allowing easier access to this technology. The use of IVF and ICSI has become a standard treatment for infertility, with Australia having a high utilisation rate of ART. During the last decade, infertility treatments have been applied to all types of infertility, including unexplained subfertility. This trend has resulted in the possible over-treatment of couples that have a reasonable chance of natural conception. We used modelling to determine whether over- or under-servicing of ART is occurring. Study design, size, duration A model-based approach in which we estimated the annual demand for ART based on a calculated population suffering from infertility. This estimate number of couples requiring ART was then compared to Australia’s reported ART usage, to determine if over- or under-servicing is present in the country. The demand for ART was estimated using demographic data from the Australian New Zealand Assisted Reproduction Database (ANZARD), Australian government databases and literature. Participants/materials, setting, methods The initial assumptions included an estimate of the total infertile population in Australia based on demographic data, with an infertility rate of 10% or 16% (sensitivity) and the prevalence of infertility types obtained from literature. A treatment model was based on three categories (couples with “absolute indications requiring ART”, anovulatory and unexplained infertility).The sum of couples that conceived without ART and those unable to requiring ART was estimated and compared to the ANZARD report. Main results and the role of chance Following the model calculations and based on 305,800 live births and 15,150 ART deliveries, and assuming an infertility rate of 10%, the total infertile population was approximately 40,700 couples. It was estimated that an average of 27,300 couples was calculated to need ART treatment in Australia in 2019. Out of these couples, 58% indicated absolute indications for ART (including uni- and bilateral tubal obstruction and severe male infertility), 14% were couples with anovulatory infertility (couples diagnosed with ovulation disorders) and 28% were couples with ovulatory infertility (including couples suffering from endometriosis and unexplained infertility). The reported number from the ANZARD 2019 report stated that 46,000 couples underwent ART treatment in Australia (59% overuse), with approximately 81,000 completed ART cycles. When comparing the reported number with the estimated number of cycles from the model, we found a 68% overutilisation of ART in Australia. When in the sensitivity analysis, the infertility rate for was adjusted to 16%, and it was estimated that 43,200 couples required ART treatment in Australia in 2019 which seems comparable to 46,000 people that actually received ART treatment in 2019 (6% overuse). Limitations, reasons for caution This model was developed using variables obtained from literature and the calculations were based on a hypothetical population. The model did not include possible combination of infertility causes that ART reports do, and if included, the estimated number of couples would be lower Wider implications of the findings Assuming infertility rates of 10% to 16%, Australia shows clear to limited overuse of IVF. Global ART schemes and funding policies need to be revisited to avoid ART overtreatment and to improve clinical pathways that direct the use of ART. Trial registration number Not applicable

Estimation of the concentrations of manganese, nickel, and aluminum in the semen of infertile men as oxidative stress factors

Semen samples were collected from healthy people (control group for comparison), asthenospermia infertility patients, and unexplained infertility patients from male donors who attended the Fertility Center at Al-Sadr Teaching Hospital in Al-Najaf Al-Ashraf / Iraq for the period from 1/12/2020 to 25/3 /2021. The present study aims to estimate the concentration of manganese, nickel, and aluminum in semen as one of the factors that cause oxidative stress in male infertility. The atomic absorption spectrometry was used to estimate the concentrations of the elements and the statistical analysis by the Tukey One Way method in the Graph Pad Prism program to determine the relationships between the study elements and the parameters of semen in men. The results of the study showed a significant increase (P &lt; 0.05) in the level of nickel and aluminum concentrations (490 ± 27.57 and 450.3 ± 17.92 μg/L, respectively) and a significant decrease (P &lt; 0.05) in the concentration of manganese (202 ± 8.718 ppm). ) in the semen group of men with asthenospermia in comparison with the healthy fertile group (as a control group) (161.7 ± 5.963, 307.5 ± 10.58 μg/L and 309.2 ± 1.470 ppm), respectively. The results also revealed the existence of many negative relationships between the concentration of elements and semen parameters and between the same concentrations. The study concluded that the concentrations of these elements are a factor of stress oxidants that appear in cases of asthenozoospermia or may not change in other types of infertility and remain unexplained infertility.

Показники деяких статевих гормонів та кортизолу в динаміці вагітності в жінок, які мали різні види безплідності в анамнезі

Changes in the endocrine-metabolic balance in women with a history of various types of infertility are so weighty that they determine not only the nature of menstrual and reproductive disorders, but subsequently significantly distort the course of the gestational period. Purpose - to study some indicators of sex hormones and stress hormone cortisol in women in pregnancy dynamics who had a history of different types of infertility. Materials and methods. Some hormonal profile indicators have been studied: free testosterone index (FTI), dihydrotestosterone (DHT) and cortisol in women with a history of different types of infertility at 11-12 weeks and 36-38 weeks of pregnancy. 84 women aged 20 to 49 years were examined. Among these women to the group I were included 26, these are pregnant women who had a history of endocrine infertility; to the group II - 25 pregnant women with a history of tubular-peritoneal infertility; to the group III - 13 pregnant women who had a history of a combination of endocrine and tube-peritoneal factors; to the group IV (the control group) - 20 patients who independently became pregnant without infertility. Results. There was an increase in cortisol concentration already at the beginning of gestation in the first trimester in pregnant women of the group I (80.8%), II (80%) and III (76.9%), while in the control group this indicator was significantly lower and was in 90% of patients at the level of physiological normal. In the third trimester, a further increase in cortisol was observed, both in women with a history of infertility (groups І-ІІІ) and in those who did not have infertility in the past (group ІV). FTI in pregnant women of groups I and III was significantly increased, both in the first trimester (65.4% and 76.9%) and in the third trimester (69.2% and 84.6%), compared to the indicators in groups II and IV. DHT in pregnant women I and III, both in the first trimester (61.5% and 84.6%) and in the third trimester (65.4% and 92.3%), exceeded the norm compared to the rates in the groups II and IV. Conclusions. The detected deviations in the concentration of the stress-associated hormone cortisol with a high degree of probability may indicate an increased stress load, which in pregnant women after the use of treatment cycles and assisted reproductive technologies has been manifested since the beginning of pregnancy. FTI and DHT in pregnant groups I and III were significantly increased compared to those in groups II and IV. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Keywords: pregnant women with a history of various types of infertility, dihydrotestosterone, free testosterone index, cortisol.

The clinical outcomes of selective and spontaneous fetal reduction of twins to a singleton pregnancy in the first trimester: a retrospective study of 10\xa0years

BackgroundSingleton pregnancy is encouraged to reduce pregnancy complications. In addition to single embryo transfer (SET), selective and spontaneous fetal reduction (SEFR and SPFR) can also achieve singleton pregnancies. After SEFR or SPFR, an inanimate fetus remains in the uterus. It is unclear whether the inanimate fetus would adversely affect another fetus or the mother. Previous studies have focused on the differences between pre- and post-reduction. However, studies focusing on the influence of SEFR and SPFR on the remaining fetal development and maintenance of pregnancy are rare.MethodsMaterials from 5922 patients whose embryo transfer dates ranged from March 2011 to January 2021 were collected. Both the SEFR group (n = 390) and SPFR group (n = 865) had double embryos transferred (DET) and got twin pregnancies, but subsequent selective or spontaneous fetal reduction occurred. The SET group (n = 4667) had only one embryo transferred. All were singleton pregnancies on the 65th day after embryo transfer. Clinical outcomes, including pregnancy outcomes, pregnancy complications, and newborn outcomes, were compared among the three groups.ResultsAfter adjusting for age, infertility duration, types of infertility, states of embryos, body mass index, and factors affecting SET or DET decisions, multivariate regression analysis revealed that SEFR increased the risk of miscarriage (OR 2.368, 95% CI 1.423–3.939) and preterm birth (OR 1.515, 95% CI 1.114–2.060), and reduced the gestational age (βeta -0.342, 95% CI -0.544– -0.140). SPFR increased the risk of gestational diabetes mellitus (GDM) (OR 1.657, 95% CI 1.215–2.261), preterm premature rupture of membranes (PPROM) (OR 1.649, 95% CI 1.057–2.574), and abnormal amniotic fluid volume (OR 1.687, 95% CI 1.075–2.648). Both SEFR and SPFR were associated with reduced live birth rate (OR 0.522, 95% CI 0.330–0.825; OR 0.671, 95% CI 0.459–0.981), newborn birth weight (βeta -177.412, 95% CI -235.115–-119.709; βeta -42.165, 95% CI -83.104–-1.226) as well as an increased risk of low-birth-weight newborns (OR 2.222, 95% CI 1.490–3.313; OR 1.510, 95% CI 1.092–2.087).ConclusionsDET with subsequent fetal reduction was related to poor clinical outcomes. We recommend that DET with subsequent fetal reduction should only be considered as a rescue method for multiple pregnancy patients with potential complications, and SET is more advisable.

Prediction of Fertilization Disorders in the In Vitro Fertilization/Intracytoplasmic Sperm Injection: A Retrospective Study of 106,728 Treatment Cycles.

PurposeThis study aimed to develop a risk prediction of fertilization disorders during the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).MethodsA retrospective study was performed with 106,728 fresh embryo IVF/ICSI cycles from 2009 to 2019. Basic characteristics of patients, clinical treatment data, and laboratory parameters were involved. The associations between the selected variables and risks for low fertilization rate (LFR) and total fertilization failure (TFF) were investigated. Ordinal logistic regression and the receiver operating characteristic curves (ROCs) were used to construct and evaluate the prediction models.ResultsA total of 97,181 controls, 4,343 LFR and 5,204 TFF cases were involved in this study. The model based on clinical characteristics (the ages of the couples, women’s BMI, types of infertility, ART failure history, the diminished ovarian reserve, sperm quality, insemination method, and the number of oocytes retrieved) had an AUC of 0.743 for TFF. The laboratory model showed that primary infertility, ART failure history, minimal-stimulation cycle/natural cycle, numbers of oocyte retrieved < 5, IVF, and Anti-Mullerian hormone (AMH) level < 1.1ng/ml are predictors of TFF, with an AUC of 0.742.ConclusionWe established a clinical and a laboratory prediction model for LFR/TFF. Both of the models showed relatively high AUCs.

Зміни в системі гемостазу у вагітних із різними формами безплідності в анамнезі

Most pregnant women with a history of endocrine and combined infertility are overweight, and the presence of obesity during pregnancy is associated with the development of serious hypercoagulation complications. Purpose - to study changes in the hemostasis system in pregnant women with different types of infertility in their history. Materials and methods. Changes in the hemostasis system in 127 pregnant women aged 23 to 40 years were studied, of which 102 women had a different history of infertility. Patients were assigned to 4 groups. The distribution of pregnant women into groups was based on infertility factor: group I - 35 pregnant women who had a history of endocrine infertility, group II - 37 pregnant women who had a history of infertility of tube-peritoneal genesis, group III - 30 pregnant women who had a history of combined infertility: tube-peritoneal genesis with endocrine, control (IV) group - 25 healthy pregnant women who did not have a history of infertility. To evaluate hemostasis, the levels of: activated partial thromboplastin clotting time (APTT), fibrinogen, fibrinogen B. Hemostasis indicators were performed on a semiautomatic 4-channel coagulograph «Huma Clot Qatro», which works according to the photomechanical principle. The validity for relative values was evaluated by the Fisher angular transform method. Results. Estimating the measurement data of the level of APTT in women with different types of infertility by groups in the I and III trimesters, it turned out that in the I group there were slightly increased rates in 1 (2.9%) patient in the I trimester and in 2 (8.6%) in the III trimester; in group III in 1 (3.3%) patients in the I trimester and in 2 (6.7%) in the III trimester; while group II women had a slightly different rate of APTT: no one had an increased rate in the I trimester, and the III trimester had 1 (2.7%) patient, and in group IV no one had an increased APTT, both in the I trimester and III trimester. Analyzing fibrinogen measurement data in women with different types of infertility by groups in the I and III trimesters, it turned out that in the I group, increased rates were in 1 (2.9%) patient in the I trimester and 20 (57.1%) in the III trimester; in group III, 2 (6.7%) patients in the I trimester and 20 (66.7%) in the III trimester; while the fibrinogen score in women of group II was in the I trimester - in 2 (6.7%), and in the III trimester - 20 (66.7%), and in the IV group no one had an increased level of fibrinogen in the I trimester, and in the III trimester there were 5 (20%) patients. Analyzing fibrinogen B measurement data in women with different types of infertility by groups in the I and III trimesters, it turned out that in all groups no one had an increased this indicator in the I trimester, whereas in the III trimester there were single cases: in 3 (8.6%) pregnant women of group I, in group III - in 4 (13.3%) patients, in 2 (5.4%) women of group II and in group IV, increased fibrinogen B was in 1 (4%) patients. Conclusions. High levels of fibrinogen were observed in all pregnant women regardless of the type of infertility (up to 66.7%), in the group of pregnant women who did not have a history of infertility, this indicator was increased only in 20% of women. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local ethics committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author. Key words: APTT, fibrinogen, fibrinogen B, pregnancy after infertility.