BMAL1 improves assisted reproductive technology outcomes in patients with polycystic ovary syndrome by targeting BMP6 and regulating ovarian granulosa cell apoptosis
To investigate BMAL1 and BMP6 expressive differences in ovarian granulosa cells (OGCs) of patients with polycystic ovary syndrome (PCOS), explore regulatory relationship, assess their impacts on OGC proliferation and apoptosis, and analyze their correlations with ART outcomes of patients.
Twelve-hour ultradian rhythmic reprogramming of gene expression in the human ovary during aging
The 12-h ultradian rhythm plays a crucial role in metabolic homeostasis, but its role in ovarian aging has not been explored. This study investigates age-related changes in 12-h rhythmic gene expression across various human tissues, with a particular focus on the ovary.
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 quality outcomes.
Prenatal diagnosis following preimplantation genetic testing for monogenic conditions: a single centre record linkage study
Professional bodies currently advise all pregnant individuals undertake confirmatory prenatal diagnostic testing following preimplantation genetic testing for monogenic conditions (PGT-M). We aimed to ascertain the uptake of prenatal diagnostic testing following PGT-M in a large single-centre population.
Correction: Uniparental disomy (UPD) exclusion in embryos following Preimplantation Genetic Testing for Structural Rearrangements (PGT-SR)
Ovarian function after COVID-19: long-term effects and vaccine safety in ART patients
This study aimed to evaluate the long-term impact of mild COVID-19 infection and COVID-19 vaccination on ovarian function in patients undergoing assisted reproductive technology (ART). Specifically, we assessed ovarian outcomes between 9 and 18 months post-infection and investigated the effects of COVID-19 vaccines (inactivated virus and adenovirus) on reproductive parameters.
Oocyte/zygote/embryo maturation arrest: a clinical study expanding the phenotype of NOBOX variants
Primary ovarian insufficiency (POI) is an important cause of female infertility, stemming from follicle dysfunction or premature oocyte depletion. Pathogenic variants in genes such as NOBOX, GDF9, BMP15, and FSHR have been linked to POI. NOBOX, a transcription factor expressed in oocytes and granulosa cells, plays a pivotal role in folliculogenesis. Loss-of-function variants in NOBOX are reported in 1-2% of POI women. This study aims to describe the association of novel NOBOX variants with a distinct oocyte, zygote, and embryo maturation arrest (OZEMA) phenotype in infertile women.
A standardized training allows achieving similar clinical pregnancy rates per top-quality euploid blastocyst transfer across operators
To evaluate the performance of different embryo transfer (ET) operators in a strictly controlled scenario minimizing potential confounders.
The effect of single versus group culture on cumulus-oocyte complexes from early antral follicles
This study aimed to evaluate the effectiveness of single versus group culture strategies for cumulus-oocyte complexes (COCs) derived from early antral follicles (EAFs), with the goal of optimizing culture conditions to increase oocyte availability for assisted reproductive technologies.
Prenatal diagnosis following preimplantation genetic testing (PGT): recommendations of the Italian Society of Human Genetics (SIGU)
This document aims to provide good practice recommendations in order to support maternal-foetal medicine specialists, clinical geneticists and clinical laboratory geneticists in the management of pregnancies obtained after the transfer of an embryo tested with preimplantation genetic testing (PGT). It was drafted by geneticists expert in preimplantation genetics and prenatal genetic diagnosis belonging to the "Working Group in Cytogenomics, Prenatal and Reproductive Genetics" of the "Italian Society of Human Genetics" (SIGU). In particular, the paper addresses the diagnostic algorithm to be applied in prenatal follow-up depending on the type of PGT performed, the results obtained and the related diagnostic value based on the most recent literature data and Italian and international recommendations.
Effects of emotions on IVF/ICSI outcomes in infertile women: a systematic review and meta-analysis
To assess whether infertile women's psychological conditions, such as depression, anxiety, and stress, are associated with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) outcomes, we systematically searched for relevant articles from January 1, 2004, to March 29, 2024, in five databases, including PubMed, Web of Science, EMBASE, Cochrane Library, and PsycINFO. A random-effects model was used to examine pooled standardized mean differences (SMD) and 95% confidence interval (CI). A total of 29 articles fulfilled the inclusion criteria and were included in this meta-analysis. The statistical analysis revealed that infertile women with higher levels of anxiety [SMD: -0.17, 95% CI: (-0.27, -0.06), P = 0.002] and depression [SMD: -0.17, 95% CI: (-0.30, -0.04), P = 0.008] were less likely to have a successful pregnancy following IVF/ICSI treatment. Although not statistically significant, the results indicate a trend of increasing IVF/ICSI success with increasing participants' perceived stress levels [SMD: 0.09, 95% CI: (-0.01, 0.19), P = 0.07]. There was also no statistically significant correlation between infertility-related stress and IVF/ICSI outcomes [SMD: -0.26, 95% CI: (-0.79, 0.28), P = 0.35]. In general, it suggested that medical personnel should be aware of the mental health of infertile women involved in IVF/ICSI.
Negotiating the space and time conundrum in human zygotes: chaos theory in action
The role of granulocyte-macrophage colony-stimulating factor in female assisted reproductive technology treatment: a systematic review and meta-analysis
The objective of this study is to explore the impact of the use of granulocyte-macrophage colony-stimulating factor (GM-CSF) in female undergoing assisted reproductive technology (ART) on reproductive outcomes. A literature search was performed using electronic databases (PubMed, EMBASE, Web of Science, CNKI, Wanfang data, Geen Medical, and Cochrane Library). Risk ratio (RR), odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CI) for various outcomes were presented. The publication bias and heterogeneity were determined using funnel plot symmetry and I test separately. The combined results of the RCT studies did not reveal statistical differences between the GM-CSF group and the control group for any outcome indicators. However, our pooling of results showed that after meta-analysis of non-RCT studies, GM-CSF had a positive effect on implantation rate (OR 1.90; 95% CI 1.11-3.24), clinical pregnancy rate (OR 1.54; 95% CI 1.21-1.95), live birth rate (OR 1.43; 95% CI 1.04-1.98), and available embryo rate (OR 1.27; 95% CI 1.10-1.46). In conclusion, these results suggest that for a subset of women undergoing ART, GM-CSF may favorably affect CPR, LBR, IR, and available embryo rate (AER). TRIAL REGISTRATION: PROSPERO registration number CRD42022322778.
PGT-A: what's it for, what's wrong?
PGT-A, what's it for? Considering the increase in fetal aneuploidies with a woman's age and the high number of miscarriages associated with fetal karyotype anomalies, the concept of selecting IVF embryos based on their karyotype in order to transfer only euploid embryos and eliminate aneuploid ones was proposed. Preimplantation genetic testing for aneuploidy (PGT-A) was then established, nearly 30 years ago, with the expectation that the transfer of euploid embryos would lead to a significant improvement in medically assisted reproduction (MAR) outcomes. PGT-A, what's wrong? Despite the practice and widespread use, PGT-A has not consistently proven its effectiveness. The clinical value of PGT-A remains controversial. The initial studies reported an increase in MAR outcomes. However, these studies used embryo transfer as the reference point. More recent studies, which use intention-to-treat as the reference point, show, at best, slight improvements and, at worst, a reduction in the considered IVF outcomes. In this article, we attempt to answer two key questions: "What is it for?" and "What's wrong with PGT-A?". We also explore some of the ethical issues raised by these conclusions. Ultimately, we suggest that PGT-A should no longer be offered to infertile couples.
Egg donation advertisements: addressing the regulatory gap
Egg donation is a procedure that is powerfully advertised as a beneficial experience with limited mention of the associated risks. Egg donor recruitment advertisements target young and financially insecure women and can serve as a catalyst for interest in egg donation. In the absence of explicit egg donation advertisement regulations and without counterbalancing information from other sources, potential donors may not be able to recognize how advertisements can be misleading. In this paper, we enumerate two types of misleading information in egg donor recruitment advertisements that can influence the decision to donate that might not exist otherwise: (1) the focus on financial benefits and (2) the minimization of health risks. We draw upon existing Federal Drug Administration and Federal Trade Commission regulations that govern other types of medical advertisements and demonstrate their suitability to govern egg donor recruitment advertisements. We conclude that similar regulations could address the regulatory gap in which egg donation advertisements are situated by ensuring that information is balanced and not overly persuasive, thus better protecting the autonomy of egg donors.
Establishing oncofertility care in limited resource settings: a narrative review
While the literature has addressed the implementation of oncofertility care at developed institutions, minimal advice exists for those seeking to build oncofertility programs in limited resource settings (LRS). Our research offers a promising conversation on establishing oncofertility care in such settings from the perspective of a practitioner working to establish care in Latin America. We propose practices that have the potential to significantly improve access to and quality of care in these challenging settings.
Oocytes with impaired meiotic maturation contain increased mtDNA deletions
Induction of meiotic competence is a major goal of the controlled ovarian stimulation used in ART. Do factors intrinsic to the oocyte contribute to oocyte maturation? Deletions in mtDNA accumulate in long-lived post mitotic tissues and are found in human oocytes. If oogenesis cleanses the germline of deleterious deletions in mtDNA, meiotically competent oocytes should contain lower levels of mtDNA deletions vs. meiotically arrested oocytes. We tested this hypothesis using a novel PCR assay for a deletion ratio in human oocytes derived from IVF.
Time-lapse analysis of embryos classified as euploid, mosaic, and aneuploid after embryonic trophectoderm biopsy
Analyze morphokinetic, morphology, and KIDscore™Day5 in different PGT-A classes, focusing on putative mosaicism level and type.
Growth hormone improves the pregnancy outcomes in poor ovarian responders undergoing in vitro fertilization: an umbrella review
Poor ovarian response (POR) significantly impacts the success of assisted reproductive technology (ART), and growth hormone (GH) has been proposed as an adjuvant treatment to improve outcomes in POR patients undergoing in vitro fertilization (IVF). A systematic review and meta-analysis were conducted to evaluate the effectiveness of GH in enhancing pregnancy outcomes, registering a protocol on PROSPERO and searching multiple databases up to September 2023. Twelve systematic reviews/meta-analysis and 20 randomized controlled trials (RCTs) involving 1984 patients were included. Quality assessment was performed using AMSTAR 2, GRADE, and RoB tools. The meta-analysis revealed that GH significantly increased live birth rates [OR=1.80, 95% CI (1.22, 2.64)] and clinical pregnancy rates [OR=1.92, 95% CI (1.51, 2.43)] compared to the control group. Subgroup analysis indicated that administering 5-10 IU/d of GH combined with a long protocol during the middle and late follicular stages maximized these benefits. Despite these promising findings, most outcome indicators exhibited low-quality evidence, highlighting the need for improved research standards to ensure solid evidence supports treatment strategies for POR, thereby promoting reliable application of GH in IVF treatments.
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).
Clinical exome sequencing for carrier screening in assisted reproductive technology and sperm donation
To assess the efficacy of clinical exome sequencing (CES) in individuals involved in assisted reproductive technology (ART) or sperm donor programs, with a specific focus on its impact on clinical decision-making.