Journal of Assisted Reproduction and Genetics最新文献

Objective: To investigate the distribution of ABO blood groups among infertile couples in Southern China (Ganzhou region) and to explore the association between blood types and male reproductive parameters.

Methods: This single-center retrospective study analyzed data from 696 infertile couples who sought treatment at a tertiary reproductive medicine center in Southern China between 2016 and 2024. ABO blood group distributions in infertile men and women were compared with those of a large-scale reference population from Southern China (n ≈ 14.41 million). Chi-square tests, Cramér's V effect size, and the observed-to-expected ratio (O/E) were used to evaluate associations between couple blood type combinations and semen parameters, including sperm concentration, total sperm count, progressive motility, and normal morphology.

Results: Blood group O was significantly overrepresented in infertile men (39.51% vs. 34.21%, P = 0.008) and women (41.67% vs. 34.19%, P < 0.001), whereas blood group AB was underrepresented (men: 6.18% vs. 8.91%, P = 0.008; women: 6.47% vs. 8.91%, P = 0.008). The O/O couple blood type combination showed a significantly higher prevalence among infertile couples (16.81% vs. 11.70%, O/E = 1.44, P < 0.001), while combinations involving A/B and B/AB occurred less frequently (O/E = 0.57-0.78, P < 0.05). Male blood type was associated with sperm normal morphology (O < A < B < AB, P = 0.02), but not with sperm concentration or progressive motility.

Conclusion: Blood group O-particularly the O/O couple combination-may be associated with an increased risk of infertility, whereas combinations involving B or AB blood groups may confer a potential protective effect. The ABO blood group type may influence male fertility, partly through its association with sperm morphology. These findings provide region-specific evidence and underscore the need for large-scale, multi-center studies to further validate the observed associations.

Purpose: The purpose of this study is to assess whether discontinuing routine serum hormone testing following gonadotropin-releasing hormone (GnRH) agonist trigger affects the incidence of empty follicle syndrome (EFS) and embryological outcomes in controlled ovarian stimulation (COS) cycles.

Methods: This retrospective cohort study analyzed 3834 COS cycles at a single fertility center from May 2020 to May 2024. Cycles were grouped based on post-trigger testing: 1964 with routine serum hormone measurement and 1870 without. The primary outcome was EFS, defined as failure to retrieve oocytes despite adequate follicular development. Secondary outcomes included the number of oocytes retrieved, mature oocytes, fertilization rates, and utilizable embryos.

Results: The incidence of EFS did not significantly differ between groups (0.87% with testing vs. 1.07% without; p = 0.06). In GnRH agonist-triggered cycles, the incidence was 0.74% with testing and 0.96% without (p = 0.53). After adjusting for age, trigger medication type, and estradiol level, there was no significant difference in the odds of EFS (adjusted OR 1.26; 95% CI, 0.63 to 2.53; p = 0.52). Secondary outcomes showed statistically significant improvements in the group without testing: oocytes retrieved (mean 12.6 vs. 12.0; p = 0.03), mature oocytes (mean 7.3 vs. 6.4; p < 0.01), and embryos suitable for clinical use (mean 4.0 vs. 3.6; p < 0.01). Fertilization rates were similar between groups.

Conclusion: The discontinuation of routine hormone testing following the GnRH agonist trigger did not increase the incidence of EFS and was associated with comparable embryological outcomes. These findings suggest that routine testing may be unnecessary in most cases, supporting a selective approach, potentially reducing clinical burden and cost without compromising patient care.

We describe a 26-year-old IVF patient, with primary infertility, who underwent oocyte retrieval following ovarian stimulation. During the procedure, we encountered premature follicular luteinization confined to large follicles in the right ovary, while the smaller follicles in the left ovary were not affected. Repeated blood tests in the late follicular phase ruled out premature LH rise and showed an abnormal progesterone rise. We maintain that ovarian tissue mechanical pressure may lead to abnormal follicular luteinization, independent of the LH surge.

The assessment of oocyte and blastocyst quality plays a pivotal role in reproductive biology, directly influencing the success of assisted reproductive technologies (ART) in both humans and farm animals. In livestock, technologies such as Ovum Pick-Up and In Vitro Embryo Production (OPU-IVEP) have revolutionized genetic improvement strategies by enabling the production of a higher number of genetically superior offspring from elite females. However, the manual evaluation of oocytes and embryos remains subjective, time-consuming, and susceptible to human error. Recent advances in Artificial Intelligence (AI), particularly in computer vision and deep learning, have opened new avenues for automating the assessment process. AI models such as convolutional neural networks (CNNs) have demonstrated high accuracy in classifying oocyte and embryo quality, providing standardized, rapid, and reproducible evaluations. This review focuses on the applications of artificial intelligence in bovine oocyte and blastocyst grading, highlighting its potential to improve assessment accuracy, support OPU-IVEP programs, and enhance reproductive efficiency.

Purpose: Does fertility preservation (FP) through oocyte cryopreservation provide realistic reproductive opportunities for diminished ovarian reserve (DOR)? Literature suggests cumulative live birth rates of 30-45% with 8-10 oocytes under 35 years old. Insufficient data exist to define whether DOR patients should be offered FP systematically.

Methods: This retrospective single-center study analyzed data from 304 women undergoing oocyte cryopreservation (January 2016-December 2024). Patients were stratified into cohort 1 (Anti-Müllerian hormone-AMH-≤ 0.5 ng/mL, n = 49) and cohort 2 (AMH > 0.5 ng/mL, n = 255). Primary outcomes included retrieved oocytes (RO) and vitrified oocytes (VO). Secondary outcome examined DuoStim results. Statistical analysis included correlation assessments, ANCOVA, and multiple linear regression.

Results: DOR patients achieved lower oocyte yields compared to cohort 2 (RO: 3.1 ± 2.3 vs. 9.0 ± 6.5; VO: 2.3 ± 1.9 vs. 7.4 ± 5.1; p < 0.001), despite higher gonadotropin doses. AMH strongly correlated with RO (ρ = 0.636, p < 0.001) and VO (ρ = 0.624, p < 0.001). Linear regression confirmed AMH (B = 1.151, p < 0.001) and age (B =  - 0.139, p = 0.002) as significant predictors of VO. In DuoStim subgroup, DOR patients achieved 3.3 ± 2.1 total VO compared to 6.9 ± 3.3 in cohort 2 (p = 0.001).

Conclusion: DOR patients achieve oocyte yields substantially below thresholds associated with reasonable live birth rates, raising concerns regarding FP efficacy. These findings highlight the need for personalized counseling that considers individual patient characteristics and provides evidence-based, realistic expectations for FP. A revision of current AMH thresholds may improve patient selection and cost-effectiveness of FP programs. Younger DOR patients may benefit from oocyte cryopreservation for FP, emphasizing the importance of age stratification.

Purpose: To investigate whether targeting the ER-mitochondria axis can improve embryonic development in a post-ovulatory aging (POA) model by evaluating organelle-specific modulation.

Methods: Fresh oocytes were collected immediately after ovulation, and post-ovulatory aged oocytes were obtained using a mouse model. Fresh oocytes were treated with thapsigargin (an ER stress inducer) or CCCP (a mitochondrial inhibitor), and ER stress (GRP78 fluorescence) and mitochondrial superoxide status (MitoSOX™ fluorescence) were assessed. Aged oocytes were treated with salubrinal (an ER stress modulator), 5-aminolevulinic acid (5-ALA, a mitochondrial modulator), or both. Embryonic development was evaluated via blastocyst formation and cell death rates.

Results: In fresh oocytes, CCCP increased GRP78 fluorescence, and thapsigargin increased MitoSOX fluorescence, consistent with bidirectional ER-mitochondria stress propagation. In POA oocytes, salubrinal reduced GRP78 fluorescence but not MitoSOX, whereas 5-ALA reduced MitoSOX fluorescence but not GRP78; the combined treatment showed no additive effects on either proxy marker. Despite the lack of additivity at the marker level, blastocyst formation increased and apoptosis decreased in all treatment groups, with no additional benefit of combined treatment compared with single agents.

Conclusions: In this POA model, ER-mitochondria coupling detected in freshly ovulated oocytes appeared attenuated. While our single-marker readouts (GRP78 and MitoSOX) are limited proxies, independent targeting of either organelle modestly improved blastocyst formation. These data support a hypothesis-generating framework for future studies in maternal aging models. Results were obtained under 20% O₂ culture and may be conservative relative to physiologic (5%) O₂ conditions.

Purpose: To assess the impact of transvaginal ovarian drilling (TVOD) on euploidy rates following repeat in vitro fertilization (IVF) in subjects with polycystic ovarian syndrome (PCOS).

Materials and methods: A single institution retrospective cohort study between January 2017 and December 2024, all patients with PCOS, as confirmed by Rotterdam criteria, who had TVOD performed prior to a repeat IVF cycle and underwent PGT-A in both the prior and repeat cycles were included and compared to a well-matched control. The primary outcome was the number of transferable embryos per cycle. Secondary outcomes included: blastocyst yield, euploid yield, and rates of aneuploidy.

Results: Eighteen subjects met criteria in our study time frame and were compared to 57 control subjects. The mean age for the TVOD and control groups was 35.3 ± 4.6 and 36.5 ± 4.4 respectively (p = 0.34). TVOD was associated with a doubling of blastocyst yield, a sixfold increase in the yield of euploid blasts, and a nearly fourfold decrease in the percentage of aneuploid blasts. When compared to controls, TVOD resulted in a significant improvement in the yield of euploid embryos, from + 1.3 to + 2.4 (p = 0.01), and transferable embryos from + 1.5 to + 3.9 (p = 0.001). TVOD also resulted in a decrease in the percentage of aneuploid embryos from - 8.5 to - 49% (p < 0.001).

Conclusion: TVOD appears to have positively impacted the yield of transferable embryos and euploid embryos in patients with PCOS when compared to a well-matched control.

Purpose: The purpose of this study is to assess the impact of acute anomalous high-temperature exposure on mouse ovaries, hormone profiles, estrous cyclicity, and folliculogenesis.

Methods: Reproductively young CD-1 mice (6-12 weeks old) were housed in temperature-adjustable chambers under control (28 °C) or heat stress conditions (35 °C) for 1 or 4 consecutive days. Ovaries were collected either immediately after exposure or after a 3-week delay period.

Results: Body weights remained unchanged across groups. Ovary weight was significantly reduced immediately following 4 days of heat exposure, while ovary length trended toward a decrease. Serum hormones-AMH, FSH, and progesterone-were not significantly different between groups. All animals cycled at least twice during a 2-week monitoring period. Follicle counts across all follicle stages were also not significantly different between groups.

Conclusion: Short-term exposure to elevated temperature (35 °C) leads to a transient reduction in ovary weight without altering hormone levels, cyclicity, or folliculogenesis. These findings suggest that acute heat stress may primarily affect the ovarian stroma, warranting further investigation into its structural and functional consequences.

Purpose: To examine how live birth rates, preterm birth, and major birth defects are affected by parental cancer history and conception method.

Methods: IVF births were identified by linking the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System to birth certificates in three States. For each IVF-conceived birth, the subsequent 10 naturally conceived births (from birth certificates) created the comparison group. Parental cancer history was identified by linkage to state cancer registries. Preterm birth (PTB) was defined from birth certificates; birth defects (BD) from state BD registries. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) for PTB and BDs were calculated with logistic regression.

Results: Overall, 30.5% of female cancer survivors who underwent IVF had a live birth. Of 814,658 total births, 9.1% were PT and 4.4% had BDs. IVF was associated with increased risk of PTB and major BDs regardless of parental cancer history. Maternal, but not paternal, cancer history was associated with an increased risk of PTB. No increase in BDs was observed with parental cancer history alone. Risks of both PTB and BDs were highest among multiple births.

Conclusions: IVF use was associated with increased risk of PTB and major BDs. Parental cancer history did not elevate the risk of BDs, which remains low. Based on these data, cancer survivors attempting to conceive with or without IVF can be counseled that the magnitude of risk for PTB and major BD was similar for cancer survivors compared with those who conceive without a parental cancer history.