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The First Lugano Workshop on the role of adenomyosis in ART 第一届卢加诺讲习班，讨论子宫腺肌症在抗逆转录病毒治疗中的作用。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104444

Mauro Cozzolino , Serdar Bulun , Dominique De Ziegler , Caterina Exacoustos , Human Fatemi , Juan Antonio Garcia-Velasco , Andrew Horne , Felice Petraglia , Pietro Santulli , Edgardo Somigliana , Kim Soorin , Thierry Van den Bosch , Paola Viganò , Peter Humaidan

Adenomyosis is an important clinical condition with uncertain prevalence, and clinical focus on adenomyosis in patients undergoing assisted reproductive technology (ART) has increased during recent years. Recognizing the limited clinical knowledge on the impact of adenomyosis on ART outcomes, the First Lugano Adenomyosis Workshop was a symposium involving experts in the field of adenomyosis, covering basic research, imaging, surgery and infertility to highlight current advances and future research areas over a wide range of topics related to adenomyosis. Adenomyosis is characterized by altered oestrogen and progesterone signalling pathways. Although the criteria of the Morphological Uterus Sonographic Assessment (MUSA) Consortium apply to patients with infertility, the presence of direct signs and localization in the different myometrial layers, particularly the inner myometrium, need more focus. In addition to the MUSA criteria, clinical symptoms and the magnitude of uterine enlargement should also be considered. Whilst pre-treatment with gonadotrophin-releasing hormone agonist with or without an aromatase inhibitor in frozen embryo transfer cycles seems promising, many issues related to therapy remain unanswered. During the Workshop, therapeutic progress over the past decades as well as novel insights were presented and discussed. The role of this opinion paper is to stimulate discussion and spark further interest in adenomyosis and the role of adenomyosis in infertility.

子宫腺肌症是一种重要的临床疾病，发病率不确定，近年来临床对辅助生殖技术（ART）患者子宫腺肌症的关注有所增加。认识到子宫腺肌症对ART结果影响的临床知识有限，第一届卢加诺子宫腺肌症研讨会是一个涉及子宫腺肌症领域专家的研讨会，涵盖基础研究，影像学，手术和不孕症，以突出子宫腺肌症相关广泛主题的当前进展和未来研究领域。子宫腺肌症的特征是雌激素和孕激素信号通路的改变。虽然子宫形态超声评估（MUSA）联盟的标准适用于不孕症患者，但不同子宫肌层，特别是子宫内膜的直接体征和定位需要更多的关注。除MUSA标准外，还应考虑临床症状和子宫增大的大小。虽然在冷冻胚胎移植周期中使用促性腺激素释放激素激动剂（含或不含芳香酶抑制剂）进行预处理似乎很有希望，但许多与治疗相关的问题仍未得到解决。在研讨会期间，介绍和讨论了过去几十年的治疗进展以及新的见解。这篇观点论文的作用是激发人们对子宫腺肌症和子宫腺肌症在不孕症中的作用的讨论和进一步的兴趣。

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引用次数: 0

Cairo Consensus on Accreditation as the Basis for Future-Proofing the ART Laboratory 就认证问题达成开罗共识，以此作为 ART 实验室面向未来的基础

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104106

Cairo Consensus Group 2023, Alpha Scientists in Reproductive Medicine

An international consensus meeting was convened to discuss globally applicable strategies for ‘future-proofing’ ART laboratories. The central theme was how the application of the foundational principles of laboratory accreditation enables any centre to create an ethos and framework that will support future-proofing in all regards. Discussions focussed on ART laboratory services from egg retrieval and semen specimen receipt to embryo transfer, as well as pertinent cryobanking activities. Issues related to whether ART treatment should be considered an essential service, overall clinic operations, general patient care, and the provision of clinical treatment, were not included as they fall under the purview of physicians and public health authorities. This report details the 16 core consensus points reached, which are supported by extensive practical recommendations that cover the gamut of ART laboratory operations.

引用次数: 0

Culture media with antioxidants improved preimplantation embryo development and clinical outcomes of patients of advanced age 含有抗氧化剂的培养基可改善高龄患者的着床前胚胎发育和临床结果。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104415

Shigetoshi Mizumoto, Yozo Nagao, Hitomi Watanabe, Keiko Tanaka, Takeshi Kuramoto

Research question

What are the clinical effects of using culture media supplemented with antioxidants (AOX) throughout the IVF process?

Design

Prospective randomized single-centre study. Cumulus–oocyte complexes and semen samples collected from 127 treatment cycles were divided evenly between the study arm (culture media with AOX) and the control arm (culture media without AOX). The primary endpoint was the good-quality blastocyst (GQB) rate on day 5–6 per metaphase II (MII) oocyte.

Results

Fertilization rate and day 5–6 blastocyst rate per MII oocyte differed significantly in favour of the study arm, whereas GQB rate did not. A subgroup analysis, stratified by maternal age, revealed significant improvements in the study arm for day 3 embryo development rate, day 5–6 blastocyst rate, GQB rate and blastocyst utilization rate for patients aged 35–40 years, while the impacts on these endpoints were much smaller in patients aged <35 years. Ninety-four single vitrified blastocyst transfers (SVBT) were performed in each arm. The blastocysts derived from the study arm showed better results of SVBT for patients aged 35–40 years, defined by embryo implantation rate, fetal heartbeat rate and live birth rate, whereas these variables did not differ significantly between the two arms when assessing the results for patients of all ages and patients aged <35 years.

Conclusions

Embryo development and SVBT outcomes of treatment cycles of patients aged 35–40 years improved significantly when using AOX-supplemented culture media throughout the IVF process.

研究问题：在整个试管婴儿过程中使用添加了抗氧化剂（AOX）的培养基有何临床效果？前瞻性随机单中心研究。将从 127 个治疗周期中收集的积液-卵母细胞复合物和精液样本平均分配给研究组（含 AOX 的培养基）和对照组（不含 AOX 的培养基）。主要终点是第 5-6 天每个分裂期 II（MII）卵母细胞的优质囊胚（GQB）率：结果：受精率和第 5-6 天每个 MII 卵母细胞的囊胚率在研究组中差异显著，而 GQB 率则没有差异。按产妇年龄分层的亚组分析表明，对于 35-40 岁的患者，研究组在第 3 天胚胎发育率、第 5-6 天囊胚率、GQB 率和囊胚利用率方面均有显著改善，而对于年龄在 35-40 岁的患者，这些终点的影响要小得多：在整个体外受精过程中使用添加 AOX 的培养基时，35-40 岁患者治疗周期的胚胎发育和 SVBT 结果均有显著改善。

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引用次数: 0

Influence of the shortened warming protocol on human blastocyst viability: an in-vitro experimental study 缩短升温程序对人胚泡活力的影响：体外实验研究。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104454

Kenji Ezoe, Tetsuya Miki, Nanoha Fujiwara, Keiichi Kato

Research question

Does the shortened warming protocol impact the cell viability and outgrowth competence of human vitrified blastocysts warmed with or without fatty acids?

Design

In this study, 326 discarded vitrified human blastocysts donated for research by consenting couples were used. The blastocysts were randomly allocated to five groups depending on the warming solutions, protocols and recovery culture media: the control-conventional, control-shortened, FA-conventional, FA-shortened, and FA-shortened/recovery culture with fatty acid (FA-shortened/RF) groups. The blastocysts were warmed with or without fatty acids following the manufacturer's instruction (conventional method) or using the shortened method, in which blastocysts were immersed in a thawing solution for 1 min and then cultured in the recovery medium for 2 h. The embryo volume recovery, cell viability, intracytoplasmic lipid droplets and outgrowth competence were evaluated.

Results

The degree of blastocyst volume recovery was significantly higher after shortened warming than after conventional warming (P = 0.0130–0.0278). Cell membrane collapse was observed during the shortened warming. The blastocyst survival rate and expansion status after the recovery culture were comparable among the five groups. However, the proportion of necrotic cells was increased in the control-shortened, FA-shortened and FA-shortened/RF groups (P = 0.0160–0.0498). The adhesion rates were comparable among all the groups; however, the outgrowth area was significantly higher in the FA-conventional group than in the other groups at 96 h (P = 0.0026–0.0487).

Conclusions

The efficacy of the shortened warming protocol depends on the warming solutions used. The shortened protocol effectively improves the daily workflow; however, to prioritize clinical outcomes, each laboratory should thoroughly examine its impact before introducing it.

研究问题：在加或不加脂肪酸的情况下，加热时间的缩短是否会影响人玻璃化囊胚的细胞活力和生长能力？设计：在这项研究中，326个废弃的玻璃化人类囊胚被自愿捐赠给研究。根据加热溶液、方案和恢复培养基的不同，将囊胚随机分为5组：对照组-常规组、对照组-缩短组、fa -常规组、fa -缩短组和fa -缩短/脂肪酸恢复培养组（fa -缩短/RF）。按说明书（常规方法）加或不加脂肪酸加热囊胚，或采用缩短的方法，即囊胚在解冻液中浸泡1分钟，然后在恢复培养基中培养2小时。评估胚胎体积恢复、细胞活力、胞浆内脂滴和生长能力。结果：缩短加热时间后囊胚体积恢复程度显著高于常规加热时间（P = 0.0130 ~ 0.0278）。在缩短的升温过程中，观察到细胞膜塌陷。五组间囊胚存活率及恢复培养后囊胚扩张情况具有可比性。而对照组缩短组、fa -缩短组和fa -缩短/RF组的坏死细胞比例增加（P = 0.0160 ~ 0.0498）。各组间黏附率具有可比性；在96 h时，fa -常规组的生长面积显著高于其他组（P = 0.0026-0.0487）。结论：缩短加热方案的效果取决于所使用的加热溶液。缩短的协议有效改善了日常工作流程；然而，为了优先考虑临床结果，每个实验室在引入它之前应该彻底检查它的影响。

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引用次数: 0

Sperm recovery and ICSI outcomes in non-obstructive azoospermia with cryptorchidism treated by orchiopexy: a systematic review and meta-analysis 通过睾丸吻合术治疗隐睾的非梗阻性无精子症患者的精子恢复和 ICSI 结果：系统回顾和荟萃分析。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104392

ZiHan Qin , QiaoHua Xiong , MingHan Lu , ShuHua Li , YuJun Chen , WenHan Ma , Ling Ma , Chun Zhou , Quanfei Zhu , YuanZhen Zhang , Ming Zhang , JunHao Lei

The aim of this meta-analysis was to quantify the available data concerning sperm retrieval rate (SRR) subsequent to testicular sperm extraction (TESE) and the clinical pregnancy rate (CPR) and live birth rate (LBR) subsequent to TESE and intracytoplasmic sperm injection (ICSI) in patients with non-obstructive azoospermia with cryptorchidism treated by orchidopexy. Furthermore, the aim was to explore the potential predictors of SRR, CPR and LBR within this population. Extensive searches were conducted in PubMed, Embase, Cochrane and Web of Science databases, and 23 articles were included in the study, with 1496 patients. The overall SRR per TESE cycle in the total evaluated trials was 60.9% (55.7–66.2%). Factors such as age at TESE, age at orchidopexy, testicular volume, and FSH, LH and testosterone levels did not affect final SRR. Meta-analyses were conducted on 13 studies each for CPR and LBR, including 913 and 799 ICSI cycles, respectively. The overall CPR per ICSI cycle was 37.6% (29.1–46.1%), and the overall LBR per ICSI cycle was 32.6% (24.9–40.4%). Factors as mentioned above, and the age of women undergoing ICSI, did not affect CPR or LBR per ICSI cycle. Although this meta-analysis extensively investigated outcomes of TESE and potential predictors of SRR, CPR and LBR for patients with non-obstructive azoospermia with cryptorchidism treated by orchidopexy, no effective predictors of outcomes were identified.

这项荟萃分析旨在量化睾丸取精术（TESE）后的取精率（SRR）、睾丸取精术和卵胞浆内单精子显微注射术（ICSI）后的临床妊娠率（CPR）和活产率（LBR）方面的现有数据。此外，研究的目的还在于探索这一人群中SRR、CPR和LBR的潜在预测因素。研究在PubMed、Embase、Cochrane和Web of Science数据库中进行了广泛检索，共纳入23篇文章，涉及1496名患者。在所有接受评估的试验中，每个TESE周期的总体SRR为60.9%（55.7%-66.2%）。TESE时的年龄、睾丸切除术时的年龄、睾丸体积以及FSH、LH和睾酮水平等因素均不影响最终的SRR。针对CPR和LBR各进行了13项研究的元分析，分别包括913个和799个ICSI周期。每个 ICSI 周期的总体 CPR 为 37.6%（29.1-46.1%），每个 ICSI 周期的总体 LBR 为 32.6%（24.9-40.4%）。上述因素和接受卵胞浆内单精子显微注射的妇女的年龄并不影响每个卵胞浆内单精子显微注射周期的 CPR 或 LBR。尽管该荟萃分析广泛研究了TESE的结果以及通过睾丸切除术治疗的非梗阻性无精子症合并隐睾患者的SRR、CPR和LBR的潜在预测因素，但并未发现有效的结果预测因素。

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引用次数: 0

Donor sperm: only for the rich and straight 捐献精子：只适合有钱人和正直的人。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.104434

Guido Pennings

Although single women and lesbian couples are given access to donor spermatozoa, all kinds of restrictions limit their actual use of donor insemination. These restrictions are frequently justified by the increase in safety (lowering the genetic risk) or well-being of donor-conceived persons. However, these restrictions directly result in stratified reproduction in which only the rich (those with the necessary financial means) and the straight (those who conform to dominant views of parenthood) are allowed to reproduce.

虽然单身妇女和女同性恋夫妇可以获得捐精者的精子，但她们在实际使用捐精授精时受到各种限制。这些限制往往以提高安全性（降低遗传风险）或提高捐精受孕者的福利为理由。然而，这些限制直接导致了生育分层，只有富人（拥有必要经济能力的人）和异性恋者（符合主流生育观的人）才能生育。

引用次数: 0

Inside Front Cover - Affiliations and First page of TOC

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/S1472-6483(24)00960-X

引用次数: 0

Semen cryopreservation for an oncological reason: a retrospective study 基于肿瘤原因的精子冷冻：一项回顾性研究

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2025-01-01 DOI: 10.1016/j.rbmo.2024.103898

Ana Santana-Plata , Rocio Rivera-Egea , Nicolás Garrido

Research question

How do cancer type and treatment affect semen quality before and after treatment, and what effect does it have in their clinical management of infertility? Also, what is the rate of patients using cryopreserved semen samples after treatment?

Design

Patients who cryopreserved spermatozoa for oncological reasons between 2000 and 2022 in IVI clinics in Spain were retrospectively reviewed. Semen parameters were analysed before and after treatment, and utilization and destruction rates were calculated. Total motile sperm count (TMSC) was used for assisted reproductive technology (ART) counselling.

Results

A total of 724 patients cryopreserved their semen during the study period. The semen parameters of the cancer patients' semen before and after treatment were heterogeneous, with significant differences between cancer type and semen parameters. The utilization rate was relatively low (0.4%), whereas the destruction rate was 23.1%.

Conclusion

Cancer and antineoplastic treatment affect everyone differently. Therefore, sperm cryopreservation should be offered to all patients before starting treatment to ensure their reproductive future. Furthermore, in addition to considering the semen parameters defined by the World Health Organization, it is important to use TMSC in the diagnosis of men to choose appropriate ART according to type of cancer.

癌症类型和治疗方法对治疗前后的精液质量有何影响，对不育症的临床治疗有何影响？此外，患者在治疗后使用冷冻保存精液样本的比例是多少？我们对西班牙 IVI 诊所 2000 年至 2022 年间因肿瘤原因冷冻保存精子的患者进行了回顾性研究。对治疗前后的精液参数进行了分析，并计算了利用率和销毁率。总活力精子计数（TMSC）用于抗逆转录病毒疗法咨询。在研究期间，724 名患者对精液进行了冷冻保存。癌症患者在治疗前后的精液参数差异很大，癌症类型和精液参数之间存在显著差异。利用率相对较低（0.4%），而销毁率为 20%。癌症和抗肿瘤治疗对每个人的影响都不同。因此，在开始治疗前，所有患者都应进行精子冷冻保存，以确保他们的生殖前景。此外，除了考虑世卫组织规定的精液参数外，在诊断男性时还必须使用 TMSC，以便根据癌症类型选择合适的抗逆转录病毒疗法。

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引用次数: 0

Ultra-fast vitrification and rapid elution of human oocytes: Part II – verification of blastocyst development from mature oocytes 人类卵母细胞的超快速玻璃化和快速洗脱：第二部分 - 验证成熟卵母细胞的囊胚发育。

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-12-01 DOI: 10.1016/j.rbmo.2024.104690

Kathryn Wozniak , Ryan Reichelderfer , Seyed Ghaemi , Danielle Hupp , Peter Fuzesi , Guy Ringler , Richard P. Marrs , Mitchel C. Schiewe

Research question

Will ultra-fast vitrification (UFV) and rapid elution of mature human oocytes retain the reliable, high survival rates and meiotic spindle normality seen in the germinal vesicle model, and will these oocytes maintain their developmental competence to form blastocyst-stage embryos following artificial oocyte activation (AOA)?

Design

Conventional vitrification treatment was compared with UFV treatment in mature, germinal-vesicle-derived oocytes (Phase 2, Expt. 2, n = 50) and substandard donor oocytes, metaphase I–metaphase II (MII) oocytes and poor-quality MII oocytes (n = 222). Post-warming survival, the integrity of the meiotic spindle and AOA-related development were assessed.

Results

Overall survival rates were higher (P = 0.003) for UFV/rapid elution treatment (94–100%, mean = 98%) compared with conventional vitrification/control dilution treatment (80–90%, mean = 83.3%). MII oocytes derived from immature germinal vesicles following conventional vitrification/control dilution or UFV/rapid elution treatments proved to be capable of activated development (54–71% cleavage rate), with four blastocysts produced. AOA treatment with DMAP exposure yielded optimal activated development. When vitrifying mature oocytes, both UFV and conventional vitrification treatments exhibited normal activated development and blastocyst production (34.9% and 31.7%, respectively).

Conclusions

Considering that oocyte freezing was deemed non-experimental based primarily on healthy live births from frozen-oocyte-derived embryo transfer the validation of normal blastocyst formation using the novel UFV approach is a critical accomplishment. The UFV method for oocyte cryopreservation represents a strategic deviation from traditional semi-equilibration vitrification protocols. UFV is a more time-efficient approach that consistently yields a higher survival rate, and thus has the potential to create more embryos. These findings justify proceeding with strategic clinical trial applications.

研究问题：超快速玻璃化（UFV）和快速洗脱成熟人类卵母细胞能否保持生殖囊模型中可靠的高存活率和减数分裂纺锤体的正常性，以及这些卵母细胞能否在人工卵母细胞活化（AOA）后保持其形成囊胚期胚胎的发育能力？在成熟的生殖泡衍生卵母细胞（第 2 阶段，试验 2，n = 50）和不合格的供体卵母细胞、分裂期 I-分裂期 II（MII）卵母细胞和劣质 MII 卵母细胞（n = 222）中，比较常规玻璃化处理和 UFV 处理。对加热后的存活率、减数分裂纺锤体的完整性和与 AOA 相关的发育情况进行了评估：结果：与传统玻璃化/对照稀释处理（80-90%，平均 = 83.3%）相比，UFV/快速洗脱处理（94-100%，平均 = 98%）的总存活率更高（P = 0.003）。经传统玻璃化/对照稀释或 UFV/快速洗脱处理后，从未成熟生殖囊中提取的 MII 卵母细胞被证明能够活化发育（裂解率为 54-71%），并产生了 4 个囊胚。暴露于 DMAP 的 AOA 处理产生了最佳的活化发育。在对成熟卵母细胞进行玻璃化处理时，UFV 和传统玻璃化处理均表现出正常的活化发育和囊胚生成（分别为 34.9% 和 31.7%）：考虑到卵母细胞冷冻被认为是非实验性的，主要是基于冷冻卵母细胞衍生胚胎移植的健康活产，使用新型 UFV 方法验证正常囊胚形成是一项重要成就。用于卵母细胞冷冻保存的 UFV 方法是对传统的半平衡玻璃化方案的战略性偏离。UFV 是一种更省时省力的方法，能持续获得更高的存活率，因此有可能产生更多的胚胎。这些发现证明了进行战略性临床试验应用的合理性。

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引用次数: 0

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IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-12-01 DOI: 10.1016/S1472-6483(24)00900-3

引用次数: 0

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