Pub Date : 2024-11-01DOI: 10.1016/j.rbmo.2024.104535
Gunel TALIBOVA , Ibrahim Cumhur BAŞSORGUN , Mustafa Faruk USTA , Saffet OZTURK
<div><h3>Objective</h3><div>Azoospermia, characterized by the absence of sperm in ejaculate, affects about 1% of general population. Non-obstructive azoospermia (NOA), which constitutes 60% of azoospermic infertility cases, remains poorly understood at the molecular level. DNA double-strand breaks (DSBs) being formed for different reasons such as DNA replication, DNA lesions, crossing-over and genotoxic agents are repaired timely and correctly to maintain genome integrity. In response to sensing DSBs, the histone variant H2AX is phosphorylated at serine 139 by ATM kinase to form γH2AX. Thus, the main DSB repair pathways such as homologous recombination (HR) and canonical non-homologous end joining (cNHEJ) are activated. While the KU70 and KU80 proteins play key roles in cNHEJ repair, the NBS1, RAD51, and BRCA1 proteins contribute HR-based repair. Importantly, absence or expressional changes in these proteins is found to be associated with male infertility development. Our study aims to elucidate the role of γH2AX, KU70, KU80, NBS1, RAD51, and BRCA1 proteins in losing fertility in NOA patients.</div></div><div><h3>Materials and Methods</h3><div>After taking ethical committee approval (protocol no. 13.05.2020/KAEK-345), we utilized previously collected testicular sperm extraction (TESE) samples in this study. We categorized the TESE samples according their histopathological status into four groups: hypospermatogenesis (n=6), primary spermatocyte arrest (n=6), round spermatid arrest (n=6), and Sertoli cell-only syndrome (n=6). Additionally, a control group having normal spermatogenesis (n=6) was created. With immunohistochemistry, we stained all the aforementioned proteins and analyzed their expression patterns with the ImageJ software. The resulting data were then evaluated using the non-parametric Mann-Whitney U test.</div></div><div><h3>Results</h3><div>The relative levels of γH2AX were significantly higher in primary spermatocyte and round spermatid arrest groups when compared to the control group (<em>P</em><0.01). The NBS1 protein was mainly localized in the nuclei of the spermatogenic cells, and its levels significantly reduced in patients with primary spermatocyte and round spermatid arrest groups (<em>P</em><0.05). Additionally, significant reductions in the KU70 (<em>P</em><0.01), KU80 (<em>P</em><0.01) and RAD51 (<em>P</em><0.05) proteins were observed in the total and seminiferous tubules of the primary spermatocyte and round spermatid arrest groups when compared with the control group. In contrast, BRCA1 protein levels significantly increased in the hypospermatogenesis, primary spermatocyte arrest and round spermatid arrest groups compared to the control group (<em>P</em><0.01).</div></div><div><h3>Conclusions</h3><div>The significant reductions in NBS1, KU70, KU80, and RAD51 proteins, along with increasing BRCA1 levels may be associated with developing spermatogenic arrest in NOA patients. Further studies are required
{"title":"THE DOUBLE-STRAND BREAK PROTEINS NBS1, KU70, KU80, RAD51 AND BRCA1 EXHIBIT SIGNIFICANT ALTERATIONS IN NON-OBSTRUCTIVE AZOOSPERMIC INFERTILE MEN HAVING PRIMARY SPERMATOCYTE AND ROUND SPERMATID ARREST","authors":"Gunel TALIBOVA , Ibrahim Cumhur BAŞSORGUN , Mustafa Faruk USTA , Saffet OZTURK","doi":"10.1016/j.rbmo.2024.104535","DOIUrl":"10.1016/j.rbmo.2024.104535","url":null,"abstract":"<div><h3>Objective</h3><div>Azoospermia, characterized by the absence of sperm in ejaculate, affects about 1% of general population. Non-obstructive azoospermia (NOA), which constitutes 60% of azoospermic infertility cases, remains poorly understood at the molecular level. DNA double-strand breaks (DSBs) being formed for different reasons such as DNA replication, DNA lesions, crossing-over and genotoxic agents are repaired timely and correctly to maintain genome integrity. In response to sensing DSBs, the histone variant H2AX is phosphorylated at serine 139 by ATM kinase to form γH2AX. Thus, the main DSB repair pathways such as homologous recombination (HR) and canonical non-homologous end joining (cNHEJ) are activated. While the KU70 and KU80 proteins play key roles in cNHEJ repair, the NBS1, RAD51, and BRCA1 proteins contribute HR-based repair. Importantly, absence or expressional changes in these proteins is found to be associated with male infertility development. Our study aims to elucidate the role of γH2AX, KU70, KU80, NBS1, RAD51, and BRCA1 proteins in losing fertility in NOA patients.</div></div><div><h3>Materials and Methods</h3><div>After taking ethical committee approval (protocol no. 13.05.2020/KAEK-345), we utilized previously collected testicular sperm extraction (TESE) samples in this study. We categorized the TESE samples according their histopathological status into four groups: hypospermatogenesis (n=6), primary spermatocyte arrest (n=6), round spermatid arrest (n=6), and Sertoli cell-only syndrome (n=6). Additionally, a control group having normal spermatogenesis (n=6) was created. With immunohistochemistry, we stained all the aforementioned proteins and analyzed their expression patterns with the ImageJ software. The resulting data were then evaluated using the non-parametric Mann-Whitney U test.</div></div><div><h3>Results</h3><div>The relative levels of γH2AX were significantly higher in primary spermatocyte and round spermatid arrest groups when compared to the control group (<em>P</em><0.01). The NBS1 protein was mainly localized in the nuclei of the spermatogenic cells, and its levels significantly reduced in patients with primary spermatocyte and round spermatid arrest groups (<em>P</em><0.05). Additionally, significant reductions in the KU70 (<em>P</em><0.01), KU80 (<em>P</em><0.01) and RAD51 (<em>P</em><0.05) proteins were observed in the total and seminiferous tubules of the primary spermatocyte and round spermatid arrest groups when compared with the control group. In contrast, BRCA1 protein levels significantly increased in the hypospermatogenesis, primary spermatocyte arrest and round spermatid arrest groups compared to the control group (<em>P</em><0.01).</div></div><div><h3>Conclusions</h3><div>The significant reductions in NBS1, KU70, KU80, and RAD51 proteins, along with increasing BRCA1 levels may be associated with developing spermatogenic arrest in NOA patients. Further studies are required","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104535"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The isolation of the motile sperm without DNA fragmentation is essential for in vitro fertilization success. Recently, microfluidic sperm sorting techniques have been used for selecting the progressive motile sperms directly from ejaculate. However, the effect of microfluidic device usage on fertilization and pregnancy rate is unclear. This study aimed to evaluate the microfluidic device usage on the pregnancy rate with fresh and frozen embryos.
Study design
A retrospective study in which 249 participant was included in our In Vitro Fertilization Center has been analyzed between January 2016 and December 2018. Sperm samples from the group consisting of 144 participants were selected using the swim-up technique, as the other group consisting of 105 participants were selected using a microfluidic device. Fertile Chip® device was used for microfluidic sperm sorting preparation as the swim-up technique was applied for conventional sperm preparations. Sperm motility parameters, fertilization and pregnancy rates were evaluated.
Results
The male age, female age, mature oocyte number, and transferred embryo number did not vary significantly between microfluidic technique and swim-up technique groups. The sperm concentration, progressive motility levels, and fertilization rates were significantly higher in the microfluidic technique group (p<0.05). The clinical pregnancy rate did not differ between the microfluidic and swim-up technique groups. Interestingly, the pregnancy rate in the microfluidic technique group was slightly higher than the swim-up technique group in terms of frozen embryo transfer (Table 1).
Conclusion
The use of microfluidic devices significantly increased the fertilization rates. The routine use of the microfluidic device may show a slightly higher success in pregnancy rates.
{"title":"MICROFLUIDIC SPERM SORTING ON FRESH AND FROZEN IVF CYCLES","authors":"Bülent Ayas , Adem Kocaman , Ayşe Zehra Özdemir , Davut Güven","doi":"10.1016/j.rbmo.2024.104534","DOIUrl":"10.1016/j.rbmo.2024.104534","url":null,"abstract":"<div><h3>Objective</h3><div>The isolation of the motile sperm without DNA fragmentation is essential for in vitro fertilization success. Recently, microfluidic sperm sorting techniques have been used for selecting the progressive motile sperms directly from ejaculate. However, the effect of microfluidic device usage on fertilization and pregnancy rate is unclear. This study aimed to evaluate the microfluidic device usage on the pregnancy rate with fresh and frozen embryos.</div></div><div><h3>Study design</h3><div>A retrospective study in which 249 participant was included in our In Vitro Fertilization Center has been analyzed between January 2016 and December 2018. Sperm samples from the group consisting of 144 participants were selected using the swim-up technique, as the other group consisting of 105 participants were selected using a microfluidic device. Fertile Chip® device was used for microfluidic sperm sorting preparation as the swim-up technique was applied for conventional sperm preparations. Sperm motility parameters, fertilization and pregnancy rates were evaluated.</div></div><div><h3>Results</h3><div>The male age, female age, mature oocyte number, and transferred embryo number did not vary significantly between microfluidic technique and swim-up technique groups. The sperm concentration, progressive motility levels, and fertilization rates were significantly higher in the microfluidic technique group (p<0.05). The clinical pregnancy rate did not differ between the microfluidic and swim-up technique groups. Interestingly, the pregnancy rate in the microfluidic technique group was slightly higher than the swim-up technique group in terms of frozen embryo transfer (Table 1).</div></div><div><h3>Conclusion</h3><div>The use of microfluidic devices significantly increased the fertilization rates. The routine use of the microfluidic device may show a slightly higher success in pregnancy rates.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104534"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Objective</h3><div>This study aims to elucidate the etiological factors and clinical outcomes associated with mono-pronuclear (1PN) and tripronuclear (3PN) fertilization, in comparison to the bi-pronuclear(2PN) fertilization, within the framework of ICSI cycles. We seek to examine the association between abnormal fertilization patterns and various factors, including patient demographics, cycle characteristics, semen parameters, and oocyte quality. The goal is to clarify the impact of abnormal pronuclear patterns on embryo development and clinical outcomes.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study was conducted at the Bursa Uludağ University ART Center from 2011 to 2024. The study included a total of 2,319 ICSI cycles, categorized into four groups based on fertilization outcomes: Group 1 (n=348) comprised cycles with at least one 1PN zygote; Group 2 (n=581) comprised cycles with at least one 3PN zygote; Group 3 (n=135) included cycles with both 1PN and 3PN zygotes; and Group 4 (n=1,255) served as the control group, characterized by normal fertilization with a rate exceeding 80%. ICSI was uniformly applied to all oocytes. Fertilization status was assessed 16-18 hours after insemination to categorize cycles into the respective groups. We analyzed patients’ baseline characteristics, hormonal parameters, cycle attributes, oocyte quality, and semen parameters across the four groups to identify factors affecting fertilization outcomes. Additionally clinical outcomes, including clinical pregnancy rates and embryo development, were analyzed.</div></div><div><h3>Results</h3><div>A comparative analysis was conducted to evaluate baseline characteristics and ovarian stimulation profiles across study groups. The analysis revealed significant statistical differences in both female (p<0.001) and male ages (p<0.001) among the groups. No significant differences were observed in BMI (p=0.327) or infertility duration (p=0.541); however, infertility etiology (p<0.001) varied significantly between groups. Sperm concentration (p=0.552) and motility (p=0.511) values were similar across the groups. Although Group 4 exhibited a statistically significantly higher fertilization rate (p<0.001) compared to other groups, there were no notable differences in cleavage rate (p=0.413), blastulation rate (p=0.653), or implantation rate (p=0.148) among the groups.</div></div><div><h3>Discussion</h3><div>This study elucidates the potential impact of 1PN and 3PN fertilization on ART outcomes. Female age and infertility etiology significantly influenced abnormal fertilization rates. Similar semen parameters across groups indicate that the oocytes, rather than sperm, may be the primary source of abnormal fertilization.</div></div><div><h3>Conclusion</h3><div>Although abnormal pronuclear patterns negatively affect fertilization rates in ICSI cycles, they do not impact embryonic development or clinical outcomes. Further research is e
{"title":"IMPACT OF MONOPRONUCLEAR AND TRIPRONUCLEAR PATTERNS ON ICSI OUTCOMES: ANALYZING CONTRIBUTING FACTORS AND CLINICAL IMPLICATIONS","authors":"Sabina AGHAYEVA , Aslıgül BULUT , Kiper ASLAN , Cihan ÇAKIR","doi":"10.1016/j.rbmo.2024.104580","DOIUrl":"10.1016/j.rbmo.2024.104580","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to elucidate the etiological factors and clinical outcomes associated with mono-pronuclear (1PN) and tripronuclear (3PN) fertilization, in comparison to the bi-pronuclear(2PN) fertilization, within the framework of ICSI cycles. We seek to examine the association between abnormal fertilization patterns and various factors, including patient demographics, cycle characteristics, semen parameters, and oocyte quality. The goal is to clarify the impact of abnormal pronuclear patterns on embryo development and clinical outcomes.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study was conducted at the Bursa Uludağ University ART Center from 2011 to 2024. The study included a total of 2,319 ICSI cycles, categorized into four groups based on fertilization outcomes: Group 1 (n=348) comprised cycles with at least one 1PN zygote; Group 2 (n=581) comprised cycles with at least one 3PN zygote; Group 3 (n=135) included cycles with both 1PN and 3PN zygotes; and Group 4 (n=1,255) served as the control group, characterized by normal fertilization with a rate exceeding 80%. ICSI was uniformly applied to all oocytes. Fertilization status was assessed 16-18 hours after insemination to categorize cycles into the respective groups. We analyzed patients’ baseline characteristics, hormonal parameters, cycle attributes, oocyte quality, and semen parameters across the four groups to identify factors affecting fertilization outcomes. Additionally clinical outcomes, including clinical pregnancy rates and embryo development, were analyzed.</div></div><div><h3>Results</h3><div>A comparative analysis was conducted to evaluate baseline characteristics and ovarian stimulation profiles across study groups. The analysis revealed significant statistical differences in both female (p<0.001) and male ages (p<0.001) among the groups. No significant differences were observed in BMI (p=0.327) or infertility duration (p=0.541); however, infertility etiology (p<0.001) varied significantly between groups. Sperm concentration (p=0.552) and motility (p=0.511) values were similar across the groups. Although Group 4 exhibited a statistically significantly higher fertilization rate (p<0.001) compared to other groups, there were no notable differences in cleavage rate (p=0.413), blastulation rate (p=0.653), or implantation rate (p=0.148) among the groups.</div></div><div><h3>Discussion</h3><div>This study elucidates the potential impact of 1PN and 3PN fertilization on ART outcomes. Female age and infertility etiology significantly influenced abnormal fertilization rates. Similar semen parameters across groups indicate that the oocytes, rather than sperm, may be the primary source of abnormal fertilization.</div></div><div><h3>Conclusion</h3><div>Although abnormal pronuclear patterns negatively affect fertilization rates in ICSI cycles, they do not impact embryonic development or clinical outcomes. Further research is e","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104580"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rbmo.2024.104506
Ibrahim Elkhatib
Blastocyst cryopreservation is a key component of PGT-A procedures. In non-PGT-A cycles, collapsing blastocysts before vitrification is commonly recommended to improve blastocyst viability. However, in PGT-A cycles insufficient information is provided on the matter. The European Society of Human Reproduction and Embryology recommends an immediate freeze post-biopsy, although a definitive timeframe remains elusive. Some studies support prolonged culture post-biopsy (> 3 hours), citing improved implantation and pregnancy rates. Conversely, others advocate for rapid cryopreservation, endorsing an immediate approach within an hour, while most blastocysts are still collapsed due to the biopsy procedure. To date, no conclusive timing has been agreed upon. We retrospectively studied 1141 single euploid blastocyst transfers (seFET) conducted between April 2021 and February 2023. Blastocysts were scored at 1-hour post-trophectoderm (TE) biopsy as follows: 0 for complete collapse, 1 for starting re-expansion, and 2 for clear re-expanded cavity.
A total of 569 seFET resulted in live birth (49.8%), 387 (33.9%) did not lead to pregnancy, 76 (6.7%) resulted in biochemical miscarriage, and 107 (9.4%) resulted in clinical miscarriage. One-hour post-biopsy, 64.0% of blastocysts re-expanded to Grade 2, 29.3% to Grade 1, and 6.7% showed no re-expansion (Grade 0). LB rate was 54.2%, 44.3% and 32.5% (P<0.001) among embryos that re-expanded to Grade 2, 1 or 0, respectively. Regression analysis showed re-expanding to Grade 2 at 1-hour post-biopsy was significantly and independently associated with LB compared to embryos that did not re-expand (i.e., Grade 0) (aOR: 1.77, 95% CI: 1.01–3.12), after adjusting for embryo quality (inner cell mass (ICM), TE grade, day of biopsy), BMI and endometrial preparation protocol. Embryos with greater re-expansion 1-hour post-biopsy had higher re-expansion slopes post-warming, indicating faster and greater re-expansion to the point of transfer. Differences were significant for all trophectoderm categories (Grade A, B, and C; P=0.016, <0.001 and <0.001, respectively).
Embryo re-expansion 1-hour post-biopsy was associated with post-warming re-expansion and increased LB rates.
{"title":"BLASTOCYST RE-EXPANSION ONE HOUR POST-BIOPSY: AN INDEPENDENT PREDICTOR OF LIVE BIRTH","authors":"Ibrahim Elkhatib","doi":"10.1016/j.rbmo.2024.104506","DOIUrl":"10.1016/j.rbmo.2024.104506","url":null,"abstract":"<div><div>Blastocyst cryopreservation is a key component of PGT-A procedures. In non-PGT-A cycles, collapsing blastocysts before vitrification is commonly recommended to improve blastocyst viability. However, in PGT-A cycles insufficient information is provided on the matter. The European Society of Human Reproduction and Embryology recommends an immediate freeze post-biopsy, although a definitive timeframe remains elusive. Some studies support prolonged culture post-biopsy (> 3 hours), citing improved implantation and pregnancy rates. Conversely, others advocate for rapid cryopreservation, endorsing an immediate approach within an hour, while most blastocysts are still collapsed due to the biopsy procedure. To date, no conclusive timing has been agreed upon. We retrospectively studied 1141 single euploid blastocyst transfers (seFET) conducted between April 2021 and February 2023. Blastocysts were scored at 1-hour post-trophectoderm (TE) biopsy as follows: 0 for complete collapse, 1 for starting re-expansion, and 2 for clear re-expanded cavity.</div><div>A total of 569 seFET resulted in live birth (49.8%), 387 (33.9%) did not lead to pregnancy, 76 (6.7%) resulted in biochemical miscarriage, and 107 (9.4%) resulted in clinical miscarriage. One-hour post-biopsy, 64.0% of blastocysts re-expanded to Grade 2, 29.3% to Grade 1, and 6.7% showed no re-expansion (Grade 0). LB rate was 54.2%, 44.3% and 32.5% (P<0.001) among embryos that re-expanded to Grade 2, 1 or 0, respectively. Regression analysis showed re-expanding to Grade 2 at 1-hour post-biopsy was significantly and independently associated with LB compared to embryos that did not re-expand (i.e., Grade 0) (aOR: 1.77, 95% CI: 1.01–3.12), after adjusting for embryo quality (inner cell mass (ICM), TE grade, day of biopsy), BMI and endometrial preparation protocol. Embryos with greater re-expansion 1-hour post-biopsy had higher re-expansion slopes post-warming, indicating faster and greater re-expansion to the point of transfer. Differences were significant for all trophectoderm categories (Grade A, B, and C; P=0.016, <0.001 and <0.001, respectively).</div><div>Embryo re-expansion 1-hour post-biopsy was associated with post-warming re-expansion and increased LB rates.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104506"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rbmo.2024.104515
Dr. Marcos Meseguer
The application of artificial intelligence (AI) in assisted reproduction addresses the complex landscape of infertility, a prevalent condition affecting a significant percentage of the reproductive-age population. Advances in reproductive medicine, marked by milestones such as in vitro fertilization (IVF) and intracytoplasmic sperm microinjection (ICSI), have led to the development of assisted reproduction techniques (ART). While multiple embryo transfer (MET) has traditionally been employed to increase pregnancy chances, it carries risks. Therefore, embryo selection techniques have suffered a rapid increase in interest. The introduction of incubators with time-lapse technology allowed embryo analysis without disturbing culture conditions and involved the introduction of the first embryo selection algorithms. Consequently, developing and including AI approaches is the current challenge. This presentation addresses real-world challenges in the embryology field by applying deep learning methods. The final goal is to design, develop, and validate tools that support the daily routine in an IVF laboratory, ultimately improving success rates in assisted reproductive clinics. The complexity of the solved tasks increases systematically, providing consistent knowledge based on embryology. Specific goals involve solving concrete tasks with different methodologies and exploring novel AI techniques. The tasks include fecundation, viability, quality, and prediction of euploid embryos. The technical approaches encompass automation, segmentation, supervised contrastive learning, and inductive transfer techniques. The findings contribute to the field of embryology, showcasing potential applications of innovative AI methodologies. The incorporation of AI into the sperm selection process is one of the most explored areas in recent years within the field of assisted reproduction too and several AI-tools have been developed for analyzing oocyte quality according to its morphology. Ovarian stimulation is also one of the directions in the landscape of assisted reproduction which can be improved with the help of AI and there are studies in this direction using AI. Future goals introduce consistent integration into consultation and embryology laboratories, taking into account real clinical conditions, contributing to improved success rates in assisted reproduction clinics, and further exploring non-invasive techniques for genetic analysis.
{"title":"NON-INVASIVE PGTA by AI","authors":"Dr. Marcos Meseguer","doi":"10.1016/j.rbmo.2024.104515","DOIUrl":"10.1016/j.rbmo.2024.104515","url":null,"abstract":"<div><div>The application of artificial intelligence (AI) in assisted reproduction addresses the complex landscape of infertility, a prevalent condition affecting a significant percentage of the reproductive-age population. Advances in reproductive medicine, marked by milestones such as in vitro fertilization (IVF) and intracytoplasmic sperm microinjection (ICSI), have led to the development of assisted reproduction techniques (ART). While multiple embryo transfer (MET) has traditionally been employed to increase pregnancy chances, it carries risks. Therefore, embryo selection techniques have suffered a rapid increase in interest. The introduction of incubators with time-lapse technology allowed embryo analysis without disturbing culture conditions and involved the introduction of the first embryo selection algorithms. Consequently, developing and including AI approaches is the current challenge. This presentation addresses real-world challenges in the embryology field by applying deep learning methods. The final goal is to design, develop, and validate tools that support the daily routine in an IVF laboratory, ultimately improving success rates in assisted reproductive clinics. The complexity of the solved tasks increases systematically, providing consistent knowledge based on embryology. Specific goals involve solving concrete tasks with different methodologies and exploring novel AI techniques. The tasks include fecundation, viability, quality, and prediction of euploid embryos. The technical approaches encompass automation, segmentation, supervised contrastive learning, and inductive transfer techniques. The findings contribute to the field of embryology, showcasing potential applications of innovative AI methodologies. The incorporation of AI into the sperm selection process is one of the most explored areas in recent years within the field of assisted reproduction too and several AI-tools have been developed for analyzing oocyte quality according to its morphology. Ovarian stimulation is also one of the directions in the landscape of assisted reproduction which can be improved with the help of AI and there are studies in this direction using AI. Future goals introduce consistent integration into consultation and embryology laboratories, taking into account real clinical conditions, contributing to improved success rates in assisted reproduction clinics, and further exploring non-invasive techniques for genetic analysis.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104515"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rbmo.2024.104571
Duygu Kütük , İbrahim Orçun Olcay , Berkay Akçay , Sinan Özkavukçu
<div><h3>Objective</h3><div>After the fertilization stage, extending embryo culture (blastocyst culture) until day 5 may be the most appropriate and alternative way to select embryos for transfer. Extending embryo developmental follow-up until day 5/6 is a selection tool to select embryos with a higher probability of implantation rather than improving embryo quality. The developmental potential of D5, D6 and D7 blastocysts gradually decreases with increasing culture time. Therefore, the traditional practice in the laboratory is to select embryos for transfer, biopsy or cryopreservation at D5/D6. Studies on D7 blastocysts are very limited and controversial. Clinically, in some patients, if blastocysts cannot form at D5/D6 due to poor embryo quality due to advanced maternal age or other reasons, they can be cultured until D7. Therefore, the use of slowly developing D7 blastocysts will be of great importance for these patients.</div></div><div><h3>Materials and methods</h3><div>This is a retrospective study planned to monitor paternal and maternal age, preimplantation genetic diagnosis/screening results and pregnancy status of patients who came for IVF treatment during the 7th day embryo development process.</div></div><div><h3>Results</h3><div>84 embryos of 73 patients who came to Bahçeci Umut IVF Center and completed their development on the 7th day and were frozen by NGS were included in the study. NGS results of 14 patients were normal, NGS results of 54 patients were abnormal, DNA was not detected in 2 patients, and biopsy was performed on 2 patients but was not performed upon the patient's request. Of the 15 female patients who were <35; 8 out of 17 embryos were abnormal (%47,05), 7 were normal (%41,17) and 2 embryos were biopsied for genetic processing but were not studied (%11,76). The results of 7 patients were abnormal (%46,7), the results of 6 patients were normal (%40) and 2 patients did not have biopsies taken for NGS and the material was not studied (%13,3). Of the 6 patients, 2 patients whose genetic screening results were normal had negative pregnancy results, but 2 patients were found to have pregnancies. 2 patients did not transfer their embryos despite the results. Of the 58 female patients who were >35; 53 embryos out of 67 embryos of 58 patients were abnormal (%79,1), 12 embryos were normal (%17,9) and DNA was not detected in 2 embryos (%2,98). The results of 9 patients were normal (% 15,5), 47 patients were abnormal (% 81) and DNA was not detected in 2 patients (%3,44). Of the 5 patients with normal NGS results (%55,5), 2 had live births (% 40) and 2 had miscarriages (% 40). In the 4 patients with normal NGS results, pregnancy did not occur after embryo transfer (%45).</div></div><div><h3>Conclusions</h3><div>In slowly developing embryos, when developmental follow-up is performed until Day 7, embryo transfer should definitely be planned with NGS. In older women (>35 years old), if the embryo has completed its developme
{"title":"COMPARISON OF PREGNANCY ACHIEVEMENT IN DAY 7 EMBRYOS WITH NGS DEPENDING ON AGE","authors":"Duygu Kütük , İbrahim Orçun Olcay , Berkay Akçay , Sinan Özkavukçu","doi":"10.1016/j.rbmo.2024.104571","DOIUrl":"10.1016/j.rbmo.2024.104571","url":null,"abstract":"<div><h3>Objective</h3><div>After the fertilization stage, extending embryo culture (blastocyst culture) until day 5 may be the most appropriate and alternative way to select embryos for transfer. Extending embryo developmental follow-up until day 5/6 is a selection tool to select embryos with a higher probability of implantation rather than improving embryo quality. The developmental potential of D5, D6 and D7 blastocysts gradually decreases with increasing culture time. Therefore, the traditional practice in the laboratory is to select embryos for transfer, biopsy or cryopreservation at D5/D6. Studies on D7 blastocysts are very limited and controversial. Clinically, in some patients, if blastocysts cannot form at D5/D6 due to poor embryo quality due to advanced maternal age or other reasons, they can be cultured until D7. Therefore, the use of slowly developing D7 blastocysts will be of great importance for these patients.</div></div><div><h3>Materials and methods</h3><div>This is a retrospective study planned to monitor paternal and maternal age, preimplantation genetic diagnosis/screening results and pregnancy status of patients who came for IVF treatment during the 7th day embryo development process.</div></div><div><h3>Results</h3><div>84 embryos of 73 patients who came to Bahçeci Umut IVF Center and completed their development on the 7th day and were frozen by NGS were included in the study. NGS results of 14 patients were normal, NGS results of 54 patients were abnormal, DNA was not detected in 2 patients, and biopsy was performed on 2 patients but was not performed upon the patient's request. Of the 15 female patients who were <35; 8 out of 17 embryos were abnormal (%47,05), 7 were normal (%41,17) and 2 embryos were biopsied for genetic processing but were not studied (%11,76). The results of 7 patients were abnormal (%46,7), the results of 6 patients were normal (%40) and 2 patients did not have biopsies taken for NGS and the material was not studied (%13,3). Of the 6 patients, 2 patients whose genetic screening results were normal had negative pregnancy results, but 2 patients were found to have pregnancies. 2 patients did not transfer their embryos despite the results. Of the 58 female patients who were >35; 53 embryos out of 67 embryos of 58 patients were abnormal (%79,1), 12 embryos were normal (%17,9) and DNA was not detected in 2 embryos (%2,98). The results of 9 patients were normal (% 15,5), 47 patients were abnormal (% 81) and DNA was not detected in 2 patients (%3,44). Of the 5 patients with normal NGS results (%55,5), 2 had live births (% 40) and 2 had miscarriages (% 40). In the 4 patients with normal NGS results, pregnancy did not occur after embryo transfer (%45).</div></div><div><h3>Conclusions</h3><div>In slowly developing embryos, when developmental follow-up is performed until Day 7, embryo transfer should definitely be planned with NGS. In older women (>35 years old), if the embryo has completed its developme","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104571"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rbmo.2024.104557
Begum Durkut , Melike Ucak , Saliha Surme , Ibrahim Halil Kavakli , Ciler Celik-Ozenci
<div><h3>Objective</h3><div>Circadian rhythm (CR) orchestrates various physiological processes on a 24-hour basis, governed by molecular clock genes (MCGs); <em>BMAL1, CLOCK, PER</em>s, and <em>CRY</em>s. Clinical data indicate that disruption of maternal CR during pregnancy is associated with intrauterine growth restriction (IUGR), a condition linked to defects in trophoblast migration and invasion, yet the underlying molecular mechanisms need to be explored. This study aims to elucidate rhythmic expression pattern of <em>BMAL1</em> in human villous trophoblast (HVT) and to investigate the specific pathways governed by <em>BMAL1</em> related to trophoblast migration and invasion.</div></div><div><h3>Materials and methods</h3><div>We utilized a pLenti-<em>BMAL1</em>-DLuc lentivirus for <em>in vitro</em> circadian rhythm monitoring of <em>BMAL1</em> gene. <em>BMAL1</em> expression was analyzed using JTK-Cycle, robust non-parametric algorithm for detecting rhythmic elements in genome-scale data. Non-target, and <em>BMAL1</em>-silenced groups were established using HVT cells. <em>BMAL1</em>-silenced group was created using shRNA-silencing strategy. Following transduction and subsequent selection, cells were harvested every six hours over 48-hour period, corresponding to Zeitgeber Time (ZT) points 0- 48, following dexamethasone treatment used for cell-cycle synchronization. <em>CLOCK, PER</em>s, <em>CRY</em>s, <em>RORα</em>, and <em>NR1D1</em> expression were quantified every 6 hours via qPCR. Trophoblast migration/invasion, influenced by BMAL1, were assessed through transwell assay, and related protein expressions (β-catenin, integrin-β1, integrin-ɑ5) were evaluated using western blotting. Statistical significance was determined at p<0.05 using two-way ANOVA and Tukey's post hoc test.</div></div><div><h3>Results</h3><div>The outcomes from JTK-Cycle analysis, revealed the inherent rhythmic expression pattern of <em>BMAL1</em> in HVT cells. This natural expression displayed an average period of 23.3 hours and an average amplitude of 429,7 abs. BMAL1 silencing was confirmed at the protein level. Rhythmic expression of other MCGs; <em>CLOCK, PER1/2/3, CRY1/2, RORα</em>, and <em>NR1D1</em> genes were altered significantly in <em>BMAL1</em>-silenced group(p<0.05). Following <em>BMAL1</em> silencing, a notable reduction in the migration and invasion capabilities of HVT cells was observed(p<0.05). Additionally, <em>BMAL1</em> depletion correlated with a significant decrease in β-catenin expression from ZT30 onwards, and a decrease in integrin-β1 expression from ZT36 onwards(p<0.05). Conversely, there was a significant increase in integrin-ɑ5 protein expression beginning at ZT24(p<0.05).</div></div><div><h3>Conclusions</h3><div><em>BMAL1</em> is rhythmically expressed in HVT cells, and its silencing disrupts rhythmic expression of key MCGs and leads to alterations in trophoblast migration and invasion-related pathways. Specifically, <em>BMAL1<
{"title":"UNRAVELING THE IMPACT OF BMAL1-MEDIATED CIRCADIAN RHYTHM DISRUPTION ON TROPHOBLAST INVASION AND MIGRATION THROUGH WNT/Β-CATENIN AND INTEGRINMEDIATED SIGNALING PATHWAYS","authors":"Begum Durkut , Melike Ucak , Saliha Surme , Ibrahim Halil Kavakli , Ciler Celik-Ozenci","doi":"10.1016/j.rbmo.2024.104557","DOIUrl":"10.1016/j.rbmo.2024.104557","url":null,"abstract":"<div><h3>Objective</h3><div>Circadian rhythm (CR) orchestrates various physiological processes on a 24-hour basis, governed by molecular clock genes (MCGs); <em>BMAL1, CLOCK, PER</em>s, and <em>CRY</em>s. Clinical data indicate that disruption of maternal CR during pregnancy is associated with intrauterine growth restriction (IUGR), a condition linked to defects in trophoblast migration and invasion, yet the underlying molecular mechanisms need to be explored. This study aims to elucidate rhythmic expression pattern of <em>BMAL1</em> in human villous trophoblast (HVT) and to investigate the specific pathways governed by <em>BMAL1</em> related to trophoblast migration and invasion.</div></div><div><h3>Materials and methods</h3><div>We utilized a pLenti-<em>BMAL1</em>-DLuc lentivirus for <em>in vitro</em> circadian rhythm monitoring of <em>BMAL1</em> gene. <em>BMAL1</em> expression was analyzed using JTK-Cycle, robust non-parametric algorithm for detecting rhythmic elements in genome-scale data. Non-target, and <em>BMAL1</em>-silenced groups were established using HVT cells. <em>BMAL1</em>-silenced group was created using shRNA-silencing strategy. Following transduction and subsequent selection, cells were harvested every six hours over 48-hour period, corresponding to Zeitgeber Time (ZT) points 0- 48, following dexamethasone treatment used for cell-cycle synchronization. <em>CLOCK, PER</em>s, <em>CRY</em>s, <em>RORα</em>, and <em>NR1D1</em> expression were quantified every 6 hours via qPCR. Trophoblast migration/invasion, influenced by BMAL1, were assessed through transwell assay, and related protein expressions (β-catenin, integrin-β1, integrin-ɑ5) were evaluated using western blotting. Statistical significance was determined at p<0.05 using two-way ANOVA and Tukey's post hoc test.</div></div><div><h3>Results</h3><div>The outcomes from JTK-Cycle analysis, revealed the inherent rhythmic expression pattern of <em>BMAL1</em> in HVT cells. This natural expression displayed an average period of 23.3 hours and an average amplitude of 429,7 abs. BMAL1 silencing was confirmed at the protein level. Rhythmic expression of other MCGs; <em>CLOCK, PER1/2/3, CRY1/2, RORα</em>, and <em>NR1D1</em> genes were altered significantly in <em>BMAL1</em>-silenced group(p<0.05). Following <em>BMAL1</em> silencing, a notable reduction in the migration and invasion capabilities of HVT cells was observed(p<0.05). Additionally, <em>BMAL1</em> depletion correlated with a significant decrease in β-catenin expression from ZT30 onwards, and a decrease in integrin-β1 expression from ZT36 onwards(p<0.05). Conversely, there was a significant increase in integrin-ɑ5 protein expression beginning at ZT24(p<0.05).</div></div><div><h3>Conclusions</h3><div><em>BMAL1</em> is rhythmically expressed in HVT cells, and its silencing disrupts rhythmic expression of key MCGs and leads to alterations in trophoblast migration and invasion-related pathways. Specifically, <em>BMAL1<","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104557"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rbmo.2024.104540
Merve Gorgulu , Gizem Gamze Tas , Gamze Zengin , Hakan Er , Sevim Ercan Kelek , Leyla Sati
Objective
Alcohol addiction is recognized as a serious public health issue today. The World Health Organization classifies alcohol as substances that cause both physiological and psychological dependence when consumed over prolonged periods. Studies clearly indicate that chronic alcohol consumption has detrimental effects on the male reproductive system, suggesting that it is a risk factor for male fertility with reproductive and endocrine problems. Acetaldehyde, which is formed by the metabolism of alcohol, causes the production of free radicals when oxidized, which triggers apoptotic processes and oxidative stress. It is known that chronic alcohol use results in oxidative stress. However, various studies have shown that acetyl-L-carnitine (ALCAR) has antioxidant effects on several biological mechanisms under different conditions. Therefore, we aimed to investigate the potential effects of ALCAR administration on sperm motility, testicular histopathology, apoptosis, and oxidative stress in rats chronically exposed to ethanol (EtOH).
Materials and Methods
Rats were randomly separated into 4 groups. Over the course of the 4-week period, EtOH (5 g/kg, 25% w/v), ALCAR (50 mg/kg), and EtOH (5 g/kg, 25% w/v) + ALCAR (50 mg/kg) were given to rats by oral gavage daily (n=10/group). However, the control group received only distilled water. Epididymal sperm motility and testicular weight index were measured in line with testicular histopathology and modified Johnsen scoring. TUNEL assay was used for the assessment of the apoptotic index. Total oxidants and antioxidant status were analyzed with ELISA.
Results
Sperm motility and testicular modified Johnsen scores were decreased in the EtOH group (p<0.001). However, the EtOH+ALCAR group showed similar levels as to the control group. Even though no significant difference was determined for testicular weight index, immature germ cells spilled into the lumen, vacuolization in the intertubular area, and expansion in the interstitial area were observed in the EtOH group in contrast to normal testicular histology in the EtOH+ALCAR group. Chronic alcohol administration caused a significant increase in the apoptotic index (p<0.05) and oxidative stress (p<0.001). Nevertheless, we detected decreased apoptotic index and oxidative stress levels in the EtOH+ALCAR group compared to the EtOH group.
Conclusion
Our results indicate that ALCAR, an antioxidant compound, may have beneficial effects against the damages caused by chronic use of alcohol, such as poor sperm motility, testicular atrophy, and increased oxidative stress. However, the exact efficacy of ALCAR on the treatment for male infertility and metabolic consequences of chronic alcohol consumption needs to be confirmed by further investigations.
{"title":"EFFECT OF ACETYL L-CARNITINE ADMINISTRATION ON TESTICULAR HISTOPATHOLOGY, APOPTOSIS, AND OXIDATIVE STRESS IN AN EXPERIMENTAL CHRONIC ALCOHOLISM MODEL","authors":"Merve Gorgulu , Gizem Gamze Tas , Gamze Zengin , Hakan Er , Sevim Ercan Kelek , Leyla Sati","doi":"10.1016/j.rbmo.2024.104540","DOIUrl":"10.1016/j.rbmo.2024.104540","url":null,"abstract":"<div><h3>Objective</h3><div>Alcohol addiction is recognized as a serious public health issue today. The World Health Organization classifies alcohol as substances that cause both physiological and psychological dependence when consumed over prolonged periods. Studies clearly indicate that chronic alcohol consumption has detrimental effects on the male reproductive system, suggesting that it is a risk factor for male fertility with reproductive and endocrine problems. Acetaldehyde, which is formed by the metabolism of alcohol, causes the production of free radicals when oxidized, which triggers apoptotic processes and oxidative stress. It is known that chronic alcohol use results in oxidative stress. However, various studies have shown that acetyl-L-carnitine (ALCAR) has antioxidant effects on several biological mechanisms under different conditions. Therefore, we aimed to investigate the potential effects of ALCAR administration on sperm motility, testicular histopathology, apoptosis, and oxidative stress in rats chronically exposed to ethanol (EtOH).</div></div><div><h3>Materials and Methods</h3><div>Rats were randomly separated into 4 groups. Over the course of the 4-week period, EtOH (5 g/kg, 25% w/v), ALCAR (50 mg/kg), and EtOH (5 g/kg, 25% w/v) + ALCAR (50 mg/kg) were given to rats by oral gavage daily (n=10/group). However, the control group received only distilled water. Epididymal sperm motility and testicular weight index were measured in line with testicular histopathology and modified Johnsen scoring. TUNEL assay was used for the assessment of the apoptotic index. Total oxidants and antioxidant status were analyzed with ELISA.</div></div><div><h3>Results</h3><div>Sperm motility and testicular modified Johnsen scores were decreased in the EtOH group (p<0.001). However, the EtOH+ALCAR group showed similar levels as to the control group. Even though no significant difference was determined for testicular weight index, immature germ cells spilled into the lumen, vacuolization in the intertubular area, and expansion in the interstitial area were observed in the EtOH group in contrast to normal testicular histology in the EtOH+ALCAR group. Chronic alcohol administration caused a significant increase in the apoptotic index (p<0.05) and oxidative stress (p<0.001). Nevertheless, we detected decreased apoptotic index and oxidative stress levels in the EtOH+ALCAR group compared to the EtOH group.</div></div><div><h3>Conclusion</h3><div>Our results indicate that ALCAR, an antioxidant compound, may have beneficial effects against the damages caused by chronic use of alcohol, such as poor sperm motility, testicular atrophy, and increased oxidative stress. However, the exact efficacy of ALCAR on the treatment for male infertility and metabolic consequences of chronic alcohol consumption needs to be confirmed by further investigations.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104540"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rbmo.2024.104561
Busra Korpe , Caner Kose
Objective
This study aimed to investigate menopausal symptoms and their frequencies while exploring their potential correlation with systemic inflammation in perimenopausal and postmenopausal women.
Materials and Methods
The study involved a comparative analysis of menopausal symptoms and systemic inflammation markers between perimenopausal (n=213) and postmenopausal women (n=219). Participants were assessed with the Menopause Rating Scale (MRS) for somatic, urogenital and psychological symptoms and systemic immune-inflammation index (SII) levels. Regression analysis was conducted to identify parameters strongly associated with high somatic and total MRS scores.
Results
Total MRS and somatic domain scores were found to be significantly higher in perimenopausal women compared to postmenopausal women. Additionally, perimenopausal women exhibited elevated levels of systemic inflammation, as indicated by higher SII levels. Regression analysis revealed that being perimenopausal, being smoker and having higher SII results were the most significant parameters related to increased somatic scores. In contrast, parity and exercise were found to be associated with lower somatic scores.
Conclusion
The findings of this study highlight the heightened somatic symptomatology and systemic inflammation observed in perimenopausal women. Specifically, being in the perimenopausal phase, being a smoker and having elevated systemic inflammation markers were identified as strong factors associated with increased somatic scores. These results underscore the importance of considering systemic inflammation in the management of menopausal symptoms, particularly during the perimenopausal transition.
{"title":"MENOPAUSAL SYMPTOMS AND SYSTEMIC INFLAMMATION: A COMPARATIVE STUDY IN PERIMENOPAUSAL AND POSTMENOPAUSAL WOMEN","authors":"Busra Korpe , Caner Kose","doi":"10.1016/j.rbmo.2024.104561","DOIUrl":"10.1016/j.rbmo.2024.104561","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate menopausal symptoms and their frequencies while exploring their potential correlation with systemic inflammation in perimenopausal and postmenopausal women.</div></div><div><h3>Materials and Methods</h3><div>The study involved a comparative analysis of menopausal symptoms and systemic inflammation markers between perimenopausal (n=213) and postmenopausal women (n=219). Participants were assessed with the Menopause Rating Scale (MRS) for somatic, urogenital and psychological symptoms and systemic immune-inflammation index (SII) levels. Regression analysis was conducted to identify parameters strongly associated with high somatic and total MRS scores.</div></div><div><h3>Results</h3><div>Total MRS and somatic domain scores were found to be significantly higher in perimenopausal women compared to postmenopausal women. Additionally, perimenopausal women exhibited elevated levels of systemic inflammation, as indicated by higher SII levels. Regression analysis revealed that being perimenopausal, being smoker and having higher SII results were the most significant parameters related to increased somatic scores. In contrast, parity and exercise were found to be associated with lower somatic scores.</div></div><div><h3>Conclusion</h3><div>The findings of this study highlight the heightened somatic symptomatology and systemic inflammation observed in perimenopausal women. Specifically, being in the perimenopausal phase, being a smoker and having elevated systemic inflammation markers were identified as strong factors associated with increased somatic scores. These results underscore the importance of considering systemic inflammation in the management of menopausal symptoms, particularly during the perimenopausal transition.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104561"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.rbmo.2024.104568
Gönül Özer , Sevinc Özmen
Objective
Is there a difference in pregnancy outcomes among women undergoing modified natural cycle frozen embryo transfer (mNC-FET) with or without progesterone as luteal phase support (LPS)?
Materials and Methods
A retrospective analysis was conducted on 2216 modified natural cycle frozen embryo transfer (mNC-FET) cycles performed at Memorial Sisli Hospital between 2011 and 2023. The study included patients under 38 years of age who underwent top-quality (TQ) or good-quality (GQ) single embryo transfer in mNC-FET cycles. Excluded from the study were medium-quality (MQ) or poor-quality (PQ) embryo transfer cycles, double embryo transfer cycles, and embryo transfer cycles with preimplantation genetic testing for aneuploidy (PGD/A). During the mNC-FET cycles, patients were monitored using transvaginal ultrasonography starting from the second day of the menstrual cycle to determine the day of ovulation. Based on follicle size and hormone levels, ovulation was induced with a single subcutaneous dose of recombinant human chorionic gonadotropin (r-hCG, Ovitrelle 250 µg). The cycles were divided into three separate groups for analysis: Group A (n=493) did not receive any luteal phase support; Group B (n=1327) received 200 mg of vaginal micronized progesterone twice daily; and Group C (n=396) received 200 mg of vaginal micronized progesterone twice daily along with 25 mg of subcutaneous progestin daily. Groups were compared in terms of cycle characteristics and pregnancy outcomes.
Results
Demographic and fresh cycle characteristics of the groups were similar. There was no statistically significant difference between the groups regarding pregnancy outcomes. Live birth rates were 58.4% in Group A, 60.8% in Group B and 60.1% in Group C (p=0.650). Clinical pregnancy rates were 65.9%, 69.1% and 68.2%, respectively (p=0.432). Biochemical abortion rates were 4.5%, 6.6% and 5.3%, respectively (p=0.186) and clinical abortion rates were 6.3%, 6.7% and 5.3%, respectively (p=0.828).
Conclusion
The study showed that women under 38 years of age undergoing mNC FET had similar pregnancy outcomes with or without the use of progesterone for luteal phase support. Consequently, the administration of progesterone for luteal phase support seems unnecessary. In these cases, hCG given for triggering and the presence of corpus luteum are sufficient for luteal phase support. Randomised controlled trials are needed to support these findings.
{"title":"IS PROGESTERONE SUPPLEMENTATION REQUIRED FOR LUTEAL PHASE SUPPORT DURING MODIFIED NATURAL CYCLE FROZEN EMBRYO TRANSFER?","authors":"Gönül Özer , Sevinc Özmen","doi":"10.1016/j.rbmo.2024.104568","DOIUrl":"10.1016/j.rbmo.2024.104568","url":null,"abstract":"<div><h3>Objective</h3><div>Is there a difference in pregnancy outcomes among women undergoing modified natural cycle frozen embryo transfer (mNC-FET) with or without progesterone as luteal phase support (LPS)?</div></div><div><h3>Materials and Methods</h3><div>A retrospective analysis was conducted on 2216 modified natural cycle frozen embryo transfer (mNC-FET) cycles performed at Memorial Sisli Hospital between 2011 and 2023. The study included patients under 38 years of age who underwent top-quality (TQ) or good-quality (GQ) single embryo transfer in mNC-FET cycles. Excluded from the study were medium-quality (MQ) or poor-quality (PQ) embryo transfer cycles, double embryo transfer cycles, and embryo transfer cycles with preimplantation genetic testing for aneuploidy (PGD/A). During the mNC-FET cycles, patients were monitored using transvaginal ultrasonography starting from the second day of the menstrual cycle to determine the day of ovulation. Based on follicle size and hormone levels, ovulation was induced with a single subcutaneous dose of recombinant human chorionic gonadotropin (r-hCG, Ovitrelle 250 µg). The cycles were divided into three separate groups for analysis: Group A (n=493) did not receive any luteal phase support; Group B (n=1327) received 200 mg of vaginal micronized progesterone twice daily; and Group C (n=396) received 200 mg of vaginal micronized progesterone twice daily along with 25 mg of subcutaneous progestin daily. Groups were compared in terms of cycle characteristics and pregnancy outcomes.</div></div><div><h3>Results</h3><div>Demographic and fresh cycle characteristics of the groups were similar. There was no statistically significant difference between the groups regarding pregnancy outcomes. Live birth rates were 58.4% in Group A, 60.8% in Group B and 60.1% in Group C (p=0.650). Clinical pregnancy rates were 65.9%, 69.1% and 68.2%, respectively (p=0.432). Biochemical abortion rates were 4.5%, 6.6% and 5.3%, respectively (p=0.186) and clinical abortion rates were 6.3%, 6.7% and 5.3%, respectively (p=0.828).</div></div><div><h3>Conclusion</h3><div>The study showed that women under 38 years of age undergoing mNC FET had similar pregnancy outcomes with or without the use of progesterone for luteal phase support. Consequently, the administration of progesterone for luteal phase support seems unnecessary. In these cases, hCG given for triggering and the presence of corpus luteum are sufficient for luteal phase support. Randomised controlled trials are needed to support these findings.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104568"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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