Reproductive biomedicine online最新文献

{"title":"INVESTIGATION OF THE POSSIBLE RELATIONSHIP OF INSEMINATED SPERM PROPERTIES IN ASSISTED REPRODUCTION TECHNIQUES CYCLES WITH EMBRYO MORPHOKINETIC PARAMETERS AND ANEUPLOIDY","authors":"DUYGU KÜTÜK ,&nbsp;ŞİRİN KİNETLİ ,&nbsp;İBRAHİM ORÇUN OLCAY ,&nbsp;TÜLAY İREZ ,&nbsp;BERKAY AKÇAY ,&nbsp;NECATİ FINDIKLI","doi":"10.1016/j.rbmo.2024.104533","DOIUrl":"10.1016/j.rbmo.2024.104533","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate and evaluate the aneuploidy status and morphokinetic relationships of embryos according to the sperm source used.</div></div><div><h3>Methods</h3><div>In our study, morphokinetic evaluation of embryos formed by testicular and ejaculate sperm was performed. Morphokinetic and PGD results of 1157 blastocysts obtained from 155 patients who applied to Bahçeci IVF center between 2016 and 2020 and had PGD indication were evaluated retrospectively according to ejaculate and testicular sperm usage.</div></div><div><h3>Results</h3><div>In morphokinetic evaluations, it was understood that the development of testicular sperm was shorter than the development of ejaculate sperm (p&lt;0.05). It was shown that female age is effective in the development of aneuploid embryos in patients using both ejaculate and testicular sperm in the evaluation before and after the age of 35 (p&lt;0.05). PGD analysis showed that the time lapse process in normal and abnormal embryos was longer in normal embryos, especially at the PN formation and deletion stage was observed (p&lt;0.05).</div></div><div><h3>Conclusions</h3><div>As a result, it has been understood that the age of men and women is a factor in the development of aneuploidy; testicular and ejaculate sperm develop aneuploidy embryos at similar rates, time lapse parameters show different processes in the two types of sperm samples, but there are no different rates in terms of aneuploidy, therefore, with this study, it is understood that new morphokinetic models are needed.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104533"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142085","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}

{"title":"THE PREDICTIVE POWER OF FSH RECEPTOR GENE EXPRESSION ANALYSIS FOR PERSONALIZED OVARIAN STIMULATION PREDICTIONS","authors":"Zeynep Gunes ,&nbsp;Dagan Wells","doi":"10.1016/j.rbmo.2024.104541","DOIUrl":"10.1016/j.rbmo.2024.104541","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Traditional biomarkers for predicting response to Controlled Ovarian Stimulation (COS) have limited capabilities, highlighted by the portion of patients who do not fit the response pattern predicted by their AMH levels and age. Identifying biomarkers that enable better forecasting of response to COS is desirable, potentially revealing patients at elevated risk of hyperstimulation and those who might produce a fewer than optimal number of oocytes. It has been proposed that alternative transcripts of the follicle-stimulating hormone receptor (FSHR) gene might contribute to variation in response to COS. We examined this hypothesis and produced the first comprehensive catalogue of FSHR transcript variants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and Methods&lt;/h3&gt;&lt;div&gt;Patterns of FSHR mRNA splice variants were analysed in 126 patients. RNA extracted from granulosa cells was subjected to long-read nanopore sequencing, enabling analysis of the entire FSHR transcript in a single continuous sequence ‘read’.This was essential for determining whether variants affecting different parts of the transcript occur together or independently. Patients were categorised based on their COS response (high, low or normal), in addition to being classified by age, AMH level and the number of oocytes retrieved. Expression patterns of FSHR were compared to response to COS.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Full-length FSHR transcript was detected in 97.6% of patients, and skipping Exon 6 was observed in 68%. In total, 9 distinct FSHR mRNA variants were detected. Five novel transcripts were identified involving partial insertion of ∼100bp segments of introns 1 or 2, seen in 6.6% of patients. Inconsistent responses to COS were identified in 53% and 33% of the patients predicted via their age or AMH levels, respectively. As expected, older age was associated with higher FSH requirement per oocyte collected (p=0.02), and AMH levels declined with age (p=0.01). AMH levels and amount of FSH injection per oocyte retrieved were negatively correlated (p&lt;0.001). Interestingly, women ≥38 expressed novel variants more often than their younger counterparts (p=0.02), potentially indicative of an age-related decline in transcriptional fidelity in granulosa cells, which may have wider clinical relevance. The only transcript potentially linked to an altered response to COS was that lacking exon 6, which was associated with greater numbers of oocytes produced (p=0.009). This transcript was observed less often in older patients with low response to COS (&lt;em&gt;p&lt;/em&gt;= 0.03).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&amp;Conclusion&lt;/h3&gt;&lt;div&gt;AMH and age-dependent response predictions were unreliable in many patients, highlighting the importance of discovering more powerful biomarkers. Our findings suggest that skipping Exon 6 may be associated with greater sensitivity to COS, indicating that FSHR mRNA profiling could potentially play a role in personalisation of stimulation protocols. T","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104541"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142198","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}

{"title":"THE SIGNIFICANCE OF DISTURBANCES IN DNA DOUBLE-STRAND BREAK FORMATION AND REPAIR IN NON-OBSTRUCTIVE AZOOSPERMIA PATIENTS","authors":"Özlem Okutman ,&nbsp;Ali Sami Gürbüz ,&nbsp;Ahmet Şalvarcı ,&nbsp;Cécile Lang ,&nbsp;Jean Muller ,&nbsp;Necati Fındıklı ,&nbsp;Stephane Viville","doi":"10.1016/j.rbmo.2024.104539","DOIUrl":"10.1016/j.rbmo.2024.104539","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The ultimate treatment management of NOA involves testicular sperm extraction; however, in almost half of the men with NOA, no sperm can be retrieved. DNA defects such as double-strand breaks (DSBs) can disturb meiotic recombination and cause infertility in men due to complete early meiotic arrest. To date, few genes participating in DSB formation and/or repair have been associated with infertility in humans. However, the relationship between the failure of the meiotic DSB process and human infertility remains poorly understood. We aim to identify new genetic causes responsible for the nonobstructive azoospermia (NOA) with meiotic arrest by using exome sequencing&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;This case-control study was conducted on two Turkish consanguineous families, comprising infertile men with NOA. Testicular histopathology results showed meiotic arrest at the spermatid stage. Karyotypes were normal and no Y chromosome microdeletion was detected in the affected men. Ethical approval was obtained from the Comité de Protection de la Personne (CPP) of Strasbourg University Hospital.Saliva samples from index cases and both parents were collected after obtaining written informed consent. Exome sequencing was performed using the GenomEast Platform (IGBMC, Strasbourg, France). Detected variants were annotated and ranked by VaRank (v1.4.3).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Exome sequencing revealed homozygous pathogenic variations in two genes namely &lt;em&gt;C11orf80&lt;/em&gt; (also known as &lt;em&gt;TOPBBL&lt;/em&gt;) and &lt;em&gt;RAD51AP2.&lt;/em&gt; The first gene is related to meiotic DNA DSB formation, while the latter is associated with DSB repair in the respective families. Meiosis could not be completed in either situation, resulting in spermatogenesis arrests at the pachytene stage of meiosis 1. Two recent reports described four NOA men from two families presenting homozygous truncating variants in &lt;em&gt;C11orf80&lt;/em&gt;. Similarly, homozygous or compound heterozygous loss-of-function variations in &lt;em&gt;RAD51AP2&lt;/em&gt; were previously identified in four men diagnosed with idiopathic NOA. Since the identification of both genes were after the latest systematic review, they were neither scored norvalidated for the male infertility. The gene-disease relationship (GDR) was evaluated by including published patients and variants as well as results from the actual study. &lt;em&gt;C11orf80&lt;/em&gt; and &lt;em&gt;RAD51AP2&lt;/em&gt; were scored as 13 and 14 respectively with a classification of “strong” for both genes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Our findings support the role of &lt;em&gt;C11orf80&lt;/em&gt; and &lt;em&gt;RAD51AP2&lt;/em&gt; as genetic contributors to human infertility by causing meiotic arrest during spermatogenesis in men.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The main limitation of our study is the small number of cases included. However, it provides fresh data regarding on NOA phenotypes associated with meiotic arrest. For men with a similar phen","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104539"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142200","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}

{"title":"PROSPECTIVE STUDY OF THE RELATIONSHIP BETWEEN MATERNAL SERUM 25-HYDROXY VITAMIN D LEVELS DURING THE ANTENATAL PERIOD AND OVARIAN RESERVE IN FEMALE NEWBORNS","authors":"Aysegul Durmus Keskin ,&nbsp;Anıl Erturk ,&nbsp;Nergis Kender Erturk","doi":"10.1016/j.rbmo.2024.104553","DOIUrl":"10.1016/j.rbmo.2024.104553","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the relationship between maternal serum 25-hydroxy vitamin D [25(OH)D] levels during the antenatal period and ovarian reserve in female newborns, and to investigate the connection between these parameters.</div></div><div><h3>Materials and Methods</h3><div>This prospective cohort study at Bursa Yuksek Ihtisas Hospital (July 2023-April 2024) included 200 pregnant women, with 95 completing the study by delivering at 37 weeks or later without complications. 25(OH)D and anti-mullerian hormone (AMH) levels were measured in maternal blood between 12-24 weeks of gestation, before delivery, and in neonatal cord blood. Participants were divided into three groups based on second-trimester 25(OH)D levels: &lt;10 ng/ml (Group 1), 10-20 ng/ml (Group 2), and ≥20 ng/ml (Group 3). Comparisons were made for demographic data, maternal 25(OH)D and AMH levels, and cord blood AMH and 25(OH)D levels. Spearman correlation analysis was used to analyze relationships between parameters.Logistic regression analyzed factors affecting cord blood AMH.</div></div><div><h3>Results</h3><div>Of the 95 patients, 36 were in Group 1, 43 in Group 2, and 16 in Group 3. The groups were similar in terms of age, BMI, gestational week, antenatal vitamin D supplementation, birth weight, and Apgar scores. There was no statistically significant difference between the groups in terms of pre-delivery maternal AMH and neonatal cord blood AMH levels. There was no correlation between maternal second trimester 25(OH)D levels and pre-delivery maternal AMH and cord blood AMH levels. However, maternal second trimester 25(OH)D levels were significantly positively correlated with neonatal cord blood 25(OH)D levels and maternal pre-delivery 25(OH)D levels. Additionally, neonatal cord blood 25(OH)D levels were significantly positively correlated with cord blood AMH levels (r=0.215, p=0.037). Factors affecting neonatal cord blood AMH levels were evaluated using linear regression analysis. According to the regression model, which included age, birth weight, and neonatal cord blood 25(OH)D as independent variables, the regression model was significant, and cord blood 25(OH)D was found to have a significant impact on neonatal AMH levels (R² = 0.097, p=0.025).</div></div><div><h3>Conclusion</h3><div>Vitamin D levels impact the female reproductive system, with maternal vitamin D levels correlating with those in newborns. This suggests maternal vitamin D may affect gonadal development in female fetuses. Neonatal AMH measurement, an ovarian folliculogenesis marker, can help identify these effects. Umbilical cord AMH levels in female fetuses might be influenced by neonatal vitamin D levels. Therefore, adequate maternal vitamin D supplementation during pregnancy is crucial for healthy gonadal development in female newborns. Larger, well-designed randomized studies are needed for more definitive conclusions.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104553"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142279","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}

{"title":"THE IMPACT OF POST-THAW BLASTOCELE EXPANSION GRADE PROGRESSION ON ONGOING PREGNANCY RATES IN FROZEN-THAWED BLASTOCYST TRANSFER CYCLES","authors":"Zuhal Yapici Coskun ,&nbsp;Onur Ince ,&nbsp;Figen Besyaprak ,&nbsp;Neslihan Coskun Akcay ,&nbsp;Ayten Sever ,&nbsp;Lale Karakoc Sokmensuer ,&nbsp;Sezcan Mumusoglu","doi":"10.1016/j.rbmo.2024.104577","DOIUrl":"10.1016/j.rbmo.2024.104577","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to examine the impact of the degree of progression in blastocele expansion grade from pre-vitrification to post-thaw stages on ongoing pregnancy rates (OPRs) in frozen-thawed blastocyst transfer cycles.</div></div><div><h3>Materials and Methods</h3><div>This retrospective cohort study was conducted at Hacettepe University, IVF Unit, between January 2014 and June 2024. The study included patients aged 20-44 years, with a BMI ≤ 35, who underwent single blastocyst embryo transfer with no preimplantation genetic tests or a partner with azoospermia. Embryos were initially graded at the pre-vitrification stage using the Gardner grading system. After thawing, they were re-evaluated 4-6 hours later to assess changes in the degree of blastocyst cavity expansion. Embryos were categorized into No progression, +1 progression (progression by one stage), and +2 progression (progression by two stages) groups. Data analysis included adjustments for BMI, maternal age, FET protocol type, and cycle number. The primary outcome, ongoing pregnancy, was defined as the presence of an intrauterine fetal heartbeat.</div></div><div><h3>Results</h3><div>The study included 449 single blastocyst transfer cycle. The OPRs for each combination of blastocyst morphological grade and blastocele expansion grade progression groups, and the odds ratios (OR) of OPRs compared to the reference group (poor embryo transfer with no progression of expansion) are presented in the Table 1. Univariately, both blastocyst morphology (excellent, good, average, and poor grading) and the degree of progression in blastocele expansion grade (0, +1, and +2 grading) have moderate accuracy in predicting pregnancy outcomes, with AUC values of 0.621 [0.574-0.667] and 0.630 [0.584-0.677], respectively. However, the DeLong test results show no statistically significant difference between the two AUC values (p = 0.617).</div></div><div><h3>Discussion and Conclusion</h3><div>These findings suggest that blastocysts with an advancement in blastocele expansion grade compared to their pre-vitrification evaluation have higher OPRs than those with no advancement. The results indicate that embryological evaluation at the post-thaw stage could be a predictive factor for OPRs.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104577"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142281","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}

{"title":"TRANSVAGINAL ETHANOL SCLEROTHERAPY FOR ENDOMETRIOMAS: COMPLICATIONS, EFFECT ON OVARIAN RESERVE AND RECURRENCE RATES","authors":"Batuhan Aslan ,&nbsp;Necati Berk Kaplan ,&nbsp;Yavuz Emre Şükür","doi":"10.1016/j.rbmo.2024.104546","DOIUrl":"10.1016/j.rbmo.2024.104546","url":null,"abstract":"<div><h3>Objective</h3><div>Surgical excision of endometriomas, especially with repeated procedures, can compromise ovarian reserve. Transvaginal ethanol sclerotherapy has become an increasingly popular treatment for endometriomas. However, the pre- and post-operative complications of transvaginal ethanol sclerotherapy for endometriomas are not well-documented. This study aims to report and describe the failures and complications associated with transvaginal ethanol sclerotherapy.</div></div><div><h3>Materials and Methods</h3><div>This was a prospective cohort study conducted at Ankara University School of Medicine between January 2022 and June 2024. The study protocol was approved by the university's ethics committee, and all participants provided written informed consent for the use of their medical data. During the study period, the inclusion criteria for ethanol sclerotherapy were women presenting with at least one endometrioma larger than 30 mm in diameter and requiring treatment for pain or infertility prior to assisted reproductive therapy. All study participants underwent preoperative evaluation using the IOTA Adnex model. Recurrence was defined as an endometrioma larger than 20 mm after 3 months.</div></div><div><h3>Results</h3><div>A total of 48 patients underwent ethanol sclerotherapy. No major complications were observed in any patient. The mean age of the patients was 32.36 ± 4.03 years, their BMI was 25.65 ± 4.93, and their pre-procedure AMH level was 2.51 ± 1.44 ng/mL. The mean post-procedure AMH level was 2.3 ± 1.40 ng/mL, indicating a slight decrease of 0.21 ng/mL on average. The minimum and maximum differences in AMH levels were -0.82 ng/mL and 0.55 ng/mL, respectively. No significant difference was found between the pre- and post-procedure AMH means (p=0.176). A total of 5 (10.41%)minor complications were observed among the 48 patients. Alcohol leakage occurred in 2 cases. One patient experienced urticaria-like symptoms, while another reported nausea and vomiting due to alcohol intoxication. Anaphylaxis was observed in 1 patient, likely due to the administered antibiotic, and was readily managed with adrenaline, steroids, and antihistamine treatments. Mild fever was reported in 1 patient and was addressed with oral antibiotics. Additionally, 1 patient experienced abdominal pain after the procedure, which resolved within 24 hours of follow-up. After 3 months follow up only 6 (12.5%) patients had recurrence.</div></div><div><h3>Conclusion</h3><div>Transvaginal ethanol sclerotherapy has proven to be an effective treatment, with a minimal impact on ovarian reserve, acceptable complication rates, and recurrence rates comparable to cystectomy.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104546"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141721","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}

{"title":"DOES SIZE MATTER? THE ROLE OF OVARIAN ENDOMETRIOMAS IN AFFECTING OVARIAN FUNCTION AND ICSI OUTCOMES","authors":"Selen Mutlu ,&nbsp;Cihan Çakır ,&nbsp;Işıl Kasapoğlu ,&nbsp;Berrin Avcı","doi":"10.1016/j.rbmo.2024.104545","DOIUrl":"10.1016/j.rbmo.2024.104545","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this study was to evaluate the impact of ovarian endometrioma,particularly its size and bilaterality,on ICSI outcomes.The study sought to determine how endometriomas affect ovarian reserve,ovarian stimulation responses,embryo quality and reproductive outcomes in patients undergoing assisted reproductive technology(ART) due to endometriosis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;This retrospective cohort study analyzed data from ARTcycles performed at Uludağ University ART Center between January2011 and December2024.A total of 460 patients undergoing their first ICSI cycles were included. The study group consisted of 230 patients diagnosed with endometrioma. The control group included 230 patients with unexplained infertility,matched by age,AMH,and AFC using propensity score matching. Patients were classified into five groups:four based on endometrioma size,categorized into percentiles(0-25,25-50,50-75,75-100),and control group of women with unexplained infertility. Comparative assessments were made across the five groups regarding baseline characteristics,basal hormonal parameters,ovarian stimulation profiles. Embryological development parameters and clinical outcomes were analyzed to evaluate differences among the groups. The primary outcome measure was the implantation rate.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;When endometrioma size was categorized into percentiles,Group1 included those with a size≤2.5 cm(n=66),Group2 with a size&gt;2.5–≤4 cm(n=48),Group3 with a size&gt;4–≤6 cm(n=64),and Group4 with a size&gt;6 cm(n=52).Apart from the increase in basal FSH values&lt;em&gt;(p&lt;0.001)&lt;/em&gt; corresponding to the size of the endometrioma, no significant differences were observed in other basal hormone parameters, antral follicle count(AFC)&lt;em&gt;(p=0.171)&lt;/em&gt;,or AMH levels&lt;em&gt;(p=0.273)&lt;/em&gt;.Additionally,the Follicular Output Rate (FOI)&lt;em&gt;(p=0.454)&lt;/em&gt; and Follicular Output Rate Test(FORT)values&lt;em&gt;(p=0.712)&lt;/em&gt;,which assess ovarian response, were similar across all groups, including the control group. Compared to the control group, the presence of endometriomas was associated with a reduction in the number of oocytes(p&lt;0.001) and blastocyst count(p=0.003) after OPU, while blastocyst formation(p=0.491) and implantation rates(p=0.472)remained unaffected. Although the increase in endometrioma size negatively impacted embryological parameters, it didn't alter the clinical outcomes&lt;em&gt;(p=0.541)&lt;/em&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;This study demonstrates that ovarian endometriomas reduce the number of oocytes and blastocysts retrieved,suggesting a potential negative impact of increased endometrioma size on ovarian function.Implantation rates were comparable between women with endometriomas and those with unexplained infertility.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Our study didn't observe significant differences in embryo quality or clinical pregnancy rates in the presence of endometriomas","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104545"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141722","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}

{"title":"AUTOMATISATION AND STANDARDIZATION TO DECRYPT BLASTOCYST MORPHOKINETICS","authors":"Danilo Cimadomo","doi":"10.1016/j.rbmo.2024.104514","DOIUrl":"10.1016/j.rbmo.2024.104514","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Time-Lapse Microscopy (TLM) is an advanced tool used to continuously monitor the in vitro development of embryos, providing uninterrupted observation without disturbing the culture environment. Over time, TLM has enabled more precise and detailed data collection; however, clinical interpretations often remain subjective and are influenced by inter-observer variability. While static embryo assessment primarily relies on discrete morphological observations, TLM introduces a morphodynamic approach, capturing sequential developmental changes over time. This allows for a deeper understanding of embryo viability, but the clinical value of TLM remains controversial due to inconsistent evidence. Despite several trials comparing TLM with standard embryo selection methods, though, the findings are conflicting. Some studies suggest that TLM might improve pregnancy and implantation rates, while others show no significant differences. This discrepancy is primarily attributed to several confounding factors, including variability in laboratory protocols, subjective evaluations, and differences in the criteria for embryo selection and exclusion. For instance, variability within aneuploid and euploid embryos makes definitive classification challenging, as highlighted by the subjective interpretations and discordant ratings among embryologists.&lt;/div&gt;&lt;div&gt;To address these limitations, the integration of AI in TLM has been proposed to standardize and automate the embryo assessment process, minimizing the impact of human bias. AI-powered tools, such as CHLOE™ and iDAScore, were developed to objectively quantify key morphokinetic parameters, identify critical thresholds of developmental incompetence, and classify embryos based on standardized algorithms. These tools can be leveraged to generate novel models of embryo selection based on the data they generate, such as the “quantitative standardized blastocyst expansion assay” (qSEA), an embryo selection scheme that leverages AI to track blastocyst expansion and identify specific growth patterns that correlate with embryonic viability. The qSEA provides a robust framework for evaluating blastocyst quality and potentially improving the prediction of euploid embryos’ reproductive competence.&lt;/div&gt;&lt;div&gt;Special attention was paid to Day7 and low-quality blastocysts (LQB), which historically have been associated with lower competence. However, emerging data suggest that these embryos, although less competent, are not absolutely incompetent. With AI support, we consistently and reliably redefined their clinical value, minimizing the inherent bias due to their deselection at many IVF clinics worldwide.&lt;/div&gt;&lt;div&gt;Recently, we have also introduced novel morphokinetic markers such as blastocyst spontaneous collapse and cytoplasmic strings (Cyt-S). Spontaneous collapse is identified as a potential biomarker of reduced competence. AI algorithms were exploited to automatically detect these collapses, their quantify, their ","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104514"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141823","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}

{"title":"COMPARING BLASTOCYST EUPLOIDY RATES BETWEEN PROGESTIN-PRIMED AND GONADOTROPHIN-RELEASING HORMONE ANTAGONIST PROTOCOLS IN ANEUPLOIDY GENETIC TESTING: A RETROSPECTIVE ANALYSIS","authors":"MURAT BERKKANOGLU ,&nbsp;KEVIN COETZEE ,&nbsp;HASAN BULUT ,&nbsp;HANDE NALAN TORE ,&nbsp;KEMAL OZGUR","doi":"10.1016/j.rbmo.2024.104543","DOIUrl":"10.1016/j.rbmo.2024.104543","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to compare the euploidy rate of blastocysts following the progestin-primed ovarian stimulation (PPOS) protocol and the gonadotropin-releasing hormone antagonist protocol in women undergoing preimplantation genetic testing for aneuploidy (PGT-A).</div></div><div><h3>Materials &amp; Methods</h3><div>This is a retrospective study. The data of the total of 269 women undergoing PGT-A were analyzed. They were divided into two groups. 1) The antagonist group (n:153): an antagonist given once daily from day 6 of ovarian stimulation till the day of the ovulation trigger; and 2) The PPOS (n:116) group: medroxyprogesteron from the first or sixth day of ovarian stimulation till the day of ovulation trigger. The primary outcome is the euploidy rate of blastocysts.</div></div><div><h3>Results</h3><div>Basal characteristics were similar in the two groups; a substantial similarity of the main outcome measures in the two treatment groups has also been found. The mean ages (±Std) were 34,9 ±4,7 for group 1 and 33,8 ±3,8 for group 2, respectively (p=0,102). The means of antral follicle counts (±Std) were 15,6 ±11,3 for group 1 and 14,7 ±8,2 for group 2, respectively (p=0,732). The means of duration of infertility (±Std) were 4,3 ±3,7 for group 1 and 4,4 ±3,8 for group 2, respectively (p=0,962). The means of body mass index (±Std) were 25,1 ±4,6 for group 1 and 25,3 ±4,7 for group 2, respectively (p=0,654). The rates of formation of euploid blastocysts per oocytes were 55,8% for group 1 and 55% for group 2 respectively (p=0,931). Further subgroup analysis also showed there were not significant differences between below and above 35 years old patient data. The euploidy rates under 35 years old were 67,1% for group 1 and 58,6% for group 2 (p=0,153) and over 35 years old were 40,2% for group 1 and 58,6% for group 2 (p=0,469) respectively.</div></div><div><h3>Conclusion</h3><div>There are some studies showing there is no significant difference in rate of euploidy between PPOS and antagonist protocols.^1,2 But, there is a recent retrospective study showing that PPOS protocol could potentially reduce the euploidy rate in aging IVF patients when compared to the conventional GnRH-antagonist approach.³ However, in our study we found no significant difference in the rate of euploid embryo between the antagonist and the PPOS groups in general population and also at younger or older age groups. Therefore, our results encourage the use of PPOS protocol for candidates for preimplantation genetic testing. Since our study is also a retrospective study, randomized control studies investigating the effect of PPOS on the euploidy rate and on the live birth rate are warranted.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104543"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142196","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}

{"title":"REEVALUATING AZOOSPERMIA: IDENTIFICATION OF CRYPTOZOOSPERMIA AND ITS IMPACT ON INFERTILITY TREATMENT WITH INTRACYTOPLASMIC SPERM INJECTION","authors":"Mustafa Emre Bakırcıoğu ,&nbsp;Kadir Can Sahin ,&nbsp;Süleyman Tosun ,&nbsp;Numan Bayazıt ,&nbsp;Sami Cengiz ,&nbsp;Cenk Özcan ,&nbsp;Ulun Uluğ","doi":"10.1016/j.rbmo.2024.104536","DOIUrl":"10.1016/j.rbmo.2024.104536","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Cryptozoospermia is a challenging condition characterized by extremely low sperm counts in the ejaculate, only detectable after centrifugation and meticulous microscopic examination. Due to either incomplete evaluation or inadequacy of traditional semen analyses, most patients with cryptozoospermia are diagnosed as azoospermia in many centers, leading suboptimal treatment and incorrect therapeutic strategies. We aim to present the demographic, clinical and follow-up data of patients who were diagnosed with azoospermia in an external center and diagnosed with cryptozoospermia in our center.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;We retrospectively analyzed the data of 515 patients who applied to our center due to infertility and underwent semen analysis between April 2021 and April 2024. The clinical and demographic data of the patients with cryptozoospermia were analyzed comparatively with the data of 239 non-obstructive azoospermia patients who underwent micro-TESE. The ICSI outcomes (fertilization and clinical pregnancy rates) were compared between the groups which underwent fresh ejaculated sperm and testicular sperm were used the same day of oocyte pick up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;695 semen analyses of 515 patients were analyzed, and 372 of these patients had azoospermia. When the samples of these patients were re-examined after Percoll centrifugation, 93 samples were found to have motile sperm cells. Of these patients, 19 patients with previously diagnosed cryptozoospermia, hypogonadotropic hypogonadism, or severe oligoasthenoteratospermia were excluded, and 74 (19,9 %) patients who were previously diagnosed with azoospermia in another center and found to have cryptozoospermia were included in the final analysis.&lt;/div&gt;&lt;div&gt;Demographic and clinical data of these patients and comparative analysis of demographic and clinical characteristics of cryptozoospermia and non-obstructive azoospermia patients are given in Table 1. Comparison between fresh ejaculated sperm and testicular sperm usage for ICSI did not show difference between fertilization and pregnancy rates (Table 2).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;In our study, we found that nearly 20% of men initially diagnosed with azoospermia actually had sperm present in their ejaculate with meticulous sperm detection. Patients with cryptozoospermia exhibited significantly higher levels of FSH, total testosterone and testicular volume compared to men with azoospermia. Additionally, we observed higher rates of parental consanguinity and AZFc microdeletion in Y chromosome in cryptozoospermia patients, indicating potential genetic factors contributing to this condition. Importantly, using ejaculated sperm for ICSI resulted in comparable fertilization and pregnancy rates to those achieved with surgically retrieved testicular sperm, suggesting that non-invasive sperm retrieval methods could be a viable option for many patients, potentially avoi","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104536"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142278","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}