Pub Date : 2023-11-25eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad043
Markus Hengstschläger
{"title":"Artificial intelligence as a door opener for a new era of human reproduction.","authors":"Markus Hengstschläger","doi":"10.1093/hropen/hoad043","DOIUrl":"10.1093/hropen/hoad043","url":null,"abstract":"","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad043"},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad046
Yaping Jiang, Lei Jin, Bo Huang, Li Wu, Xinling Ren, Hui He
<p><strong>Study question: </strong>Is early rescue ICSI (E-RICSI) an effective and safe technique compared to conventional ICSI?</p><p><strong>Summary answer: </strong>Despite the higher multi-pronucleus (PN) rate compared to conventional ICSI, E-RICSI did not add extra risks to clinical and neonatal outcomes.</p><p><strong>What is known already: </strong>Based on the finding that the second polar body was released in 80% of fertilized oocytes by 4 h after exposure to spermatozoa and in ∼90% of fertilized oocytes by 6 h, E-RICSI brings forward the timing of rescue ICSI to 6 h after initial insemination, and effectively prevents oocyte aging and embryo-uterus asynchrony. However, some researchers still voice concerns about the efficacy and safety of E-RICSI, and comparative studies are limited.</p><p><strong>Study design size duration: </strong>A retrospective cohort study was conducted on patients who underwent conventional ICSI or E-RICSI treatment between January 2015 and December 2020 at a university-affiliated hospital. Using 1:1 propensity score matching, 1496 cases entered each group.</p><p><strong>Participants/materials setting methods: </strong>In total, 1496 couples undergoing conventional ICSI oocyte retrieval cycles and 1496 undergoing E-RICSI oocyte retrieval cycles were enrolled in this study, and basic clinical characteristics, embryologic data, clinical outcomes and neonatal data were compared between groups. The embryos in the E-RICSI group were divided into two subgroups: those fertilized by iIVF (IVF subgroup) and those fertilized by E-RICSI (E-RICSI subgroup); the embryologic data, clinical outcomes, and neonatal data for these subgroups were also compared with the conventional ICSI group. Logistic regression was used for statistical analysis with potential confounder adjustment.</p><p><strong>Main results and the role of chance: </strong>The 2PN rate, blastocyst formation rate, and viable blastocyst formation rate of the E-RICSI group were significantly lower compared to the conventional ICSI group (2PN rate: <i>P</i> < 0.001; blastocyst formation rate: <i>P</i> < 0.001; viable blastocyst formation rate: <i>P</i> = 0.004), and the multi-PN rate in the E-RICSI group was significantly higher than the conventional ICSI group (<i>P</i> < 0.001). However, the number of 2PN embryos, normal cleavage embryo rate, Day 3 high-quality cleavage embryo rate, and high-quality blastocyst rate were similar between groups. When considering the IVF embryos and E-RCSI embryos in the E-RICSI group independently, the 2PN rate of the conventional ICSI group was significantly lower than E-RICSI subgroup but higher than the IVF subgroup, whereas the blastocyst formation rate and viable blastocyst formation rate were higher than E-RICSI embryos but comparable to IVF embryos. As for the clinical and neonatal outcomes, the implantation rate of the E-RICSI subgroup was significantly lower than the IVF subgroup but comparable to the conventional ICSI gro
{"title":"Cumulative live birth rate and neonatal outcomes after early rescue ICSI: a propensity score matching analysis.","authors":"Yaping Jiang, Lei Jin, Bo Huang, Li Wu, Xinling Ren, Hui He","doi":"10.1093/hropen/hoad046","DOIUrl":"https://doi.org/10.1093/hropen/hoad046","url":null,"abstract":"<p><strong>Study question: </strong>Is early rescue ICSI (E-RICSI) an effective and safe technique compared to conventional ICSI?</p><p><strong>Summary answer: </strong>Despite the higher multi-pronucleus (PN) rate compared to conventional ICSI, E-RICSI did not add extra risks to clinical and neonatal outcomes.</p><p><strong>What is known already: </strong>Based on the finding that the second polar body was released in 80% of fertilized oocytes by 4 h after exposure to spermatozoa and in ∼90% of fertilized oocytes by 6 h, E-RICSI brings forward the timing of rescue ICSI to 6 h after initial insemination, and effectively prevents oocyte aging and embryo-uterus asynchrony. However, some researchers still voice concerns about the efficacy and safety of E-RICSI, and comparative studies are limited.</p><p><strong>Study design size duration: </strong>A retrospective cohort study was conducted on patients who underwent conventional ICSI or E-RICSI treatment between January 2015 and December 2020 at a university-affiliated hospital. Using 1:1 propensity score matching, 1496 cases entered each group.</p><p><strong>Participants/materials setting methods: </strong>In total, 1496 couples undergoing conventional ICSI oocyte retrieval cycles and 1496 undergoing E-RICSI oocyte retrieval cycles were enrolled in this study, and basic clinical characteristics, embryologic data, clinical outcomes and neonatal data were compared between groups. The embryos in the E-RICSI group were divided into two subgroups: those fertilized by iIVF (IVF subgroup) and those fertilized by E-RICSI (E-RICSI subgroup); the embryologic data, clinical outcomes, and neonatal data for these subgroups were also compared with the conventional ICSI group. Logistic regression was used for statistical analysis with potential confounder adjustment.</p><p><strong>Main results and the role of chance: </strong>The 2PN rate, blastocyst formation rate, and viable blastocyst formation rate of the E-RICSI group were significantly lower compared to the conventional ICSI group (2PN rate: <i>P</i> < 0.001; blastocyst formation rate: <i>P</i> < 0.001; viable blastocyst formation rate: <i>P</i> = 0.004), and the multi-PN rate in the E-RICSI group was significantly higher than the conventional ICSI group (<i>P</i> < 0.001). However, the number of 2PN embryos, normal cleavage embryo rate, Day 3 high-quality cleavage embryo rate, and high-quality blastocyst rate were similar between groups. When considering the IVF embryos and E-RCSI embryos in the E-RICSI group independently, the 2PN rate of the conventional ICSI group was significantly lower than E-RICSI subgroup but higher than the IVF subgroup, whereas the blastocyst formation rate and viable blastocyst formation rate were higher than E-RICSI embryos but comparable to IVF embryos. As for the clinical and neonatal outcomes, the implantation rate of the E-RICSI subgroup was significantly lower than the IVF subgroup but comparable to the conventional ICSI gro","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad046"},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad044
Do-Yeal Ryu, Won-Ki Pang, Elikanah Olusayo Adegoke, Md Saidur Rahman, Yoo-Jin Park, Myung-Geol Pang
<p><strong>Study question: </strong>How does bisphenol-A (BPA) influence male fertility, and which mechanisms are activated following BPA exposure?</p><p><strong>Summary answer: </strong>BPA exposure causes hormonal disruption and alters mitochondrial dynamics and activity, ultimately leading to decreased male fertility.</p><p><strong>What is known already: </strong>As public health concerns following BPA exposure are rising globally, there is a need to understand the exact mechanisms of BPA on various diseases. BPA exposure causes hormonal imbalances and affects male fertility by binding the estrogen receptors (ERs), but the mechanism of how it mediates the hormonal dysregulation is yet to be studied.</p><p><strong>Study design size duration: </strong>This study consisted of a comparative study using mice that were separated into a control group and a group exposed to the lowest observed adverse effect level (LOAEL) (n = 20 mice/group) after a week of acclimatization to the environment. For this study, the LOAEL established by the US Environmental Protection Agency of 50 mg/kg body weight (BW)/day of BPA was used. The control mice were given corn oil orally. Based on the daily variations in BW, both groups were gavaged every day from 6 to 11 weeks (6-week exposure). Before sampling, mice were stabilized for a week. Then, the testes and spermatozoa of each mouse were collected to investigate the effects of BPA on male fertility. IVF was carried out using the cumulus-oocyte complexes from female hybrid B6D2F1/CrljOri mice (n = 3) between the ages of eight and twelve weeks.</p><p><strong>Participants/materials setting methods: </strong>Signaling pathways, apoptosis, and mitochondrial activity/dynamics-related proteins were evaluated by western blotting. ELISA was performed to determine the levels of sex hormones (FSH, LH, and testosterone) in serum. Hematoxylin and eosin staining was used to determine the effects of BPA on histological morphology and stage VII/VIII testicular seminiferous epithelium. Blastocyst formation and cleavage development rate were evaluated using IVF.</p><p><strong>Main results and the role of chance: </strong>BPA acted by binding to ERs and G protein-coupled receptors and activating the protein kinase A and mitogen-activated protein kinase signaling pathways, leading to aberrant hormone levels and effects on the respiratory chain complex, ATP synthase and protein-related apoptotic pathways in testis mitochondria (<i>P </i><<i> </i>0.05). Subsequently, embryo cleavage and blastocyst formation were reduced after the use of affected sperm, and abnormal morphology of seminiferous tubules and stage VII and VIII seminiferous epithelial cells (<i>P </i><<i> </i>0.05) was observed. It is noteworthy that histopathological lesions were detected in the testes at the LOAEL dose, even though the mice remained generally healthy and did not exhibit significant changes in BW following BPA exposure. These observations suggest that testicul
{"title":"Bisphenol-A disturbs hormonal levels and testis mitochondrial activity, reducing male fertility.","authors":"Do-Yeal Ryu, Won-Ki Pang, Elikanah Olusayo Adegoke, Md Saidur Rahman, Yoo-Jin Park, Myung-Geol Pang","doi":"10.1093/hropen/hoad044","DOIUrl":"https://doi.org/10.1093/hropen/hoad044","url":null,"abstract":"<p><strong>Study question: </strong>How does bisphenol-A (BPA) influence male fertility, and which mechanisms are activated following BPA exposure?</p><p><strong>Summary answer: </strong>BPA exposure causes hormonal disruption and alters mitochondrial dynamics and activity, ultimately leading to decreased male fertility.</p><p><strong>What is known already: </strong>As public health concerns following BPA exposure are rising globally, there is a need to understand the exact mechanisms of BPA on various diseases. BPA exposure causes hormonal imbalances and affects male fertility by binding the estrogen receptors (ERs), but the mechanism of how it mediates the hormonal dysregulation is yet to be studied.</p><p><strong>Study design size duration: </strong>This study consisted of a comparative study using mice that were separated into a control group and a group exposed to the lowest observed adverse effect level (LOAEL) (n = 20 mice/group) after a week of acclimatization to the environment. For this study, the LOAEL established by the US Environmental Protection Agency of 50 mg/kg body weight (BW)/day of BPA was used. The control mice were given corn oil orally. Based on the daily variations in BW, both groups were gavaged every day from 6 to 11 weeks (6-week exposure). Before sampling, mice were stabilized for a week. Then, the testes and spermatozoa of each mouse were collected to investigate the effects of BPA on male fertility. IVF was carried out using the cumulus-oocyte complexes from female hybrid B6D2F1/CrljOri mice (n = 3) between the ages of eight and twelve weeks.</p><p><strong>Participants/materials setting methods: </strong>Signaling pathways, apoptosis, and mitochondrial activity/dynamics-related proteins were evaluated by western blotting. ELISA was performed to determine the levels of sex hormones (FSH, LH, and testosterone) in serum. Hematoxylin and eosin staining was used to determine the effects of BPA on histological morphology and stage VII/VIII testicular seminiferous epithelium. Blastocyst formation and cleavage development rate were evaluated using IVF.</p><p><strong>Main results and the role of chance: </strong>BPA acted by binding to ERs and G protein-coupled receptors and activating the protein kinase A and mitogen-activated protein kinase signaling pathways, leading to aberrant hormone levels and effects on the respiratory chain complex, ATP synthase and protein-related apoptotic pathways in testis mitochondria (<i>P </i><<i> </i>0.05). Subsequently, embryo cleavage and blastocyst formation were reduced after the use of affected sperm, and abnormal morphology of seminiferous tubules and stage VII and VIII seminiferous epithelial cells (<i>P </i><<i> </i>0.05) was observed. It is noteworthy that histopathological lesions were detected in the testes at the LOAEL dose, even though the mice remained generally healthy and did not exhibit significant changes in BW following BPA exposure. These observations suggest that testicul","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad044"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad042
Nathalie B Neeser, Andrea Martani, Eva De Clercq, Christian De Geyter, Nicolas Vulliemoz, Bernice S Elger, Tenzin Wangmo
<p><strong>Study question: </strong>What is the existing empirical literature on the psychosocial health and wellbeing of the parents and offspring born at an advanced parental age (APA), defined as 40 years onwards?</p><p><strong>Summary answer: </strong>Although the studies show discrepancies in defining who is an APA parent and an imbalance in the empirical evidence for offspring, mothers, and fathers, there is a drive towards finding psychotic disorders and (neuro-)developmental disorders among the offspring; overall, the observed advantages and disadvantages are difficult to compare.</p><p><strong>What is known already: </strong>In many societies, children are born to parents at advanced ages and there is rising attention in the literature towards the consequences of this trend.</p><p><strong>Study design size duration: </strong>The systematic search was conducted in six electronic databases (PubMed including Medline, Embase, Scopus, PsycInfo, CINAHL, and SocINDEX) and was limited to papers published between 2000 and 2021 and to English-language articles. Search terms used across all six electronic databases were: ('advanced parental age' OR 'advanced maternal age' OR 'advanced paternal age' OR 'advanced reproductive age' OR 'late parent*' OR 'late motherhood' OR 'late fatherhood') AND ('IVF' OR 'in vitro fertilization' OR 'in-vitro-fertilization' OR 'fertilization in vitro' OR 'ICSI' OR 'intracytoplasmic sperm injection' OR 'reproductive techn*' OR 'assisted reproductive technolog*' OR 'assisted reproduction' OR 'assisted conception' OR 'reproduction' OR 'conception' OR 'birth*' OR 'pregnan*') AND ('wellbeing' OR 'well-being' OR 'psycho-social' OR 'social' OR 'ethical' OR 'right to reproduce' OR 'justice' OR 'family functioning' OR 'parental competenc*' OR 'ageism' OR 'reproductive autonomy' OR 'outcome' OR 'risk*' OR 'benefit*').</p><p><strong>Participants/materials setting methods: </strong>The included papers were empirical studies in English published between 2000 and 2021, where the study either examined the wellbeing and psychosocial health of parents and/or their children, or focused on parental competences of APA parents or on the functioning of families with APA parents. A quality assessment of the identified studies was performed with the QATSDD tool. Additionally, 20% of studies were double-checked at the data extraction and quality assessment stage to avoid bias. The variables sought were: the geographical location, the year of publication, the methodological approach, the definitions of APA used, what study group was at the centre of the research, what research topic was studied, and what advantages and disadvantages of APA were found.</p><p><strong>Main results and the role of chance: </strong>A total number of 5403 articles were identified, leading to 2543 articles being included for title and abstract screening after removal of duplicates. This resulted in 98 articles included for a full-text reading by four researchers. Ult
{"title":"Building a family at advanced parental age: a systematic review on the risks and opportunities for parents and their offspring.","authors":"Nathalie B Neeser, Andrea Martani, Eva De Clercq, Christian De Geyter, Nicolas Vulliemoz, Bernice S Elger, Tenzin Wangmo","doi":"10.1093/hropen/hoad042","DOIUrl":"10.1093/hropen/hoad042","url":null,"abstract":"<p><strong>Study question: </strong>What is the existing empirical literature on the psychosocial health and wellbeing of the parents and offspring born at an advanced parental age (APA), defined as 40 years onwards?</p><p><strong>Summary answer: </strong>Although the studies show discrepancies in defining who is an APA parent and an imbalance in the empirical evidence for offspring, mothers, and fathers, there is a drive towards finding psychotic disorders and (neuro-)developmental disorders among the offspring; overall, the observed advantages and disadvantages are difficult to compare.</p><p><strong>What is known already: </strong>In many societies, children are born to parents at advanced ages and there is rising attention in the literature towards the consequences of this trend.</p><p><strong>Study design size duration: </strong>The systematic search was conducted in six electronic databases (PubMed including Medline, Embase, Scopus, PsycInfo, CINAHL, and SocINDEX) and was limited to papers published between 2000 and 2021 and to English-language articles. Search terms used across all six electronic databases were: ('advanced parental age' OR 'advanced maternal age' OR 'advanced paternal age' OR 'advanced reproductive age' OR 'late parent*' OR 'late motherhood' OR 'late fatherhood') AND ('IVF' OR 'in vitro fertilization' OR 'in-vitro-fertilization' OR 'fertilization in vitro' OR 'ICSI' OR 'intracytoplasmic sperm injection' OR 'reproductive techn*' OR 'assisted reproductive technolog*' OR 'assisted reproduction' OR 'assisted conception' OR 'reproduction' OR 'conception' OR 'birth*' OR 'pregnan*') AND ('wellbeing' OR 'well-being' OR 'psycho-social' OR 'social' OR 'ethical' OR 'right to reproduce' OR 'justice' OR 'family functioning' OR 'parental competenc*' OR 'ageism' OR 'reproductive autonomy' OR 'outcome' OR 'risk*' OR 'benefit*').</p><p><strong>Participants/materials setting methods: </strong>The included papers were empirical studies in English published between 2000 and 2021, where the study either examined the wellbeing and psychosocial health of parents and/or their children, or focused on parental competences of APA parents or on the functioning of families with APA parents. A quality assessment of the identified studies was performed with the QATSDD tool. Additionally, 20% of studies were double-checked at the data extraction and quality assessment stage to avoid bias. The variables sought were: the geographical location, the year of publication, the methodological approach, the definitions of APA used, what study group was at the centre of the research, what research topic was studied, and what advantages and disadvantages of APA were found.</p><p><strong>Main results and the role of chance: </strong>A total number of 5403 articles were identified, leading to 2543 articles being included for title and abstract screening after removal of duplicates. This resulted in 98 articles included for a full-text reading by four researchers. Ult","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad042"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Study question: </strong>Is dietary non-enzymatic antioxidant capacity related to semen quality?</p><p><strong>Summary answer: </strong>The only statistically significant association of semen quality parameters with dietary total antioxidant capacity (DTAC) detected was an inverse association between DTAC and ejaculate volume.</p><p><strong>What is known already: </strong>Growing interest exists regarding the role of diet in influencing semen quality. While DTAC is linked to favorable health outcomes, its association with semen quality, especially among men attending infertility clinics, remains understudied.</p><p><strong>Study design size duration: </strong>This cross-sectional study was carried out between June and December of 2020. In total, 1715 participants were included in the final analysis.</p><p><strong>Participants/materials setting methods: </strong>Men who attended an infertility clinic in China were enrolled. Experienced clinical technicians performed the semen analysis. The DTAC indices included the ferric-reducing ability of plasma, oxygen radical absorbance capacity, total reactive antioxidant potential, and Trolox equivalent antioxidant capacity. The quantile regression model was used for multivariate analysis.</p><p><strong>Main results and the role of chance: </strong>After adjustment for a variety of confounding variables, a significant inverse association was identified between DTAC and ejaculate volume (β<sub>continuous FRAP</sub> = -0.015, 95% CI = -0.023, -0.006, β<sub>T3 vs T1</sub> = -0.193, 95% CI = -0.379, -0.006, <i>P</i><sub>trend</sub> = 0.007; β<sub>continuous TRAP</sub> = -0.019, 95% CI = -0.041, 0.002, β<sub>T3 vs T1</sub> = -0.291, 95% CI = -0.469, -0.112, <i>P</i><sub>trend</sub> = 0.002). The majority of DTAC indices have no statistically significant association with semen quality parameters.</p><p><strong>Limitations reasons for caution: </strong>We cannot infer causality because of the nature of the cross-sectional study design. The robustness of the conclusion may be compromised by the exactness of non-enzymatic antioxidant capacity estimation.</p><p><strong>Wider implications of the findings: </strong>Our findings demonstrated no association between DTAC indices and semen quality parameters among men attending an infertility clinic, except for ejaculate volume. Even though our findings are mostly non-significant, they contribute novel knowledge to the field of study while also laying the groundwork for future well-designed studies.</p><p><strong>Study funding/competing interests: </strong>This work was supported by the JieBangGuaShuai Project of Liaoning Province [grant number 2021JH1/10400050], the Clinical Research Cultivation Project of Shengjing Hospital [grant number M1590], and the Outstanding Scientific Fund of Shengjing Hospital [grant number M1150]. The sponsors had no role in study design, or in the collection, analysis, and interpretation of data, or in the writing of the report, or
研究问题:饮食中的非酶抗氧化能力与精液质量有关吗?总结回答:精液质量参数与饲料总抗氧化能力(DTAC)之间唯一有统计学意义的关联是DTAC与射精量之间的负相关。已知情况:人们对饮食在影响精液质量中的作用越来越感兴趣。虽然DTAC与良好的健康结果有关，但它与精液质量的关系，特别是在不育诊所就诊的男性中，仍未得到充分研究。研究设计规模持续时间:本横断面研究于2020年6月至12月进行。总共有1715名参与者被纳入最终分析。参与者/材料设置方法:在中国不孕不育诊所就诊的男性。经验丰富的临床技术人员进行精液分析。DTAC指标包括血浆铁还原能力、氧自由基吸收能力、总活性抗氧化电位和Trolox等效抗氧化能力。多因素分析采用分位数回归模型。主要结果及偶发因素的作用:调整多种混杂变量后，DTAC与射精量呈显著负相关(β连续FRAP = -0.015, 95% CI = -0.023， -0.006， βT3 vs T1 = -0.193, 95% CI = -0.379， -0.006, Ptrend = 0.007;β连续TRAP = -0.019, 95% CI = -0.041, 0.002， βT3 vs T1 = -0.291, 95% CI = -0.469， -0.112, Ptrend = 0.002)。大多数DTAC指标与精液质量参数无显著相关性。谨慎的局限性:由于横断面研究设计的性质，我们不能推断因果关系。结论的稳健性可能会受到非酶抗氧化能力估计的准确性的影响。研究结果的更广泛意义:我们的研究结果表明，除了射精量外，在不育诊所就诊的男性中，DTAC指数和精液质量参数之间没有关联。尽管我们的发现大多不重要，但它们为研究领域贡献了新的知识，同时也为未来精心设计的研究奠定了基础。研究经费/利益竞争:本文由辽宁省节邦瓜槐项目[批准号2021JH1/10400050]、盛京医院临床科研培养项目[批准号M1590]、盛京医院优秀科学基金[批准号M1150]资助。赞助方在研究设计、数据收集、分析和解释、报告撰写或文章发表决定中没有任何作用。没有需要申报的利益冲突。试验注册号:无。
{"title":"Association between dietary total antioxidant capacity and semen quality among men attending an infertility clinic: a cross-sectional study.","authors":"Dong-Hui Huang, Yi-Xiao Zhang, Xiao-Bin Wang, Ming-Hui Sun, Ren-Hao Guo, Xu Leng, Qiang Du, Hong-Yu Chen, Yu-Xin Nan, Qi-Jun Wu, Bo-Chen Pan, Yu-Hong Zhao","doi":"10.1093/hropen/hoad041","DOIUrl":"10.1093/hropen/hoad041","url":null,"abstract":"<p><strong>Study question: </strong>Is dietary non-enzymatic antioxidant capacity related to semen quality?</p><p><strong>Summary answer: </strong>The only statistically significant association of semen quality parameters with dietary total antioxidant capacity (DTAC) detected was an inverse association between DTAC and ejaculate volume.</p><p><strong>What is known already: </strong>Growing interest exists regarding the role of diet in influencing semen quality. While DTAC is linked to favorable health outcomes, its association with semen quality, especially among men attending infertility clinics, remains understudied.</p><p><strong>Study design size duration: </strong>This cross-sectional study was carried out between June and December of 2020. In total, 1715 participants were included in the final analysis.</p><p><strong>Participants/materials setting methods: </strong>Men who attended an infertility clinic in China were enrolled. Experienced clinical technicians performed the semen analysis. The DTAC indices included the ferric-reducing ability of plasma, oxygen radical absorbance capacity, total reactive antioxidant potential, and Trolox equivalent antioxidant capacity. The quantile regression model was used for multivariate analysis.</p><p><strong>Main results and the role of chance: </strong>After adjustment for a variety of confounding variables, a significant inverse association was identified between DTAC and ejaculate volume (β<sub>continuous FRAP</sub> = -0.015, 95% CI = -0.023, -0.006, β<sub>T3 vs T1</sub> = -0.193, 95% CI = -0.379, -0.006, <i>P</i><sub>trend</sub> = 0.007; β<sub>continuous TRAP</sub> = -0.019, 95% CI = -0.041, 0.002, β<sub>T3 vs T1</sub> = -0.291, 95% CI = -0.469, -0.112, <i>P</i><sub>trend</sub> = 0.002). The majority of DTAC indices have no statistically significant association with semen quality parameters.</p><p><strong>Limitations reasons for caution: </strong>We cannot infer causality because of the nature of the cross-sectional study design. The robustness of the conclusion may be compromised by the exactness of non-enzymatic antioxidant capacity estimation.</p><p><strong>Wider implications of the findings: </strong>Our findings demonstrated no association between DTAC indices and semen quality parameters among men attending an infertility clinic, except for ejaculate volume. Even though our findings are mostly non-significant, they contribute novel knowledge to the field of study while also laying the groundwork for future well-designed studies.</p><p><strong>Study funding/competing interests: </strong>This work was supported by the JieBangGuaShuai Project of Liaoning Province [grant number 2021JH1/10400050], the Clinical Research Cultivation Project of Shengjing Hospital [grant number M1590], and the Outstanding Scientific Fund of Shengjing Hospital [grant number M1150]. The sponsors had no role in study design, or in the collection, analysis, and interpretation of data, or in the writing of the report, or ","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad041"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10639034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-25eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad040
L Cacciottola, F Vitale, J Donnez, M M Dolmans
<p><strong>Study question: </strong>To what extent does regenerative medicine with stem cell therapy help to address infertility issues for future clinical application?</p><p><strong>Summary answer: </strong>Regenerative medicine using different stem cell sources is yielding promising results in terms of protecting the ovarian reserve from damage and senescence, and improving fertility potential in various preclinical settings.</p><p><strong>What is known already: </strong>Regenerative medicine using stem cell therapy is emerging as a potential strategy to address a number of issues in the field of human reproduction. Indeed, different types of adult and fetal mesenchymal stem cells (MSCs) have been tested with promising results, owing to their ability to differentiate into different tissue lineages, move toward specific injured sites (homing), and generate a secretome with wound-healing, proangiogenic, and antioxidant capacities.</p><p><strong>Study design size duration: </strong>Guided by the checklist for preferred reporting items for systematic reviews and meta-analyses, we retrieved relevant studies from PubMed, Medline, and Embase databases until June 2023 using the following keywords: 'mesenchymal stem cells' AND 'ovarian follicles' OR 'ovarian tissue culture' OR 'ovarian follicle culture' OR 'cumulus oocyte complex'. Only peer-reviewed published articles written in English were included.</p><p><strong>Participants/materials setting methods: </strong>The primary outcome for the experimental strategies was evaluation of the ovarian reserve, with a focus on follicle survival, number, and growth. Secondary outcomes involved analyses of other parameters associated with the follicle pool, such as hormones and growth factors, ovarian tissue viability markers including oxidative stress levels, oocyte growth and maturation rates, and of course pregnancy outcomes.</p><p><strong>Main results and the role of chance: </strong>Preclinical studies exploring MSCs from different animal origins and tissue sources in specific conditions were selected (n = 112), including: <i>in vitro</i> culture of granulosa cells, ovarian tissue and isolated ovarian follicles; ovarian tissue transplantation; and systemic or intraovarian injection after gonadotoxic or age-related follicle pool decline. Protecting the ovarian reserve from aging and gonadotoxic damage has been widely tested <i>in vitro</i> and <i>in vivo</i> using murine models and is now yielding initial data in the first ever case series of patients with premature ovarian insufficiency. Use of MSCs as feeder cells in ovarian tissue culture was found to improve follicle outcomes and oocyte competence, bringing us one step closer to future clinical application. MSCs also have proved effective at boosting revascularization in the transplantation site when grafting ovarian tissue in experimental animal models.</p><p><strong>Limitations reasons for caution: </strong>While preclinical results look promising in te
{"title":"Use of mesenchymal stem cells to enhance or restore fertility potential: a systematic review of available experimental strategies.","authors":"L Cacciottola, F Vitale, J Donnez, M M Dolmans","doi":"10.1093/hropen/hoad040","DOIUrl":"10.1093/hropen/hoad040","url":null,"abstract":"<p><strong>Study question: </strong>To what extent does regenerative medicine with stem cell therapy help to address infertility issues for future clinical application?</p><p><strong>Summary answer: </strong>Regenerative medicine using different stem cell sources is yielding promising results in terms of protecting the ovarian reserve from damage and senescence, and improving fertility potential in various preclinical settings.</p><p><strong>What is known already: </strong>Regenerative medicine using stem cell therapy is emerging as a potential strategy to address a number of issues in the field of human reproduction. Indeed, different types of adult and fetal mesenchymal stem cells (MSCs) have been tested with promising results, owing to their ability to differentiate into different tissue lineages, move toward specific injured sites (homing), and generate a secretome with wound-healing, proangiogenic, and antioxidant capacities.</p><p><strong>Study design size duration: </strong>Guided by the checklist for preferred reporting items for systematic reviews and meta-analyses, we retrieved relevant studies from PubMed, Medline, and Embase databases until June 2023 using the following keywords: 'mesenchymal stem cells' AND 'ovarian follicles' OR 'ovarian tissue culture' OR 'ovarian follicle culture' OR 'cumulus oocyte complex'. Only peer-reviewed published articles written in English were included.</p><p><strong>Participants/materials setting methods: </strong>The primary outcome for the experimental strategies was evaluation of the ovarian reserve, with a focus on follicle survival, number, and growth. Secondary outcomes involved analyses of other parameters associated with the follicle pool, such as hormones and growth factors, ovarian tissue viability markers including oxidative stress levels, oocyte growth and maturation rates, and of course pregnancy outcomes.</p><p><strong>Main results and the role of chance: </strong>Preclinical studies exploring MSCs from different animal origins and tissue sources in specific conditions were selected (n = 112), including: <i>in vitro</i> culture of granulosa cells, ovarian tissue and isolated ovarian follicles; ovarian tissue transplantation; and systemic or intraovarian injection after gonadotoxic or age-related follicle pool decline. Protecting the ovarian reserve from aging and gonadotoxic damage has been widely tested <i>in vitro</i> and <i>in vivo</i> using murine models and is now yielding initial data in the first ever case series of patients with premature ovarian insufficiency. Use of MSCs as feeder cells in ovarian tissue culture was found to improve follicle outcomes and oocyte competence, bringing us one step closer to future clinical application. MSCs also have proved effective at boosting revascularization in the transplantation site when grafting ovarian tissue in experimental animal models.</p><p><strong>Limitations reasons for caution: </strong>While preclinical results look promising in te","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad040"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10637864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-18eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad039
V Vloeberghs, N De Munck, A Racca, I Mateizel, K Wouters, H Tournaye
<p><strong>Study question: </strong>What is the added value of enzymatic processing of testicular biopsies on testicular sperm retrieval (SR) rates for patients with non-obstructive azoospermia (NOA)?</p><p><strong>Summary answer: </strong>In addition to mechanical mincing, enzymatic digestion increased SR rates in testicular biopsies of NOA patients.</p><p><strong>What is known already: </strong>Many studies focus on the surgical approach to optimize recovery of testicular sperm in NOA, and in spite of that, controversy still exists about whether the type of surgery makes any difference as long as multiple biopsies are taken. Few studies, however, focus on the role of the IVF laboratory and the benefit of additional lab procedures, e.g. enzymatic digestion, in order to optimize SR rates.</p><p><strong>Study design size duration: </strong>This retrospective single-center cohort study included all patients who underwent their first testicular sperm extraction (TESE) by open multiple-biopsy method between January 2004 and July 2022. Only patients with a normal karyotype, absence of Y-q deletions and a diagnosis of NOA based on histology were included. The primary outcome was SR rate after mincing and/or enzymes. The secondary outcome was cumulative live birth (CLB) after ICSI with fresh TESE and subsequent ICSI cycles with frozen TESE.</p><p><strong>Participants/materials setting methods: </strong>Multiple biopsies were obtained from the testis, unilaterally or bilaterally, on the day of oocyte retrieval. Upon mechanical mincing, biopsies were investigated for 30 min; when no or insufficient numbers of spermatozoa were observed, enzymatic treatment was performed using Collagenase type IV. Multivariable regression analysis was performed to predict CLB per TESE by adjusting for the following confounding factors: male FSH level, female age, and requirement of enzymatic digestion to find sperm.</p><p><strong>Main results and the role of chance: </strong>We included 118 patients, of whom 72 (61.0%) had successful SR eventually. Spermatozoa were retrieved after mechanical mincing for 28 patients (23.7%; 28/118) or after additional enzymatic digestion for another 44 patients (37.2%; 44/118). Thus, of the 90 patients requiring enzymatic digestion, sperm were retrieved for 44 (48.9%). Male characteristics were not different between patients with SR after mincing or enzymatic digestion, in regard to mean age (34.5 vs 34.5 years), testis volume (10.2 vs 10.6 ml), FSH (17.8 vs 16.9 IU/l), cryptorchidism (21.4 vs 34.1%), varicocele (3.6 vs 4.6%), or histological diagnosis (Sertoli-cell only 53.6 vs 47.7%, maturation arrest 21.4 vs 38.6%, sclerosis/atrophy 25.0 vs 13.6%).Of the 72 patients with sperm available for ICSI, 23/72 (31.9%) achieved a live birth (LB) after the injection with fresh testicular sperm (and fresh or frozen embryo transfers). Of the remaining 49 patients without LB, 34 (69.4%) had supernumerary testicular sperm frozen. Of these 34 patients,
研究问题：对于非梗阻性无精子症（NOA）患者，睾丸活检的酶处理对睾丸精子回收率（SR）的附加值是什么？简要回答：除了机械切碎外，酶消化还增加了NOA患者睾丸活检的SR率。已知情况：许多研究都集中在优化NOA中睾丸精子回收的手术方法上，尽管如此，关于只要进行多次活检，手术类型是否有任何不同，仍然存在争议。然而，很少有研究关注试管婴儿实验室的作用和额外实验室程序的好处，例如酶消化，以优化SR率。研究设计规模持续时间：这项回顾性单中心队列研究包括2004年1月至2022年7月期间通过开放式多次活检方法首次进行睾丸精子提取（TESE）的所有患者。仅包括核型正常、Y-q缺失缺失和根据组织学诊断为NOA的患者。主要结果是切碎和/或酶切后的SR率。次要结果是新鲜TESE ICSI后的累积活产（CLB），以及冷冻TESE的后续ICSI周期。参与者/材料设置方法：在取卵当天，从睾丸单侧或双侧进行多次活检。在机械切碎后，对30例患者进行了活检 min；当没有观察到精子数量或精子数量不足时，使用Ⅳ型胶原酶进行酶处理。通过调整以下混杂因素，进行多变量回归分析，预测每次TESE的CLB：男性FSH水平、女性年龄和酶消化寻找精子的要求。主要结果和机会的作用：我们纳入了118名患者，其中72人（61.0%）最终成功SR。28名患者（23.7%；28/118）在机械切碎后或另外44名患者（37.2%；44/118）在额外的酶消化后回收精子。因此，在90名需要酶消化的患者中，有44名（48.9%）获得了精子。在平均年龄方面，切碎或酶消化后的SR患者的男性特征没有差异（34.5 vs 34.5 年），睾丸体积（10.2 vs 10.6 ml）、FSH（17.8 vs 16.9 IU/l）、隐睾（21.4 vs 34.1%）、精索静脉曲张（3.6 vs 4.6%）或组织学诊断（支持细胞仅53.6 vs 47.7%，成熟停滞21.4 vs 38.6%，硬化/萎缩25.0 vs 13.6%）。在72名可用于ICSI的精子患者中，23/72（31.9%）在注射新鲜睾丸精子（以及新鲜或冷冻胚胎移植）后实现活产（LB）。在剩下的49名没有LB的患者中，34名（69.4%）的睾丸精子冷冻过多。在这34名患者中，19名（55.9%）患者使用冷冻睾丸精子继续进行ICSI，9/19名（47.4%）患者在使用冷冻睾丸精液进行ICSI后获得LB。因此，在回收精子的情况下，每次TESE的总CLB为32/118（27.1%），或每次TESE为32/72（44.4%）。在女性特征（有精子的夫妇）中，只有女性年龄（30.3比32.7 年；P = 0.042）在具有LB的组中显著低于没有LB的组。酶消化后获得的睾丸精子的CLB为31.8%（14/44），而单独切碎后获得的精子CLB为64.3%（18/28）。多变量逻辑回归分析表明，当需要酶消化时，每TESE的CLB显著降低（OR:0.23（0.08-0.7）；P = 0.01）。注意的局限性原因：研究的局限性与回顾性设计有关。然而，仅选择具有NOA和特定特征（正常核型和缺失Y-q缺失）的患者，并首次进行TESE，加强了我们的研究结果。研究结果的更广泛含义：与仅机械切碎相比，酶处理提高了NOA患者睾丸活检的SR率，证明了适当的实验室方案的重要性。然而，NOA患者应该被告知，当在酶消化后发现精子时，与那些不需要酶消化的患者相比，他们生下自己基因孩子的机会可能更低。研究资金/竞争利益：无报告。试用注册号：不适用。
{"title":"Enzymatic tissue processing after testicular biopsy in non-obstructive azoospermia enhances sperm retrieval.","authors":"V Vloeberghs, N De Munck, A Racca, I Mateizel, K Wouters, H Tournaye","doi":"10.1093/hropen/hoad039","DOIUrl":"10.1093/hropen/hoad039","url":null,"abstract":"<p><strong>Study question: </strong>What is the added value of enzymatic processing of testicular biopsies on testicular sperm retrieval (SR) rates for patients with non-obstructive azoospermia (NOA)?</p><p><strong>Summary answer: </strong>In addition to mechanical mincing, enzymatic digestion increased SR rates in testicular biopsies of NOA patients.</p><p><strong>What is known already: </strong>Many studies focus on the surgical approach to optimize recovery of testicular sperm in NOA, and in spite of that, controversy still exists about whether the type of surgery makes any difference as long as multiple biopsies are taken. Few studies, however, focus on the role of the IVF laboratory and the benefit of additional lab procedures, e.g. enzymatic digestion, in order to optimize SR rates.</p><p><strong>Study design size duration: </strong>This retrospective single-center cohort study included all patients who underwent their first testicular sperm extraction (TESE) by open multiple-biopsy method between January 2004 and July 2022. Only patients with a normal karyotype, absence of Y-q deletions and a diagnosis of NOA based on histology were included. The primary outcome was SR rate after mincing and/or enzymes. The secondary outcome was cumulative live birth (CLB) after ICSI with fresh TESE and subsequent ICSI cycles with frozen TESE.</p><p><strong>Participants/materials setting methods: </strong>Multiple biopsies were obtained from the testis, unilaterally or bilaterally, on the day of oocyte retrieval. Upon mechanical mincing, biopsies were investigated for 30 min; when no or insufficient numbers of spermatozoa were observed, enzymatic treatment was performed using Collagenase type IV. Multivariable regression analysis was performed to predict CLB per TESE by adjusting for the following confounding factors: male FSH level, female age, and requirement of enzymatic digestion to find sperm.</p><p><strong>Main results and the role of chance: </strong>We included 118 patients, of whom 72 (61.0%) had successful SR eventually. Spermatozoa were retrieved after mechanical mincing for 28 patients (23.7%; 28/118) or after additional enzymatic digestion for another 44 patients (37.2%; 44/118). Thus, of the 90 patients requiring enzymatic digestion, sperm were retrieved for 44 (48.9%). Male characteristics were not different between patients with SR after mincing or enzymatic digestion, in regard to mean age (34.5 vs 34.5 years), testis volume (10.2 vs 10.6 ml), FSH (17.8 vs 16.9 IU/l), cryptorchidism (21.4 vs 34.1%), varicocele (3.6 vs 4.6%), or histological diagnosis (Sertoli-cell only 53.6 vs 47.7%, maturation arrest 21.4 vs 38.6%, sclerosis/atrophy 25.0 vs 13.6%).Of the 72 patients with sperm available for ICSI, 23/72 (31.9%) achieved a live birth (LB) after the injection with fresh testicular sperm (and fresh or frozen embryo transfers). Of the remaining 49 patients without LB, 34 (69.4%) had supernumerary testicular sperm frozen. Of these 34 patients, ","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad039"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad038
C De Geyter, L Matt, I De Geyter, R Moffat, C Meier
<p><strong>Study question: </strong>How does subclinical hypothyroidism, defined in infertile women during preconception by thyroid-stimulating hormone (TSH) >2.5 or >4.5 mIU/l, with or without thyroid peroxidase antibodies (anti-TPO) >100 IU/ml, impact thyroid hormone levels during pregnancy and after birth?</p><p><strong>Summary answer: </strong>During pregnancy, TSH levels remain similar to those in preconception, even with supplementary thyroxine, whereas the serum levels of anti-TPO progressively decline.</p><p><strong>What is known already: </strong>Overt hypothyroidism impacts both pregnancy and offspring but randomized clinical trials and cohort studies failed to detect the benefit of treatment with thyroxine in cases with low-threshold TSH or with anti-TPO during pregnancy.</p><p><strong>Study design size duration: </strong>First, the prevalence and reproducibility of two candidate cut-off levels of subclinical hypothyroidism in a cohort of 177 infertile women was compared with 171 women not aiming for pregnancy. Second, the impact of distinct setpoints of TSH in preconception (with or without anti-TPO) was monitored during pregnancy in 87 previously infertile women by high-frequency monitoring of thyroid function. Both studies were carried out from 2007 to 2019.</p><p><strong>Participants/materials setting methods: </strong>Reproducibility and prevalence of subclinical hypothyroidism were examined in infertile women presenting in the fertility care unit of an academic institution. Women not aiming for pregnancy participated as controls. In both groups, TSH and anti-TPO were measured two times on different occasions. In addition, a group of previously infertile women with known preconception setpoints of TSH (with or without anti-TPO) were followed up prospectively throughout pregnancy and after birth. During pregnancy, serum was sampled weekly until Week 12, then monthly until delivery, and once after birth. Only cases with preconception TSH >4.5 mIU/l were supplemented with thyroxine. After collection of all samples, the serum levels of anti-TPO and the major thyroid hormones were measured. Prolactin with known fluctuations during pregnancy was used as reference.</p><p><strong>Main results and the role of chance: </strong>Measures of both TSH and anti-TPO at two different time points were accurate and reproducible. The odds of subclinical hypothyroidism in infertile women and controls were similar. During pregnancy, TSH closely followed preconception TSH levels, whereas serum levels of the thyroid hormones predominantly remained within or above (not below) the reference. Treatment of infertile women with preconception TSH >4.5 mIU/l with thyroxine resulted in higher free thyroxine (fT4) serum levels. The serum levels of anti-TPO declined as pregnancies evolved.</p><p><strong>Limitations reasons for caution: </strong>The numbers of participants both in the prevalence study and in pregnancy did not reach the <i>a priori</i> estimated num
{"title":"In infertile women with subclinical hypothyroidism, with or without thyroid peroxidase antibodies, serum TSH during pregnancy follows preconception values and thyroid hormones remain stable.","authors":"C De Geyter, L Matt, I De Geyter, R Moffat, C Meier","doi":"10.1093/hropen/hoad038","DOIUrl":"10.1093/hropen/hoad038","url":null,"abstract":"<p><strong>Study question: </strong>How does subclinical hypothyroidism, defined in infertile women during preconception by thyroid-stimulating hormone (TSH) >2.5 or >4.5 mIU/l, with or without thyroid peroxidase antibodies (anti-TPO) >100 IU/ml, impact thyroid hormone levels during pregnancy and after birth?</p><p><strong>Summary answer: </strong>During pregnancy, TSH levels remain similar to those in preconception, even with supplementary thyroxine, whereas the serum levels of anti-TPO progressively decline.</p><p><strong>What is known already: </strong>Overt hypothyroidism impacts both pregnancy and offspring but randomized clinical trials and cohort studies failed to detect the benefit of treatment with thyroxine in cases with low-threshold TSH or with anti-TPO during pregnancy.</p><p><strong>Study design size duration: </strong>First, the prevalence and reproducibility of two candidate cut-off levels of subclinical hypothyroidism in a cohort of 177 infertile women was compared with 171 women not aiming for pregnancy. Second, the impact of distinct setpoints of TSH in preconception (with or without anti-TPO) was monitored during pregnancy in 87 previously infertile women by high-frequency monitoring of thyroid function. Both studies were carried out from 2007 to 2019.</p><p><strong>Participants/materials setting methods: </strong>Reproducibility and prevalence of subclinical hypothyroidism were examined in infertile women presenting in the fertility care unit of an academic institution. Women not aiming for pregnancy participated as controls. In both groups, TSH and anti-TPO were measured two times on different occasions. In addition, a group of previously infertile women with known preconception setpoints of TSH (with or without anti-TPO) were followed up prospectively throughout pregnancy and after birth. During pregnancy, serum was sampled weekly until Week 12, then monthly until delivery, and once after birth. Only cases with preconception TSH >4.5 mIU/l were supplemented with thyroxine. After collection of all samples, the serum levels of anti-TPO and the major thyroid hormones were measured. Prolactin with known fluctuations during pregnancy was used as reference.</p><p><strong>Main results and the role of chance: </strong>Measures of both TSH and anti-TPO at two different time points were accurate and reproducible. The odds of subclinical hypothyroidism in infertile women and controls were similar. During pregnancy, TSH closely followed preconception TSH levels, whereas serum levels of the thyroid hormones predominantly remained within or above (not below) the reference. Treatment of infertile women with preconception TSH >4.5 mIU/l with thyroxine resulted in higher free thyroxine (fT4) serum levels. The serum levels of anti-TPO declined as pregnancies evolved.</p><p><strong>Limitations reasons for caution: </strong>The numbers of participants both in the prevalence study and in pregnancy did not reach the <i>a priori</i> estimated num","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad038"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-22eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad037
S Makieva, M K Sachs, M Xie, A Velasco, S El-Hadad, D R Kalaitzopoulos, I Dedes, R Stiller, B Leeners
<p><strong>Study question: </strong>Does double vitrification and thawing of an embryo compromise the chance of live birth after a single blastocyst transfer?</p><p><strong>Summary answer: </strong>The live birth rate (LBR) obtained after double vitrification was comparable to that obtained after single vitrification.</p><p><strong>What is known already: </strong>Double vitrification-warming (DVW) is commonly practiced to accommodate surplus viable embryos suitable for transfer, to allow retesting of inconclusively diagnosed blastocysts in preimplantation genetic testing (PGT), and to circumvent limitations associated with national policies on embryo culture in certain countries. Despite its popularity, the evidence concerning the impact of DVW practice on ART outcomes is limited and lacking credibility. This is the first thorough investigation of clinical pregnancy and LBR following DVW in the case where the first round of vitrification occurred at the zygote stage and the second round occurred at the blastocyst stage in the absence of biopsy.</p><p><strong>Study design size duration: </strong>This is a retrospective observational analysis of n = 407 single blastocyst transfers whereby embryos created by IVF/ICSI were vitrified-warmed once (single vitrification-warming (SVW) n = 310) or twice (DVW, n = 97) between January 2017 and December 2021.</p><p><strong>Participants/materials setting methods: </strong>In the SVW group, blastocysts were vitrified on Day 5/6 and warmed on the day of embryo transfer (ET). In the DVW group, two pronuclear (2PN) zygotes were first vitrified-warmed and then re-vitrified on Day 5/6 and warmed on the day of ET. Exclusion criteria were ETs from PGT and vitrified-warmed oocyte cycles. All of the ETs were single blastocyst transfers performed at the University Hospital Zurich in Switzerland following natural or artificial endometrial preparation.</p><p><strong>Main results and the role of chance: </strong>The biochemical pregnancy rate, clinical pregnancy rate (CPR), and LBR were all comparable between the DVW and SVW groups. The CPR for DVW was 44.3% and for SVW it was 42.3% (<i>P</i> = 0.719). The LBR for DVW was 30.9% and for SVW it was 28.7% (<i>P</i> = 0.675). The miscarriage rate was additionally similar between the groups: 27.9% for DVW and 32.1% for SVW groups (<i>P</i> = 0.765).</p><p><strong>Limitations reasons for caution: </strong>The study is limited by its retrospective nature. Caution should be taken concerning interpretation of these findings in cases where DVW occurs at different stages of embryo development.</p><p><strong>Wider implications of the findings: </strong>The result of the present study on DVW procedure provides a framework for counselling couples on their chance of clinical pregnancy per warming cycle. It additionally provides confidence and reassurance to laboratory professionals in certain countries where national policies limit embryo culture strategies making DVW inevitable.</p><p><s
{"title":"Double vitrification and warming does not compromise the chance of live birth after single unbiopsied blastocyst transfer.","authors":"S Makieva, M K Sachs, M Xie, A Velasco, S El-Hadad, D R Kalaitzopoulos, I Dedes, R Stiller, B Leeners","doi":"10.1093/hropen/hoad037","DOIUrl":"10.1093/hropen/hoad037","url":null,"abstract":"<p><strong>Study question: </strong>Does double vitrification and thawing of an embryo compromise the chance of live birth after a single blastocyst transfer?</p><p><strong>Summary answer: </strong>The live birth rate (LBR) obtained after double vitrification was comparable to that obtained after single vitrification.</p><p><strong>What is known already: </strong>Double vitrification-warming (DVW) is commonly practiced to accommodate surplus viable embryos suitable for transfer, to allow retesting of inconclusively diagnosed blastocysts in preimplantation genetic testing (PGT), and to circumvent limitations associated with national policies on embryo culture in certain countries. Despite its popularity, the evidence concerning the impact of DVW practice on ART outcomes is limited and lacking credibility. This is the first thorough investigation of clinical pregnancy and LBR following DVW in the case where the first round of vitrification occurred at the zygote stage and the second round occurred at the blastocyst stage in the absence of biopsy.</p><p><strong>Study design size duration: </strong>This is a retrospective observational analysis of n = 407 single blastocyst transfers whereby embryos created by IVF/ICSI were vitrified-warmed once (single vitrification-warming (SVW) n = 310) or twice (DVW, n = 97) between January 2017 and December 2021.</p><p><strong>Participants/materials setting methods: </strong>In the SVW group, blastocysts were vitrified on Day 5/6 and warmed on the day of embryo transfer (ET). In the DVW group, two pronuclear (2PN) zygotes were first vitrified-warmed and then re-vitrified on Day 5/6 and warmed on the day of ET. Exclusion criteria were ETs from PGT and vitrified-warmed oocyte cycles. All of the ETs were single blastocyst transfers performed at the University Hospital Zurich in Switzerland following natural or artificial endometrial preparation.</p><p><strong>Main results and the role of chance: </strong>The biochemical pregnancy rate, clinical pregnancy rate (CPR), and LBR were all comparable between the DVW and SVW groups. The CPR for DVW was 44.3% and for SVW it was 42.3% (<i>P</i> = 0.719). The LBR for DVW was 30.9% and for SVW it was 28.7% (<i>P</i> = 0.675). The miscarriage rate was additionally similar between the groups: 27.9% for DVW and 32.1% for SVW groups (<i>P</i> = 0.765).</p><p><strong>Limitations reasons for caution: </strong>The study is limited by its retrospective nature. Caution should be taken concerning interpretation of these findings in cases where DVW occurs at different stages of embryo development.</p><p><strong>Wider implications of the findings: </strong>The result of the present study on DVW procedure provides a framework for counselling couples on their chance of clinical pregnancy per warming cycle. It additionally provides confidence and reassurance to laboratory professionals in certain countries where national policies limit embryo culture strategies making DVW inevitable.</p><p><s","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad037"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-14eCollection Date: 2023-01-01DOI: 10.1093/hropen/hoad035
Na Chen, Jingyu Li, Yexing Li, Yiyuan Zhang, Jiarong Li, Jie Gao, Jingmei Hu, Linlin Cui, Zi-Jiang Chen
<p><strong>Study question: </strong>What are the factors influencing the occurrence of monozygotic (MZ) twins in offspring conceived by assisted reproductive technology (ART)?</p><p><strong>Summary answer: </strong>Parental ages, the transfer of fresh versus frozen embryos, and the grade of blastocysts are all related to MZ twinning in ART offspring.</p><p><strong>What is known already: </strong>Offspring conceived by ART have significantly increased risk of MZ twins, which may be due to the characteristics of the infertile population. The objective of this study was to explore the incidence of monozygotic (MZ) twins after ART and to clarify the risk factors for MZ twinning.</p><p><strong>Study design size duration: </strong>A total of 255 monozygotic twins were enrolled in this cohort study, and then matched with singletons at a ratio of 1:4 randomly (with 1020 in the control group). All offspring were conceived by single embryo transfer.</p><p><strong>Participants/materials setting methods: </strong>The collected data were divided into the following three aspects for analysis: characteristics of the infertile population, gamete or embryo manipulations, and factors related to embryo development.</p><p><strong>Main results and the role of chance: </strong>The incidence of MZ twins was 1.638% (255 out of 15 567 pregnancies after single embryo transfers). Compared to singleton births, a significantly lower rate of frozen embryo transfers (FET; 78.0% vs 86.1% <i>P</i> = 0.002) was seen amongst the MZ twins. Amongst fresh ETs, the rate of blastocyst transfers in the MZ twins group was higher compared to that in the control group (92.9% vs 75.4%, <i>P</i> = 0.005). We also found that certain grades of blastocysts in terms of trophectoderm (TE) development, inner cell mass + TE development and the classification of 'top-quality' embryos were associated with the incidence of MZ twinning (<i>P</i> = 0.025, <i>P</i> = 0.012, <i>P</i> = 0.020, respectively). Logistic regression analysis revealed that higher paternal age (odds ratio (OR) = 0.94, 95% CI = 0.89-1.00, <i>P</i> = 0.029) and FET (OR = 0.48, 95% CI = 0.33-0.68, <i>P</i> = 0.001) may be protective factors against MZ twinning. However, higher maternal age (OR = 1.07, 95% CI = 1.01-1.13, <i>P</i> = 0.027) and the transfer of blastocysts (OR = 4.31, 95% CI = 1.46-12.73, <i>P</i> = 0.008) appeared to be associated with an increased risk of MZ twinning. Amongst blastocyst transfers, a C grade TE may be protective factor against MZ twinning (B: OR = 1.90, 95% CI = 1.18-3.07, <i>P</i> = 0.009; A: OR = 1.58, 95% CI = 0.93-2.67, <i>P</i> = 0.089).</p><p><strong>Limitations reasons for caution: </strong>First, our definition of MZ twins was based on twins' birth after single embryo transfers (SET), rather than ultrasound examination during early pregnancy. Second, the parental characteristics of the two groups were homogenous, so it was difficult to find any associations between infertility factors and the
{"title":"Risk factors associated with monozygotic twinning in offspring conceived by assisted reproductive technology.","authors":"Na Chen, Jingyu Li, Yexing Li, Yiyuan Zhang, Jiarong Li, Jie Gao, Jingmei Hu, Linlin Cui, Zi-Jiang Chen","doi":"10.1093/hropen/hoad035","DOIUrl":"10.1093/hropen/hoad035","url":null,"abstract":"<p><strong>Study question: </strong>What are the factors influencing the occurrence of monozygotic (MZ) twins in offspring conceived by assisted reproductive technology (ART)?</p><p><strong>Summary answer: </strong>Parental ages, the transfer of fresh versus frozen embryos, and the grade of blastocysts are all related to MZ twinning in ART offspring.</p><p><strong>What is known already: </strong>Offspring conceived by ART have significantly increased risk of MZ twins, which may be due to the characteristics of the infertile population. The objective of this study was to explore the incidence of monozygotic (MZ) twins after ART and to clarify the risk factors for MZ twinning.</p><p><strong>Study design size duration: </strong>A total of 255 monozygotic twins were enrolled in this cohort study, and then matched with singletons at a ratio of 1:4 randomly (with 1020 in the control group). All offspring were conceived by single embryo transfer.</p><p><strong>Participants/materials setting methods: </strong>The collected data were divided into the following three aspects for analysis: characteristics of the infertile population, gamete or embryo manipulations, and factors related to embryo development.</p><p><strong>Main results and the role of chance: </strong>The incidence of MZ twins was 1.638% (255 out of 15 567 pregnancies after single embryo transfers). Compared to singleton births, a significantly lower rate of frozen embryo transfers (FET; 78.0% vs 86.1% <i>P</i> = 0.002) was seen amongst the MZ twins. Amongst fresh ETs, the rate of blastocyst transfers in the MZ twins group was higher compared to that in the control group (92.9% vs 75.4%, <i>P</i> = 0.005). We also found that certain grades of blastocysts in terms of trophectoderm (TE) development, inner cell mass + TE development and the classification of 'top-quality' embryos were associated with the incidence of MZ twinning (<i>P</i> = 0.025, <i>P</i> = 0.012, <i>P</i> = 0.020, respectively). Logistic regression analysis revealed that higher paternal age (odds ratio (OR) = 0.94, 95% CI = 0.89-1.00, <i>P</i> = 0.029) and FET (OR = 0.48, 95% CI = 0.33-0.68, <i>P</i> = 0.001) may be protective factors against MZ twinning. However, higher maternal age (OR = 1.07, 95% CI = 1.01-1.13, <i>P</i> = 0.027) and the transfer of blastocysts (OR = 4.31, 95% CI = 1.46-12.73, <i>P</i> = 0.008) appeared to be associated with an increased risk of MZ twinning. Amongst blastocyst transfers, a C grade TE may be protective factor against MZ twinning (B: OR = 1.90, 95% CI = 1.18-3.07, <i>P</i> = 0.009; A: OR = 1.58, 95% CI = 0.93-2.67, <i>P</i> = 0.089).</p><p><strong>Limitations reasons for caution: </strong>First, our definition of MZ twins was based on twins' birth after single embryo transfers (SET), rather than ultrasound examination during early pregnancy. Second, the parental characteristics of the two groups were homogenous, so it was difficult to find any associations between infertility factors and the ","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 4","pages":"hoad035"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10570986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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