Showing papers in "Human Fertility in 2020"
TL;DR: In conclusion, intrauterine platelet-rich plasma may be effective in the improvement of pregnancy outcome in repeated implantation failure.
Abstract: Repeated implantation failure is a major challenge in reproductive medicine and despite several methods that have been described for management, there is little consensus on which is the most effec...
43 citations
TL;DR: This review aims to discuss the proposed cellular and molecular mechanisms of zinc deficiency on the male reproductive system, the importance of OS and mechanisms by which zinc deficiency induces OS and depletion of other antioxidants.
Abstract: Zinc (Zn) is necessary for the normal function of the male reproductive system and spermatozoa. Although influences of zinc deficiency on impaired spermatogenesis and male infertility have been widely considered, the molecular and cellular mechanisms of these abnormalities are not well understood. General abnormalities, including hypogonadism, Leydig cells damage, deficiency of sex hormone production and impaired spermatogenesis, as well as inflammation, antioxidant depletion, sperm death and male infertility can be observed during zinc deficiency. However, it is not obvious which pathways are relevant to the pathogenesis of zinc deficiency. Oxidative stress (OS) induced by reactive oxygen species is likely as the main mechanism of zinc deficiency which is associated with sperm DNA fragmentation, decrease in sperm membrane integrity, apoptosis, depletion of antioxidants, and consequently poor sperm quality and male infertility. Therefore, identification of these pathways will give valuable information regarding the mechanisms of zinc deficiency on the male reproductive system and the potential way for developing a better clinical approach. In this review, we aim to discuss the proposed cellular and molecular mechanisms of zinc deficiency on the male reproductive system, the importance of OS and mechanisms by which zinc deficiency induces OS and depletion of other antioxidants.
40 citations
TL;DR: A review article summarises the reported genetic causes of Asthenozoospermia.
Abstract: Infertility is a worldwide problem affecting about 15% of couples trying to conceive. Asthenozoospermia (AZS) is one of the major causes of male infertility, diagnosed by reduced sperm motility, and has no effective therapeutic treatment. To date, a few genes have been found to be associated with AZS in humans and mice, but in most of cases its molecular aetiology remains unknown. Genetic causes of AZS may include chromosomal abnormalities, specific mutations of nuclear and mitochondrial genes. However recently, epigenetic factors, altered microRNAs expression signature, and proteomics have shed light on the pathophysiological basis of AZS. This review article summarises the reported genetic causes of AZS.
30 citations
TL;DR: A good estimation of absolute TL was developed based on FITC-fluorescent spheres and showed that TL is not affected by varicocele or surgery, however, MV is able to partially reduce altered seminal parameters, ssSDF and dsSDF values invaricocele patients.
Abstract: Varicocele is one of the main causes of male infertility and microsurgical varicocelectomy (MV) seems to be the best procedure for its repair and to reduce testicular oxidative stress (ROS). As ROS causes guanine modifications, we postulated that DNA damage could be more intense in telomeres due to their G-rich nature. We studied the effect of MV on sperm telomere length (TL), single- and double-strand DNA fragmentation (ssSDF and dsSDF) and seminal parameters. Sperm telomeres from 12 fertile donors and 20 varicocele patients before and nine months after MV were labelled using FITC-PNA qFISH (a new method to obtain absolute TL from relative fluorescence intensity using FITC-fluorescent spheres). Both ssSDF and dsSDF were analysed using the alkaline and neutral Comet assays, respectively. The results showed that varicocele and MV had no effect on TL. Seminal parameters, ssSDF and dsSDF of varicocele patients were altered. Although these parameters improved after MV, values did not reach those seen in fertile donors. A good estimation of absolute TL was developed based on FITC-fluorescent spheres. The results showed that TL is not affected by varicocele or surgery. However, MV is able to partially reduce altered seminal parameters, ssSDF and dsSDF values in varicocele patients.
21 citations
TL;DR: Interviews with 31 women who identified as undergoing egg freezing for social reasons revealed a desire for more detailed information about potential outcomes from egg freezing and suggested ways in which clinics might address the emotional challenges of undertaking this process as an unpartnered person.
Abstract: Very few studies have explored women’s experiences of social egg freezing and the limited primary research on this topic has suggested that users find the process of freezing eggs emotionally chall
21 citations
TL;DR: The quality of information on treatment choices was the highest for oncofertility websites, and availability and quality should be improved, and high-quality resources are recommended by physicians.
Abstract: As cancer survival rates continue to increase, so does the relevance of starting or expanding a family after cancer, impacting quality of life However, the option of fertility preservation is not always addressed by physicians before treatment In the meanwhile, many patients look for health information online Although potentially helpful in the decision-making process, the Internet could also have adverse effects for this vulnerable patient group when information is incorrect We aimed to assess the availability and quality of information on female oncofertility on websites of (inter)national oncology, fertility and oncofertility organizations Availability was identified using an original checklist Quality was measured by reliability (DISCERN and LIDA instruments), usability (LIDA instrument), and readability (Flesch Kincaid Grade Level test) Of all investigated websites, 52% contained information on oncofertility, with 32% containing a stand-alone page Of those sites, the amount of treatment options covered were equivalent between specialty sites and general fertility and oncology sites (p = 007) The quality of information on treatment choices was the highest for oncofertility websites Reliability and usability did not differ significantly between websites No websites evaluated were at the recommended 7th-8th grade reading level Availability and quality should be improved, and high-quality resources are recommended by physicians
21 citations
TL;DR: ORP and DFI showed significant negative correlations with semen parameters (sperm concentration, motility and total sperm count) in infertile men with a varicocele.
Abstract: Varicocele is a common cause of male infertility. It is reported that low sperm concentration, motility and morphology are indicative of increased sperm DNA fragmentation index (DFI) in men with va...
17 citations
TL;DR: The findings support the notion that OS has an important contribution to the reproductive potential in IVF patients, the ideal biomarkers of outcome measures, however, need to be further explored.
Abstract: This study was designed to evaluate the levels of oxidative stress (OS) markers, total non-enzymatic antioxidant capacity (TAC) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) in the serum and follicular ...
17 citations
TL;DR: This is the first study to demonstrate differences between sperm and seminal plasma miRNA expression level and to identify a correlation between the sperm concentration and miRNAs expression level, which could have the potential be used as non-invasive biomarkers to diagnose males with impaired sperm production.
Abstract: Approximately 15% of couples are unable to conceive after one year of unprotected intercourse. Because sperm can be accessed with ease, it is reasonable to search for non-invasive biomarkers in sem...
16 citations
TL;DR: Oral intake of probiotics has the potential to be one of the ways to deal with oxidative damage of sperm and lead to a significant increase in sperm concentration and motility and a significant reduction in oxidative stress and inflammatory markers.
Abstract: Decreased sperm motility is one of the main causes of male infertility. The aim of this study was to evaluate the effects of probiotic supplementation on semen quality, seminal oxidative stress bio...
15 citations
TL;DR: These high success rates with vSET confirm larger studies using selected patients and are likely to deliver similar, if not higher, live birth rates per cycle started than rates typically reported in national registries with conventional IVF and transfer of one or more fresh and/or frozen embryos.
Abstract: This study reports the results of a 2-year long IVF programme ('One by One') in which all patients (median age 40 years; range 27-45 years) were offered preimplantation genetic testing for aneuploidy (PGT-A) and had all blastocysts vitrified (freeze-only), followed later by single vitrified-warmed blastocyst transfer (vSET) in managed cycles. Between January 2016 and December 2017, a total of 155 patients started 222 treatment cycles and 99 (45%) cycles resulted in one or more vitrified blastocysts (untested or with normal copy number for all chromosomes) available for transfer. Seventeen patients (11%) aged ≤35 years opted out of PGT-A. Over this period, 85 vSETs in 74 patients resulted in an implantation rate of 80% (68/85) and a singleton clinical pregnancy rate of 66% (56/85). Cumulative live birth rates will not be known for 1-2 years. Nevertheless, these high success rates with vSET confirm larger studies using selected patients and are likely to deliver similar, if not higher, live birth rates per cycle started than rates typically reported in national registries with conventional IVF and transfer of one or more fresh and/or frozen embryos.
TL;DR: The results suggest patients carrying variants in p53 and VEGF would be at risk of RIF, and thosecarrying variants in APOE gene would suffer RPL.
Abstract: Recurrent pregnancy loss (RPL; defined as the loss of three or more consecutive pregnancies) and recurrent implantation failure (RIF; when implantation is not achieved after at least three cycles o...
TL;DR: The meta-analysis shows that sufficient vitamin D status is associated with better outcomes in IVF, and there are many demographic, geographic and clinical parameters that need to be ascertained before concluding that the better results are due to the higher levels of vitamin D.
Abstract: To investigate the influence of vitamin D status on in vitro fertilisation (IVF) results, a meta-analysis of 15 cohort studies of 3711 women undergoing IVF was performed. Women were classified into...
TL;DR: A prospective cohort study to investigate whether urinary concentrations of hydroxylated polycyclic aromatic hydrocarbons (OH-PAHs) were associated with early pregnancy loss in women undergoing in vitro fertilization-embryo transfer (IVF-ET) found only 2 + 3-PHE was found to be associated positively with early miscarriage.
Abstract: Various factors have been reported to be associated with early miscarriages, including microbial infection, chemical toxicity, maternal disorders and genetic abnormalities. In the present study, a prospective cohort study was conducted to investigate whether urinary concentrations of hydroxylated polycyclic aromatic hydrocarbons (OH-PAHs) were associated with early pregnancy loss in women undergoing in vitro fertilization-embryo transfer (IVF-ET). Risk of spontaneous pregnancy loss in patients exposed to PAHs was analysed using 40 patients who had experienced early pregnancy loss compared to 40 who had normal live births. Single spot morning urine samples were collected from each patient 30 days after embryo transfer when clinical pregnancy was confirmed and ten urinary OH-PAHs were measured. After adjustment for age and BMI using a Log Binomial Model, only 2 + 3-PHE was found to be associated positively with early miscarriage. Using Receiver Operating Characteristic (ROC) curve analysis, the Area Under the Curve (AUC) was 0.78 (p＜0.001), suggesting that 2 + 3-PHE might provide a potential biomarker to predict the miscarriage risk in patients exposed to high level of PAHs.
TL;DR: The miRNome profile of endometrial tissues during the implantation window can predict the pregnancy outcome and these data are crucial for opening new perspectives to predict implantation failure and consequently, to increase ART success.
Abstract: This is a retrospective study to evaluate if the miRNome profile of endometrium samples collected during the implantation window predicts Assisted Reproduction Technology (ART) outcomes. We first investigated the endometrial miRNome profile according to the receptivity status in 20 patients with repeated implantation failures (RIF) (discovery cohort). After customized embryo transfer, the miRNome profiles of receptive patients with a positive or negative β-hCG, and with early miscarriage or live birth were analysed. Some differentially expressed miRNAs were selected for validation by RT-qPCR in endometrial samples from 103 RIF patients (validation cohort). Analysis of the different miRNome profiles identified endometrial receptivity, implantation failure, and early miscarriage-associated miRNA signatures that included 11, 261, and 76 miRNAs, respectively. However, only four miRNAs associated with the endometrial receptivity status (miR-455-3p and miR-4423-3p) and implantation failure (miR-152-3p and miR-155-5p) were significantly validated in endometrial samples. The miRNome profile of endometrial tissues during the implantation window can predict the pregnancy outcome. These data are crucial for opening new perspectives to predict implantation failure and consequently, to increase ART success.
TL;DR: The findings highlight the importance of gender for understanding fertility patient experiences, and how concerns surrounding gender identity may differentially influence men's and women's perceived stress when trying to create a family through assisted reproductive technology.
Abstract: This cross-sectional study examined the association between identity concerns and perceived stress in 522 diverse men (n = 236) and women (n = 286), seeking to become parents through fertility trea...
TL;DR: The use of TL incubators is appropriate in ART by virtue of their high specification, facility for low oxygen culture and provision of minimally disturbed culture conditions which limit exposure of human embryos to environmental stress.
Abstract: Time-lapse (TL) incubators are increasingly used in in vitro fertilization (IVF) laboratories but there have been few studies of their effectiveness in comparison to other incubator types. Moreover...
TL;DR: O Opinion still remains divided amongst clinicians managing male factor infertility as to whether varicoceles alter the probability of spontaneous conception and/or pregnancy and live birth rates after fertility treatment, and there are no randomized controlled trials comparing the clinical/cost effectiveness of varicocele treatment versus the immediate use of ICSI on pregnancy rates.
Abstract: Varicoceles are reported to be present in a significant proportion of men presenting with subfertility and are more common amongst this group than in the general population. Opinion still remains d...
TL;DR: Jointal zone endometrium thickness and contractility seem to determine gamete and embryo transportation and implantation, and endometriosis and adenomyosis prevalently co-exist, with clear relation and negative effects on the JZE.
Abstract: Junctional zone endometrium (JZE) thickness and contractility seem to determine gamete and embryo transportation and implantation. Proper function depends on concentration levels, mode and timing of oestrogen and progesterone production. Most probably, the remodelling of spiral arteries, and the development of endometrium and decidua are also highly dependent on JZE activity. Fibroids that are adjacent to JZE affect JZE contractility contributing to abnormal or failed implantation. Disruption of the JZE continuity provokes adenomyosis, a condition that causes chronic inflammation and fibrosis, which negatively affects the normal function of JZE. Imaging by magnetic resonance imaging and three-dimensional sonography can diagnose JZE abnormal appearance, alterations in thickening and contractility frequency, usually in the advanced stage of the disease. Failures of assisted reproduction, and adverse early pregnancy outcomes have also been associated with abnormal JZE. Altered uterine contractions due to JZE changes are strongly associated with poor reproductive outcome and early pregnancy loss. Endometriosis and adenomyosis prevalently co-exist, with clear relation and negative effects on the JZE. The presence of endometriosis should alert to the possibility of coexisting adenomyosis. Co-existence of endometriosis may mask the extent of the negative impact of adenomyosis in infertility.
TL;DR: It is suggested that artificial shrinkage before blastocyst vitrification improves survival and clinical pregnancy rate, but not implantation or live birth rate.
Abstract: Embryo vitrification is increasingly used in IVF. Artificial shrinkage (collapse) before vitrification has been proposed to maximise blastocyst survival after warming. However, its effectiveness on blastocyst survival rate and vitrified-warmed blastocyst transfer cycle outcome remains to be confirmed. Therefore, we performed a systematic MEDLINE search according to PRISMA guidelines on all articles published up to April 2018 and related to human blastocyst collapse before vitrification using the following keywords: (i) blastocyst; (ii) collapse; (iii) artificial shrinkage; and (iv) vitrification. The following outcomes were analysed and included in the meta-analysis: (i) blastocyst survival rate after warming; (ii) implantation rate; (iii) clinical pregnancy rate; and (iv) live birth rate after vitrified-warmed blastocyst transfer (commonly named frozen-thawed blastocyst transfer). Eight articles were included. Briefly, blastocyst survival (OR 5.04, 95% CI 2.43-10.46) and clinical pregnancy rate (OR 1.87, 95% CI 1.26-2.77) were significantly higher in collapse than in control group. However, implantation rate (OR 2.50, 95% CI 0.67-9.28) and live birth rate (OR 1.35, 95% CI 0.88-2.09) were comparable in both groups. In conclusion, this systematic review and meta-analysis suggests that artificial shrinkage before blastocyst vitrification improves survival and clinical pregnancy rate, but not implantation or live birth rate. Further randomised studies are warranted to improve the level of evidence and confirm these findings.
TL;DR: Given individuals’ willingness to engage in treatment, patients should be offered additional support to consider wide psychosocial implications of continuing treatment.
Abstract: Biological parenthood is a central life-goal for many couples that can become blocked when they experience infertility. Many couples who undergo fertility treatment will face failure and consequently have to decide whether to continue with treatment. The present study used the qualitative methodology of Interpretative Phenomenological Analysis to examine self-regulatory approaches that underlie decision-making about continuing treatment. One-time, one-on-one, semi-structured, in-depth interviews were conducted with 16 individuals (eight heterosexual couples) after they had experienced at least one treatment failure and were considering whether to undergo another treatment. After treatment failure, individuals used several approaches to remain engaged with biological parenthood, including reframing treatment failure as a learning tool and emphasizing the importance of persistence in achieving success. The apparent decision to continue with treatment was considered non-negotiable and largely made by women in the partnership. Once the decision was made to pursue treatment, it was not discussed further. Given individuals’ willingness to engage in treatment, patients should be offered additional support to consider wide psychosocial implications of continuing treatment.
TL;DR: FPPOS may be used in women with DOR without compromising the number of oocytes retrieved and seems a viable alternative to the flexible GnRH-ant protocol, which was compared with the new flexible progestin primed ovarian stimulation protocol.
Abstract: The aim of this retrospective cohort study was to compare the effectiveness of the new flexible progestin primed ovarian stimulation (fPPOS) protocol with the flexible gonadotropin-releasing-hormon...
TL;DR: The intrauterine infusion of G-CSF before frozen-thawed embryo transfer significantly reduced miscarriage rates and improve the live birth rates, while intrautine perfusion with physiological saline did not reduce miscarriage rates.
Abstract: The objective of this study was to investigate the clinical benefits of intrauterine perfusion with G-CSF in patients undergoing a frozen-thawed embryo transfer (FET) after at least two previous im...
TL;DR: 2D-HyCoSy has a similar diagnostic performance to 3D/4D- HyCoSy, and high heterogeneity was found for both sensitivity and specificity.
Abstract: In this meta-analysis, we aimed to compare the diagnostic accuracy of 2D- and 3D/4D-HyCoSy for the assessment of tubal occlusion in women with infertility, using a laparoscopic tubal chromoperturba...
TL;DR: Within the PCOS group, the subjects with AITD showed significantly higher body mass indexes, waist circumferences and homeostasis model assessment for insulin resistance levels than the patients without AITd.
Abstract: This study was performed to compare the prevalence of autoimmune thyroid disease (AITD) assessed by thyroid peroxidase antibody (anti-TPO Ab) and thyroid ultrasonography (USG) in Korean women with ...
TL;DR: By changing the expression and the activity of VDR gene, which leads to the change in expression of vitamin D-responsive genes, these polymorphisms and haplotypes could possibly have an effect on immune system in the female reproductive tract.
Abstract: Unexplained infertility refers to the absence of a definable cause of reproductive failure Vitamin D receptor (VDR) acts as a transcription factor and regulates a number of vitamin D-responsive ge
TL;DR: In conclusion, hysteroscopy should be recommended as a first-line procedure in all cases with female infertility, and a special effort should be made for its implementation in the development of new high-tech procedures for identification and treatment infertility-associated conditions.
Abstract: Hysteroscopy has evolved from the traditional art of examining the uterine cavity for diagnostic purposes to an invaluable modality to concomitantly diagnose and (see and) treat a multitude of intr...
TL;DR: The data suggests that although ET increases with increasing BMI, there are no differences in cycle outcome, which implies that an ET <8 mm may not jeopardize pregnancy outcome in women with lower BMI.
Abstract: To date there is limited published data assessing whether body mass index (BMI) influences endometrial thickness (ET) and whether this impacts on pregnancy outcomes in single blastocyst FET cycles. The objective of this study, therefore, was to examine the relationship between BMI and ET on the outcome of single blastocyst FET cycles over a five-year period from 2012 until 2016. Patient age, BMI, endometrial pattern and ET prior to FET were recorded. Pregnancy outcomes included: implantation rate, clinical pregnancy rate and live birth rate. A total of 464 cycles met the inclusion criteria and the female age was 36.0 ± 3.0 years (mean ± SD). The mean ± SD BMI was 23.3 ± 3.1 kg/m2 and median ± SD ET was 8.1 ± 1.5 mm. BMI and ET were modestly correlated (Pearson r = 0.244) and there was an association between higher BMI category and higher median ET (7.2, 8.0, 8.3, 8.9 mm; p < 0.001). However, there was no association between ET and pregnancy outcome, either unadjusted, or adjusted for BMI, age, endometrial pattern or embryo quality. The data suggests that although ET increases with increasing BMI, there are no differences in cycle outcome. Importantly, this implies that an ET <8 mm may not jeopardize pregnancy outcome in women with lower BMI. The development of a norm referenced test for BMI and ET may prove to be a helpful adjunct in the clinical IVF setting.
TL;DR: The results of this study highlight the need for educational strategies to improve young men's knowledge about fertility and the factors that influence it, particularly about the potential adverse effect of STIs on fertility.
Abstract: Most previous studies about fertility knowledge and attitudes among men have been based on quantitative methods using questionnaires with fixed-choice response options. The aims of this qualitative...
TL;DR: A population of 203 women attending the IVF clinic, Ahmedabad, India, was conducted to explore the role of stimulation protocol and the number of oocytes retrieved on oxidative stress in follicular fluid and IVF outcome.
Abstract: The study was conducted on a population of 203 women attending the IVF clinic, Ahmedabad, India, to explore the role of stimulation protocol and the number of oocytes retrieved on oxidative stress ...