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Assisted Reproductive Technology: Clinical Perspectives on Enhancing Fertility Outcomes
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Assisted Reproductive Technology: Clinical Perspectives on Enhancing Fertility Outcomes

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Reproductive Medicine & Andrology".

Deadline for manuscript submissions: closed (20 March 2024) | Viewed by 3416

Special Issue Editor

Dr. Valeria Stella Vanni

E-Mail Website
Guest Editor
Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milan, Italy
Interests: assisted reproduction technology; infertility
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Special Issue titled "Assisted Reproductive Technology: Clinical Perspectives on Enhancing Fertility Outcomes" delves into the realm of assisted reproductive technology (ART) and its potential to improve fertility outcomes for individuals and couples facing reproductive challenges. With infertility becoming increasingly prevalent worldwide, this collection of articles offers a comprehensive overview of the latest clinical perspectives, research findings, and advancements in ART techniques.

The Special Issue begins by exploring the current landscape of ART, discussing the various methods available to individuals seeking fertility assistance. It highlights the significance of a multidisciplinary approach, involving reproductive endocrinologists, embryologists, geneticists, and psychologists, in providing comprehensive care to patients. The articles emphasize the importance of tailoring treatment plans to individual needs, considering factors such as age, medical history, and underlying causes of infertility.

Several articles in the Special Issue focus on specific ART techniques, such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and preimplantation genetic testing (PGT). These articles delve into the latest advancements in these techniques, including improvements in laboratory protocols, embryo selection methods, and genetic screening technologies. The authors discuss how these advancements contribute to higher success rates and improved outcomes for patients undergoing ART procedures.

Furthermore, the Special Issue addresses the ethical considerations surrounding ART, including the debate over multiple embryo transfer and the potential risks associated with certain procedures. The articles emphasize the importance of informed consent, patient autonomy, and ethical decision-making in the field of reproductive medicine.

In addition to clinical perspectives, the Special Issue also incorporates research-based articles that explore novel approaches for enhancing fertility outcomes. These studies investigate the impact of lifestyle modifications, such as diet, exercise, and stress reduction, on reproductive health. They also explore the potential of innovative technologies, such as artificial intelligence and machine learning, in optimizing fertility treatment protocols.

Overall, the Special Issue offers a comprehensive and up-to-date examination of the field of ART. It provides valuable insights for clinicians, researchers, and individuals seeking fertility assistance, aiming to improve the efficacy, safety, and overall success rates of ART procedures.

Dr. Valeria Stella Vanni
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • assisted reproductive technology (ART)
  • fertility
  • pregnancy
  • in vitro fertilization (IVF)
  • intracytoplasmic sperm injection (ICSI)
  • multidisciplinary approach
  • reproductive endocrinologists
  • embryologists

Published Papers (3 papers)

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Research

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11 pages, 245 KiB  
Article
The Association between Embryo Development and Chromosomal Results from PGT-A in Women of Advanced Age: A Prospective Cohort Study
by Pornchanit Santamonkunrot, Sonsiri Samutchinda, Pornsri Niransuk, Chonthicha Satirapod and Matchuporn Sukprasert
J. Clin. Med. 2024, 13(2), 626; https://doi.org/10.3390/jcm13020626 - 22 Jan 2024
Viewed by 1405
Abstract
Embryo morphology and morphokinetics have been studied for their association with euploid embryos. However, the results are controversial, especially in the advanced-aged women group, when the risk of aneuploidy increases significantly. This prospective cohort study evaluated the association between embryo development between day-3 [...] Read more.
Embryo morphology and morphokinetics have been studied for their association with euploid embryos. However, the results are controversial, especially in the advanced-aged women group, when the risk of aneuploidy increases significantly. This prospective cohort study evaluated the association between embryo development between day-3 cleavage and day-5 blastocyst stages and euploidy rates, determined using preimplantation genetic testing for aneuploidy (PGT-A). Embryos from women aged 35 years and above who underwent intracytoplasmic sperm injections and PGT-A were studied. Day-3 cleavage-stage embryos were evaluated for their cell number, and day-5 blastocyst-stage embryos were evaluated for their morphological grade. Embryo development from day 3 to day 5 was categorized as either good or poor development and evaluated for its association with the PGT-A results. We evaluated 325 embryos from 101 infertile couples. It was found that 55.17% of blastocysts with good development and 29.83% with poor development were euploid. A significant association was found between embryo development and euploidy rates in advanced-aged women (p < 0.001). Also, there were significantly higher rates of euploid embryos with good blastocyst morphological grades, especially blastocyst expansion grades and trophectoderm grades. In conclusion, embryo morphokinetics shows promising results in predicting euploidy in advanced female age. Full article
(This article belongs to the Special Issue Assisted Reproductive Technology: Clinical Perspectives on Enhancing Fertility Outcomes)

Review

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23 pages, 852 KiB  
Review
Isthmocele and Infertility
by Giorgio Maria Baldini, Dario Lot, Antonio Malvasi, Doriana Di Nanni, Antonio Simone Laganà, Cecilia Angelucci, Andrea Tinelli, Domenico Baldini and Giuseppe Trojano
J. Clin. Med. 2024, 13(8), 2192; https://doi.org/10.3390/jcm13082192 - 10 Apr 2024
Viewed by 878
Abstract
Isthmocele is a gynecological condition characterized by a disruption in the uterine scar, often associated with prior cesarean sections. This anatomical anomaly can be attributed to inadequate or insufficient healing of the uterine wall following a cesarean incision. It appears that isthmocele may [...] Read more.
Isthmocele is a gynecological condition characterized by a disruption in the uterine scar, often associated with prior cesarean sections. This anatomical anomaly can be attributed to inadequate or insufficient healing of the uterine wall following a cesarean incision. It appears that isthmocele may impact a woman’s quality of life as well as her reproductive capacity. The incidence of isthmocele can range from 20% to 70% in women who have undergone a cesarean section. This review aims to sum up the current knowledge about the effect of isthmocele on fertility and the possible therapeutic strategies to achieve pregnancy. However, currently, there is not sufficiently robust evidence to indicate the need for surgical correction in all asymptomatic patients seeking fertility. In cases where surgical correction of isthmocele is deemed necessary, it is advisable to evaluate residual myometrial thickness (RMT). For patients with RMT >2.5–3 mm, hysteroscopy appears to be the technique of choice. In cases where the residual tissue is lower, recourse to laparotomic, laparoscopic, or vaginal approaches is warranted. Full article
(This article belongs to the Special Issue Assisted Reproductive Technology: Clinical Perspectives on Enhancing Fertility Outcomes)
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Other

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14 pages, 1563 KiB  
Systematic Review
The Impact of High BMI on Pregnancy Outcomes and Complications in Women with PCOS Undergoing IVF—A Systematic Review and Meta-Analysis
by Salih Atalah Alenezi, Raheela Khan and Saad Amer
J. Clin. Med. 2024, 13(6), 1578; https://doi.org/10.3390/jcm13061578 - 10 Mar 2024
Viewed by 925
Abstract
(1) Background: Current evidence indicates that women with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilization (IVF) have an increased likelihood of adverse pregnancy outcomes. The objective of this systematic review was to clarify the role of a PCOS-related high body mass [...] Read more.
(1) Background: Current evidence indicates that women with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilization (IVF) have an increased likelihood of adverse pregnancy outcomes. The objective of this systematic review was to clarify the role of a PCOS-related high body mass index (BMI) in these unfavourable pregnancy outcomes. (2) Methods: A comprehensive search of electronic databases was conducted to identify studies investigating the impact of high BMI on pregnancy outcomes in women with PCOS undergoing IVF. RevMan software (v5.4) was used to calculate the odds ratio (OR) and 95% confidence interval (CI). (3) Results: Nineteen eligible studies (n = 7680) were identified, including 16 retrospective cohort studies (n = 6934), two prospective cohort studies (n = 525), and one cross-sectional study (n = 221). Pooled analysis showed significantly higher odds of clinical pregnancy (OR, 1.16 [95% CI, 1.04–1.29]; z = 2.73; p = 0.006; I2 = 30%) and livebirths (OR, 1.88 [95% CI, 1.56–2.27]; z = 6.54; p < 0.0001; I2 = 55%) in women with PCOS with a normal versus a high BMI. Meta-analysis showed significantly increased odds of miscarriages in women with PCOS with a high versus a normal BMI (OR, 0.76 [95% CI, 0.60–0.95]; z = 2.42; p = 0.02; I2 = 53%). Pooled analysis of three studies (n = 993) showed significantly higher ORs of gestational diabetes mellitus (OR 3.96 [95% CI 1.62–9.68]; z = 3.01; p = 0.003; I2 = 58%) and gestational hypertension (OR 2.16 [95% CI 1.32–3.54]; z = 3.05; p = 0.002; I2 = 68%) in women with PCOS with a high versus a normal BMI. Meta-analysis of three studies reported significantly greater odds of a caesarean section for women with PCOS with a high versus a normal BMI (OR 0.45 [95% CI 0.29–0.69]; z = 3.66; p = 0.0003; I2 = 0%). (4) Conclusions: The increased likelihood of adverse pregnancy outcomes observed in women with PCOS undergoing IVF seems to be attributable to a PCOS-related high BMI. Full article
(This article belongs to the Special Issue Assisted Reproductive Technology: Clinical Perspectives on Enhancing Fertility Outcomes)
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