Search Results (592)

Background/Objectives: Uterine artery pulsatility index (UtA-PI) is a key biomarker of placental function, but its clinical interpretation in assisted reproductive technology (ART) pregnancies is uncertain. This meta-analysis aimed to assess trimester- and method-specific UtA-PI differences between ART and spontaneous conceptions (SC) and to examine associated risks for preeclampsia (PE) and small-for-gestational-age (SGA) neonates to contextualize its findings. Methods: A systematic search of MEDLINE, Scopus, and the Cochrane Library was conducted through 25 June 2025. We included observational studies comparing UtA-PI and perinatal outcomes in singleton ART versus SC pregnancies. The primary outcome was the standardized mean difference (SMD) in first (until the 13⁺⁶ gestational week) and second trimester (14⁺⁰–23⁺⁶ gestational weeks) UtA-PI measurements; secondary outcomes were PE and SGA rates. Analyses were stratified by ART modalities. Random-effects models were used, and study quality was evaluated using the Newcastle–Ottawa Scale and risk of bias with QUIPS tool (INPLASY registration: INPLASY202560104). Results: Thirteen cohort studies were included. Overall, ART pregnancies had significantly lower UtA-PI values than SC in both the first (SMD = −0.28; 95% CI: −0.53 to −0.03) and second trimesters (SMD = −0.20; 95% CI: −0.36 to −0.04). These reductions were driven by oocyte donation (first-trimester SMD = −0.70; 95% CI: −1.21 to −0.18; second-trimester SMD = −0.46; 95% CI: −0.65 to −0.26) and artificial cycle frozen embryo transfers (ET) (first-trimester SMD = −0.69; 95% CI: −1.00 to −0.39). These lower UtA-PI values typically suggest better placental perfusion and a lower risk of placental related complications. However, ART pregnancies had an elevated overall risk for PE (risk ratio [RR] = 2.32; 95% CI: 1.72 to 3.12), with the highest risk in oocyte donation (RR = 6.11; 95% CI: 3.35 to 11.17) and artificial cycle frozen ET (RR = 3.45; 95% CI: 1.51 to 7.90). Conclusions: ART pregnancies, particularly from oocyte donation and artificial cycle frozen ET, show lower UtA-PI values despite a significantly elevated risk for PE. This finding suggests that mechanisms other than placental perfusion contribute to PE development. Clinically, the ART method is an independent risk factor for PE, and UtA-PI interpretation should be adjusted accordingly. Further research is crucial to elucidate the underlying pathophysiology. Full article

Fermentation is a crucial stage in the production of washed mild coffees, as it enables the generation of compounds that influence overall quality. The conditions to optimize this process are still unknown. This study evaluated the effects of fermenting coffee fruits and depulped coffee under two conditions: an open tank (semi-anaerobic-SA) and a closed tank (self-induced anaerobic fermentation, SIAF) over 192 h. Samples were taken every 24 h using a sacrificial bioreactor. A randomized complete block design with a factorial arrangement (2 × 2 + 1), plus a standard control, was employed, incorporating two factors: coffee type and fermentation condition. High-throughput sequencing of 16S and ITS amplicons identified an average of 260 ± 71 and 101 ± 24 OTUs, respectively. Weisella was the dominant lactic acid bacteria, followed by Leuconostoc and Lactiplantibacillus. Acetic acid bacteria, mainly Acetobacter, were more abundant under semi-anaerobic conditions. The yeast genera most affected by the fermentation condition were Pichia, Issatchenkia, and Wickerhamomyces. Repeated measures analysis revealed significant differences in pH, glucose consumption, lactic acid production, dry matter content, embryo viability, and the percentage of healthy beans. Principal component analysis was used to develop an index that integrates physical, physiological, and sensory quality variables, thereby clarifying the impact of each treatment. Samples from shorter fermentation times and SIAF conditions scored closest to 1.0, reflecting the most favorable outcomes. Otherwise, samples from longer fermentation times in both depulped and coffee fruits scored 0.497 and 0.369, respectively, on the SA condition. These findings support technically and economically beneficial fermentation strategies. Full article

Background/Objectives: The success of artificial reproductive technologies (ARTs) depends on different factors, such as patient-specific reproductive features, ovarian response to stimulation, oocyte and embryo quality, and endometrial receptivity. This study aimed to evaluate their association with oocyte yield, fertilization, endometrial thickness, and pregnancy outcomes. Methods: A prospective clinical study included 128 women undergoing IVF/ICSI. Baseline hormone levels (E2, P4, FSH, LH, AMH) were assessed prior to stimulation. E2 levels were monitored during stimulation, and P4 was measured on the day of oocyte retrieval. Patients were grouped based on P4 levels (<2 ng/mL vs. ≥2 ng/mL). IVF outcomes and endometrial characteristics were statistically analyzed. Results: Lower P4 levels (<2 ng/mL) on the day of oocyte retrieval were significantly associated with higher fertilization rates (p < 0.003), more fertilized oocytes (p < 0.001), and increased pregnancy rates (p < 0.001). Elevated P4 (≥2 ng/mL) correlated with a higher frequency of thin endometrium (<7 mm, p < 0.007). E2 levels on the hCG trigger day correlated positively with the number of retrieved and mature oocytes and fertilization outcomes (p < 0.05). Patients who achieved pregnancy had lower P4 and BMI, and higher E2, AMH, and endometrial thickness. ROC identified a P4 threshold of 1.99 ng/mL with moderate predictive value. Conclusions: Elevated progesterone levels on the day of oocyte retrieval negatively impact fertilization and pregnancy outcomes, likely due to impaired endometrial receptivity. Combined assessment of P4, E2, AMH, and endometrial thickness may enhance embryo transfer planning and improve IVF success rates. Full article

In this study, we aimed to correlate embryonic ploidy status studied with non-invasive preimplantation genetic testing for aneuploidy with the basic patient characteristics of the infertile couple to gain insight into the effects of parental physical health on embryo ploidy. We recruited 131 couples, who were stratified into 4 groups based on female age. We gathered general patient characteristics of the couple and determined the female’s hormonal status. We included 316 embryos in our study. Embryos were either transferred in the uterus in a fresh cycle or vitrified for later use. We collected spent embryo culture medium on either day 5 or 6 and performed whole genome amplification before using Next Generation Sequencing. Pregnancy outcomes were noted and cross-referenced with patient characteristics and the embryo’s ploidy status in a retrospective manner. While we have indirectly observed a level of maternal contamination, we nevertheless found a significant correlation between embryo ploidy status and cell free deoxyribonucleic acid concentration in spent embryo culture, as well a correlation between female age and embryo ploidy status. We observed a significant correlation between male body mass index and cell free deoxyribonucleic acid concentration in spent embryo culture medium and between male body mass index and pregnancy outcome. We illustrated a connection between male body mass index and cell free deoxyribonucleic acid, independent of female markers. This is the first study to observe not only female but male parameters in correlation to cell free deoxyribonucleic acid. Full article

Transvaginal ultrasound-guided follicle aspiration remains the gold standard for oocyte retrieval in assisted reproductive technology (ART). This procedure employs either a single-lumen aspiration needle (SLN) or double-lumen aspiration needle (DLN), both of which are effective modalities for oocyte retrieval. The primary objective of this review is to systematically compare the impact and clinical outcomes associated with the use of SLN versus DLN in women undergoing ART. A systematic literature search was conducted across two databases, PubMed and Google Scholar, encompassing publications from their inception until May 2025, and articles published in English. A total of five studies were included in the final analysis. The oocyte yield and the number of MII oocyte did not differ significantly between the groups. Procedural duration was markedly shorter in the SLN group compared to the DLN group. No significant differences were observed in procedure-related complications across groups. Two randomized controlled trials reported comparable fertilization rates and numbers of high-quality embryos between the two needle types. Additionally, clinical pregnancy rates, ongoing pregnancy rates, and live birth rates were similar between the SLN and DLN groups. In conclusion, the utilization ofan SLN for oocyte retrieval demonstrates comparable efficacy to that of a DLN. Full article

The sea urchin Paracentrotus lividus is a good model in ecotoxicology, but adults living along the Italian coasts have a limited reproductive period. In this species, natural or human-driven pressures may lead to limited gamete availability for ecotoxicological surveys. This study investigates the quality of early developmental stages of wild and cultured sea urchins to be used in ecotoxicology, avoiding field collection of mature specimens. Adult sea urchins were cultured in the laboratory for 2 years. Every 45 days, fertilization and larval quality were checked and compared to those from adults sampled in the wild. Fertilization was never affected, differently from development, which was impaired in the larvae obtained from sea urchins reared for more than one year. Fertilization and embryotoxicity were performed using copper nitrate in wild and cultured sea urchins. Fertilization did not differ up to ten months, while similar embryotoxicity was only found up to 5 months. This study promotes rearing sea urchins in ‘ready-to-spawn’ conditions for ecotoxicology surveys by recommending 10- and 5-month rearing times to assess fertilization and embryo toxicity, respectively. Here, we provided a baseline in marine ecotoxicology to obtain gametes on demand, irrespective of reproductive period and other pressures that may impact gamete availability. Full article

Objectives: Gonadotropin-releasing hormone (GnRH) antagonist protocols are preferred in polycystic ovary syndrome (PCOS) patients undergoing in vitro fertilization (IVF) as they provide the best combination of flexibility, acceptable outcomes, and safety. Numerous studies have compared outcomes between GnRH agonist long protocol and standard flexible antagonist protocol. However, there are scant studies investigating the effectiveness of antagonist administration from day 1 of ovarian stimulation in PCOS patients. Methods: We performed a retrospective cohort study to compare laboratory and clinical outcomes in IVF between standard flexible day 5/day 6 versus day 1 GnRH antagonist protocol in PCOS patients. Results: Our data indicates significantly superior oocyte yield and top-quality embryo proportion in patients with antagonists from day 1. Cumulative clinical pregnancy rates also tended to be superior in this group. Conclusions: Our findings indicate that administration of GnRH antagonists from day 1 of stimulation in PCOS patients undergoing IVF may lead to superior results. Full article

Fertility potential ever more diminishes due to the complex, multifactorial, and still not entirely clarified process of reproductive aging in women and men. Gamete quality and reproductive lifespan are compromised by biologic factors like mitochondrial dysfunction, increased oxidative stress (OS), and incremental telomere shortening. Clinically confirmed biomarkers, including follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH), are used to estimate ovarian reserve and reproductive status, but these markers have limited predictive validity and an incomplete representation of the complexity of reproductive age. Recent advances in artificial intelligence (AI) have the capacity to address the integration and interpretation of disparate and complex sets of data, like imaging, molecular, and clinical, for consideration. AI methodologies that improve the accuracy of reproductive outcome predictions and permit the construction of personalized treatment programs are machine learning (ML) and deep learning. To promote fertility evaluations, here, as part of its critical discussion, the roles of mitochondria, OS, and telomere biology as latter-day biomarkers of reproductive aging are presented. We also address the current status of AI applications in reproductive medicine, promises for the future, and applications involving embryo selection, multi-omics set integration, and estimation of reproductive age. Finally, to ensure that AI technology is used ethically and responsibly for reproductive care, model explainability, heterogeneity of data, and other ethical issues remain as residual concerns. Full article

Background: Preimplantation genetic testing for aneuploidy (PGT-A) is a popular approach in assisted reproductive technology that improves embryo selection and implantation rates. Traditional approaches rely on trophectoderm (TE) biopsy, which is an invasive procedure that might jeopardize embryo integrity and create technical constraints such as mosaicism-related misclassification. Non-invasive preimplantation genetic testing (niPGT) has emerged as a possible alternative, using embryonic cell-free DNA (cfDNA) extracted from wasted culture media or blastocoel fluid to assess chromosomal status without requiring direct embryo manipulation. Methods: This systematic study investigates the molecular mechanisms behind cfDNA release, its biological properties, and the technological concerns that influence its utilization in niPGT. We look at recent advances in next-generation sequencing (NGS), whole-genome amplification (WGA), and bioinformatic techniques that improve cfDNA-based aneuploidy detection. In addition, we compare the sensitivity, specificity, and concordance rates of niPGT to conventional TE biopsy, highlighting the major aspects impacting its diagnostic performance. Results: The release of cfDNA from embryos is influenced by apoptotic and necrotic processes, active DNA shedding, and extracellular vesicle secretion, which results in fragmented chromosomal material of different qualities and quantities. While niPGT has shown promise as a noninvasive screening approach, significant variability in cfDNA yield, maternal DNA contamination, and sequencing biases all have an impact on test accuracy. Studies show that niPGT and TE biopsies have moderate-to-high concordance, although there are still issues in detecting mosaicism, segmental aneuploidies, and DNA degradation artifacts. Conclusions: NiPGT is a safer and less intrusive alternative to TE biopsy, with potential clinical benefits. However, technical advancements are required to improve cfDNA collecting procedures, reduce contamination, and improve sequencing accuracy. Additional large-scale validation studies are needed to create standardized methodologies and ensure that niPGT achieves the diagnostic reliability requirements required for widespread clinical deployment in IVF programs. Full article

Sperm DNA fragmentation (SDF) is increasingly regarded as a biomarker of male infertility, but its predictive value for intracytoplasmic sperm injection (ICSI) outcomes remains controversial. This retrospective cohort study analyzed 870 fresh single-blastocyst ICSI cycles performed between January 2023 and December 2024. SDF was measured using the Sperm Chromatin Dispersion test and patients were categorized into low (SDF ≤ 20%, n = 664) and high (SDF > 20%, n = 206) groups. Higher SDF was significantly associated with reduced semen quality, lower fertilization rates, and poorer blastocyst development. In multivariable analysis, each 1% increase in SDF reduced the odds of achieving a fertilization rate > 80% by 1.6% (OR = 0.984, 95% CI: 0.971–0.997, p = 0.015) and decreased the chance of obtaining top-quality blastocysts on day 5 by 2.5% (OR = 0.975, 95% CI: 0.958–0.992, p = 0.004). A trend toward impaired day-3 embryo quality was observed (OR = 0.983, p = 0.068). No significant association was found with clinical pregnancy (OR = 0.989, p = 0.155), while the relationship with miscarriage was borderline (OR = 0.961, p = 0.053). These findings suggest that elevated SDF adversely impacts early embryological outcomes in ICSI, supporting its use as a prognostic tool during ART counseling. Full article

Chromosomal structural rearrangements (SR) can impair gametogenesis, increasing the risk of embryos carrying unbalanced chromosomal content (i.e., with a gain or loss of chromosomal material). In such cases, assisted reproduction technologies (ARTs) with preimplantation genetic testing for structural rearrangements (PGT-SR) is recommended to identify embryos with a normal or balanced karyotype. However, data on IVF laboratory outcomes in this context remain limited. This retrospective cohort study analyzed 548 ART cycles, comprising 129 with PGT-SR and 419 with PGT-A, conducted at a single university-affiliated center. Following propensity score matching, laboratory outcomes were compared using logistic regression. The fertilization rate was comparable between groups, but the PGT-SR group had significantly lower blastocyst development (36.7% vs. 47.1%) and top-quality blastocyst development rates (9.6% vs. 21.1%). No significant differences were found either in the blastocyst development rate on days 5, 6, 7, or in euploidy rates. In the PGT-SR cohort, the generalized linear mixed-effects model indicated no significant effect of carrier gender on the normal/balanced blastocyst rate, while the type of SR was strongly associated with it: non-reciprocal SRs yielded a higher rate of normal/balanced blastocysts (89.9%) compared to reciprocal translocations (45.7%). These findings indicate that patients undergoing PGT-SR generate fewer blastocysts available for biopsy, and that in cases involving reciprocal translocations, the proportion of normal/balanced blastocysts suitable for transfer is significantly reduced. These results underscore the importance of personalized counseling in managing expectations and supporting informed clinical decision-making. Full article

Endometriosis, a chronic estrogen-dependent disorder defined by ectopic endometrial-like tissue growth, causes pelvic pain and infertility in reproductive-age women. Despite its prevalence, the underlying mechanisms driving lesion persistence and reproductive impairment remain unclear. This review synthesizes recent pathophysiological advances, highlighting how hormonal dysregulation, immune dysfunction, epigenetic alterations, and oxidative stress collectively foster lesion persistence and treatment resistance. Critically, these molecular disturbances disrupt critical reproductive functions—including oocyte quality, endometrial receptivity, and embryo implantation. We further explore emerging non-hormonal therapeutic strategies, including MAPK and PI3K/AKT inhibitors as well as epigenetic agents targeting HOXA10 methylation and microRNA modulation, which offer fertility-sparing alternatives to conventional hormonal suppression. To enhance clinical translation, we propose a multi-level prevention framework—encompassing at the primary level, risk reduction; at the secondary level, biomarker-guided intervention; and at the tertiary level, fertility preservation—to anticipate disease progression and personalize reproductive care. By delineating shared pathways between endometriosis and infertility, this work advances precision medicine approaches for affected patients. Full article

To minimize the deleterious effects of oxidative stress and improve oocyte competence, we assessed the impact of melatonin during in vitro pre-maturation (pre-IVM) in bovine cumulus–oocyte complexes (COCs). We compared three groups: control (conventional IVM), pre-IVM control (without melatonin), and pre-IVM + MTn (with melatonin). The analyses included levels of reactive oxygen species (ROS), mitochondrial activity, oocyte lipid content, and the expression of genes related to oxidative stress and lipid metabolism in oocytes and cumulus cells. We also examined embryo quality by evaluating kinetics of development and gene expression. The pre-IVM + MTn group exhibited an increase (p ≤ 0.05) in ROS levels and a decrease (p ≤ 0.05) in lipid content, while maintaining mitochondrial activity similar (p > 0.05) to that of the control group. Regarding gene expression, the effect of pre-IVM, independent of melatonin, was characterized by a decrease in FABP3 transcripts in cumulus cells and reductions in GSS and NFE2L2 transcripts in oocytes (p ≤ 0.05). The pre-IVM + MTn group also displayed a decrease (p ≤ 0.05) in CAT and SOD2 transcript levels. In terms of embryonic development, the pre-IVM + MTn group achieved a higher blastocyst rate on D7 (p ≤ 0.05) compared to the control group (30.8% versus 25.8%), but with similar rates (p > 0.05) to the pre-IVM control group (30.8% versus 35.9%). However, there was a decrease in the levels of the PLAC8 transcript. This study indicates that, under the conditions tested, melatonin did not significantly benefit oocyte competence. Full article

This review aims to discuss how heat stress affects ovarian follicles and oocytes, steroidogenesis, and embryo development in ruminants. The literature shows that quiescent primordial follicles appear to be less susceptible to heat stress, but from the primary follicle stage onwards, they begin to suffer the consequences of heat stress. These adverse effects are exacerbated when the follicles are cultured in vitro. In antral follicles, heat stress reduces granulosa cell viability and proliferation in both in vivo and in vitro models. Oocyte maturation, both nuclear and cytoplasmic, is also compromised, and embryo quality declines under elevated thermal conditions. These effects are linked to intracellular disturbances, including oxidative imbalance, mitochondrial dysfunction, and altered hormonal signaling. The differences between in vivo and in vitro responses reflect the complexity of the biological impact of heat stress and emphasize the protective role of the physiological microenvironment. A better understanding of how heat stress alters the function of ovarian follicles, oocytes, and embryos is crucial. This knowledge is critical to devise effective strategies that mitigate damage, support fertility, and improve outcomes in assisted reproduction for livestock exposed to high environmental temperatures. Full article

Objective: This retrospective observational study evaluated the efficacy and safety of an ovarian stimulation protocol for embryo banking that involves continuous administration of clomiphene citrate (CC) in combination with gonadotropins, without the use of GnRH antagonists. Methods: Conducted at the Serum IVF Clinic in Athens, Greece, the study included 250 women aged 25–45 who underwent IVF for embryo banking. The protocol involved administering 150 mg of CC daily from day 2 of the menstrual cycle until the day before hCG trigger, alongside 150 IU/day of Meriofert. Outcomes assessed included oocyte yield, fertilization rates, incidence of ovarian hyperstimulation syndrome (OHSS), and hormonal correlations. Comparative and regression analyses explored differences between age groups and predictors of success. Results: The protocol demonstrated a favorable safety profile with no cases of OHSS and yielded a mean of 10.25 oocytes per patient. Group analysis showed significantly more oocytes retrieved in women under 40 (mean: 12.5) versus those over 40 (mean: 8.43), while fertilization rates were paradoxically higher in the older cohort (59.16% vs. 30.68%, p < 0.0001). Regression models revealed basal FSH to be a significant inverse predictor of oocyte yield, but it was positively associated with fertilization rate. Continuous CC use effectively suppressed premature LH surges without compromising oocyte or embryo quality, allowing flexible and cost-effective stimulation with minimal monitoring. Conclusions: Continuous administration of clomiphene citrate in combination with gonadotropins presents a promising, antagonist-free ovarian stimulation protocol for embryo banking. The approach is economically efficient, reduces monitoring requirements, and maintains safety and effectiveness and is particularly notable in women over 40. Further studies are warranted to validate these findings and refine protocol mechanisms. Full article