scholarly journals Impact of Melatonin Supplementation in Women with Unexplained Infertility Undergoing Fertility Treatment

Antioxidants ◽  
2019 ◽  
Vol 8 (9) ◽  
pp. 338 ◽  
Author(s):  
Javier Espino ◽  
María Macedo ◽  
Graciela Lozano ◽  
Águeda Ortiz ◽  
Carmina Rodríguez ◽  
...  
Keyword(s):  
Therapeutic Potential ◽  
Oocyte Quality ◽  
Unexplained Infertility ◽  
Fertility Treatment ◽  
Success Rates ◽  
Vitro Fertilization ◽  
Oxidative Balance ◽  
Human Fertility ◽  
Follicular Puncture

Unexplained infertility occurs when common causes for a couple’s inability to conceive have been excluded. Although origins of idiopathic infertility are still unclear, factors, such as an altered oxidative balance, are believed to be involved. Melatonin is an outstanding antioxidant reportedly present in the follicular fluid (FF), which has been suggested as a useful tool in the management of human fertility. Herein, we observed that intrafollicular concentrations of melatonin were blunted in women with unexplained infertility (UI), which was associated with a marked oxidative imbalance in UI patients’ FF. Based on these findings, this randomized pilot study was aimed at assessing whether exogenous melatonin ameliorated oxidative stress and improved in vitro fertilization (IVF) success rates in UI. Thus, 3 mg/day or 6 mg/day of melatonin were given to UI patients for a period spanning from the first appointment to control ovarian stimulation until the day of follicular puncture. Our results indicate that melatonin supplementation, irrespective of the two doses tested, ameliorated intrafollicular oxidative balance and oocyte quality in UI patients, and that this translated into a slight increase in the rate of pregnancies/live births. Therefore, although the indoleamine has shown therapeutic potential in this clinical setting, larger clinical trials in populations with different backgrounds are encouraged to corroborate the usefulness of melatonin.

scholarly journals The obligate need for accuracy in reporting preclinical studies relevant to clinical trials: autologous germline mitochondrial supplementation for assisted human reproduction as a case study

2020 ◽  
Vol 14 ◽  
pp. 263349412091735
Author(s):  
Jonathan L. Tilly ◽  
Dori C. Woods
Keyword(s):  
Energy Transfer ◽  
In Vitro Fertilization ◽  
Clinical Studies ◽  
Human Reproduction ◽  
Fertility Treatment ◽  
Success Rates ◽  
Vitro Fertilization ◽  
Mouse Study ◽  
Mitochondrial Supplementation

A now large body of work has solidified the central role that mitochondria play in oocyte development, fertilization, and embryogenesis. From these studies, a new technology termed autologous germline mitochondrial energy transfer was developed for improving pregnancy success rates in assisted reproduction. Unlike prior clinical studies that relied on the use of donor, or nonautologous, mitochondria for microinjection into eggs of women with a history of repeated in vitro fertilization failure to enhance pregnancy success, autologous germline mitochondrial energy transfer uses autologous mitochondria collected from oogonial stem cells of the same woman undergoing the fertility treatment. Initial trials of autologous germline mitochondrial energy transfer during - in vitro fertilization at three different sites with a total of 104 patients indicated a benefit of the procedure for improving pregnancy success rates, with the birth of children conceived through the inclusion of autologous germline mitochondrial energy transfer during in vitro fertilization. However, a fourth clinical study, consisting of 57 patients, failed to show a benefit of autologous germline mitochondrial energy transfer– in vitro fertilization versus in vitro fertilization alone for improving cumulative live birth rates. Complicating this area of work further, a recent mouse study, which claimed to test the long-term safety of autologous mitochondrial supplementation during in vitro fertilization, raised concerns over the use of the procedure for reproduction. However, autologous mitochondria were not actually used for preclinical testing in this mouse study. The unwarranted fears that this new study’s erroneous conclusions could cause in women who have become pregnant through the use of autologous germline mitochondrial energy transfer during- in vitro fertilization highlight the critical need for accurate reporting of preclinical work that has immediate bearing on human clinical studies.

scholarly journals Estradiol and Progesterone Levels are Related to Redox Status in the Follicular Fluid During In Vitro Fertilization

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Bartira Marques Pizarro ◽  
Aline Cordeiro ◽  
Mila Weydtt Reginatto ◽  
Samir P C Campos ◽  
Ana Cristina A Mancebo ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
In Vitro Fertilization ◽  
Follicular Fluid ◽  
Redox Status ◽  
Oocyte Quality ◽  
Fertility Treatment ◽  
Blood Contamination ◽  
Oxidative Stress Biomarkers ◽  
Vitro Fertilization

Abstract Studies have reported a possible association between the levels of oxidative stress biomarkers in follicular fluid (FF) and infertility treatment outcomes. FF analysis can provide important information about oocyte quality. This study aimed to evaluate the possible correlation between oxidative stress biomarker and intrafollicular hormone levels and clinical and laboratory parameters in women during controlled ovarian stimulation. These women were undergoing in vitro fertilization with intracytoplasmic sperm injection (ICSI).The FF samples were acquired from September 2012 to February 2014 from women undergoing private fertility treatment in Rio de Janeiro, Brazil. A total of 196 women who were undergoing ICSI and had different infertility diagnoses were recruited. The FF from each patient (average patient age of 36.3 ± 4.3 years) was collected following puncture of just one follicle with the largest diameter. After ruling out blood contamination by spectrophotometry, 163 patient samples were utilized in the study. In the FF, the progesterone levels were negatively correlated with (a) hydrogen peroxide scavenging capacity (HPSC) (r = −0.294, P < 0.0001), (b) total number of follicles (r = −0.246, P < 0.001) and (c) total number of oocytes punctured (r = −0.268, P = 0.0001). The concentration of serum estradiol exhibited a positive correlation with intrafollicular HPSC (r = 0.165, P = 0.037). Our data indicate that the FF levels of estradiol and progesterone are related to the FF redox status, which is closely associated with the number of oocytes obtained during ICSI procedures.

scholarly journals Does Laparoscopy and Hysteroscopy Have a Place in the Diagnosis of Unexplained Infertility?

2020 ◽  
Vol 38 (01) ◽  
pp. 029-035
Author(s):  
Mohan S. Kamath ◽  
Judith F.W. Rikken ◽  
Jan Bosteels
Keyword(s):  
Intrauterine Insemination ◽  
Semen Analysis ◽  
Unexplained Infertility ◽  
Fertility Treatment ◽  
Future Research ◽  
Vitro Fertilization ◽  
Tubal Patency ◽  
The Impact

AbstractThe standard fertility workup includes assessment of ovulation, semen analysis, and evaluation of tubal patency. If the fertility workup is found to be normal, a diagnosis of unexplained infertility is made. The role of laparoscopy in fertility workup has been a matter of debate. The current review presents the evidence for and against laparoscopy and hysteroscopy during fertility workup and subsequently prior to fertility treatment. After appraising the literature, we found the role of diagnostic laparoscopy in fertility workup is limited and is dependent on factors like prevalence of pelvic infection, setting, and availability of expertise. Moreover, whenever a laparoscopy is planned as a part of the fertility workup, the preparation should include ability to carry out simultaneous therapeutic intervention to maximize the benefit. Similarly, the routine use of hysteroscopy in women with unexplained infertility cannot be recommended. There is a need to investigate the impact of choice of tubal test on chances of spontaneous conception and treatment outcomes in women with unexplained infertility. Our future research agenda should also include high-quality multicenter randomized trials assessing the cost-effectiveness of screening and operative hysteroscopy prior to intrauterine insemination or in vitro fertilization.

scholarly journals The Presence of Immature GV− Stage Oocytes during IVF/ICSI Is a Marker of Poor Oocyte Quality: A Pilot Study

2020 ◽  
Vol 8 (1) ◽  
pp. 4
Author(s):  
Pia Astbury ◽  
Goutham N. Subramanian ◽  
Jessica Greaney ◽  
Chris Roling ◽  
Jacqui Irving ◽  
...  
Keyword(s):  
Dna Damage ◽  
Pilot Study ◽  
Germinal Vesicle ◽  
Oocyte Retrieval ◽  
Oocyte Quality ◽  
Outcome Data ◽  
Developmental Competence ◽  
Success Rates ◽  
Vitro Fertilization

Here we investigate whether the presence of germinal vesicle-stage oocytes (GV− oocytes) reflects poor oocyte developmental competence (or quality). This was a prospective, non-randomised, cohort pilot-study involving 60 patients undergoing in vitro fertilization/ intracytoplasmic sperm injection for whom complete pregnancy outcome data were available. Patients in whom GV− oocytes were retrieved (GV+) at transvaginal oocyte retrieval (TVOR) were compared with those from whom no GVs were retrieved (GV−). We found that GV+ (n = 29) and GV− (n = 31) patients were similarly aged (35.4 vs. 36.4 years; p = 0.446). GV+ patients had a mean of 2.41 ± 2.03 GVs and comparable yields of MII oocytes to GV− patients (11 ± 6.88 vs. 8.26 ± 4.84; p = 0.077). Compared with GV− patients, GV+ patients had markedly lower implantation rates (11.8% vs. 30.2%; p = 0.022) as well as oocyte utilisation rates for clinical pregnancy (2.3% vs. 6.8%; p = 0.018) and live-birth (1.9% vs. 5.7%; p = 0.029). DNA damage levels measured using γH2AX immunostaining were not different in oocytes from women <36 years versus those ≥36 years (p = 0.606). Thus, patients who have GV− stage oocytes at TVOR exhibit poor oocyte quality reflected in reduced per-oocyte pregnancy success rates and uniformly high levels of oocyte DNA damage.

How Does the Inclusion of Twins Conceived via Fertility Treatments Influence the Results of Twin Studies?

2012 ◽  
Vol 15 (6) ◽  
pp. 746-752 ◽  
Author(s):  
S. Alexandra Burt ◽  
Kelly L. Klump
Keyword(s):  
Twin Studies ◽  
The United States ◽  
Fertility Treatment ◽  
State University ◽  
Behavioral Differences ◽  
Vitro Fertilization ◽  
Fertility Treatments ◽  
Control And Prevention ◽  
Twin Families

Rates of twinning have risen dramatically over the last 30 years, from 1 in 53 births in 1980 to 1 in 30 births in 2009 (Martin et al. (January 2012). Three decades of twin births in the United States, 1980–2009. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Health Statistics). This increase is largely attributable to increases in the use of fertility treatments (i.e., ovulation induction and in vitro fertilization) combined with delays in parenthood. Although this increase means that more twins are available for recruitment into twin studies, it also has potential consequences for the heritability estimates obtained in these studies. This study sought to evaluate this possibility, making use of the ongoing Michigan Twins Project (N = 7,261 families with twins aged 3–17 years), an arm of the Michigan State University Twin Registry. Results revealed that, on average, twins conceived via fertility treatments had lower rates of behavior problems than those conceived naturally, although these behavioral differences could be explained largely by demographic and socio-economic differences across the two types of twin families. Twin similarity did not meaningfully differ across fertility treatment status. We thus conclude that estimates of genetic and environmental influences obtained from twin studies over the last 10–15 years are more or less unaffected by the inclusion of twins conceived via fertility treatments in their samples.

P–219 mtDNA content in bovine cumulus cells does not predict oocytés developmental competence

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Á Martíne. Moro ◽  
I Lamas-Toranzo ◽  
L González-Brusi ◽  
A Pérez-Gómez ◽  
P Bermejo-Álvarez
Keyword(s):  
Cumulus Cell ◽  
Cumulus Cells ◽  
Oocyte Quality ◽  
Blastocyst Stage ◽  
Early Embryo ◽  
Developmental Competence ◽  
Success Rates ◽  
Developmental Potential ◽  
Mtdna Sequence

Abstract Study question Does cumulus cell mtDNA content correlate with oocyte developmental potential in the bovine model? Summary answer The relative amount of mtDNA content did not vary significantly in oocytes showing different developmental outcomes following IVF What is known already Cumulus cells are closely connected to the oocyte through transzonal projections, serving essential metabolic functions during folliculogenesis. These oocyte-supporting cells are removed and discarded prior to ICSI, thereby constituting an interesting biological material on which to perform molecular analysis aimed to predict oocyte developmental competence. Previous studies have positively associated oocytés mtDNA content with developmental potential in both animal models and women. However, it remains debatable whether mtDNA content in cumulus cells could be used as a proxy to infer oocyte developmental potential. Study design, size, duration Bovine cumulus cells were allocated into three groups according to the developmental potential of the oocyte: 1) oocytes developing to blastocysts following IVF (Bl+Cl+), 2) oocytes cleaving following IVF but arresting their development prior to the blastocyst stage (Bl-Cl+), and 3) oocytes not cleaving following IVF (Bl-Cl-). Relative mtDNA content was analysed in 40 samples/group, each composed by the cumulus cells from one cumulus-oocyte complex (COC). Participants/materials, setting, methods Bovine cumulus-oocyte complexes were obtained from slaughtered cattle and individually matured in vitro (IVM). Following IVM, cumulus cells were removed by hyaluronidase treatment, pelleted, snap frozen in liquid nitrogen and stored at –80 ºC until analysis. Cumulus-free oocytes were fertilized and cultured in vitro individually and development was recorded for each oocyte. Relative mtDNA abundance was determined by qPCR, amplifying a mtDNA sequence (COX1) and a chromosomal sequence (PPIA). Statistical differences were tested by ANOVA. Main results and the role of chance Relative mtDNA abundance did not differ significantly (ANOVA p &gt; 0.05) between the three groups exhibiting different developmental potential (1±0.06 vs. 1.19±0.05 vs. 1.11±0.05, for Bl+Cl+ vs. Bl-Cl+ vs. Bl-Cl-, mean±s.e.m.). Limitations, reasons for caution Experiments were conducted in the bovine model. Although bovine folliculogenesis, monoovulatory ovulation and early embryo development exhibit considerable similarities with that of humans, caution should be taken when extrapolating these data to humans. Wider implications of the findings: The use of molecular markers for oocyte developmental potential in cumulus cells could be used to enhance success rates following single-embryo transfer. Unfortunately, mtDNA in cumulus cells was not found to be a good proxy for oocyte quality. Trial registration number Not applicable

A Baby at All Costs? Exploring the Use and Provision of Unproven Adjuvant Treatments in the Context of IVF

2021 ◽  
Author(s):  
Georgina L. Jones ◽  
Victoria Lang ◽  
Nicky Hudson
Keyword(s):  
Reproductive Technologies ◽  
Patient Survey ◽  
Fertility Treatment ◽  
Vitro Fertilization ◽  
The Past ◽  
The United Kingdom ◽  
Wide Range ◽  
National Patient ◽  
Psychosocial Perspective

AbstractThe year 2018 marked 40 years since the birth of Louise Brown, the first baby born as a result of pioneering in vitro fertilization (IVF) treatment. Since then, advances have seen a wide range of reproductive technologies emerge into clinical practice, including adjuvant treatments often referred to as IVF “add-ons.” However, these “optional extras” have faced growing criticism, especially when they have often come at additional financial cost to the patient and have little evidence supporting their efficacy to improve pregnancy or birth rates. Despite this, according to the latest national patient survey by the Human Fertilisation and Embryology Authority, three quarters of patients who had fertility treatment in the United Kingdom in the past two years had at least one type of treatment add-on highlighting the growing demand for these interventions. This article uses a psychosocial perspective to consider the motivations behind patient and clinician behavior along with the wider societal and economic factors that may be impacting upon the increase in the use of adjuvant treatments in fertility clinics more widely. It suggests the reasons fertility patients use unproven “optional extras” are complex, with interpersonal, psychological, and social factors intertwining to generate an increase in the use of IVF add-ons.

scholarly journals Aromatase P450 activity in the natural menstrual cycle and during controlled ovarian stimulation

2017 ◽  
Vol 66 (5) ◽  
pp. 46-55 ◽  
Author(s):  
Pavel P. Yakovlev
Keyword(s):  
Reproductive System ◽  
Oocyte Quality ◽  
Aromatase Activity ◽  
Female Reproductive System ◽  
Vitro Fertilization ◽  
P450 Enzyme ◽  
Follicular Response ◽  
P450 Activity

The Aim of the study was to assess modern considerations about the role of aromatase P450 enzyme in female reproductive system and the effect of its activity on the protocols of in vitro fertilization (IVF). Materials: foreign and Russian literature data from 1978 to 2016. Methods:review and synthesis of publications has been performed. Conclusions: Ovarian aromatase is the key steroidogenesis enzyme of the female reproductive system. Its activity depends on many factors, both of intraovarian and extragonadal origin. The ovarian follicular response and oocyte quality in IVF may depend on aromatase activity.

scholarly journals Poor ovarian reserve and male infertility in a rural in vitro fertilization setup: a case report

2021 ◽  
Vol 10 (10) ◽  
pp. 4020
Author(s):  
Neha V. Harne ◽  
Vaibhav K. Nadkarni ◽  
Purnima Nadkarni ◽  
Jigna Garasia
Keyword(s):  
Semen Analysis ◽  
Oocyte Quality ◽  
Reproductive Age ◽  
Vitro Fertilization ◽  
Advanced Reproductive Age ◽  
Sperm Chromosomes ◽  
Definition Of ◽  
Poor Ovarian Reserve ◽  
Strict Definition

Female fertility begins to decline many years prior to the onset of menopause despite continued regular ovulatory cycles. Although there is no strict definition of advanced reproductive age in women, infertility becomes more pronounced after the age of 35. In the female, the number of oocytes decreases with age until the menopause. Oocyte quality also diminishes, due in part to increased aneuploidy because of factors such as changes in spindle integrity. Although older male age affects the likelihood of conception, abnormalities in sperm chromosomes and in some components of the semen analysis are less important than the frequency of intercourse. Age is as accurate as any other predictor of conception with assisted reproductive technology.

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