Sperm-structure-integrating nanodecorated microrobots have shown promise in medicine delivery and infertility treatment.A variety of spermbots use cutting-edge nanomaterials and 3D printing technology to enhance their...Sperm-structure-integrating nanodecorated microrobots have shown promise in medicine delivery and infertility treatment.A variety of spermbots use cutting-edge nanomaterials and 3D printing technology to enhance their functioning,such as biomimetic sperms and flagellate microorganisms.The success rates of assisted reproductive technology techniques like in vitro fertilisation(IVF)and intracytoplasmic sperm injection(ICSI)may increase as a result of these developments.Furthermore,the incorporation of artificial intelligence(AI)into spermbots has the potential to optimize reproductive therapies by reducing inherited illnesses through genetic screening and editing.However,before the widespread implementation of spermbots in clinical practice,several critical aspects must be addressed.Thorough investigations into biocompatibility,ethical considerations,and long-term safety are necessary to ensure that these technologies are safe and effective for in vivo applications.展开更多
Background:Hepatitis B virus(HBV)is one of the most widespread viruses worldwide and a major cause of hepatitis,cirrhosis,and hepatocellular carcinoma.Previous studies have revealed the impacts of HBV infection on fer...Background:Hepatitis B virus(HBV)is one of the most widespread viruses worldwide and a major cause of hepatitis,cirrhosis,and hepatocellular carcinoma.Previous studies have revealed the impacts of HBV infection on fertility.An increasing number of infertile couples with chronic hepatitis B(CHB)virus infection choose assisted reproductive technology(ART)to meet their fertility needs.Despite the high prevalence of HBV,the effects of HBV infection on assisted reproduction treatment remain limited and contradictory.Objective:The aim of this study was to provide a comprehensive overview of the effect of HBV infection on fertility and discuss its effects on pregnancy outcomes,vertical transmission,pregnancy complications,and viral activity during ART treatment.Methods:We conducted a literature search in PubMed for studies on HBV infection and ART published from 1996 to 2022.Results:HBV infection negatively affected fertility in both males and females.Existing research shows that HBV infection may increase the risk of pregnancy complications in couples undergoing assisted reproduction treatment.The impact of HBV infection on the pregnancy outcomes of ART is still controversial.Current evidence does not support that ART increases the risk of vertical transmission of HBV,while relevant studies are limited.With the development of ART,the risk of HBV reactivation(HBVr)is increasing,especially due to the wide application of immunosuppressive therapy.Conclusions:Regular HBV infection screening and HBVr risk stratification and management are essential to prevent HBVr during ART.The determination of optimal strategy and timing of prophylactic anti-HBV therapy during ART still needs further investigation.展开更多
As the application of acupuncture has been increased year by year in the field of overseas reproduction, it has become crucial to give a scientific and objective evaluation of the safety and efficacy of acupuncture in...As the application of acupuncture has been increased year by year in the field of overseas reproduction, it has become crucial to give a scientific and objective evaluation of the safety and efficacy of acupuncture in the field of assisted reproduction, which attaches great importance to the sustainable development of acupuncture in the field of reproduction. This article aims to introduce the current situation of overseas clinical study in the field of assisted reproduction, analyze the existing issues profoundly and put forward measures to solve them, in order to enhance the level of international clinical study of acupuncture.展开更多
BACKGROUND Acute myocardial infarction(AMI)during pregnancy is rare,especially in twin pregnancy,and it can endanger the lives of the mother and children.Except for conventional cardiovascular risk factors,pregnancy a...BACKGROUND Acute myocardial infarction(AMI)during pregnancy is rare,especially in twin pregnancy,and it can endanger the lives of the mother and children.Except for conventional cardiovascular risk factors,pregnancy and assisted reproduction can increase the risk of AMI during pregnancy.AMI develops secondary to different etiologies,such as coronary spasm and spontaneous coronary artery dissection.CASE SUMMARY A 33-year-old woman,with twin pregnancy in the 31st week of gestation,presented to the hospital with intermittent chest tightness for 12 wk,aggravation for 1 wk,and chest pain for 4 h.Combined with the electrocardiogram and hypersensitive troponin results,she was diagnosed with acute ST-elevation myocardial infarction.Although the patient had no related medical history,she presented several risk factors,such as age greater than 30 years,assisted reproduction,and hyperlipidemia.After diagnosis,the patient received antiplatelet and anticoagulant treatment.Cesarean section and coronary angiography performed 7 d later showed stenosis and thrombus shadow of the right coronary artery.After receiving medication,the patient was in good condition.CONCLUSION This case suggests that,with the widespread use of assisted reproductive technology,more attention should be paid to perinatal healthcare,especially when chest pain occurs,to facilitate early diagnosis and intervention of AMI,and the etiology of AMI in pregnancy needs to be differentiated,especially between coronary spasm and spontaneous coronary artery dissection.展开更多
AIM: To profile semen parameters of Malawian men seeking fertility testing. METHODS: Semen analysis is a key element in the fertility evaluation of men and permits male reproductive potential to be evaluated. Semen sa...AIM: To profile semen parameters of Malawian men seeking fertility testing. METHODS: Semen analysis is a key element in the fertility evaluation of men and permits male reproductive potential to be evaluated. Semen samples were collected from consenting men after 3-5 d of sexual abstinence. The samples were collected from 130 males; 78 were male partners of infertile couples while 52 were healthy semen donors. Seminal volume, motility and morphology were assessed. The results were analyzed on Prism 5. All data are expressed as mean ± SD. Student's t-test was used for statistical analysis. Differences were regarded as statistically signifi cant if P < 0.05.RESULTS: Semen volume, sperm concentration, progressive motility and normal morphology were significantly higher in the control group when compared to the participant group. On the other hand, no statistically signifi cant difference was found between the control group total sperm motility when compared to the participant group. Oligozoospermia was found in 25 cases, teratozoospermia detected in 17 cases and abnormal seminal plasma in 16 cases. Asthenozoospermia and azoosper-mia were found in 12 and 8 participants, respectively. This study has shown that most of the infertile patients seeking fertility testing had oligozoospermia. Teratozoospermia was the second most common abnormality found in the patients seeking fertility testing. CONCLUSION: Our study is in agreement with previous studies which reported that these parameters have been shown to be good predictors for fertilization.展开更多
It is well-documented that male overweight and obesity causes endocrine disorders that might diminish the male reproductive capacity; however, reports have been conflicting regarding the influence of male body mass in...It is well-documented that male overweight and obesity causes endocrine disorders that might diminish the male reproductive capacity; however, reports have been conflicting regarding the influence of male body mass index （BMI） on semen quality and the outcome of assisted reproductive technology （ART）. The aim of this study was to investigate whether increased male BMI affects sperm quality and the outcome of assisted reproduction in couples with an overweight or obese man and a non-obese partner. Data was prospectively collected from 612 infertile couples undergoing ART at a Danish fertility center. Self-reported information on paternal height and weight were recorded and BMI was calculated. The men were divided into four BMI categories： underweight BMI 〈 20 kgm^-2, normal BMI 20-24.9 kg m^-2, overweight BMI 25-29.9 kgm^-2 and obese BMI 〉 30 kgm^-2. Conventional semen analysis was performed according to the World Health Organization guideline and sperm DNA integrity was analyzed by the Sperm Chromatin Structure Assay （SCSA）. No statistically significant effect of male BMI was seen on conventional semen parameters （sperm concentration, total sperm count, seminal volume and motility） or on SCSA-results. Furthermore, the outcome of ART regarding fertilization rate, number of good quality embryos （GQE）, implantation and pregnancy outcome was not influenced by the increasing male BMIo展开更多
Identifying embryos with the highest likelihood of successful implantation is a critical component of the in vitro fertilization(IVF)process.Visual assessments are limited by the subjectivity of embryologists,making c...Identifying embryos with the highest likelihood of successful implantation is a critical component of the in vitro fertilization(IVF)process.Visual assessments are limited by the subjectivity of embryologists,making consistent evaluation of embryo health challenging with traditional methods.Recent advances in artificial intelligence(AI)-particularly in computer vision and deep learning-have enabled the automated analysis of embryo morphology images,reducing subjectivity and improving evaluation efficiency.Through an extensive literature search using keywords such as“embryo health assessment”and“artificial intelligence,”the present review focuses on AI-driven approaches for automated embryo evaluation.It examines AI techniques applied to embryo assessment across the early development,blastocyst,and full developmental stages.This review indicated the promising potential of AI technologies in enhancing the precision,consistency,and speed of embryo selection.AI models have been reported to outperform manual evaluations across several parameters,offering promising opportunities to improve success rates and operational efficiency in reproductive medicine.Additionally,this review discusses the current limitations of AI implementation in clinical settings and explores future research directions.Overall,the review provides insight into AI’s growing role in advancing embryo selection and highlights the path toward fully automated evaluation systems in assisted reproductive technology.展开更多
BACKGROUND Acupuncture,an ancient practice,is gaining recognition as a complementary and alternative medicine,especially in assisted reproductive technology.It plays a crucial role in enhancing embryo transfer success...BACKGROUND Acupuncture,an ancient practice,is gaining recognition as a complementary and alternative medicine,especially in assisted reproductive technology.It plays a crucial role in enhancing embryo transfer success rates.Research indicates that acupuncture can improve blood flow,increase endometrial receptivity regulate pressure,and affect neuroendocrine activities in the ovaries and uterus during embryo implantation,therefore improving pregnancy outcomes.AIM To highlight recent developments related to acupuncture's influence on embryo transfer and elucidating the precise mechanisms by which acupuncture influences embryo transfer.METHODS We searched database including PubMed,Cochrane Library up to September 2024 for relevant studies and patents to evaluate the effects of acupuncture on women undergoing in vitro fertilization(IVF).The experimental design included an intervention group using needling,and a control group consisting of no needling or sham needling.The main outcome is clinical pregnancy rate(CPR),while secondary includes live birth rate(LBR)and biochemical pregnancy rate(BPR).We examined the influence of adjunctive needling on pregnancy outcomes by analyzing variations in the main outcomes.RESULTS A total of 145 randomized controlled trials involving 27748 participants were analyzed.Data revealed that the overall CPR was significantly elevated in all acupuncture cohorts compared to the control group[relative risk(RR):1.21,95%CI:1.07-1.38,P=0.01].In contrast,the aggregated LBR did not exhibit a corresponding increase,and notable statistical heterogeneity was observed among the studies.Acupuncture-assisted frozen-thawed embryo transfer enhanced the BPR(RR:1.51,95%CI:1.21-1.89,P=0.03)and improved endometrial morphology(RR:1.41,95%CI:1.13-1.75,P=0.01).Furthermore,IVF outcomes were significantly superior in the acupuncture group when acupuncture was administered during controlled ovarian hyperstimulation(RR:1.71,95%CI:1.08-2.13,95%CI:1.08-4.21,P=0.03).CONCLUSION We find that acupuncture positively influences pregnancy rates in women receiving IVF treatment.Nonetheless,there are no established guidelines for optimal acupuncture protocols.Considering the methodological limitations identified in current research,there is a need for larger,methodologically rigorous studies.展开更多
The rapidly evolving environment of assisted reproductive technology(ART)requires consideration of how new innovations are reshaping clinical practice as much as research.In particular,there are three key areas that,w...The rapidly evolving environment of assisted reproductive technology(ART)requires consideration of how new innovations are reshaping clinical practice as much as research.In particular,there are three key areas that,while full of promise,also present significant challenges:the use of artificial intelligence(AI)in embryo selection,the impact of personalized medicine on ART success rates,and the ethical considerations of genetic screening of embryos[1].This letter is meant to provoke further discussion and highlight the need for harmonized global guidelines as these advances continue to reshape the reproductive medicine environment.展开更多
Reproductive medicine has been transformed by assisted reproductive technologies(ART),providing multiple options for infertile couples to conceive biological offspring.The medical and legal frameworks,governing the pr...Reproductive medicine has been transformed by assisted reproductive technologies(ART),providing multiple options for infertile couples to conceive biological offspring.The medical and legal frameworks,governing the practice of embryologists in ART,focus on the ethical and safe handling of gametes and embryos.Embryologists play a crucial role in the success of ART procedures,requiring technical expertise and a thorough understanding of legal and ethical considerations.The importance of quality control,safety protocols,and sterility in ART laboratories is essential to ensure optimal embryo development and patient well-being.The legal responsibilities of an embryologist under the Assisted Reproductive Technology(Regulation)Act,2021 in India are required.This review emphasizes the importance of record-keeping,patient confidentiality,informed consent,and adherence to legal and ethical standards to minimize the risk of malpractice claims.Overall,this narrative review provides a detailed overview of the medical,legal,and ethical frameworks governing embryologists'practice in ART,underscoring the significance of responsible and ethical conduct in this rapidly advancing field.展开更多
Assisted reproduction provides a wide spectrum of treatments and strategies addressing infertility.However,distinct groups of infertile patients with unexplained infertility,congenital disorders,and other complex case...Assisted reproduction provides a wide spectrum of treatments and strategies addressing infertility.However,distinct groups of infertile patients with unexplained infertility,congenital disorders,and other complex cases pose a challenge in in vitro fertilization(IVF)practices.This special cohort of patients is associated with futile attempts,IVF overuse,and dead ends in management.Cutting edge research on animal models introduced this concept,along with the development of artificial organs with the aim to mimic the respective physiological functions in reproduction.Extrapolation on clinical application leads to the future use of infertility management in humans.To date,the successful clinical application of artificial reproductive organs in humans is not feasible because further animal model studies are required prior to clinical trials.The application of these artificial organs could provide a solution to infertility cases with no other options.This manuscript presents an overview on the current status,future prospects,and considerations on the potential clinical application of artificial ovary,uterus,and gametes in humans.This paper presents how the IVF practice landscape may be shaped and challenged in the future,along with the subsequent concerns in assisted reproductive treatments.展开更多
This paper＇s purpose is to present a reflective analysis about the process of transnationalization in which the technique of assisted human reproduction has been going to the extent that such a procedure has been rev...This paper＇s purpose is to present a reflective analysis about the process of transnationalization in which the technique of assisted human reproduction has been going to the extent that such a procedure has been revealed as a true ＂fertility tourism＂, offered through packages for those people who have financial conditions, but cannot through natural means to realize the dream of membership. Through the dialectic method of discourse, promoting the comparison of the thought of many authors who focus on issues such as globalization, commodification of human, technical exacerbation detriment of humans, and their interpersonal relations, the author seeks to introduce issues that are the order of day with respect to this global market arising from the tremendous advances reproductive techniques in a society marked by economic interests, it turns much more to the consumer and considers the human being as an additional asset to be sold, since its conception. The author acknowledges that they cease for tourism human reproduction is a trade that is worth of human frailty, because relying on one of the most intimate aspects of life： the desire to be a mother or father or ultimately, the perpetuation of the species.展开更多
Kamil Gill,PhD,Kamil Gill is a biologist who graduated from the University of Szczecin(Poland)with a Master degree.Dr.Gill earned his scientific degree from the Pomeranian Medical University in Szczecin(PUM).His docto...Kamil Gill,PhD,Kamil Gill is a biologist who graduated from the University of Szczecin(Poland)with a Master degree.Dr.Gill earned his scientific degree from the Pomeranian Medical University in Szczecin(PUM).His doctoral thesis was entitled:"Molecular markers of male infertility-evaluation of selected human sperm chromatin parameters and its influence on the zygote and embryo development in assisted reproduction conditions".展开更多
Medically assisted reproduction(MAR)techniques are highly dependent on the sperm quantity and quality.Low sperm concentrations can be bypassed at least to some point by the usage of more sophisticated MAR techniques l...Medically assisted reproduction(MAR)techniques are highly dependent on the sperm quantity and quality.Low sperm concentrations can be bypassed at least to some point by the usage of more sophisticated MAR techniques like intracytoplasmic sperm injection(ICSI).Compared to this,disruptions in established indicators of sperm quality like motility or morphology pose greater challenges for the therapy of couple infertility.展开更多
Objective:To investigate the influence of season on live birth and clinical pregnancy rates,as well as assisted reproductive technology(ART)outcomes,in the Hainan region.Methods:Patients were categorized into four gro...Objective:To investigate the influence of season on live birth and clinical pregnancy rates,as well as assisted reproductive technology(ART)outcomes,in the Hainan region.Methods:Patients were categorized into four groups based on the dates of artificial insemination and transplantation:spring,summer,autumn,or winter.The main outcome measures were clinical pregnancy rates and live birth rates.Secondary outcomes included body mass index(BMI),oocyte number,two pronuclei(2PN)cleavage rate,total gonadotropin(Gn)dosage and days,age,2PN fertilization rate,sperm concentration,sperm PR rate,anti-Müllerian hormone(AMH),and endometrial thickness.Outpatient semen quality indicators included sperm PR rate,total sperm count,sperm concentration,and total sperm motility.Results:This retrospective cohort study analyzed 2,016 artificial insemination cycles and 1,783 ovarian retrieval cycles from January 2017 to October 2022,and assessed the semen quality of 6,651 outpatients from May 2017 to October 2022.In artificial insemination cycles,sperm PR rate and clinical pregnancy rate were highest in winter,with a statistically significant difference between groups(P<0.05).Clinical pregnancy rate was influenced by both age and sperm PR rate(P<0.05).In ovarian retrieval cycles,the winter group had significantly higher clinical pregnancy,2PN fertilization,and 2PN cleavage rates than the other groups.The autumn group had higher live birth rates,though not significantly different.Additionally,winter months showed higher total sperm concentration and total sperm number compared to other seasons.Conclusion:Seasonality affected clinical pregnancy and live birth rates in artificial insemination cycles but not in ovarian retrieval cycles in the Hainan region.These findings suggest that while there is no need to choose a specific season for ovarian retrieval cycles,artificial insemination in winter may be preferable for patients.展开更多
Total or severe teratospermia affects the prognosis of fertility and causes serious problems for patients undergoing assisted reproduction[1].The pathophysiological mechanism of teratospermia is unclear.It has been sh...Total or severe teratospermia affects the prognosis of fertility and causes serious problems for patients undergoing assisted reproduction[1].The pathophysiological mechanism of teratospermia is unclear.It has been shown that patients with sperm parameters abnormalities and abnormal morphology have a high rate of fragmentation and sperm DNA decondensation[2,3],and that sperm DNA fragmentation analysis could be used as a predictor factor of fertility potential[4].展开更多
High levels of sperm DNA fragmentation(SDF)are associated with reduced assisted reproductive technology(ART)outcomes.Currently,SDF is not included in routine clinical assessment of male partners of infertile couples,b...High levels of sperm DNA fragmentation(SDF)are associated with reduced assisted reproductive technology(ART)outcomes.Currently,SDF is not included in routine clinical assessment of male partners of infertile couples,but the 6th edition of the World Health Organization(WHO)manual for semen analysis included the SDF assessment in the chapter on extended semen examinations.展开更多
Assisted procreation techniques have revolutionized the management of infertility and have offered hope to millions of infertile couples. The main aim of these procedures is to produce healthy offspring. However recen...Assisted procreation techniques have revolutionized the management of infertility and have offered hope to millions of infertile couples. The main aim of these procedures is to produce healthy offspring. However recent studies on short term outcome of ART have reported a higher incidence of low birth weight, development delay, imprinting defects, sex and autosomal structural abnormalities, major and minor congenital malformation and certain cancers in babies conceived via ART. Further the health of ART conceived children beyond the neonatal period have been less well evaluated. A large number of infertile couples opting for ART have an underlying genetic aetiology. These genetic aberrations are iatrogenitically transmitted via ART. Thus it is important that all couples undergo a detailed and comprehensive genetic evaluation prior to ART.展开更多
Fertility preservation and pregnancymanagement are critical considerations for patients undergoing organtransplantation.Innovations in assisted reproductive technologies,hormonalmodulation,and personalized medicine ha...Fertility preservation and pregnancymanagement are critical considerations for patients undergoing organtransplantation.Innovations in assisted reproductive technologies,hormonalmodulation,and personalized medicine have expanded options for these patients,who face unique challenges due to immunosuppressive therapy and organ functionconcerns.This mini-review explores advancements in cryopreservationtechniques,pre-conception counseling,and multidisciplinary strategies forsafe pregnancies post-transplantation.Emphasis is placed on balancing maternalhealth,graft function,and fetal outcomes.The integration of reproductive andtransplant medicine is paving the way for improved quality of life andreproductive autonomy for this patient population.展开更多
BACKGROUND Dyschromatosis universalis hereditaria(DUH)is a rare type of autosomal dominant inheritance disease.It has varying gene mutation sites among different ethnicities.SASH1 and ABCB6 have been identified as the...BACKGROUND Dyschromatosis universalis hereditaria(DUH)is a rare type of autosomal dominant inheritance disease.It has varying gene mutation sites among different ethnicities.SASH1 and ABCB6 have been identified as the causative genes of this disorder.CASE SUMMARY A 30-year-old woman presented with irregular black pigmentation spots to our department.Upon examination,the pigmentations were found to be especially dense on the extremities and the face.She had no family history of inbreeding,nor any previous chemical exposure.Genetic testing confirmed that the disease occu-rred because the patient has a SASH1 gene mutation.Following the use of assisted reproductive technology and preimplantation genetic testing for monogenic disorders,the patient give birth to a health baby.CONCLUSION Using assisted reproductive technology/preimplantation genetic testing for monogenic disorders is an option for DUH patients to reduce the risk of trans-mitting the pathogenic variant to their offspring.展开更多
文摘Sperm-structure-integrating nanodecorated microrobots have shown promise in medicine delivery and infertility treatment.A variety of spermbots use cutting-edge nanomaterials and 3D printing technology to enhance their functioning,such as biomimetic sperms and flagellate microorganisms.The success rates of assisted reproductive technology techniques like in vitro fertilisation(IVF)and intracytoplasmic sperm injection(ICSI)may increase as a result of these developments.Furthermore,the incorporation of artificial intelligence(AI)into spermbots has the potential to optimize reproductive therapies by reducing inherited illnesses through genetic screening and editing.However,before the widespread implementation of spermbots in clinical practice,several critical aspects must be addressed.Thorough investigations into biocompatibility,ethical considerations,and long-term safety are necessary to ensure that these technologies are safe and effective for in vivo applications.
基金supported by the Key Laboratory of Clinical Cancer Pharmacology,the Zhejiang Provincial Natural Science Foundation of China(No.LY21H310001)the Zhejiang Province Medical Health Science and Technology Plan Project(Nos.2020RC028 and 2018KY566)the Clinical Research Fund Project of Zhejiang Medical Association(No.2018ZYC-A30),China.
文摘Background:Hepatitis B virus(HBV)is one of the most widespread viruses worldwide and a major cause of hepatitis,cirrhosis,and hepatocellular carcinoma.Previous studies have revealed the impacts of HBV infection on fertility.An increasing number of infertile couples with chronic hepatitis B(CHB)virus infection choose assisted reproductive technology(ART)to meet their fertility needs.Despite the high prevalence of HBV,the effects of HBV infection on assisted reproduction treatment remain limited and contradictory.Objective:The aim of this study was to provide a comprehensive overview of the effect of HBV infection on fertility and discuss its effects on pregnancy outcomes,vertical transmission,pregnancy complications,and viral activity during ART treatment.Methods:We conducted a literature search in PubMed for studies on HBV infection and ART published from 1996 to 2022.Results:HBV infection negatively affected fertility in both males and females.Existing research shows that HBV infection may increase the risk of pregnancy complications in couples undergoing assisted reproduction treatment.The impact of HBV infection on the pregnancy outcomes of ART is still controversial.Current evidence does not support that ART increases the risk of vertical transmission of HBV,while relevant studies are limited.With the development of ART,the risk of HBV reactivation(HBVr)is increasing,especially due to the wide application of immunosuppressive therapy.Conclusions:Regular HBV infection screening and HBVr risk stratification and management are essential to prevent HBVr during ART.The determination of optimal strategy and timing of prophylactic anti-HBV therapy during ART still needs further investigation.
文摘As the application of acupuncture has been increased year by year in the field of overseas reproduction, it has become crucial to give a scientific and objective evaluation of the safety and efficacy of acupuncture in the field of assisted reproduction, which attaches great importance to the sustainable development of acupuncture in the field of reproduction. This article aims to introduce the current situation of overseas clinical study in the field of assisted reproduction, analyze the existing issues profoundly and put forward measures to solve them, in order to enhance the level of international clinical study of acupuncture.
基金National Natural Science Foundation of China,No.81900641.
文摘BACKGROUND Acute myocardial infarction(AMI)during pregnancy is rare,especially in twin pregnancy,and it can endanger the lives of the mother and children.Except for conventional cardiovascular risk factors,pregnancy and assisted reproduction can increase the risk of AMI during pregnancy.AMI develops secondary to different etiologies,such as coronary spasm and spontaneous coronary artery dissection.CASE SUMMARY A 33-year-old woman,with twin pregnancy in the 31st week of gestation,presented to the hospital with intermittent chest tightness for 12 wk,aggravation for 1 wk,and chest pain for 4 h.Combined with the electrocardiogram and hypersensitive troponin results,she was diagnosed with acute ST-elevation myocardial infarction.Although the patient had no related medical history,she presented several risk factors,such as age greater than 30 years,assisted reproduction,and hyperlipidemia.After diagnosis,the patient received antiplatelet and anticoagulant treatment.Cesarean section and coronary angiography performed 7 d later showed stenosis and thrombus shadow of the right coronary artery.After receiving medication,the patient was in good condition.CONCLUSION This case suggests that,with the widespread use of assisted reproductive technology,more attention should be paid to perinatal healthcare,especially when chest pain occurs,to facilitate early diagnosis and intervention of AMI,and the etiology of AMI in pregnancy needs to be differentiated,especially between coronary spasm and spontaneous coronary artery dissection.
文摘AIM: To profile semen parameters of Malawian men seeking fertility testing. METHODS: Semen analysis is a key element in the fertility evaluation of men and permits male reproductive potential to be evaluated. Semen samples were collected from consenting men after 3-5 d of sexual abstinence. The samples were collected from 130 males; 78 were male partners of infertile couples while 52 were healthy semen donors. Seminal volume, motility and morphology were assessed. The results were analyzed on Prism 5. All data are expressed as mean ± SD. Student's t-test was used for statistical analysis. Differences were regarded as statistically signifi cant if P < 0.05.RESULTS: Semen volume, sperm concentration, progressive motility and normal morphology were significantly higher in the control group when compared to the participant group. On the other hand, no statistically signifi cant difference was found between the control group total sperm motility when compared to the participant group. Oligozoospermia was found in 25 cases, teratozoospermia detected in 17 cases and abnormal seminal plasma in 16 cases. Asthenozoospermia and azoosper-mia were found in 12 and 8 participants, respectively. This study has shown that most of the infertile patients seeking fertility testing had oligozoospermia. Teratozoospermia was the second most common abnormality found in the patients seeking fertility testing. CONCLUSION: Our study is in agreement with previous studies which reported that these parameters have been shown to be good predictors for fertilization.
文摘It is well-documented that male overweight and obesity causes endocrine disorders that might diminish the male reproductive capacity; however, reports have been conflicting regarding the influence of male body mass index （BMI） on semen quality and the outcome of assisted reproductive technology （ART）. The aim of this study was to investigate whether increased male BMI affects sperm quality and the outcome of assisted reproduction in couples with an overweight or obese man and a non-obese partner. Data was prospectively collected from 612 infertile couples undergoing ART at a Danish fertility center. Self-reported information on paternal height and weight were recorded and BMI was calculated. The men were divided into four BMI categories： underweight BMI 〈 20 kgm^-2, normal BMI 20-24.9 kg m^-2, overweight BMI 25-29.9 kgm^-2 and obese BMI 〉 30 kgm^-2. Conventional semen analysis was performed according to the World Health Organization guideline and sperm DNA integrity was analyzed by the Sperm Chromatin Structure Assay （SCSA）. No statistically significant effect of male BMI was seen on conventional semen parameters （sperm concentration, total sperm count, seminal volume and motility） or on SCSA-results. Furthermore, the outcome of ART regarding fertilization rate, number of good quality embryos （GQE）, implantation and pregnancy outcome was not influenced by the increasing male BMIo
基金supported in part by the National Natural Science Foundation of China(No.61905033)in part by the Chongqing Provincial Natural Science Foundation of China(No.cstc2018jcyjAX0314).
文摘Identifying embryos with the highest likelihood of successful implantation is a critical component of the in vitro fertilization(IVF)process.Visual assessments are limited by the subjectivity of embryologists,making consistent evaluation of embryo health challenging with traditional methods.Recent advances in artificial intelligence(AI)-particularly in computer vision and deep learning-have enabled the automated analysis of embryo morphology images,reducing subjectivity and improving evaluation efficiency.Through an extensive literature search using keywords such as“embryo health assessment”and“artificial intelligence,”the present review focuses on AI-driven approaches for automated embryo evaluation.It examines AI techniques applied to embryo assessment across the early development,blastocyst,and full developmental stages.This review indicated the promising potential of AI technologies in enhancing the precision,consistency,and speed of embryo selection.AI models have been reported to outperform manual evaluations across several parameters,offering promising opportunities to improve success rates and operational efficiency in reproductive medicine.Additionally,this review discusses the current limitations of AI implementation in clinical settings and explores future research directions.Overall,the review provides insight into AI’s growing role in advancing embryo selection and highlights the path toward fully automated evaluation systems in assisted reproductive technology.
基金Supported by Funding from the Jiangsu Provincial Science and Technology Plan Special Foundation,No.BE2022712The Special Research Project on The Development Plan of Traditional Chinese Medicine Technology in Jiangsu Province,No.ZT202120.
文摘BACKGROUND Acupuncture,an ancient practice,is gaining recognition as a complementary and alternative medicine,especially in assisted reproductive technology.It plays a crucial role in enhancing embryo transfer success rates.Research indicates that acupuncture can improve blood flow,increase endometrial receptivity regulate pressure,and affect neuroendocrine activities in the ovaries and uterus during embryo implantation,therefore improving pregnancy outcomes.AIM To highlight recent developments related to acupuncture's influence on embryo transfer and elucidating the precise mechanisms by which acupuncture influences embryo transfer.METHODS We searched database including PubMed,Cochrane Library up to September 2024 for relevant studies and patents to evaluate the effects of acupuncture on women undergoing in vitro fertilization(IVF).The experimental design included an intervention group using needling,and a control group consisting of no needling or sham needling.The main outcome is clinical pregnancy rate(CPR),while secondary includes live birth rate(LBR)and biochemical pregnancy rate(BPR).We examined the influence of adjunctive needling on pregnancy outcomes by analyzing variations in the main outcomes.RESULTS A total of 145 randomized controlled trials involving 27748 participants were analyzed.Data revealed that the overall CPR was significantly elevated in all acupuncture cohorts compared to the control group[relative risk(RR):1.21,95%CI:1.07-1.38,P=0.01].In contrast,the aggregated LBR did not exhibit a corresponding increase,and notable statistical heterogeneity was observed among the studies.Acupuncture-assisted frozen-thawed embryo transfer enhanced the BPR(RR:1.51,95%CI:1.21-1.89,P=0.03)and improved endometrial morphology(RR:1.41,95%CI:1.13-1.75,P=0.01).Furthermore,IVF outcomes were significantly superior in the acupuncture group when acupuncture was administered during controlled ovarian hyperstimulation(RR:1.71,95%CI:1.08-2.13,95%CI:1.08-4.21,P=0.03).CONCLUSION We find that acupuncture positively influences pregnancy rates in women receiving IVF treatment.Nonetheless,there are no established guidelines for optimal acupuncture protocols.Considering the methodological limitations identified in current research,there is a need for larger,methodologically rigorous studies.
文摘The rapidly evolving environment of assisted reproductive technology(ART)requires consideration of how new innovations are reshaping clinical practice as much as research.In particular,there are three key areas that,while full of promise,also present significant challenges:the use of artificial intelligence(AI)in embryo selection,the impact of personalized medicine on ART success rates,and the ethical considerations of genetic screening of embryos[1].This letter is meant to provoke further discussion and highlight the need for harmonized global guidelines as these advances continue to reshape the reproductive medicine environment.
文摘Reproductive medicine has been transformed by assisted reproductive technologies(ART),providing multiple options for infertile couples to conceive biological offspring.The medical and legal frameworks,governing the practice of embryologists in ART,focus on the ethical and safe handling of gametes and embryos.Embryologists play a crucial role in the success of ART procedures,requiring technical expertise and a thorough understanding of legal and ethical considerations.The importance of quality control,safety protocols,and sterility in ART laboratories is essential to ensure optimal embryo development and patient well-being.The legal responsibilities of an embryologist under the Assisted Reproductive Technology(Regulation)Act,2021 in India are required.This review emphasizes the importance of record-keeping,patient confidentiality,informed consent,and adherence to legal and ethical standards to minimize the risk of malpractice claims.Overall,this narrative review provides a detailed overview of the medical,legal,and ethical frameworks governing embryologists'practice in ART,underscoring the significance of responsible and ethical conduct in this rapidly advancing field.
文摘Assisted reproduction provides a wide spectrum of treatments and strategies addressing infertility.However,distinct groups of infertile patients with unexplained infertility,congenital disorders,and other complex cases pose a challenge in in vitro fertilization(IVF)practices.This special cohort of patients is associated with futile attempts,IVF overuse,and dead ends in management.Cutting edge research on animal models introduced this concept,along with the development of artificial organs with the aim to mimic the respective physiological functions in reproduction.Extrapolation on clinical application leads to the future use of infertility management in humans.To date,the successful clinical application of artificial reproductive organs in humans is not feasible because further animal model studies are required prior to clinical trials.The application of these artificial organs could provide a solution to infertility cases with no other options.This manuscript presents an overview on the current status,future prospects,and considerations on the potential clinical application of artificial ovary,uterus,and gametes in humans.This paper presents how the IVF practice landscape may be shaped and challenged in the future,along with the subsequent concerns in assisted reproductive treatments.
文摘This paper＇s purpose is to present a reflective analysis about the process of transnationalization in which the technique of assisted human reproduction has been going to the extent that such a procedure has been revealed as a true ＂fertility tourism＂, offered through packages for those people who have financial conditions, but cannot through natural means to realize the dream of membership. Through the dialectic method of discourse, promoting the comparison of the thought of many authors who focus on issues such as globalization, commodification of human, technical exacerbation detriment of humans, and their interpersonal relations, the author seeks to introduce issues that are the order of day with respect to this global market arising from the tremendous advances reproductive techniques in a society marked by economic interests, it turns much more to the consumer and considers the human being as an additional asset to be sold, since its conception. The author acknowledges that they cease for tourism human reproduction is a trade that is worth of human frailty, because relying on one of the most intimate aspects of life： the desire to be a mother or father or ultimately, the perpetuation of the species.
文摘Kamil Gill,PhD,Kamil Gill is a biologist who graduated from the University of Szczecin(Poland)with a Master degree.Dr.Gill earned his scientific degree from the Pomeranian Medical University in Szczecin(PUM).His doctoral thesis was entitled:"Molecular markers of male infertility-evaluation of selected human sperm chromatin parameters and its influence on the zygote and embryo development in assisted reproduction conditions".
文摘Medically assisted reproduction(MAR)techniques are highly dependent on the sperm quantity and quality.Low sperm concentrations can be bypassed at least to some point by the usage of more sophisticated MAR techniques like intracytoplasmic sperm injection(ICSI).Compared to this,disruptions in established indicators of sperm quality like motility or morphology pose greater challenges for the therapy of couple infertility.
文摘Objective:To investigate the influence of season on live birth and clinical pregnancy rates,as well as assisted reproductive technology(ART)outcomes,in the Hainan region.Methods:Patients were categorized into four groups based on the dates of artificial insemination and transplantation:spring,summer,autumn,or winter.The main outcome measures were clinical pregnancy rates and live birth rates.Secondary outcomes included body mass index(BMI),oocyte number,two pronuclei(2PN)cleavage rate,total gonadotropin(Gn)dosage and days,age,2PN fertilization rate,sperm concentration,sperm PR rate,anti-Müllerian hormone(AMH),and endometrial thickness.Outpatient semen quality indicators included sperm PR rate,total sperm count,sperm concentration,and total sperm motility.Results:This retrospective cohort study analyzed 2,016 artificial insemination cycles and 1,783 ovarian retrieval cycles from January 2017 to October 2022,and assessed the semen quality of 6,651 outpatients from May 2017 to October 2022.In artificial insemination cycles,sperm PR rate and clinical pregnancy rate were highest in winter,with a statistically significant difference between groups(P<0.05).Clinical pregnancy rate was influenced by both age and sperm PR rate(P<0.05).In ovarian retrieval cycles,the winter group had significantly higher clinical pregnancy,2PN fertilization,and 2PN cleavage rates than the other groups.The autumn group had higher live birth rates,though not significantly different.Additionally,winter months showed higher total sperm concentration and total sperm number compared to other seasons.Conclusion:Seasonality affected clinical pregnancy and live birth rates in artificial insemination cycles but not in ovarian retrieval cycles in the Hainan region.These findings suggest that while there is no need to choose a specific season for ovarian retrieval cycles,artificial insemination in winter may be preferable for patients.
文摘Total or severe teratospermia affects the prognosis of fertility and causes serious problems for patients undergoing assisted reproduction[1].The pathophysiological mechanism of teratospermia is unclear.It has been shown that patients with sperm parameters abnormalities and abnormal morphology have a high rate of fragmentation and sperm DNA decondensation[2,3],and that sperm DNA fragmentation analysis could be used as a predictor factor of fertility potential[4].
文摘High levels of sperm DNA fragmentation(SDF)are associated with reduced assisted reproductive technology(ART)outcomes.Currently,SDF is not included in routine clinical assessment of male partners of infertile couples,but the 6th edition of the World Health Organization(WHO)manual for semen analysis included the SDF assessment in the chapter on extended semen examinations.
文摘Assisted procreation techniques have revolutionized the management of infertility and have offered hope to millions of infertile couples. The main aim of these procedures is to produce healthy offspring. However recent studies on short term outcome of ART have reported a higher incidence of low birth weight, development delay, imprinting defects, sex and autosomal structural abnormalities, major and minor congenital malformation and certain cancers in babies conceived via ART. Further the health of ART conceived children beyond the neonatal period have been less well evaluated. A large number of infertile couples opting for ART have an underlying genetic aetiology. These genetic aberrations are iatrogenitically transmitted via ART. Thus it is important that all couples undergo a detailed and comprehensive genetic evaluation prior to ART.
基金Supported by European Union-Next Generation EU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008.
文摘Fertility preservation and pregnancymanagement are critical considerations for patients undergoing organtransplantation.Innovations in assisted reproductive technologies,hormonalmodulation,and personalized medicine have expanded options for these patients,who face unique challenges due to immunosuppressive therapy and organ functionconcerns.This mini-review explores advancements in cryopreservationtechniques,pre-conception counseling,and multidisciplinary strategies forsafe pregnancies post-transplantation.Emphasis is placed on balancing maternalhealth,graft function,and fetal outcomes.The integration of reproductive andtransplant medicine is paving the way for improved quality of life andreproductive autonomy for this patient population.
文摘BACKGROUND Dyschromatosis universalis hereditaria(DUH)is a rare type of autosomal dominant inheritance disease.It has varying gene mutation sites among different ethnicities.SASH1 and ABCB6 have been identified as the causative genes of this disorder.CASE SUMMARY A 30-year-old woman presented with irregular black pigmentation spots to our department.Upon examination,the pigmentations were found to be especially dense on the extremities and the face.She had no family history of inbreeding,nor any previous chemical exposure.Genetic testing confirmed that the disease occu-rred because the patient has a SASH1 gene mutation.Following the use of assisted reproductive technology and preimplantation genetic testing for monogenic disorders,the patient give birth to a health baby.CONCLUSION Using assisted reproductive technology/preimplantation genetic testing for monogenic disorders is an option for DUH patients to reduce the risk of trans-mitting the pathogenic variant to their offspring.
