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
The use of fresh versus frozen spermatozoa in men with nonobstructive azoospermia (NOA) undergoingin vitro fertilization (IVF)has been a debated hot topic among reproductive specialists. Each approach presents distinc...The use of fresh versus frozen spermatozoa in men with nonobstructive azoospermia (NOA) undergoingin vitro fertilization (IVF)has been a debated hot topic among reproductive specialists. Each approach presents distinct advantages and disadvantages,with fresh sperm typically showing superior sperm quality, while frozen sperm offers logistical flexibility and a reliable backup forrepeated cycles. This review summarizes the latest advancements in sperm retrieval and cryopreservation techniques, providingpractitioners with a comprehensive analysis of each option’s strengths and limitations. Comparative studies indicate that, althoughfresh sperm often has better quality metrics, cryopreservation methods such as vitrification have significantly improved postthawoutcomes, making frozen sperm a viable choice in assisted reproductive technologies (ART). The findings show comparablerates for fertilization, implantation, clinical pregnancy, and live birth between fresh and frozen microdissection testicular spermextraction (micro-TESE) sperm in many cases, although patient-specific factors such as timing, cost-effectiveness, and proceduralconvenience should guide the final decision. Ultimately, the choice of using fresh or frozen sperm should align with the individualneeds and conditions of patients. This tailored approach, supported by the latest advancements, can optimize ART outcomes andprovide personalized reproductive care.展开更多
In vitro fertilization(IVF)is one of the most used assisted reproductive technology(ART)techniques today.However,the success of IVF procedures heavily relies on maintaining a sterile environment in laboratories.This n...In vitro fertilization(IVF)is one of the most used assisted reproductive technology(ART)techniques today.However,the success of IVF procedures heavily relies on maintaining a sterile environment in laboratories.This narrative review examines the effects of microbiological contamination in IVF laboratories,exploring its sources,impacts on IVF outcomes,and preventive measures.We conducted a complete literature search using databases such as PubMed and Google Scholar,focusing on studies published within the last fifteen years.Our findings highlight that microbiological contamination can significantly impair embryo quality,reduce implantation and pregnancy rates,and increase the risk of miscarriage and infection.The review also discusses current best practices for contamination prevention and identifies areas for future research.This work emphasizes the critical importance of stringent sterility protocols in IVF laboratories and calls for continued vigilance and innovation in maintaining optimal conditions for assisted reproduction.展开更多
Sperm cryopreservation is an essential technique for male fertility preservation,especially in men who are undergoing medical treatment.Conventional cryopreservation methods face limitations such as oxidative stress,D...Sperm cryopreservation is an essential technique for male fertility preservation,especially in men who are undergoing medical treatment.Conventional cryopreservation methods face limitations such as oxidative stress,DNA fragmentation,and cytotoxicity associated with traditional cryoprotectants like dimethyl sulfoxide(DMSO).Recent breakthroughs have focused on improving post-thaw sperm viability with novel cryoprotectants and innovative freezing strategies.Prospective approaches include the use of amino acid-based cryoprotectants,deep eutectic solvents,and antioxidants that have been described to prevent oxidative damage and maintain DNA integrity.Vitrification,a high-speed freezing technique that prevents ice crystal formation,has demonstrated superior outcomes compared to conventional slow freezing.Moreover,the Direct Dropping Method,a cryoprotectant-free approach,has been introduced as a contamination-minimizing technique that preserves sperm functionality.Multiomics tools are also utilized to determine biomarkers for protocol optimization.Despite these advancements,cryoprotectant toxicity is a central challenge,emphasizing the necessity for safer agents.Future research must focus on long-term sperm functionality and individualized cryopreservation strategies to maximize reproductive outcomes.The current review highlights the challenges associated with sperm cryopreservation,explores innovative strategies and novel cryoprotectants,underscores the significance of maintaining DNA integrity,and proposes future research directions to improve fertility preservation outcomes.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
Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of t...Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation.Additionally,the presence of leukocytes,bacteria,and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development.Hence,removal of leukocytes,bacteria,and dead spermatozoa is an important step of sperm processing for assisted reproduction.Currently,several sperm processing techniques have been evolved and optimized in the field of assisted reproduction.The requirements for in vitro fertilization(IVF),intracytoplasmic sperm injection(ICSI),and testicular sperm extraction(TESE)are different than those of intrauterine insemination(IUI).The yield of as many motile,morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure.In ICSI,where injection of a single spermatozoon into the oocyte is performed by the embryologist,sperm selection techniques play a crucial role in the ICSI procedure.Finally,sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing.Additionally,sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.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
Rationale:Recurrent pregnancy loss and recurrent implantation failure are frequently linked to immune dysregulation,particularly heightened natural killer(NK)cell activity,cytokine imbalance,and autoantibody presence....Rationale:Recurrent pregnancy loss and recurrent implantation failure are frequently linked to immune dysregulation,particularly heightened natural killer(NK)cell activity,cytokine imbalance,and autoantibody presence.Lipid emulsion therapy,originally designed for parenteral nutrition,is increasingly recognized for its immunomodulatory potential in reproductive medicine.Patient concerns:A 34-year-old woman with five years of infertility,four first-trimester miscarriages,and three failed in vitro fertilization(IVF)cycles despite transfer of morphologically optimal embryos presented for evaluation.Diagnosis:Routine genetic,endocrine,metabolic,thrombophilia,and anatomical investigations were unremarkable.Immunological testing revealed elevated antiphospholipid and anti-thyroid peroxidase(anti-TPO)antibodies,increased NK cell activity,an imbalanced Th1/Th2 cytokine ratio,and raised tumor necrosis factor-alpha(TNF-α),suggesting immune-mediated reproductive dysfunction.Interventions:The patient underwent IVF with transfer of a single euploid blastocyst following intravenous lipid emulsion therapy(20%,100 mL),administered before transfer,on transfer day,and biweekly until 12 weeks.Associated therapies included aspirin,enoxaparin,progesterone,levothyroxine,and supplementation.Outcomes:Serum beta-human chorionic gonadotropin(β-hCG)and ultrasound confirmed pregnancy with subsequent NK cell normalization.The pregnancy was uncomplicated,resulting in spontaneous vaginal delivery of a healthy male infant.Lessons:Lipid emulsion therapy may improve implantation and pregnancy outcomes in immune-mediated recurrent pregnancy loss and recurrent implantation failure,but larger trials are required to validate efficacy and optimize protocols.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.
文摘The use of fresh versus frozen spermatozoa in men with nonobstructive azoospermia (NOA) undergoingin vitro fertilization (IVF)has been a debated hot topic among reproductive specialists. Each approach presents distinct advantages and disadvantages,with fresh sperm typically showing superior sperm quality, while frozen sperm offers logistical flexibility and a reliable backup forrepeated cycles. This review summarizes the latest advancements in sperm retrieval and cryopreservation techniques, providingpractitioners with a comprehensive analysis of each option’s strengths and limitations. Comparative studies indicate that, althoughfresh sperm often has better quality metrics, cryopreservation methods such as vitrification have significantly improved postthawoutcomes, making frozen sperm a viable choice in assisted reproductive technologies (ART). The findings show comparablerates for fertilization, implantation, clinical pregnancy, and live birth between fresh and frozen microdissection testicular spermextraction (micro-TESE) sperm in many cases, although patient-specific factors such as timing, cost-effectiveness, and proceduralconvenience should guide the final decision. Ultimately, the choice of using fresh or frozen sperm should align with the individualneeds and conditions of patients. This tailored approach, supported by the latest advancements, can optimize ART outcomes andprovide personalized reproductive care.
文摘In vitro fertilization(IVF)is one of the most used assisted reproductive technology(ART)techniques today.However,the success of IVF procedures heavily relies on maintaining a sterile environment in laboratories.This narrative review examines the effects of microbiological contamination in IVF laboratories,exploring its sources,impacts on IVF outcomes,and preventive measures.We conducted a complete literature search using databases such as PubMed and Google Scholar,focusing on studies published within the last fifteen years.Our findings highlight that microbiological contamination can significantly impair embryo quality,reduce implantation and pregnancy rates,and increase the risk of miscarriage and infection.The review also discusses current best practices for contamination prevention and identifies areas for future research.This work emphasizes the critical importance of stringent sterility protocols in IVF laboratories and calls for continued vigilance and innovation in maintaining optimal conditions for assisted reproduction.
文摘Sperm cryopreservation is an essential technique for male fertility preservation,especially in men who are undergoing medical treatment.Conventional cryopreservation methods face limitations such as oxidative stress,DNA fragmentation,and cytotoxicity associated with traditional cryoprotectants like dimethyl sulfoxide(DMSO).Recent breakthroughs have focused on improving post-thaw sperm viability with novel cryoprotectants and innovative freezing strategies.Prospective approaches include the use of amino acid-based cryoprotectants,deep eutectic solvents,and antioxidants that have been described to prevent oxidative damage and maintain DNA integrity.Vitrification,a high-speed freezing technique that prevents ice crystal formation,has demonstrated superior outcomes compared to conventional slow freezing.Moreover,the Direct Dropping Method,a cryoprotectant-free approach,has been introduced as a contamination-minimizing technique that preserves sperm functionality.Multiomics tools are also utilized to determine biomarkers for protocol optimization.Despite these advancements,cryoprotectant toxicity is a central challenge,emphasizing the necessity for safer agents.Future research must focus on long-term sperm functionality and individualized cryopreservation strategies to maximize reproductive outcomes.The current review highlights the challenges associated with sperm cryopreservation,explores innovative strategies and novel cryoprotectants,underscores the significance of maintaining DNA integrity,and proposes future research directions to improve fertility preservation outcomes.
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Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation.Additionally,the presence of leukocytes,bacteria,and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development.Hence,removal of leukocytes,bacteria,and dead spermatozoa is an important step of sperm processing for assisted reproduction.Currently,several sperm processing techniques have been evolved and optimized in the field of assisted reproduction.The requirements for in vitro fertilization(IVF),intracytoplasmic sperm injection(ICSI),and testicular sperm extraction(TESE)are different than those of intrauterine insemination(IUI).The yield of as many motile,morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure.In ICSI,where injection of a single spermatozoon into the oocyte is performed by the embryologist,sperm selection techniques play a crucial role in the ICSI procedure.Finally,sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing.Additionally,sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.
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Rationale:Recurrent pregnancy loss and recurrent implantation failure are frequently linked to immune dysregulation,particularly heightened natural killer(NK)cell activity,cytokine imbalance,and autoantibody presence.Lipid emulsion therapy,originally designed for parenteral nutrition,is increasingly recognized for its immunomodulatory potential in reproductive medicine.Patient concerns:A 34-year-old woman with five years of infertility,four first-trimester miscarriages,and three failed in vitro fertilization(IVF)cycles despite transfer of morphologically optimal embryos presented for evaluation.Diagnosis:Routine genetic,endocrine,metabolic,thrombophilia,and anatomical investigations were unremarkable.Immunological testing revealed elevated antiphospholipid and anti-thyroid peroxidase(anti-TPO)antibodies,increased NK cell activity,an imbalanced Th1/Th2 cytokine ratio,and raised tumor necrosis factor-alpha(TNF-α),suggesting immune-mediated reproductive dysfunction.Interventions:The patient underwent IVF with transfer of a single euploid blastocyst following intravenous lipid emulsion therapy(20%,100 mL),administered before transfer,on transfer day,and biweekly until 12 weeks.Associated therapies included aspirin,enoxaparin,progesterone,levothyroxine,and supplementation.Outcomes:Serum beta-human chorionic gonadotropin(β-hCG)and ultrasound confirmed pregnancy with subsequent NK cell normalization.The pregnancy was uncomplicated,resulting in spontaneous vaginal delivery of a healthy male infant.Lessons:Lipid emulsion therapy may improve implantation and pregnancy outcomes in immune-mediated recurrent pregnancy loss and recurrent implantation failure,but larger trials are required to validate efficacy and optimize protocols.
