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Background: Repeated implantation failure (RIF) refers to the condition where high quality embryos are unable tosuccessfully implant after multiple cycles of in vitro fertilization (IVF) treatment. The aim of this study is to investigatethe impact of intrauterine granulocyte colony-stimulating factor (G-CSF) and platelet-rich plasma (PRP) onpregnancy rate in patients with RIF.Materials and Methods: The present randomised clinical trial study was conducted at the IVF Centre of MehrMedical Institute in Rasht, Iran, from 2020 to 2022. The research consisted of 200 individuals who had experiencedmultiple failed cycles. These patients were randomised into two groups: intrauterine infusion of 1 ml of G-CSF andintrauterine infusion of 1 ml autologous PRP at least 48 hours before embryo transfer (ET). The groups were comparedin terms of implantation rate, and chemical, clinical, and ongoing pregnancy.Results: The implantation rate was significantly higher in patients who received PRP (P=0.016). Chemical pregnancy inthe PRP group was significantly higher than G-CSF group (P=0.003). Both clinical pregnancy and ongoing pregnancyrates were significantly higher in the PRP group (P=0.001) compared to the G-CSF group (P=0.02).Conclusion: The utilisation of PRP via intrauterine infusion is considerably more successful than G-CSF in enhancingpregnancy and live birth rates among patients with RIF.

Background: Repeated implantation failure (RIF) refers to the condition where high quality embryos are unable to successfully implant after multiple cycles of in vitro fertilization (IVF) treatment. The aim of this study is to investigate the impact of intrauterine granulocyte colony-stimulating factor (G-CSF) and platelet-rich plasma (PRP) on pregnancy rate in patients with RIF. Materials and Methods: The present randomised clinical trial study was conducted at the IVF Centre of Mehr Medical Institute in Rasht, Iran, from 2020 to 2022. The research consisted of 200 individuals who had experienced multiple failed cycles. These patients were randomised into two groups: intrauterine infusion of 1 ml of G-CSF and intrauterine infusion of 1 ml autologous PRP at least 48 hours before embryo transfer (ET). The groups were compared in terms of implantation rate, and chemical, clinical, and ongoing pregnancy. Results: The implantation rate was significantly higher in patients who received PRP (P=0.016). Chemical pregnancy in the PRP group was significantly higher than G-CSF group (P=0.003). Both clinical pregnancy and ongoing pregnancy rates were significantly higher in the PRP group (P=0.001) compared to the G-CSF group (P=0.02). Conclusion: The utilisation of PRP via intrauterine infusion is considerably more successful than G-CSF in enhancing pregnancy and live birth rates among patients with RIF. [ABSTRACT FROM AUTHOR]

To explore whether intracytoplasmic sperm injection (ICSI) would increase the malformation risk in fetuses and live births compared with conventional in vitro fertilization (IVF). Retrospective cohort study. Data were collected from couples who underwent conventional IVF or ICSI from January 2009 to December 2019 at the Center for Reproductive Medicine of Peking University Third Hospital in the People's Republic of China. A total of 46,167 conventional IVF fresh transfer cycles and 33,247 ICSI fresh transfer cycles were included. Intracytoplasmic sperm injection and conventional IVF. The primary outcomes were congenital abnormalities in live births. The secondary outcomes included the pregnancy outcomes, the malformations among the miscarriages, specific types of malformations in live births, birth weight, and sex. The rates of congenital malformations in conventional IVF and ICSI were 5.44‰ and 5.78‰, respectively. There was no statistically significant difference between the two groups, as indicated by the adjusted odds ratio of 1.098 (95% confidence interval 0.787, 1.532). The rates of specific malformations were comparable between ICSI and IVF. Additionally, no discernible disparities were noted in pregnancy outcomes, the malformations among the miscarriages,birth weight between the two groups. Our study suggested the safety of ICSI and provided novel evidence by comparing pregnancy outcomes and congenital malformations in offspring between patients undergoing conventional IVF and ICSI. [ABSTRACT FROM AUTHOR]

Background: Hyaluronan (HA) sperm selection, utilizing the affinity of mature sperm for HA, has emerged as a technique to enhance the selection of sperm for intracytoplasmic sperm injection (ICSI). However, conflicting evidence exists regarding the impact of HA-ICSI on clinical outcomes including fertilization, embryo utilization, and pregnancy rates. The study aimed to compare clinical outcomes including fertilization, utilization, and pregnancy rates between paired ICSI and HA-ICSI cycles within patients, particularly for male factor and low utilization subgroups. Methods: A retrospective study from 3,988 ICSI treatment cycles was conducted between January 2018 and March 2022. A HA-ICSI cycle was paired with the preceding ICSI cycle from the same patient. Fertilization, utilization, and clinical pregnancy rates were compared based on infertility diagnosis and utilization rate (UR) from the initial ICSI cycle. Results: There were no differences in fertilization, utilization, embryo quality, euploidy, or pregnancy rates between ICSI and HA-ICSI in all paired cycles. However, for patients with male factor infertility UR increased from 25.0% to 38.5% in their HA-ICSI cycle ([Formula: see text]). There was no difference observed for female factor infertility patients. HA-ICSI use was of particular benefit for male factor infertility patients with low ([Formula: see text]) embryo utilization in their initial ICSI cycle, evident by an increased utilization from 14.3% to 25.0% in their HA cycle ([Formula: see text]). Conclusions: This is the first study to focus on the impact of HA-ICSI on embryo utilization, particularly in patients with male factor infertility. The efficacy of HA-ICSI as a sperm selection tool appears to be limited to improving UR in patients with male factor infertility, particularly those with low utilization in a previous ICSI cycle, with no significant effect on fertilization or pregnancy rates. Conclusion: HA-ICSI may be useful for sperm selection at the time of ICSI for a select subgroup of patients. Male factor infertility patients, who have previously undertaken an ICSI cycle with less than 40% utilization, should be considered as candidates for treatment.

Objective To explore the correlation between seminal plasma oxidative stress and reproductive hormone levels with teratospermia and ICSI outcome. Methods A total of 206 male infertility patients from the reproductive medicine center of our hospital from August 2021 to December 2022 were selected as the research objects. They were grouped according to the fifth edition of the World Health Organization’s Handbook on Human Semen Testing and Processing Laboratories, of which 120 patients with percentage of normal sperm morphology ＜ 4% were included in the teratospermia group. 86 cases with percentage of normal sperm morphology ≥4% were included in the normal group. The levels of seminal plasma oxidative stress (reactive oxygen species (ROS), superoxide dismutase (SOD)) and reproductive hormones (follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T)) were detected in both groups. The influencing factors of teratospermia were analyzed. The ICSI rates of patients with different spermatozoa oxidative stress and reproductive hormone levels were compared in the teratospermia group. The correlation between the severity of teratozoospermia and seminal oxidative stress and reproductive hormone levels was analyzed. Results The proportions of advanced age, higher body mass index, smoking, drinking, varicocele and diabetes in the teratospermia group were higher than those in the control group, while sperm activity rate and forward movement sperm rate were lower than those in the control group (P＜0.05). Levels of ROS, FSH and LH in spermatozoa group were higher than those in the control group, while the levels of SOD and T in the spermatozoa group were lower than those in the control group (P＜0.05). Smoking, varicocele and ROS were independent risk factors for teratospermia, while SOD and T were independent protective factors for teratospermia (P＜ 0.05). In the teratospermia group, the fertilization rate was decreased with the increase of ROS level, and it was increased with the increase of seminal plasma SOD and T level (P＜0.05); Spearman’s correlation analysis showed a positive correlation between the severity of teratospermia and the level of seminal plasma ROS (r=0.832, P＜0.001). Furthermore, a negative correlation was observed between the severity of teratospermia and the level of SOD (r=-0.825, P＜0.001). However, there was little correlation between the severity of teratospermia and the level of T (r=0.206, P=0.024). Conclusion Oxidative stress and abnormal expression of reproductive hormones are closely related to the occurrence of teratospermia and affect the outcome of ICSI. [ABSTRACT FROM AUTHOR]

Objective: To explore the impact of poly-pronucleus (PN) incidence on the embryonic development and pregnancy outcome after intracytoplasmic sperm injection (ICSI). Methods: This is a retrospective cohort study, analyzing the clinical data of patients after ICSI between January 2016 and December 2021. The objects of study were divided into three groups according to the proportion of poly-PN: the control group (the proportion of poly-PN=0%, n=333), the low-frequency poly-PN group (0%＜the proportion of poly-PN＜20%, n=80) and the high -frequency poly -PN group (the proportion of poly -PN ≥20%, n =31). The embryonic development and pregnancy outcomes were compared among the groups, respectively. Results: The numbers of oocytes retrieved and available embryos on day 3 (D3) were higher in the low-frequency poly-PN group than those in the control group, but the rates of normal fertilization and high -scoring blastocyst formation were lower than those in the control group (all P＜0.017). Compared with the control group and the low-frequency poly-PN group, the high-frequency poly-PN group had lower rate of normal fertilization rate, lower number of available embryos on D3 (all P＜0.017), and low rate of biochemical pregnancy and high miscarriage rate (but P＞0.017). Multifactorial Logistic analysis showed that patients in the high-frequency poly-PN group had significantly lower biochemical pregnancy rate and live birth rate when compared with the control group (aOR=0.402, 95%CI: 0.186-0.870, aP=0.021; aOR=0.247, 95%CI: 0.068-0.901, aP=0.034). Conclusions: In the ICSI cycles, the incidence of poly-PN may reflect oocyte quality, and the incidence of poly -PN ≥20% may predict the poor embryo development, lower biochemical pregnancy rate and lower live birth rate. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the efficacy of physiological intracytoplasmic sperm injection (PICSI) and intracytoplasmic sperm injection (ICSI) in terms of the fertilization rate and embryo quality using sibling oocyte cycles. Methods: This prospective, cross-sectional study collected data from 76 couples who underwent their first cycle at the Hue Center for Reproductive Endocrinology and Infertility, Vietnam, between May 2019 and November 2021. The inclusion criteria were cycles with at least eight oocytes and a sperm concentration of 5×106/mL. Sperm parameters, sperm DNA fragmentation (SDF), fertilization, and the quality of cleavage-stage embryos on day 2 and blastocysts on day 5 were examined. Results: From 76 ICSI cycles, 1,196 metaphase II (MII) oocytes were retrieved, half of which were randomly allocated to either the PICSI (n=592) or ICSI (n=604) treatment group. The results showed no significant difference between the two groups in terms of fertilization (72.80% vs. 75.33%, p=0.32), day 2 cleavage rate (95.13% vs. 96.04%, p=0.51), blastulation rate (52.68% vs. 57.89%), and high-quality blastocyst rate (26.10% vs. 31.13%, p=0.13). However, in cases where SDF was low, 59 cycles consisting of 913 MII oocytes produced a considerably higher blastulation rate with PICSI than with ICSI (50.49% vs. 35.65%, p=0.00). There were no significant differences between the pregnancy outcomes of the PICSI and ICSI embryo groups following embryo transfer. Conclusion: Using variable sperm quality provided no benefit for PICSI versus ICSI in terms of embryo outcomes. When SDF is low, PICSI appears to be able to produce more blastocysts. [ABSTRACT FROM AUTHOR]

Background: The outcomes of the use of commercial in vitro maturation (IVM) medium to culture immature oocytes obtained from conventional ovulation induction, followed by rescue intracytoplasmic sperm injection (RICSI), are not ideal. It is thus difficult to widely adopt this approach in clinical practice. Therefore, it is necessary to explore methods for improving the clinical outcome of IVM., Aim: To study the effect of sperm on the developmental potential of in vitro-matured oocytes in conventional culture., Methods: This was a retrospective study of patients whose immature oocytes were harvested from conventional oocyte stimulation cycles and underwent ICSI at our hospital between June 2018 and August 2020. RICSI was performed using sperm collected on the day of oocyte harvest (old) and sperm collected on the day of RICSI (fresh) and oocytes matured in vitro after 24 h of culture in conventional medium. The rates of in vitro oocyte maturation, normal fertilization, normal cleavage, day-3 top-quality embryos, and useful blastocyst formation were compared between the two groups., Results: In total, 102 germinal vesicle (GV)-stage immature oocytes were cultured in the old sperm group. In the fresh sperm group, 122 GV-stage immature oocytes were collected and cultured in vitro for 24 h. There were no significant differences in the general conditions of males and females between the two groups ( P > 0.05). The oocyte maturation, normal fertilization, and normal cleavage rates of the old and fresh groups were 51.0% vs 55.7%, 61.5% vs 64.7%, and 93.8% vs 93.2%, respectively. None of the rates differed significantly ( P > 0.05) between the two groups. However, the day-3 top-quality embryo and useful blastocyst rates of the old and fresh sperm groups were 16.6% vs 63.4%; 6.67% vs 34.6%, respectively. The day-3 top-quality embryos and useful blastocyst rates of the old sperm group were significantly lower than those of the fresh group ( P < 0.05)., Conclusion: In vitro maturation with conventional culture medium combined with the use of fresh sperm collected on the day of RICSI is an easy-to-implement strategy for patients whose oocytes are completely or mostly immature., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)