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Background: Diastrophic dysplasia is a rare autosomal recessive disorder characterized by abnormalities in bone and cartilage development, caused by pathogenic variants in the SLC26A2 gene. Case presentation: This article presents a clinical case of preimplantation genetic testing for monogenic disorders (PGT-M) conducted for a family with two previous pregnancy losses due to diastrophic dysplasia in the fetus. We report a previously uncharacterized variant c.1358C > T in the SLC26A2 gene associated with diastrophic dysplasia. We detail the approach to performing PGT-M in the absence of material from the proband and close relatives from one partner for analysis. A testing system was developed to analyze pathogenic variants in the SLC26A2 gene, alongside with indirect markers such as short tandem repeats and single nucleotide polymorphisms. This allowed us to identify linkage groups associated with the analyzed pathogenic variants during the in vitro fertilization cycle with PGT-M, enabling the selection of an embryo that did not inherit pathogenic variants from either parent. The transfer of this embryo resulted in a successful pregnancy, resulting in the birth of a healthy child. Conclusion: To our knowledge, this is a first report of variant c.1358C > T in the SLC26A2 gene associated with diastrophic dysplasia. The successful application of PGT-M enabled the selection of an embryo free from inherited pathogenic variants from both parents, highlighting the importance of PGT-M in improving reproductive outcomes for affected families. [ABSTRACT FROM AUTHOR]

Background: The study aimed to compare the pregnancy, prenatal, and postnatal outcomes between fresh and frozen embryo transfer (ET) in intracytoplasmic sperm injection (ICSI) cycles at Al-Zahra Referral Women's Hospital in northwest Iran. Methods: A prospective study was conducted among all infertile women (N = 469) who underwent embryo transfer between 2018 and 23 at Al-Zahra referral infertility center. Patients in cycles with fresh embryo transfer and patients for whom frozen embryos were transferred were compared in terms of live birth rate and fetal outcomes. Multiple logistic regression analysis was used to estimate adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results: The majority of the participants were primary infertility 83.3%. The rate of chemical and clinical pregnancy was (21.8% vs. 17.2%) and (19% vs. 13.4%) in the fresh embryo and the frozen embryo transfers, respectively. Likewise, the rate of live births was (14.1% vs. 9.1%), respectively. The number of retrieved oocytes was significantly higher in frozen ET compared to fresh ET (P = 0.001). In the final analysis, after adjusting for potential confounders, no significant associations were found for clinical pregnancy (AOR = 1.51; 95% CI: 0.90–2.5; P = 0.125) and chemical pregnancy (AOR = 1.31; 95% CI: 0.81–2.3; P = 0.238) rates between fresh and frozen ETs. Similarly, there were no significant differences in live birth rate (AOR = 1.6; 95% CI: 0.54–12.4), preterm birth (AOR = 0.62; 95% CI: 0.33–5.5), and primary infertility (AOR = 0.73; 95% CI: 0.34–1.6) between fresh and frozen ETs. The incidence of multiple pregnancies and spontaneous abortion was (5% vs. 13.8%) and (22.2% vs. 30.2%) in the fresh embryo and frozen embryo groups, respectively. Conclusion: No significant differences in perinatal and postnatal outcomes were found between fresh and frozen embryo transfers. [ABSTRACT FROM AUTHOR]

Background: Few previous studies have addressed the impact of COVID-19 infection status on assisted reproductive technology outcomes. The purpose of this study was to assess whether COVID-19 infection affects ovulation induction outcomes and the laboratory outcomes of women undergoing assisted reproductive technology treatment. Methods: In total, 363 patients were divided into three groups: the COVID-19 infection group (group A, n = 49), the COVID-19 recovery group (group B, n = 119) and the COVID-19 non-infection group (group C, n = 195). Intergroup comparisons of baseline characteristics, stimulation characteristics and laboratory outcomes were performed. Results: The Gn dosage in group A was significantly higher than those in groups B and C. The duration of Gn treatment was longer in group A than in group B. In group B, the number of high-quality blastocysts was lower than that in group C. The rates of blastocyst formation (42.56%) and high-quality blastocyst formation (12.05%) in group B were significantly lower than those in group A (51.51%; P = 0.003, 16.58%; P = 0.026) and C (48.20%; P = 0.005, 16.49%; P = 0.002). The high-quality blastocyst rate in group C (34.20%) was the highest and was different from that in group B (28.33%). The main risk factor for high-quality blastocyst formation according to multivariate logistic regression analysis was recovery from COVID-19 (0.599, 95% CI: 0.360–0.996; P = 0.048). Conclusion: Asymptomatic or mild COVID-19 infection prior to oocyte retrieval may not has a significant negative effect on ovulation induction outcomes or laboratory outcomes, although the number of Gn days and dose of Gn may increase. In addition, we should pay attention to infertile women recovering from COVID-19 infection and be aware of the significant reduction in the number of high-quality blastocysts in this population. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association of sleep quality during pregnancy on in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) and natural conceiving (NC), as well as anxiety, depression, and perceived stress. Methods: This prospective cohort study includes 500 infertile pregnant women undergoing IVF/ICSI and 678 NC women in a Sichuan birth cohort. Data on sleep, anxiety, depression, and stress was collected in the first trimester (T1), second trimester (T2), and third trimester (T3) using integrated questionnaires. Sleep quality is quantified by the Pittsburgh Sleep Quality Index (PSQI) with a cut-point of 5 indicating poor sleep. The Self-rating Anxiety Scale (SAS), the Center for Epidemiologic Study of Depression scale (CES-D), and the Perceived Stress scale (PSS) were used for assessing anxiety, depression, and perceived stress symptoms. Additionally, the matched husbands are surveyed. Multivariable logistic regression models with adjustments for influencing factors were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of sleep quality. Results: In the IVF/ICSI group, 61.1%, 55.5%, and 66.5% of participants in T1, T2, and T3 reported poorer sleep quality compared to the NC group, which had 43.2%, 37.4%, and 46.4% throughout the same trimesters. Additionally, the IVF/ICSI group exhibited higher levels of negative psychological factors as measured by the CES-D and PSS during T1 and T2, showing statistical significance in T1 (P = 0.008, P < 0.001) and T2 (P = 0.038, P < 0.001), except at T3 (P = 0.107, P = 0.253). In addition to psychological factors and IVF/ICSI treatment, poor sleep quality was also associated with advanced age. However, there was no significant difference in sleep quality between the husbands of the IVF/ICSI and NC groups. Conclusion: The study reveals that women receiving IVF/ICSI treatment are at a higher risk of experiencing sleep disturbances throughout their pregnancy compared with women with natural conception. While partners typically do not report major sleep problems, they do exhibit increased anxiety levels. These findings underscore the necessity for screening and addressing sleep issues in women pregnant through assisted IVF/ICSI treatment, to promote their well-being during this critical period. [ABSTRACT FROM AUTHOR]

Objective: Infertile people undergoing assisted reproductive technology (ART) treatment in China may experience severe infertility-related stress and illness anxiety (IA). However, little relevant research has been conducted until now. Design: This study investigated the IA of 340 infertile people undergoing ART treatment, including 43 males, 292 females and 5 who preferred not to answer, in 2 tertiary general public hospitals in Wen Zhou, China. Main Outcome Measures: Blood samples for thyroid-stimulating hormone (TSH) levels were obtained from 107 women to explore the relationship between IA and TSH. The questionnaire contained the Mandarin version of the Fertility Problem Inventory, the Resilient Trait Scale for Chinese Adults and the Whiteley Index, measuring infertility stress, resilience and IA, respectively. Results: An incidence rate of 44.1% of IA among infertile people undergoing ART treatment in China was determined, and 30.2% of men and 46.6% of women had severe IA (χ2 = 4.05, p < 0.05). The risk of severe IA in women was around twice that in men (OR = 2.01, 95% CI: 1.01–4.01). Women's IA level was significantly associated with their TSH level (β = 0.27, p < 0.01). Resilience played a moderating role in the relationship between parenthood importance and illness anxiety. Conclusion: This study highlighted the importance and urgency of providing holistic care for illness anxiety of infertile people undergoing ART treatment in China, especially women. The findings of this study indicated that mind-body therapies and resilience empowerment workshops could be conducive to infertile people's holistic health. [ABSTRACT FROM AUTHOR]

Introduction: Endometriosis can cause of infertility, and evaluation methods for predicting clinical pregnancy outcomes are desired. Extracellular vesicles (EVs) exist in blood and it contains small non-coding RNAs (ncRNAs) that may reflect disease severity. In this study, we investigated small ncRNAs in serum EVs to identify specific biomarkers for predicting clinical pregnancy. Methods: Serum samples were collected from 48 patients who underwent assisted reproductive technology (ART). EVs were successfully isolated from serum samples and characterized using nanoparticle tracking assays, electron microscopy, and western blotting of EV's markers. We performed small RNA sequencing and analyzed microRNA (miRNA) profiles in the infertility patients with and without endometriosis to detect pregnancy-predicting biomarkers. Results: Candidate miRNAs in serum EVs were selected by comparing patients without endometriosis who became pregnant (n = 13) with those who did not (n = 21). A total of 241 miRNAs were detected; however, no trends separated the two groups. Next, EVs from patients with endometriosis were analyzed and divided into pregnant (n = 4) and non-pregnant (n = 10) cases. Among the 224 candidate miRNAs, miRNA profiles of pregnant women with endometriosis were separated from those of non-pregnant women by receiver-operating characteristics (ROC) curve analysis (area under the curve [AUC] > 0.8). In patients with endometriosis, serum EVs may be useful for predicting possible pregnancy before infertility treatment. Finally, we used small RNA sequencing of the tissue to demonstrate that pregnancy-predicting miRNAs in serum EVs were produced from endometriosis lesions. Although no predictors were found from miRNAs in serum EVs without endometriosis, miRNAs in serum EVs of patients with endometriosis could provide novel noninvasive biomarkers to predict pregnancy and have potential clinical applicability in ART. Discussion: Further studies are required to examine the functional importance of these miRNAs to elucidate the pathological mechanisms of endometriosis and pregnancy. [ABSTRACT FROM AUTHOR]

Genetic testing can be used in family law cases to determine paternity, which is the legal identification of a child’s biological father. Once the test is completed, the results can be used to establish or disprove paternity and determine legal obligations such as child support or custody arrangements. While scientific innovation offers this possibility, there may be several other factors and questions that courts have to consider. Addressing such factors is even more challenging when it is concerned with the privacy of children. This case note considers the 2023 decision of the Supreme Court of India in Aparna Ajinkya Firodia v Ajinkya Arun Firodia, which is a milestone regarding the privacy of children in paternity cases. It also considers the need for law to address factors such as the wishes and the free informed consent of the child, while weighing considerations of privacy and the potential of genetic technologies. [ABSTRACT FROM AUTHOR]

Background: Asthenozoospermia (ASZ) accounts for about 20-40% of male infertility, and genetic factors, contributing to 30-40% of the causes of ASZ, still need further exploration. Radial spokes (RSs), a T-shaped macromolecular complex, connect the peripheral doublet microtubules (DMTs) to a central pair (CP), forming a CP-RS-DMT structure to regulate the beat frequency and amplitude of sperm flagella. To date, many components of RSs and their functions in human sperm flagella remain unclear. Methods: We recruited a cohort of 323 infertile males with ASZ between August 2019 and June 2024. Genetic mutations were identified by whole-exome sequencing. Computer-aided sperm analysis, Papanicolaou staining, and electron microscopy were applied to evaluate the motility, morphology, and ultrastructure of spermatozoa, respectively. Protein mass spectrometry, western blotting, and bioinformatic analyses were performed to identify critical components of mammalian RS1 to model its structure and explore the pathological mechanism of IQUB deficiency. Intracytoplasmic sperm injection (ICSI) was applied for the patient and Iqub−/− mice. Results: We identified a novel homozygous IQUB mutation [c.842del (p.L281Pfs*28)] in an ASZ male with normal sperm morphology (ANM), which resulted in the complete loss of IQUB in sperm flagella. Deficiency of RS1, but not RS2 or RS3, was observed in both IQUB842del patient and Iqub−/− mice, and resulted in the reduction of sperm kinetic parameters, indicating the critical role of IQUB in regulating mammalian RS1 assembly and sperm flagellar beat. More importantly, we identified twelve critical components of RS1 in humans and mice, among which RSPH3, RSPH6A, RSPH9 and DYDC1 constituting the head, DYDC1, NME5, DNAJB13 and PPIL6 assembling into the head-neck complex, AK8, ROPN1L, RSPH14, DYNLL1, and IQUB forming the stalk of RS1. Along with the RS1 defect, the IQUB deficiency caused significant down-regulation of the inner dynein arms of DNAH7 and DNAH12, highlighting their nearby location with RS1. Finally, ICSI can effectively resolve the male infertility caused by IQUB genetic defects. Conclusions: We demonstrate that IQUB may serve as an adapter for sperm flagellar RS1 in both humans and mice and consolidated the causal relationship between IQUB genetic mutations and ANM, further enriching the genetic spectrum of male infertility. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of sperm source on cumulative live birth rate (CLBR) after oocyte thaw in autologous oocyte cryopreservation (AOC) patients. Methods: A retrospective cohort study of autologous oocyte thaw patients at an urban academic fertility center from 2006 to 2021. Patients were stratified by sperm source [partner sperm (PS) vs. donor sperm (DS)]. The primary outcome was CLBR per patient. Secondary outcomes were the oocyte survival rate and usable embryo rate. Statistics included Mann–Whitney U, Kruskal–Wallis, Fisher's exact, chi-square, two-sample t-tests, and multiple logistic regression (p < 0.05). Results: A total of 653 patients were included; 455 (69.7%) used PS and 198 (30.3%) used DS. Time from the first AOC to the first thaw did not differ among DS and PS users (56.8 vs. 54.0 months, p = 0.20). PS users were younger at AOC (37.9 vs. 38.5 years, p < 0.001) and thaw (42.3 vs. 43.1 years, p < 0.001). There were equivalent overall CLBRs (39.9% PS vs. 40.6% DS, p = 0.85) and CLBRs in patients < 35 years at AOC (51.2% PS vs. 100% DS, p = 0.18), 35–37 years at AOC (45.9% PS vs. 60.4% DS, p = 0.10), 38–40 years at AOC (35.4% PS vs. 35.2% DS, p = 0.93), 41–42 years at AOC (28.9% PS vs 14.3% DS, p = 0.21), and > 43 years at AOC (12.5% PS vs 16.7% DS, p = 0.83) among PS and DS users. There were no significant differences in the oocyte survival (79% PS vs 80.5% DS, p = 0.08) or the proportion of patients with usable embryos (27.3% vs 27.8%, p = 0.70) between PS and DS groups. Conclusions: In AOC patients, CLBR, oocyte survival rate, and usable embryo rate did not differ based on sperm source. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Does adjuvant growth hormone (GH) therapy in GnRH antagonist cycles improve reproductive outcomes in the general IVF population? SUMMARY ANSWER Empiric adjuvant GH therapy in GnRH antagonist cycles does not improve IVF stimulation results or reproductive outcomes, including implantation, miscarriage, and clinical pregnancy rates. WHAT IS KNOWN ALREADY Previous evidence regarding the benefits of GH therapy in IVF cycles has been inconclusive due to the lack of well-designed, large-scale randomized controlled trials (RCTs) in the general IVF population. STUDY DESIGN, SIZE, DURATION This is a phase III open-label RCT involving 288 patients undergoing antagonist IVF cycles at the Ovo clinic in Montreal, Canada, between June 2014 and January 2020. Patients were randomly assigned at a 1:1 ratio to either the GH or control group. The intervention group received daily 2.5 mg subcutaneous injections of GH from Day 1 of ovarian stimulation until the day of oocyte retrieval, while the control group received standard ovarian stimulation without any adjuvant therapy. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients were expected normal responders. All embryo transfers, both fresh and frozen, resulting from the studied IVF cycle were included in an intention-to-treat and per-protocol analyses. The primary outcome was the clinical pregnancy rate, while secondary outcomes included the number of retrieved oocytes, good-quality embryos, maturation, fertilization, implantation, and miscarriage rates. MAIN RESULTS AND THE ROLE OF CHANCE A total of 288 patients were recruited and randomly assigned at a 1:1 ratio to either the GH or the control group. After excluding cycle cancellations and patients who did not undergo transfer, 105 patients remained in each group. The overall mean age was 38.0 years, the mean BMI was 25.11 kg/m2 and the mean anti-Müllerian hormone was 2.51 ng/ml. The cycle characteristics were similar between both groups. No differences were observed regarding the total dose of gonadotropins (4600 versus 4660 IU for the GH and control groups, respectively, P  = 0.752), days of stimulation (11.4 versus 11.7 days, P  = 0.118), and endometrial thickness (10.63 versus 10.94 mm, P  = 0.372). Both the intention to treat (ITT) and per protocol analyses yielded similar results for stimulation outcomes. In the ITT analysis, no differences were found in the number of follicles ≥15 mm (7.8 versus 7.1, P  = 0.212), retrieved oocytes (11.7 versus 11.2, P  = 0.613), mature oocytes (8.5 versus 8.6, P  = 0.851), maturation rate (73.8 versus 78.4%, P  = 0.060), fertilization rate (64.3 versus 67.2%, P  = 0.388), and good quality embryos (2.5 versus 2.6, P  = 0.767). Reproductive outcomes in fresh embryo transfer showed no difference for implantation rate (38.2 versus 39.5%, P  = 0.829), miscarriage rate (26.5 versus 31.1%, P  = 0.653), clinical pregnancy rate (43.6 versus 50.0%, P  = 0.406, rate difference, 95% CI: −0.06 [−0.22, 0.09]), and live birth rate (32.1 versus 33.3%, P  = 0.860). The number of embryos needed to achieve a clinical pregnancy was 3.0 versus 2.5 in the GH and control groups, respectively. Similarly, reproductive outcomes in first frozen embryo transfer showed no difference for implantation rate (31.6 versus 45.3%, P  = 0.178), miscarriage rate (28.6 versus 26.3%, P  = 0.873), clinical pregnancy rate (35.1 versus 44.2%, P  = 0.406, P  = 0.356, rate difference, 95% CI: −0.09 [−0.28, 0.10]), and live birth rate (22.8 versus 32.6%, P  = 0.277). The number of embryos needed to achieve a clinical pregnancy was 3.1 versus 2.4 in the GH and control groups, respectively. LIMITATIONS, REASONS FOR CAUTION The study focused on expected normal responders, limiting its applicability to other patient populations such as poor responders. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that adding GH therapy to ovarian stimulation in GnRH antagonist cycles may not benefit the general IVF population. Additional high-quality RCTs are warranted to identify subgroups of patients who might benefit from this treatment. STUDY FUNDING/COMPETING INTEREST(S) EMD Serono Inc. Mississauga, Canada, supplied Saizen® for the study, free of charge. In addition, they provided funding for the statistical analysis. I-J.K. declares grants or contracts from Ferring Pharmaceuticals, consulting fees from Ferring Pharmaceuticals, honoraria from Ferring Pharmaceuticals and EMD Serono, support for attending meetings or travel from Ferring Pharmaceuticals and EMD Serono, participation on a Data Safety Monitoring Board or Advisory Board for Ferring Pharmaceuticals, and stock or stock options from The Fertility Partners; W.J. declares support for attending meetings or travel from EMD Serono; and S.P. declares stock or stock options from The Fertility Partners. All other authors have no conflicts of interest to disclose. TRIAL REGISTRATION NUMBER NCT01715324. TRIAL REGISTRATION DATE 25 October 2012. DATE OF FIRST PATIENT'S ENROLMENT 25 June 2014. [ABSTRACT FROM AUTHOR]

Background: Over the years, the numbers of centres performing assisted reproductive technology (ART) have increased in urban regions of Africa. We reviewed a 10-year record of ART in a public hospital in a bid to determine the pregnancy rate and identify factors associated with achieving clinical pregnancy. Materials and Methods: This was a retrospective, analytical, cross-sectional study of 604 women who had undergone in vitro fertilisation (IVF) or IVF/intra-cytoplasmic sperm injection, over a 10-year period, at the [Institute of Fertility Medicine, Lagos State University Teaching Hospital]. Data were obtained from the medical records of couples who had undergone IVF at the study location and analysed using relevant descriptive and inferential statistics. Regression analysis was used to determine possible predictors of clinical pregnancy outcomes at 95% confidence level and significant P value of <0.05. Results: The clinical pregnancy rate observed was 23.7%. Women aged ≥35 years of age had 2.9 odds of achieving pregnancy compared to women <35 years of age. The quality of embryo and dose of the follicle-stimulating hormone used were not significantly different when compared in pregnant and non-pregnant women (P = 0.612 vs 0.881). Endometrial preparation techniques, number of embryos transferred, types of embryos transferred, sperm quality, and source of gametes used were not significantly different in pregnant and non-pregnant women. There was a 0.77 odds of achieving pregnancy when a day-5 embryo was used compared to a day-3 embryo (P = 0.008). Conclusion: Overall, these results emphasise the multifaceted nature of IVF outcomes, urging further research to elucidate the intricate factors influencing success rates in assisted reproduction. [ABSTRACT FROM AUTHOR]

Embryo transfer in pigs is a reproductive technology with great potential because it enables the movement of high-value genetic material, in the form of embryos, with reduced transport costs and no health risks. However, its use has been limited for decades despite significant interest, primarily due to the need for laparotomy for embryo collection from donors and deposition into recipients. Over the past 30 years, various procedures have been developed to deposit embryos nonsurgically in the body of the uterus with promising results, but none sufficiently successful. Because the uterine body is not the ideal site for embryo deposition at the morula and blastocyst stages, a new method that is capable of depositing porcine embryos deep into the uterine horn has been developed. This nonsurgical deep uterine method is a simple, effective, and well-tolerated technique in gilts and sows, achieving high fertility and prolificacy using fresh, stored, and vitrified–warmed embryos under field conditions. The present review provides a brief overview of the current status of nonsurgical deep uterine embryo transfer and addresses the varied reproductive performance observed across farms when this technology was applied in commercial programs. In addition, several future directions for its on-farm commercial application are discussed. Nonsurgical embryo transfer in pigs is now a reality. This procedure was previously deemed impossible because of the complex anatomy of the porcine female reproductive tract. However, advancements have overcome these anatomical challenges and allowed embryos to be nonsurgically deposited deep into the uterine horn. The technique is simple and safe, and the promising results with stored and vitrified–warmed embryos mark a significant advance. This technology facilitates genetic exchange with minimal disease transmission, which benefits the pig industry. Photograph by E. A. Martinez. This article belongs to the Collection: Proceedings of the Annual Conference of the International Embryo Technology Society, Fort Worth, TX, USA, 18–22 January 2025. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the effect of Pyridostigmine on IGF-1 and GH levels and the outcomes of COS cycles in women with POR. Methods: A total of 110 eligible women were randomly allocated to Pyridostigmine (n: 55) and control (n: 55) groups. COS outcomes, including gonadotrophin doses, COS duration, cycle cancellation rate, number of retrieved oocytes, number of MII oocytes, and fertilization rate, were compared between the groups. Also, IGF-1 and GH levels were measured at three time points: baseline, on the 5th day of the cycle, and on the trigger day. Results: A total of 92 participants (Pyridostigmine: 44, Control: 48) were included in the final analysis. The Pyridostigmine group required significantly lower gonadotrophin doses (P < 0.0022) and had a shorter COS duration (P = 0.0019). No significant differences were observed in cycle cancellation rate, number of retrieved oocytes, number of MII oocytes, or fertilization rate. Pyridostigmine significantly accelerated GH levels over time compared to the Control group, with larger mean differences observed at each time point. The interaction between time and group indicated that the effect of the intervention on GH levels varied over the course of the COS cycle. Specifically, the intervention augmented the effect of COS agents on GH levels, as evidenced by the higher GH levels observed in the intervention group compared to the control group. For IGF-1 levels, time had a highly significant effect (P < 0.0001), but the interaction between Time and Group was not significant (P = 0.5067). Mean IGF-1 levels were higher in the Pyridostigmine group, though not statistically significant. Conclusion: Pyridostigmine improved COS efficiency by reducing gonadotrophin doses and COS duration. Further research is needed to explore its potential benefits in enhancing ovarian response in women with POR. Trial registry information: Iranian Registry of Clinical Trials (IRCT). Registration date: 2023-08-05, Registration number: IRCT20100518003950N8. [ABSTRACT FROM AUTHOR]

This article examines how the technological intervention of Assisted Reproductive Technologies (ART)3 has had a profound impact on the sociocultural practices surrounding motherhood in India. The experience of motherhood has now been divided among different individuals: the genetic mother, the gestational mother, and the social mother. This expansion of motherhood roles has led to the re-emergence of co-mothering practices, where a child is nurtured by someone other than the birth mother. As nuclear heteronormative families became the norm in India, traditional co-mothering by grandmothers and aunts went out of practice. With rising infertility and the rearrangement of familial structures through single and queer parenting, ART treatments have become socially endorsed alternatives. This article examines the representation of ART-enabled mothering in Bollywood to understand its reception and practice in the Indian sociocultural context. Through a thematic analysis of Filhaal (dir. Gulzar, 2002), Good Newwz (dir. Mehta, 2019), and Mimi (dir. Utekar, 2021), this article explores how the biological experience of motherhood is being reinterpreted by mothers, and how they navigate the stigma associated with infertility and non-biological mothering. Most importantly, this article probes how traditional family structure and gender roles are being restructured following the advent of ART-enabled motherhood. [ABSTRACT FROM AUTHOR]

Traditional socio-cultural constructions of womanhood have often focused on women's reproductive capacity, which has determined their destiny and shaped their identity over centuries. Given the long-time equation of motherhood and women's identity, infertility is an important topic that raises question about how women experience infertility and how science, through advances in assisted reproduction, has intervened in the creation of life. In the European context, Italy has one of the lowest birth rates, a phenomenon attributable to a series of adverse structural conditions. In particular, precarious work conditions, insufficient wage levels, and a high cost of living represent significant obstacles to the materialization of maternity and paternity plans. In the absence of a holistic approach to address these problems, women continue to be held responsible for reproduction. This has created a focus on assisted reproduction treatments and "reproductive tourism," the practice of traveling to another country for reproductive care, as the main solution to the problem of low birth rates. However, this solution poses new ethical dilemmas that can give rise to inequalities among women and can perpetuate the lack of international regulations protecting the rights of all the parties involved. These two issues of assisted reproduction treatments and reproductive tourism can be addressed by the reproductive justice framework that works to ensure social justice and reproductive rights. In recent years, reproductive justice has emerged as a prolific discipline raising awareness and condemning the structural and legislative problems faced by couples who wish to exercise their right to have a child. Considering the theoretical framework of reproductive justice, this paper will analyze the experience of infertility, the desire for motherhood, and the implications that assisted reproduction techniques have for women in the Italian novel Non Chiedermi Come Sei Nata (Don't Ask Me How You Were Born, 2014) by Annarita Briganti. [ABSTRACT FROM AUTHOR]

Objectives: The coexistence of intrauterine twin pregnancy and ectopic pregnancy (EP), known as heterotopic pregnancy, is a rare but potentially life‐threatening condition. In this study, we aimed to investigate the pregnancy outcomes in women with intrauterine twin pregnancies complicated with EP after assisted reproductive technology. Methods: This retrospective study analyzed the medical records of 42 women diagnosed with intrauterine twin pregnancies complicated with EP via ultrasound or surgery at our hospital between January 2005 and December 2020. We collected data on patient general characteristics, high‐risk factors, clinical symptoms, ultrasound features, treatment methods, and pregnancy outcomes. Results: Among the 42 included women, 47.6% (20/42) had a history of tubal surgery, while 52.4% (22/42) and 47.6% (20/42) received the transfer of 2 and 3 embryos, respectively. In terms of treatment, 21.4% (9/42) women received expectant management, whereas 78.6% (33/42) underwent surgical treatment, with laparoscopic surgery accounting for 71.4% (30/42). Tracking the pregnancy outcomes revealed a live birth rate of 81.0% (34/42) and a full‐term birth rate of 50.0% (21/42). The preterm birth rate was 31.0% (13/42), with a breakdown of 1 singleton (7.7%, 1/13) and 12 twin births (92.3%, 12/13) among the total 13 premature deliveries. Among the neonates, 33.3% (14/42) were singletons and 47.6% (20/42) twins. Caesarean section accounted for 31 out of 34 deliveries (91.2%). Conclusions: Though the incidence of EP in twin pregnancies has declined in the last decade, early diagnosis and proper management are still crucial for favorable outcomes in twin pregnancies with EP. [ABSTRACT FROM AUTHOR]

Elevated progesterone (EP) or inadequate progesterone levels during ART cycle monitoring may lead to cycle cancellations or further progesterone supplementation, but practice varies. It remains controversial whether modifying clinical practice in the presence or absence of EP improves clinical outcomes. This systematic review aims to investigate if progesterone levels at different phases of fresh and frozen ART cycles influence pregnancy outcomes, in particular, that pertaining to day 3 versus day 5 embryo transfers. A systematic search of EMBASE, MEDLINE, CINAHL, PubMed, SCOPUS and Web of Science identified studies from the year 2000. We included studies with women undergoing fresh and frozen IVF/ICSI cycles; with extractable per woman data on pregnancy outcomes where serum progesterone measurement was performed. We excluded interventional studies that influence clinical decisions or studies with donor cycles. The Newcastle Ottawa Scale (NOS) was used to determine the risk of bias. The primary outcome was LBR, and the secondary outcomes were OPR, CPR and MR. PICOS study protocol was used to include non-randomized studies of interventions (NRSI). Analysis was done using RevMan5 and the studies were pooled using the DerSimonian and Laird for random effects meta-analysis. The study was registered with PROSPERO (registration ID CRD42022382423). 64 studies (N = 57,988 women) were included. In fresh cycles, there is no evidence that at baseline EP impacts LBR (P > 1.5 ng/ml, OR 0.76 [95% CI 0.39–1.49], 2 studies, N = 309) and CPR (P > 1.5 ng/ml, OR 0.81 [0.38–1.71], 2 studies, N = 309). EP at ovulation trigger is associated with a lower LBR (P > 1.0 ng/ml, OR 0.40 [0.23–0.69], 2 studies, N = 2805) and CPR (P > 1.0 ng/ml, OR 0.49 [0.42–0.58], 3 studies, N = 3323; P > 1.1 ng/ml, OR 0.66 [0.53–0.83], 2 studies, N = 2444; P > 1.2 ng/ml, OR 0.61 [0.39–0.96], 6 studies, N = 844; P > 1.5 ng/ml, OR 0.37 [0.17–0.81], 6 studies, N = 13,870; P > 2.0 ng/ml, OR 0.43 [0.31–0.59], 3 studies, N = 1949) with D3 embryo but not D5 [LBR (P > 1.5 ng/ml, OR 1.02 [0.74–1.39], 3 studies, N = 5174) and CPR (P > 1.5 ng/ml, OR 0.88 [0.67–1.14], 6 studies, N = 5705)]. We could not meaningfully meta-analyse studies on the day of egg collection in fresh cycles, embryo transfer in fresh cycles, at ovulation trigger or before ovulation in natural FET cycles and FET cycles due to significant study heterogeneity. We acknowledged the limitations on including studies post year 2000 and the exclusion of studies with multiple observations, which may result in inherent publication bias and some confounding factors uncontrolled for. In conclusion, in controlled ovarian stimulation, EP at baseline did not impact on LBR; EP at ovulation trigger is associated with a lower LBR for D3 but not for D5 embryo transfer. In FET cycles, as the studies were heterogeneous, we were unable to combine the data in a meaningful way. This review is sponsored by Complete Fertility and the Ministry of Health, Malaysia. [ABSTRACT FROM AUTHOR]

Assisted reproductive technology (ART) pregnancies present a higher risk of singleton preterm birth than natural pregnancies, but the underlying molecular mechanism remains largely unknown. RNA m6A modification is a key epigenetic mechanism regulating cellular function, but the role of m6A modification, especially its "reader" YTHDC1, in preterm delivery remains undefined. To delineate the role and epigenetic mechanism of m6A modification in ART preterm delivery, the effects of YTHDC1 on trophoblastic function were evaluated by CCK-8, EdU, Transwell, and flow cytometry analyses post its overexpression or knockdown. Downstream signaling pathways of YTHDC1 were investigated by RNA-seq, and targeted mRNAs were explored by RIP-seq and MeRIP-seq. Upstream transcriptional factors of YTHDC1 were determined by ChIP-seq and luciferase reporter assays. Elevated YTHDC1 was detected in human ART-conceived preterm placentas and in murine preterm placentas post estradiol (E2) exposure. In vitro experiments showed that YTHDC1 promoted trophoblastic cell proliferation and migration, but inhibited cell apoptosis. Mechanistically, E2 was proven to upregulate YTHDC1 expression via retinoid X receptor alpha (RXRA) in trophoblastic cells. Enhanced YTHDC1 expression augmented the translation of RPL37 in an m6A-dependent manner by binding to m6A-modified RPL37 mRNA and concomitantly promoted the overall translational output. Importantly, administration of siRNA targeting YTHDC1 effectively delayed the progression of preterm delivery. In conclusion, the identified E2/RXRA/YTHDC1/RPL37 axis provides new insights into the epigenetic mechanism underlying ART-associated preterm delivery. The findings offer a potential prognostic biomarker and therapeutic target for preterm delivery. [ABSTRACT FROM AUTHOR]