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STUDY QUESTION Does advanced male partner's age impact live birth rates (LBRs) in IVF treatment when female partner's age is factored in? SUMMARY ANSWER In fresh IVF cycles LBRs decline with male partner's age ≥40 years when the female partner is aged 35–39 years, irrespective of the presence or absence of male factor; but not when the female partner is <35 years or ≥40 years of age; this decline is not observed in ICSI cycles. WHAT IS KNOWN ALREADY Advanced paternal age is associated with declining sperm parameters, impaired embryo development, compromised pregnancy outcomes, and abnormalities in the offspring in IVF/ICSI cycles. However, data on the interaction between maternal and paternal age on IVF outcomes are very limited and inconsistent. No significant effect of male partner's age on pregnancy outcomes has been noted in donor oocyte cycles. STUDY DESIGN, SIZE, DURATION Retrospective analysis of all eligible autologous IVF/ICSI cycles with oocyte retrieval and intended fresh embryo transfer (ET) from the UK's national anonymized registry, published online by the Human Fertilisation and Embryology Authority (HFEA). There were 59 951 cycles that qualified the inclusion criteria in the study period: 1 January 2017 to 31 December 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS Couples underwent IVF (n = 27 226) or ICSI (n = 32 725) treatment with partner's sperm followed by fresh ET due to unexplained (n = 31 846), tubal (n = 6605), or male infertility (n = 22 905). Treatment cycles with endometriosis (n = 5563), ovulatory disorders (n = 9970), female partner aged >44 years (n = 636), and PGT (n = 280) were excluded. Women were stratified by age in the following groups: <35, 35–39, 40–42, and 43–44 years; male partner's age as <35 (reference group), 35–37, 38–39, 40–42, 43–44, 45–50, 51–55, 55–60, and >55 years as presented by the HFEA. Some age-groups were merged in the analysis to increase the population size. Chi-square test was used to compare binominal data; and multiple logistic regression to find any association between male and female age-groups on live birth adjusting for other confounders that had a significant effect on this outcome. MAIN RESULTS AND THE ROLE OF CHANCE LBRs per oocyte retrieval as well as per ET were no different across the male partners' age-groups when the female partners were aged <35 years or in 40- to 44-year age-group, whether male-factor infertility was included or excluded and whether it was IVF or ICSI cycle. However, when IVF was the method of insemination in the female partner's age-group of 35–39 years, LBRs per oocyte retrieval dropped significantly from 27.0% in the male age-group of <35 years (reference group) to 22.9% (P  = 0.002), 22.0% (P  = 0.006), and 18.8% (P  = 0.004) in 40–44, 45–50, and >50 years age-group, respectively in population that included male-factor infertility. Likewise, LBR per retrieval declined from 27.6% in 35 years age-group to 23.5% (P  = 0.002) and 22.2% (P  = 002) in 40–44 years and older groups, respectively in cycles without male infertility. However, there was no impact of male age on LBR in any female partner's age-group when ICSI was performed in either the presence or the absence of male infertility. A similar decline in the LBR per retrieval and per ET was observed in female age-group of 35–39 years in the analyses with IVF and ICSI cycles combined. The inference remained unchanged when only the first treatment cycle was included (per patient analysis) or when single blastocyst transfer cycles were analysed, eliminating the impact of the number and stage of embryo transferred. After adjusting for confounders including male age, female age, number of previous treatment cycles, previous live birth, insemination method (IVF or ICSI), number of embryos transferred, and day (stage) of ET, male partner's age remained significantly associated with LBR in the female age-group of 35–39 years, but not when women were in <35 years or 40- to 44-year age-group, in population including as well as excluding male infertility. Miscarriage rates per single ET trended to rise (non-significantly) in IVF as well as ICSI cycle only when men were over 55 years and female partners aged <40 years, particularly when male infertility was excluded. LIMITATIONS, REASONS FOR CAUTION Information on ovarian reserve and stimulation protocols was not available. This probably would have had little impact, given the large size of the population studied. The ages of female and male partners were given in groups necessitating taking them as ordinal variable in the regression analysis. Cumulative LBRs could not be determined as the information on subsequent frozen-thawed ET cycles could not be traced and the severity or cause of abnormal semen parameters were not present in the HFEA database. Some age-groups with small number of patients were merged to obtain a reliable result. WIDER IMPLICATIONS OF THE FINDINGS This is the largest clinical data to support the laboratory evidence of the ability of oocytes from young women to reverse the age-related deterioration of sperm quality. As the ageing oocytes lose this reparatory mechanism, the ageing sperm exert a detrimental effect on the LBR. The message of this study is important in counselling of patients and planning out treatment. Further research on interaction between male and female age will increase our understanding of this matter and help to establish whether ICSI procedure is more appropriate for older male partners even when there is no apparent semen abnormality. STUDY FUNDING/COMPETING INTEREST(S) No funding was required. There is no competing interest. TRIAL REGISTRATION NUMBER N/A (retrospective analysis). [ABSTRACT FROM AUTHOR]

Abstract This study aimed to explore the relationship between female age and pregnancy outcomes in patients undergoing their first elective single embryo transfer (eSET) of in vitro fertilization (IVF) cycles. The retrospective cohort study encompassed 7089 IVF/intracytoplasmic sperm injection (ICSI) patients of the Reproductive Medicine Center, Henan Provincial Peoples’ Hospital of China, from September 1, 2016, to May 31, 2022. Patients all received the first eSET in their IVF/ICSI cycles. A generalized additive model (GAM) was employed to examine the the dose–response correlation between age and pregnancy outcomes, namely the clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR). Logistic regression model was employed to ascertain the correlation between the CPR/OPR and age. The study cohort has an average age of 30.74; 3843 patients got clinical pregnancy rate of 61.40% and ongoing pregnancy rate of 54.21%. The multiple pregnancy rate of is 1.24%. For patients aged 34 and above, the CPR decreased by 10% for every 1-year increase in age (adjusted OR 0.90, 95% CI 0.84–0.96, p

To find a useful tool for estimating the minimum number of metaphase II (MII) oocytes needed to obtain at least one euploid blastocyst according to female age. Retrospective analysis of in vitro fertilization (IVF) treatment cycles with preimplantational genetic testing for aneuploidies (PGT-A) performed over 5 years in IVIRMA Valencia (Spain), January 2017–March 2022. Approval from the Institutional Review Board of IVI Valencia (2204-VLC-040-CR). Private infertility clinic in Spain. Eligible patients were undergoing their first IVF-PGT-A treatment cycle, in which at least one MII oocyte was obtained, regardless of oocyte and semen origin. Oocyte donation cycles were included in the donor group (≤34 years old). Treatment cycles from women with their own oocytes were selected only when the oocytes were aged ≥35 years (patient group). Only trophoectoderm biopsies performed on days 5 or 6 of development and analyzed using next-generation sequencing were included. Preimplantational genetic testing for aneuploidy cycles because of a known abnormal karyotype were excluded. Not applicable. Number of MII oocytes needed to obtain one euploid blastocyst according to female age. A total of 2,660 IVF-PGT-A treatment cycles were performed in the study period in the eligible population (patients group = 2,462; donors group =198). The mean number of MII oocytes needed to obtain one euploid blastocyst increased with age, as did the number of treatment cycles that did not get at least one euploid blastocyst. An adjusted multivariate binary regression model was designed using 80% of the patient group sample (n = 2,462; training set). A calculator for the probability of obtaining at least one euploid blastocyst was created using this model. The validation of this model in the remaining 20% of the patient group sample (n = 493; validation set) showed that it could estimate the event of having at least one euploid blastocyst with an accuracy of 72.0%. Our results show a preliminary model capable of predicting the number of MII oocytes needed to obtain at least one euploid blastocyst according to female age, calculated with the largest database of IVF-PGT-A treatment cycles ever used for this purpose, including only treatment cycles using next-generation sequencing on trophoectoderm biopsies. Once this model has been properly validated, it could help with decision-making for both clinicians and patients coming to an infertility clinic. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Which specific groups of women would not benefit from repeated frozen embryo transfers (FETs)? SUMMARY ANSWER Women over 45 years of age should stop treatment after three FET attempts due to the absence of further benefits, while women aged 40–45 years and those with a diminished ovarian reserve and other causes of infertility have a lower chance of improving their cumulative live birth rate (CLBR) within five FET cycles and experience fewer advantages from repeated transfers. WHAT IS KNOWN ALREADY In real-life scenarios of ART, women who fail to achieve a live birth often choose to undergo repeated FETs via the freeze-all strategy. STUDY DESIGN, SIZE, DURATION This retrospective study included 43 972 women who underwent 86 496 oocyte retrieval cycles and 82 022 FET cycles between January 2010 and March 2023 under the freeze-all strategy. PARTICIPANTS/MATERIALS, SETTING, METHODS We categorized the population based on the female's age at the first oocyte pick-up (OPU) cycle (Groups 1–6: <30, 30–34, 35–39, 40–42, 43–44, and ≥45 years of age), number of retrieved oocytes at the first OPU cycle (Groups 1–5: 1–5, 6–10, 11–15, 16–20, and >20 oocytes), and causes of infertility (Groups 1–9: tubal factor, male factor, polycystic ovary syndrome, diminished ovarian reserve, endometriosis, other uterine factors, combined factors, unexplained infertility, and other infertility) to analyse their CLBRs within different FET cycles via Kaplan–Meier analysis (optimistic method) and the competing risk method (conservative method). We utilized multivariate Cox and Fine–Gray models to examine the associations between the CLBR and age, the number of retrieved oocytes, and nine causes of infertility. MAIN RESULTS AND THE ROLE OF CHANCE The CLBR decreased with increasing female age over five FET cycles (Groups 1–6: optimistic method: 96.4%, 94.2%, 86.0%, 50.2%, 23.1%, and 10.1%; conservative method: 87.1%, 82.0%, 67.8%, 33.9%, 13.8%, and 3.5%, respectively). Moreover, there was an increasing trend in the number of retrieved oocytes (Groups 1–5: optimistic method: 82.5%, 91.7%, 93.6%, 94.1%, and 96.2%; conservative method: 58.6%, 76.7%, 84.8%, 88.0%, and 92.5%, respectively). Furthermore, the CLBR varied across different causes of infertility (Groups 1–9: optimistic method: 91.7%, 93.1%, 96.6%, 79.2%, 89.9%, 76.1%, 90.0%, 92.9%, and 35.4%; conservative method: 77.3%, 79.4%, 88.9%, 46.7%, 72.7%, 62.1%, 74.4%, 78.8%, and 20.1%, respectively). LIMITATIONS, REASONS FOR CAUTION Calculating the actual CLBR for each person is difficult because some patients have remaining embryos that have not been transferred; additionally, the current statistical methodology uses both optimistic and conservative methods to calculate the CLBR, and in real life, the CLBR falls between the optimistic and conservative curves. WIDER IMPLICATIONS OF THE FINDINGS Our study is the first to identify specific subgroups of women who fail to benefit from repeated FETs and who require rational discontinuation of treatment following unsuccessful transfer. STUDY FUNDING/COMPETING INTEREST(S) This study was financially supported by grants from the National Natural Science Foundation of China (grant numbers: 82271732 to Y.K. 82071603 to L.W. 82001502 to Y.L. and 82201888 to X.S.). The authors declare that they have no conflicts of interest in the present study. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

This study aimed to explore the relationship between female age and pregnancy outcomes in patients undergoing their first elective single embryo transfer (eSET) of in vitro fertilization (IVF) cycles. The retrospective cohort study encompassed 7089 IVF/intracytoplasmic sperm injection (ICSI) patients of the Reproductive Medicine Center, Henan Provincial Peoples' Hospital of China, from September 1, 2016, to May 31, 2022. Patients all received the first eSET in their IVF/ICSI cycles. A generalized additive model (GAM) was employed to examine the the dose–response correlation between age and pregnancy outcomes, namely the clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR). Logistic regression model was employed to ascertain the correlation between the CPR/OPR and age. The study cohort has an average age of 30.74; 3843 patients got clinical pregnancy rate of 61.40% and ongoing pregnancy rate of 54.21%. The multiple pregnancy rate of is 1.24%. For patients aged 34 and above, the CPR decreased by 10% for every 1-year increase in age (adjusted OR 0.90, 95% CI 0.84–0.96, p < 0.0001). Similarly, the OPR decreased by 16% for every 1-year increase in age (adjusted OR 0.84, 95% CI 0.81–0.88, p < 0.0001). Patients aged 35–37 years had an acceptable OPR of 52.4% after eSET, with a low multiple pregnancy rate (1.1%). Pregnancy outcomes were significantly better in blastocyst cycles compared to cleavage embryo cycles, and this trend was more pronounced in older patients. There was a non-linear relationship between female age and pregnancy outcomes in patients undergoing their first eSET cycles. The clinical pregnancy rate and ongoing pregnancy rate decreased significantly with age, especially in women older than 34 years. For patients under 37 years old, single embryo transfer should be prioritized. For patients over 38 years old with available blastocysts, eSET is also recommended. [ABSTRACT FROM AUTHOR]

Purpose: Our objective is to predict the cumulative live birth rate (CLBR) and identify the specific subset within the population undergoing preimplantation genetic testing for monogenic disorders (PGT-M) and chromosomal structural rearrangements (PGT-SR) which is likely to exhibit a diminished expected CLBR based on various patient demographics. Methods: We performed a single-centre retrospective cohort study including 1522 women undergoing 3130 PGT cycles at a referral centre for PGT. A logistic regression analysis was performed to predict the CLBR per ovarian stimulation in women undergoing PGT-M by polymerase chain reaction (PCR) or single-nucleotide polymorphism (SNP) array, and in women undergoing PGT-SR by SNP array, array comparative genomic hybridization (CGH) or next-generation sequencing (NGS). Results: The mean age of women was 32.6 years, with a mean AMH of 2.75 µg/L. Female age and AMH significantly affected the expected CLBR irrespective of the inheritance mode or PGT technology. An expected CLBR < 10% was reached above the age of 42 years and AMH ≤ 1.25 µg/L. We found no significant difference in outcome per ovarian stimulation between the different PGT technologies, i.e. PCR, SNP array, array CGH and NGS. Whereas per embryo transfer, we noticed a significantly higher probability of live birth when SNP array, array CGH and NGS were used as compared to PCR. Conclusion: In a PGT-setting, couples with an unfavourable female age and AMH should be informed of the prognosis to allow other reproductive choices. The heatmap produced in this study can be used as a visual tool for PGT couples. [ABSTRACT FROM AUTHOR]

Abstract Background The objective of this research was to elucidate the association between the length of infertility and the outcomes of intrauterine insemination (IUI) in women of varying ages - a topic that has been the subject of investigation for numerous years, yet lacks a definitive consensus. Methods A retrospective cohort investigation involving 5268 IUI cycles was undertaken at the Reproductive Medicine Center of Nanjing Drum Tower Hospital from 2016 to 2022. Utilizing the smooth fitting curve along with threshold and saturation effect analysis, the correlation between infertility duration and IUI clinical pregnancy rates was discerned. Moreover, patients were bifurcated into two cohorts based on their respective infertility durations. A secondary examination was also performed employing propensity-score matching to mitigate the impact of confounding variables. Subsequent threshold and saturation effect analysis was carried out across various subgroups, segmented on the basis of age differentiation. Results When the duration of infertility was more than 5 years, the clinical pregnancy rate decreased with the increase of infertility duration (aOR: 0.894, 95%CI: 0.817–0.991, p = 0.043). The multivariate regression analysis suggested that longer duration of infertility (≥ 5 years) was significantly correlated with the lower clinical pregnancy rate (aOR: 0.782, 95% CI: 0.643–0.950, p = 0.01). After the propensity-score matching, the clinical pregnancy rate of women with longer infertility duration were also higher. When the duration of infertility was more than 5 years, the clinical pregnancy rate of women younger than 35 years old decreased with the increase of infertility duration (aOR: 0.906, 95%CI: 0.800–0.998, p = 0.043). Conclusions The clinical pregnancy rate and live birth rate of IUI in young women (

OBJECTIVE: Despite recent advancements in assisted reproductive technology (ART), the effective management of patients with poor ovarian response (POR) remains a formidable challenge. While various treatment strategies and predictors of live births have been documented to provide guidance to fertility specialists in managing poor responders, research efforts have predominantly encompassed all POSEIDON groups. In this study, our objective was to analyze the factors correlated with live births (LB) within a subset of the POSEIDON groups, with a particular focus on POSEIDON groups 3 and 4. PATIENTS AND METHODS: Charts of 406 patients belonging to POSEIDON groups 3 and 4 who underwent ART treatment at a university- affiliated infertility clinic following a gonadotropin- releasing hormone (GnRH) antagonist cycle between January 2016 and December 2021 were analyzed. Clinically significant factors associated with live births were incorporated into a logistic regression model for multivariate analysis to ascertain independent predictors of LB. Additionally, a receiver operating characteristic (ROC) curve analysis was conducted to establish the optimal cut-off values. RESULTS: Live births were achieved in 48 cycles (8.7%). Female age (OR, 0.930; 95% CI: 0.874-0.991; p < 0.024), baseline serum luteinizing hormone (LH) levels (OR, 0.854; 95% CI: 0.741-0.984; p < 0.029), and dual triggers (OR, 4.004; 95% CI: 1.290-12.426; p < 0.016) were identified as independent factors associated with LB following multivariate logistic regression analysis. The optimal age cut-off was determined to be 33 years, with a sensitivity of 70.8% and specificity of 75%. CONCLUSIONS: Younger age, lower baseline serum LH levels, and dual-trigger administration appear to enhance the likelihood of live birth in POSEIDON groups 3 and 4 following treatments with the GnRH antagonist protocol. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of age on the association between maternal body mass index (BMI) and cumulative live birth rates (CLBRs) following in vitro fertilization treatment. Method: We retrospectively analyzed the data of 26 567 women undergoing in vitro fertilization/intracytoplasmic sperm injection from 2016 to 2019. We conducted multivariate regression analysis of the association between CLBRs and maternal BMI and age category. Results: A total of 16 626 (62.58%) patients achieved a live birth. Women with obesity had significantly decreased CLBRs compared with women who had normal weight (odds ratio [OR] 0.73 [95% confidence interval (CI), 0.66–0.80]). The significant interaction between age and BMI suggested that the impact of BMI on CLBRs was moderated by women's age (P interaction <0.001). The association between obesity and CLBRs was inverse among women aged <30 years (OR, 0.63 [95% CI, 0.54–0.73]), 30 to 34 years (OR, 0.79 [95% CI, 0.67–0.93]), and 35 to 37 years (OR, 0.71 [95% CI, 0.52–0.98]); however, decreases in CLBRs with obesity were not observed in women aged 38 to 40 years (OR, 1.17 [95% CI, 0.70–1.94]) and ≥ 41 years (OR, 1.25 [95% CI, 0.53–2.96]). Conclusion: Maternal obesity was significantly associated with a lower likelihood of having a live birth, but the risk differed according to women's age. A higher BMI might have a less‐pronounced detrimental effect with increasing age. Synopsis: Obesity is associated with lower likelihood of having a live birth; however, high body mass index seems to have a less pronounced detrimental effect with increasing age. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of different controlled ovarian stimulation (COS) protocols, including the progestin‐primed ovarian stimulation (PPOS), long, short, and the gonadotropin‐releasing hormone antagonist protocols, on meiotic spindle visibility and position within the oocyte and clinical outcomes following ICSI. Methods: Before ICSI, spindle position (θ) just below the polar body (PB) was defined as 0° and categorized as follows: θ = 0°, 0° < θ ≤ 30°, 30° < θ ≤ 60°, 60° < θ ≤ 90°, 90° < θ ≤ 180°, between the PB and the oolemma, and nonvisible. The clinical outcomes after ICSI were retrospectively analyzed. Results: The normal fertilization rate was significantly higher in oocytes with visible spindles than in oocytes with nonvisible spindles after each COS protocol, but did not differ based on spindle positioning (0° ≤ θ ≤ 180°). The rates of pregnancy, live birth/ongoing pregnancy, and miscarriage did not differ based on spindle visibility or positioning. In multinominal logistic regression analysis, female age was associated with spindle position, and the odds of a spindle located at 30° < θ ≤ 60°, at 60° < θ ≤ 90°, or at 90° < θ ≤ 180° were increased relative to θ = 0° in older women (odds ratio; 1.020, 1.030, and 1.060, respectively; p < 0.05). Conclusion: Meiotic spindle positioning in the oocyte does not affect normal fertilization, blastulation, pregnancy, live birth/ongoing pregnancy, and miscarriage after ICSI, independent of the COS protocol used. The visibility of the meiotic spindle in oocytes impacted the normal fertilization rate, independent of controlled ovarian stimulation protocol. However, the spindle position within the ooplasm did not influence clinical outcomes, such as normal fertilization, blastulation, pregnancy, live birth, and miscarriage after controlled ovarian stimulation. Furthermore, female age did not affect spindle visibility; whereas the spindle position was associated with female age and moved away from directly beneath the polar body as female age increased. [ABSTRACT FROM AUTHOR]

Crossing over is the occurrence of disconnection and reconnection followed by a reciprocal exchange between the two chromatids in a bivalent form. The crossing event will produce parental type and recombinant type. In the event of crossing over, various factors can influence it. These factors can be due to internal and external. Recently, various factors have been reported that influence the incidence of crossing over. These factors include age, temperature, radiation, and changes in chromosome structure. This research is a type of experimental research that uses a randomized block design. Randomized block design by crossing D. melanogaster strains ?N>< ?bcl and ?N>< ?ym and their reciprocals. From the results of this cross (F1) then cross again ?N with the recessive male (from stock) then observe the phenotype of the offspring (F2) and calculate the results of the offspring. The F2 ?N crosses were treated with age variations, namely 0, 3, 6, 9, 12, 15, and 18 days. Based on the results of these crosses, the derived strains that appeared in the F2 crosses showed the phenomenon of crossing over with the influence of the age of the female and the type of strain on crossing events. the frequency or value of crossing over (formation of recombinants) decreased with the increasing age of the female. If the age of the female affects the frequency of crossing over, then the older the female, the more likely the frequency of crossing over will decrease. However, because the data obtained were incomplete, it was not possible to know the effect of female age on the frequency of crossing over of D. melanogaster crosses ?N>< ? bcl and ?N >< ?ym and their reciprocals. The condition for crossing over is the formation of a synaptonemal complex. Age of D. melanogaster females has an effect on the frequency of crossing over in crosses N? >< bcl?, N? >< ym?, and their reciprocals. The older Drosophila melanogaster is, the lower the frequency of crossing over will occur. Based on this, it was necessary to cross D. melanogaster with strains N, bcl, and ym. A cross consists of ?N >ym and their reciprocals. By crossing ?N with a recessive male from the stock, then observing the F2 phenotype, it is hoped that crossing over will occur. So that you can better understand by doing the practice directly. In this case, the effect of crossing over is seen from the age of the female and the type of strain.

Objective: To determine the effect of female age on pregnancy outcome after in vitro fertilization/embryo transfer (IVF‐ET). Methods: A prospective study was conducted involving 266 women who had IVF‐ET at Nisa Fertility and Genetic Center, Abuja, Nigeria. All eligible consenting women were recruited to the study. The main outcome measure was clinical pregnancy. Data were analyzed using IBM SPSS Statistics version 25. P < 0.05 at 95% confidence intervals was taken as significant. Results: A total of 266 patients were recruited and included in the study; 104 pregnancies were recorded, giving an overall pregnancy rate of 39.1%. The age range of the patient was 26–43 years (mean age 33.9 ± 2.41 years) while the mean number of embryo transfers per patient was 2.2. The clinical pregnancy rate for women aged below 30 years was 69.4% while the pregnancy rate for patients aged 30–34 years, 35–39 years, and 40–43 years was 52.6%, 24.7%, and 9.4%, respectively (P < 0.0001). Conclusion: The study found that the success rate of IVF‐ET decreases significantly in women aged over 34 years. Women should be counseled about the age‐related risk of infertility and referred to a fertility center as early as possible. Synopsis: The success rate of in vitro fertilization/embryo transfer decreases significantly in women aged older than 34 years. Age‐related risk of infertility should be taken into consideration. [ABSTRACT FROM AUTHOR]

Nest microclimate can be influenced by subtle differences in nest location such as topography and aspect, and can differ among nests located relatively close to each other. More favorable microclimates at nests may influence birds' nest-site selection and reproductive outcome. Yet most studies of nest microclimate have considered cavity-nesting species, and few have investigated a passerine open-cup nester. We compared the nest microclimates of 87 Hooded Warbler (Setophaga citrina) nests built in subtly different topographical positions (ridge, slope, and valley) at Tar Hollow State Forest in southern Ohio. We then examined the relationships of nest topographical position and aspect to parental age and to 3 measures of reproductive outcome. We predicted that older, more experienced birds would nest in more favorable (warmer) sites and would have greater reproductive success at these sites. We found significant differences in nest microclimate among nest sites that differed subtly in topography and aspect. As expected, nest sites in valleys had significantly lower ambient temperatures (mean, minimum, and maximum daily temperatures) than those higher up on the ridges. However, nest aspect had few effects on ambient temperature at nest sites. When considering the nest sites used by females of different ages, we found some evidence that older (after second year) females had warmer nest sites than younger (second-year) females, supporting our prediction. However, there was no evidence that older females or warmer nests were associated with greater reproductive success, contrary to our expectations. Our findings suggested that although topography significantly influences nest microclimate, factors other than temperature differences are more important determinants of reproductive success, and that other considerations influence the older birds' selection of warmer nest sites on ridges. The relationships among nest microclimate, nest site selection, and reproductive success are complex and require additional study for open-cup nesters. El microclima de los nidos puede ser influenciado por diferencias sutiles en la localización del nido como la topografía y el aspecto y puede diferir entre nidos localizados relativamente cerca uno del otro. Microclimas más favorables pueden influir en la selección de sitio de los nidos que hacen las aves y en su desenlace reproductivo. Sin embargo, muchos estudios de microclima de nido han considerado especies que anidan en cavidades y pocos han investigado especies paserinas de anidación de copa abierta. Comparamos microclimas de 87 nidos de la reinita Setophaga citrina contruidos en posiciones topográficas ligeramente distintas (cresta, ladera y valle) en Tar Hollow State Forest, al sudeste de Ohio. Examinamos luego la relación de la posición topográfica del nido con la edad parental y 3 medidas del resultado reproductivo. Nuestra predicción fue que las aves más viejas anidarían en sitios más favorables (más cálidos) y tendrían mayor éxito reproductivo en estos sitios. Encontramos diferencias significativas en microclimas de anidación entre sitios que diferían levemente en topografía y aspecto. Como era esperado, los sitios de anidación en el valle tenían temperaturas ambientales significativamente inferiores (temperatura promedio diaria, mínima y máxima) que las que estaban en la parte alta del risco. Sin embargo, el aspecto del nido tuvo pocos efectos en la temperatura ambiental de los sitios de anidación. Cuando se consideraron los sitios de anidación utilizados por las hembras de diferentes edades, encontramos algo de evidencia de que las hembras mayores (después del segundo año) tenían sitios de anidación más cálidos que las hembras menores (de segundo año), lo que apoyaba nuestra predicción. Sin embargo, no hay evidencia de que hembras mayores o nidos más cálidos necesariamente se asocien a un mayor éxito reproductivo, contrario a nuestras predicciones. Nuestros hallazgos sugieren que, aunque la topografía influye significativamente en el microclima del nido, factores distintos a las diferencias de temperatura son determinantes más importantes del éxito reproductivo y que otras consideraciones influyen en que las aves más viejas elijan sitios más cálidos de anidación en las crestas. Las relaciones entre el microclima del nido, la selección de sitio de anidación y éxito reproductivo son complejas y requieren estudios adicionales para las aves con nidos de copa abierta. Palabras clave: edad de la hembra, éxito reproductivo, microclima del nido, la reinita Setophaga citrina, topografía [ABSTRACT FROM AUTHOR]

Reduced fertility is likely the result of low oocyte developmental competence and inadequate maternal environment to support pregnancy. The aim of IVF treatment is to obtain interpretable and improvable results on the effects of parameters affecting fertility on pregnancy. Clinical information including female age (22-46), E2 levels on the day of opu and pregnancy status of 200 patients who came to Bahçeci Umut IVF Center for treatment between 2022-2023 were analyzed retrospectively (2022/20-05). Patient groups were determined as Control(NR), Polycystic Ovary Syndrome(PCOS), Advanced(DOR-I)and Early Age(DOR-G) low ovarian reserve. E2 was higher in PCOS (3421,29 ± 1998,92 pg/ml) than NR (1540,39 ± 462,63 pg/ml), DOR-I (719,65 ± 303,02 pg/ml), or DOR-G (940,70 ± 339,49 pg/ml). DOR-I and DOR-G had similar E2 (p>0.05, Table 1). DOR-I (40.36±3.082) was significantly older than other groups (p>0.05,Figure 1). NR (%16) had the highest pregnancy loss rates compared to PCOS (%10), DOR-G (%14) and DOR-I (%8). PCOS (%36) had higher live birth rates than NR(%24), DOR-G(%22) and DOR-I(%16). DOR-G (%4) had higher biochemical pregnancy than PCOS(% 0) and DOR-I(%2) groups. The percentage of embryo transfer cancellation was higher in DOR-I (%30) than NR(%6) PCOS(%10) and DOR-G(%0). Only DOR-I is is older than the NR group. E2 seems correlated with the number of oocytes collected and in the formation of indication groups. It confirms research findings that aging can lead to oocyte anomalies and infertility. [ABSTRACT FROM AUTHOR]

Whether assisted hatching (AH) is associated with a higher incidence of monozygotic twinning (MZT) in women undergoing assisted reproductive technology remains controversial; the aim of the study was to demonstrate the relationship between AH and MZT. A total of 8900 clinical pregnancies were selected among embryo transfer cycles from January 2011 to October 2019. Women receiving day (D) 3 embryos were divided into groups A-C: group A (n = 1651) and group B (n = 1045) included women aged ≤37 or ≥38 years, respectively, with zona pellucida (ZP) thinning; group C (n = 3865) included women aged ≤37 years without AH. Women aged ≤37 years who underwent blastocyst transfer and/or blastocyst ZP breaching were included in group D (n = 2339). The incidence of MZT was compared among groups A, B and C, and between groups C and D. The incidence of MZT in group B (2.2%) was significantly higher than in group A (1.0%), especially following intracytoplasmic sperm injection (ICSI), while the incidence of MZT in group A (1.0%) was significantly lower than in group C (2.2%). The MZT rate with in vitro fertilization was higher in group D (2.8%) than in group C (2.2%), but the MZT rate following ICSI was not significantly different between the two groups. ZP thinning of D3 embryos may increase the risk of MZT in older women (≥38 years), but decrease it in younger women (≤37 years). ZP breaching may be useful to reduce the incidence of MZT in ICSI-generated blastocysts. [ABSTRACT FROM AUTHOR]

What is the blastocyst conversion rate in embryo cryopreservation cycles, per year of female age? Retrospective cohort study including patients undergoing their first ovarian stimulation cycle at our center with planned freeze-all strategy January 1st, 2014-June 30th, 2020. Primary outcome was blastocyst conversion rate. Secondary outcomes included mature oocyte and fertilization rates. Patients were stratified by year of age to assess oocyte yield and embryo development outcomes. 3,362 patients were included. The median blastocyst conversion rate in patients ≤30 was 66.7% (interquartile range 50.0–86.6) and remained statistically comparable through age 40 with a significant decline among ages ≥41 (41-years: marginal effect (ME) –5.2% (–9.7 to –0.7); 42-years: ME –9.6% (–14.3 to –4.8); 43-years: ME –7.7% (–12.8 to –2.6); ≥44-years: ME –20.8% (–26.5 to –15.1)). For the entire cohort, the median mature oocyte rate was 81.8% and the median fertilization rate was 81.8%. The mature oocyte and fertilization rates remained statistically comparable for each year of age except age ≥44 which had a statistically significantly increased mature oocyte rate (ME 4.4% (1.3 to 7.5)) and statistically significantly decreased fertilization rate (ME –5.8% (–9.8 to –1.9)) In embryo cryopreservation cycles, the blastocyst conversion rate remained statistically comparable through age 40 followed by a statistically significant decline for patients ≥41; however, the mature oocyte and fertilization rates were not impacted by increasing age until age ≥44. Even in women ≥44, over 40% of fertilized oocytes developed to blastocyst. Overall, this information is useful when counseling patients during the embryo culture stage regarding predicted blastocyst yield. [ABSTRACT FROM AUTHOR]

The spongy moth (formerly known as a gypsy moth), Lymantria dispar L. (Lepidoptera: Erebidae), is a polyphagous pest that defoliates various species of trees in the genera Populus, Salix, Quercus, Acer and Pinus. Egg masses of Asian spongy moths (Lymantria dispar asiatica) were obtained from five geographically distinct locations in China (Chengdu, Xifeng, Heilongjiang, Kuduer and Longhua regions) and were carried to the lab for incubation and rearing larvae up to adult emergence. The aim was to see how locality, age and mating status influenced the flying activity of female Asian spongy moths. The findings demonstrate that age significantly affects L. dispar asiatica flying activity, with flight period and distance decreasing dramatically as age increases. Locality also significantly impacts flight ability, and mating status does not affect the L. dispar asiatica female flight ability (p > 0.05). The maximum speed was observed for females from Xifeng (7.19 ± 0.34 km/h). The females from Heilongjiang were recorded as having the maximum average speed (2.35 ± 0.08 km/h). Females from Xifeng exhibited the maximum flight duration and distance (0.94 ± 0.04 h and 1.87 ± 0.18 km). Morphological features, i.e., thorax width (cm) and wing loading, significantly influenced the L. dispar asiatica flight ability (R2 = 0.93 and R2 = −0.98). The overall pattern observed for female L. dispar asiatica flight duration was Xifeng > Kuder > Chengdu > Heilongjiang > Longhua, and for flight distance, it was Xifeng > Longhua > Heilongjiang > Kuder > Chengdu. This research offers detailed information on the dispersion rate of Spongy moths in a known or newly introduced habitat, which can help us limit the spread of this polyphagous pest. [ABSTRACT FROM AUTHOR]

Abstract Background To analyze the characteristics of basal thyroid hormone levels in infertile women consulting for assisted reproductive technology (ART) treatment. Methods This was a retrospective study. Serum TSH, FT3 and FT4 levels of women seeking ART consultation were tested routinely. Analyses were performed based on age and sampling time. One-way ANOVA or Kruskal-Wallis rank sum test was used to compare the continuous data among the groups, and the chi-square test or Fisher’s exact test was used to compare categorical data where appropriate. Results A total of 6426 women were initially included in the study. After exclusion criteria were applied, the remaining 4126 women were categorized into different groups. The prevalence of subclinical hypothyroidism significantly decreased with age and sampling time, from 21.09 to 11.91% and from 28.57 to 10.67%, respectively (P

Is female age a significant factor in the likelihood of an ongoing pregnancy in single euploid frozen embryo transfers (FET)? Retrospective study of 1923 single euploid FET cycles in 1464 women, either in a natural cycle or a hormone replacement therapy cycle. The primary outcome was the ongoing pregnancy rate (OPR). There were 990 (51.48%) ongoing pregnancies among 1923 included transfers. The OPR were 51.4%, 49.1%, 53.3% and 52.3% for women aged ≤35, >35–≤37, >37–≤40 and >40 years at oocyte retrieval (OCR), without a significant trend for decreasing OPR (P = 0.679). No significant differences in female age at embryo transfer (P = 0.609) and female age at OCR (P = 0.816) were found between the groups (ongoing pregnancy versus no pregnancy or miscarriage). Women who received good-quality embryos (P < 0.001), had a lower body mass index (BMI) (P < 0.001), had achieved at least one pregnancy previously (P < 0.001), and underwent natural cycle endometrial preparation (P < 0.001) were more likely to achieve an ongoing pregnancy. Multivariable regression analysis (adjusted for BMI, embryo quality and endometrial preparation) did not show a significant effect of female age at OCR on achieving an ongoing pregnancy. Compared with women aged ≤35 years, none of the age groups had significantly higher or lower OPR. A multinomial regression analysis showed that BMI, embryo quality and endometrial preparation were associated with miscarriage/no pregnancy versus ongoing pregnancy (P = 0.001, 0.001 and 0.001, respectively). Female age had no significant association with either outcome. Female age in itself does not have a substantial impact on the OPR in single euploid FET cycles, but the OPR is impacted significantly by embryo quality, BMI, previous parity, and a natural cycle endometrial preparation protocol. [ABSTRACT FROM AUTHOR]

AimsThis study aimed to explore the value of ovarian reserve tests (ORTs) for predicting poor ovary response (POR) and whether an age cutoff could improve this forecasting, so as to facilitate clinical decision-making for women undergoing in vitro fertilization (IVF).MethodsA retrospective cohort study was conducted on poor ovary response (POR) patients using real-world data from five reproductive centers of university-affiliated hospitals or large academic hospitals in China. A total of 89,002 women with infertility undergoing their first traditional ovarian stimulation cycle for in vitro fertilization from January 2013 to December 2019 were included. The receiver operating characteristic (ROC) curve was performed to estimate the prediction value of POR by the following ORTs: anti-Mullerian hormone (AMH), antral follicle count (AFC), basal FSH (bFSH), as well as patient age.ResultsIn this retrospective cohort, the frequency of POR in the first IVF cycle was 14.8%. Age, AFC, AMH, and bFSH were used as predicting factors for POR, of which AMH and AFC were the best indicators when using a single factor for prediction (AUC 0.862 and 0.842, respectively). The predictive values of the multivariate model included age and AMH (AUC 0.865), age and AFC (AUC 0.850), age and all three ORTs (AUC 0.873). Compared with using a single factor alone, the combinations of ORTs and female age can increase the predictive value of POR. Adding age to single AMH model improved the prediction accuracy compared with AMH alone (AUC 0.865 vs. 0.862), but the improvement was not significant. The AFC with age model significantly improved the prediction accuracy of the single AFC model (AUC 0.846 vs. 0.837). To reach 90% specificity for POR prediction, the cutoff point for age was 38 years old with a sensitivity of 40.7%, 5 for AFC with a sensitivity of 55.9%, and 1.18 ng/ml for AMH with a sensitivity of 63.3%.ConclusionAFC and AMH demonstrated a high accuracy when using ROC regression to predict POR. When testing is reliable, AMH can be used alone to forecast POR. When AFC is used as a prediction parameter, age is suggested to be considered as well. Based on the results of the cutoff threshold analysis, AFC ≤ 5 and AMH ≤ 1.18 ng/ml should be recommended to predict POR more accurately in IVF/ICSI patients.

Several methods are developing to assess the biological and functional age of women ovary. Since ovarian reserve (OR) may change over time, limited ovarian reserve needs further tests to be confirmed. The likelihood of sub -fertility treatment success is highly dependent on the women's age. With advanced age, the likelihood of having a child decreases significantly making those women in high need of assisted conception. The study aimed to assess the association between female age, ovarian reserve biomarker s (follicular stimulating hormone and anti-mullerian hormone), response to controlled ovarian stimulation (COS) represented by the dose of gonadotropin stimulation, number and quality of retrieved oocytes, cycle cancellation rate and pregnancy rate in thos e who undergo ICSI. One hundred twenty six couples complained of sub-fertility collected from Al-Kafeel Fertility and IVF Center/ Holy Kerbala/ Iraq throughout a period between 2016-2019. These couples have been evaluated and subjected to COS/ICSI and divided into two groups below and above 35 years old. As sessment of cycle day 2 FSH and AMH, response to COS, cycle cancellation rate, and the pregnancy rate has been performed, and the results compared between both. The study showed that baseline serum level of FSH and AMH did not differ between women older and younger than 35 years old (in younger women, mean serum FSH 6.6±4.0 and AMH 2.4±1.8 vs 7.7±4.3 and 2.2±2.8 respectively in older ones, p-value=0.15). Women older than 35 years old needed significantly higher doses of gonadotropin stimulation(mean total dose of r-FSH 2179.4±1222.2 vs 1987.2±947.6, p -value=0.036 and mean total dose of HMG 3122.3±1456.8 vs 2468.7±1454.8, p-value=0.02), produced significantly lower number of oocytes (6.09±4.7 vs 9.8±6.4,p -value=0.0001), lower number of mature oocytes (4.4±3.8 vs 6.7±5.1,p -value=0.005), higher rate of cycle cancellation(17.7% vs 4.6%) and insignificantly lower pregnancy rate(23.5% vs 37.7%, p-value=0.107) following ICSI in comparison with those younger than 35 years old. Age is a significant determinant factor that affects the ovarian reserve, can lead to ovarian aging, and lower the women's fertility rate. There is a weak correlation between age, FSH, and AMH levels. Older women exhibit a low response to ovarian stimulation with a higher cancellation rate, produce a small number of oocytes with low quality following COS despite their higher need for large doses of gonadotropin stimulation. The pregnancy rate is affected by advanced women's age following ICSI. [ABSTRACT FROM AUTHOR]

Objective: To appraise the fertilization rate as a predictive factor for cumulative live birth rate (CLBR).Design: Multicenter retrospective cohort study.Setting: Ten in vitro fertilization clinics, whose data were collected and processed by the assisted reproductive technology (ART) Italian National Registry.Patient(s): 7,968 couples undergoing 9,394 complete intracytoplasmic sperm injection cycles.Intervention(s): None.Main Outcome Measure(s): The primary outcome measure was the CLBR in association with the fertilization rate intervals (<65%-group 1; 65%-80%-group 2; and >80%-group 3). Further data stratification was performed on the basis of maternal age (<34, 35-38, and 39-42 years) and number of retrieved oocytes (5-7, 8-10, and > 10 oocytes).Result(s): The CLBR was progressively higher in relation to the fertilization rate in groups 1, 2, and 3 (20.1%, 34.7%, and 41.3%, respectively). The number of recovered oocytes, embryo number per cycle, and cumulative pregnancy rate followed the same trend. The decrease in CLBR with increasing maternal age was significantly correlated with the fertilization rate and CLBR in all 3 maternal age groups. Multivariate logistic regression analysis showed fertilization rate as a factor independently associated with CLBR.Conclusion(s): The present data indicated a positive association between the fertilization rate and the CLBR, suggesting the predictive clinical relevance of this parameter and its adoption as a key performance indicator. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the value of ovarian reserve tests (ORTs) for predicting poor ovary response (POR) and whether an age cutoff could improve this forecasting, so as to facilitate clinical decision-making for women undergoing in vitro fertilization (IVF). Methods: A retrospective cohort study was conducted on poor ovary response (POR) patients using real-world data from five reproductive centers of university-affiliated hospitals or large academic hospitals in China. A total of 89,002 women with infertility undergoing their first traditional ovarian stimulation cycle for in vitro fertilization from January 2013 to December 2019 were included. The receiver operating characteristic (ROC) curve was performed to estimate the prediction value of POR by the following ORTs: anti-Mullerian hormone (AMH), antral follicle count (AFC), basal FSH (bFSH), as well as patient age. Results: In this retrospective cohort, the frequency of POR in the first IVF cycle was 14.8%. Age, AFC, AMH, and bFSH were used as predicting factors for POR, of which AMH and AFC were the best indicators when using a single factor for prediction (AUC 0.862 and 0.842, respectively). The predictive values of the multivariate model included age and AMH (AUC 0.865), age and AFC (AUC 0.850), age and all three ORTs (AUC 0.873). Compared with using a single factor alone, the combinations of ORTs and female age can increase the predictive value of POR. Adding age to single AMH model improved the prediction accuracy compared with AMH alone (AUC 0.865 vs. 0.862), but the improvement was not significant. The AFC with age model significantly improved the prediction accuracy of the single AFC model (AUC 0.846 vs. 0.837). To reach 90% specificity for POR prediction, the cutoff point for age was 38 years old with a sensitivity of 40.7%, 5 for AFC with a sensitivity of 55.9%, and 1.18 ng/ml for AMH with a sensitivity of 63.3%. Conclusion: AFC and AMH demonstrated a high accuracy when using ROC regression to predict POR. When testing is reliable, AMH can be used alone to forecast POR. When AFC is used as a prediction parameter, age is suggested to be considered as well. Based on the results of the cutoff threshold analysis, AFC ≤ 5 and AMH ≤ 1.18 ng/ml should be recommended to predict POR more accurately in IVF/ICSI patients. [ABSTRACT FROM AUTHOR]

Background: To analyze the characteristics of basal thyroid hormone levels in infertile women consulting for assisted reproductive technology (ART) treatment.Methods: This was a retrospective study. Serum TSH, FT3 and FT4 levels of women seeking ART consultation were tested routinely. Analyses were performed based on age and sampling time. One-way ANOVA or Kruskal-Wallis rank sum test was used to compare the continuous data among the groups, and the chi-square test or Fisher's exact test was used to compare categorical data where appropriate.Results: A total of 6426 women were initially included in the study. After exclusion criteria were applied, the remaining 4126 women were categorized into different groups. The prevalence of subclinical hypothyroidism significantly decreased with age and sampling time, from 21.09 to 11.91% and from 28.57 to 10.67%, respectively (P < 0.001, respectively). Mean serum TSH, FT3, and FT4 levels decreased significantly with age (P = 0.017, < 0.001, < 0.001, respectively). In the context of sampling time, TSH levels from early in the morning were significantly higher (P < 0.001), while FT4 and FT3 levels were similar in different groups (P = 0.258, 0.300, respectively).Conclusions: The prevalence of subclinical hypothyroidism significantly decreased with increasing age and sampling time, as did the serum TSH levels. Even though, the establishment of reference interval of TSH level based on age or sampling time was not recommended. Full consideration of age and sampling time should be carefully taken before initiation of treatment. [ABSTRACT FROM AUTHOR]

Abstract Background In assisted reproductive technology (ART) cycles in addition to embryo quality, the receptivity of the endometrium plays the main role in clinical outcomes. Endometrial receptivity is necessary to implantation of an embryo, and ultrasound has been established as an appreciated, simple, and non-invasive technique in the evaluation of the endometrial preparation before embryo transfer in fresh in vitro fertilization (IVF) cycles. Debate on the predictive value measuring endometrial thickness before administering human chorionic gonadotropin (HCG) for ovulation triggering in ART is ongoing. In order to explore the impact of endometrial thickness on triggering day on ongoing pregnancy rate (OPR) in ART cycles, we retrospectively analyzed data from 1000 patients undergoing IVF/ICSI cycles. Results The data showed pregnancy rate was increased in the endometrial thickness of 8 mm to 11 mm then decreased, and in endometrial thickness (Ent) > 14 mm, pregnancy rate was zero. There were significant differences in endometrial thickness and pregnancy outcomes between different age groups. The pregnancy rate was higher (32%) in 23–30 years old women, and the range of Ent in this group was 6–12 mm. Also, the data showed a positive correlation between Ent with AMH and estradiol levels and the number of COC and MII oocytes and a negative correlation between female age with Ent. Conclusion The result showed that Ent on hCG administration day is associated with pregnancy outcomes in fresh IVF/ICSI cycles with different age groups, although some of the clinical parameters may have an effect on Ent. Large studies are needed to make a definitive conclusion.

CapsuleWe designed a predictive reference model to evaluate how many stimulation cycles are needed for a patient to achieve an ideal live birth rate using assisted reproductive technology.ObjectiveTo develop a counseling tool for women who wish to undergo assisted reproductive technology (ART) treatment to predict the likelihood of live birth based on age and number of oocytes retrieved.MethodsThis was a 6-year population-based retrospective cohort analysis using individual patient ART data. Between 2012 and 2017, 17,948 women were analyzed from their single ovarian stimulation cycle until they had a live birth or had used all their embryos. All consecutive women between 20 and 49 years old undergoing their ovarian stimulation cycles for ART in our center were enrolled. The cumulative live birth rate (CLBR) was defined as the delivery of a live neonate born during fresh or subsequent frozen–thawed embryo transfer cycles. Only the first delivery was considered in the analysis. Binary logistic regression was performed to identify and adjust for factors known to affect the CLBR independently. A generalized additive model was used to build a predictive model of CLBR according to the woman’s age and the number of oocytes retrieved.ResultsAn evidenced-based counseling tool was created to predict the probability of an individual woman having a live birth, based on her age and the number of oocytes retrieved in ART cycles. The model was verified by 10 times 10-fold cross-validation using the preprocessed data, and 100 area under the curve (AUC) values for receiver operating characteristic (ROC) curves were obtained on the test set. The mean AUC value was 0.7394. Our model predicts different CLBRs ranging from nearly 90% to less than 20% for women aged 20–49 years with at least 22 oocytes retrieved. The CLBRs of women aged 20–28 years were very similar, nearly on one trend line with a certain number of oocytes retrieved. Differences in the CLBR began to appear by the age of 29 years; these increased gradually in women aged >35 years.ConclusionA predictive model of the CLBR was designed to serve as a guide for physicians and for patients considering ART treatment. The number of oocytes needed to be retrieved to achieve a live birth depends on the woman’s age.

Capsule: We designed a predictive reference model to evaluate how many stimulation cycles are needed for a patient to achieve an ideal live birth rate using assisted reproductive technology. Objective: To develop a counseling tool for women who wish to undergo assisted reproductive technology (ART) treatment to predict the likelihood of live birth based on age and number of oocytes retrieved. Methods: This was a 6-year population-based retrospective cohort analysis using individual patient ART data. Between 2012 and 2017, 17,948 women were analyzed from their single ovarian stimulation cycle until they had a live birth or had used all their embryos. All consecutive women between 20 and 49 years old undergoing their ovarian stimulation cycles for ART in our center were enrolled. The cumulative live birth rate (CLBR) was defined as the delivery of a live neonate born during fresh or subsequent frozen–thawed embryo transfer cycles. Only the first delivery was considered in the analysis. Binary logistic regression was performed to identify and adjust for factors known to affect the CLBR independently. A generalized additive model was used to build a predictive model of CLBR according to the woman's age and the number of oocytes retrieved. Results: An evidenced-based counseling tool was created to predict the probability of an individual woman having a live birth, based on her age and the number of oocytes retrieved in ART cycles. The model was verified by 10 times 10-fold cross-validation using the preprocessed data, and 100 area under the curve (AUC) values for receiver operating characteristic (ROC) curves were obtained on the test set. The mean AUC value was 0.7394. Our model predicts different CLBRs ranging from nearly 90% to less than 20% for women aged 20–49 years with at least 22 oocytes retrieved. The CLBRs of women aged 20–28 years were very similar, nearly on one trend line with a certain number of oocytes retrieved. Differences in the CLBR began to appear by the age of 29 years; these increased gradually in women aged >35 years. Conclusion: A predictive model of the CLBR was designed to serve as a guide for physicians and for patients considering ART treatment. The number of oocytes needed to be retrieved to achieve a live birth depends on the woman's age. [ABSTRACT FROM AUTHOR]

Background and objective: The ovary has a biological age that does not always correspond to the chronological age; this may be of great importance for the evaluation of women reproductive outcome. This study aimed to determine the effect of maternal age on the pregnancy rate, and the ovarian reserve markers (antimullerian hormone, follicular stimulating hormone, and antral follicular count). Methods: A cross-sectional study was conducted in the in vitro fertilization center at the Maternity Teaching Hospital located in Erbil city, from January 1, 2015, to January 31, 2016. A convenience sample of 300 infertile women of different age groups was included in the study. Transvaginal ultrasound was conducted to determine antral follicular count, and blood test was done for determination of serum antimullerian hormone and follicular stimulating hormone. The study sample was divided into four age groups. Chi square test, ANOVA test, Pearson correlation, and logistic regression were used to determine the associations. Results: The biochemical pregnancy rate of the study population was 37% and the clinical pregnancy rate was 32%. The most common type of infertility among the studied sample was primary infertility (74%). Results showed a strong inverse significant correlation between antimullerian hormone and antral follicular count with age, but there was no statistically significant association between maternal age and serum follicular stimulating hormone. Conclusion: Maternal age is a significant factor that can affect ovarian reserve and causes ovarian aging. The pregnancy rate decreases with advanced maternal age. Keywords: Antimullerian hormone; Antralfollicularcount; Female age; Ovarian reserve.

SUMMARY: Double-yolked (DY) eggs are a rare phenomenon in domestic poultry and game birds, generally ~1-2% of the eggs are DY over the laying cycle. The production of such eggs is influenced by several factors from which the most important ones include genetics, selection for multiple ovulations, female age, light exposure and nutrition. It is known that higher body weight is the result of selection, and has been correlated to the increase in multiple ovulations. The increased incidence of DY eggs is a consequence of the multiple ovulations, which are more prevalent in the first 10 weeks of laying, when up to 25% of follicles develop as pairs, because the regulation of follicle maturation and ovulation is not fully established. This regulation involves endocrinological and physiological changes, which are mediated by light, and management during rearing and laying is crucial to reduce DY eggs. Restricted feeding (~50% daily feed intake of ad libitum) results in decreased follicle production and multiple ovulations, hence reduces DY egg production. Feed should contain less protein (<16%) to control body weight gain. However, if DY egg production is the goal, birds should be fed ad libitum with high protein (>16%) to achieve higher body weights. Furthermore, applying photostimulation early (6–12 weeks of age for domestic fowl), increasing photoperiod to 13–16 hours of light and light intensity to (>80 lux). [ABSTRACT FROM AUTHOR]

Objective: To explore the relative factors for miscarriage among pregnancies produced by assisted reproductive technology. Methods: A total of 242 cycles of in vitro fertilization and intra-cytoplasmic sperm injection that resulted in a clinical pregnancy from January 20 15 to December 2017 were included. Female age, BMI, basal FSH, basal LH, basal E2 total gonadotrophin dose, the days of gonadotropin use, LH on day of HCG, E2 on day of hCG, P on day of HCG, endometrial thickness on day of embryo transfer and β-HCG level at 14 to 16 days post-ET and embryo quality were analyzed by Independent samples t-test, receiver operating characteristic curve and binary logistic regression analysis. Results: Female age and β-HCG level in the miscarriage group and Ongoing pregnancy group at 14 to 16 days post-ET was 31.44± 4.40 vs. 29.59± 3.94 and 396.96± 377.66 IU/L vs. 702.85± 496.91 IU/L (P<0.05). The ROC curve is obtained for analysis of various clinical parameters, and miscarriage rate were significant difference in cut-off group based on female age (29.41% vs 9.42%) and β-HCG level at 14 to 16 days post-ET(4 .20% vs 22.76%). Binary logistic regression analysis showed that, from all of the parameters, only female age and β-HCG level at 14 to 16 days post-ET has an independent significant correlation between miscarriage rate (P= O.OO 1). Conclusion: Female age>33 or β-HCG level at 14 to 16 days post-ET ⩽ 582.6 IU/L was the risk factors of miscarriage in the IVF/ICSI. The risk factors should be taken into account in the treatment of such patients and preventive measures should be taken in advance to avoid adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Maternal investment and maternal care provided by mammalian females can change during their ontogeny. Differences may be related to the age and/or experience (parity) of the female. Several hypotheses have been postulated to explain changes in the rate of maternal care of females during their lifetime. The residual reproductive value hypothesis supposes a higher rate of maternal care in older and more experienced females, in contrast the targeted reproductive effort hypothesis predicts lower levels of maternal care in older and/or more experienced females. To test these hypotheses we investigated nursing bout frequency and time devoted to nursing as predictors of the rate of maternal care, and rate of successful nursing bouts as a predictor of maternal investment, in captive giraffe (22 females, 47 calves in four zoos). We also considered the high rate of allonursing (nursing of non-filial calves) which appeared in all herds. The nursing and allonursing bout frequency as well as the total time devoted to nursing and allonursing increased with increasing parity and age of the female, thus supporting the residual reproductive value hypothesis. In addition, maternal experience of individual females in terms of parity rather than age was responsible for variation in maternal behaviour. This suggests that variation depends on individual experiences. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the quality of sperm and the female age influence on fertilization and pregnancy rate after Intracytoplasmic Sperm Injection (ICSI) procedure. Material & Methods: This study was an observational analytic study with a retrospective cohort design. The data of infertile and subfertile male undergoing ICSI for five years were analyzed and evaluated to determine factors influencing pregnancy post-ICSI in Central General Hospital Dr. Sardjito. The Data were analyzed by using Chi-squared test, Kolmogorov-Smirnov test, and Mann-Whitney U test with the confidence level of p

The POSEIDON group (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) has introduced “the ability to retrieve the number of oocytes needed to achieve at least one euploid embryo for transfer” as an intermediate marker of successful outcome in IVF/ICSI cycles. This study aimed to develop a novel calculator to predict the POSEIDON marker. We analyzed clinical and embryonic data of infertile couples who underwent IVF/ICSI with the intention to have trophectoderm biopsy for preimplantation genetic testing for aneuploidy. We used the negative binomial distribution to model the number of euploid blastocysts and the adaptive LASSO (Least Absolute Shrinkage and Selection Operator) method for variable selection. The fitted model selected female age, sperm source used for ICSI, and the number of mature (metaphase II) oocytes as predictors (p < 0.0001). Female age was the most important factor for predicting the probability of a blastocyst being euploid given each mature oocyte (loglikelihood of age [adjusted for sperm source]: 30.9; df = 2; p < 0.0001). The final predictive model was developed using logistic regression analysis, and internally validated by the holdout method. The predictive ability of the model was assessed by the ROC curve, which resulted in an area under the curve of 0.716. Using the final model and mathematical equations, we calculated the individualized probability of blastocyst euploidy per mature retrieved oocyte and the minimum number of mature oocytes required to obtain ≥1 euploid blastocyst—with their 95% confidence interval [CI]—for different probabilities of success. The estimated predicted probabilities of a mature oocyte turn into a euploid blastocyst decreased progressively with female age and was negatively modulated overall by use of testicular sperm across age (p < 0.001). A calculator was developed to make two types of predictions automatically, one using pretreatment information to estimate the minimum number of mature oocytes to achieve ≥1 euploid blastocyst, and another based on the actual number of mature oocytes collected/accumulated to estimate the chances of having a euploid blastocyst using that oocyte cohort for IVF/ICSI. The new ART calculator may assist in clinical counseling and individualized treatment planning regarding the number of oocytes required for at least one euploid blastocyst in IVF/ICSI procedures.

The aim of this study was to investigate how female age affects the predictive effect of sperm DNA fragmentation index (DFI) on clinical outcomes with assisted reproductive technology. A total of 2371 patients, comprising 2115 men with a normal DFI (≤30), 256 men with a high DFI (>30) and women of different ages, were recruited and investigated. All patients had normal chromosome karyotypes and were undergoing their first fresh IVF or intracytoplasmic sperm injection (ICSI) cycles. Clinical outcomes were analysed according to the two DFI groups and female age ≤30 and >30 years. Binary logistic regression analysis was performed to identify factors associated with clinical outcome. The proportion of couples with at least one good-quality embryo in the DFI ≤30 group was higher than that in the DFI >30 group. When female age exceeded 30 years, clinical pregnancy rate and the proportion of couples with good-quality embryos in the DFI >30 group were lower compared with DFI ≤30; however, there were no differences in outcomes for female age ≤30 years according to DFI. When DFI >30, the cut-off value of female age was 30.5 for detecting clinical pregnancy; the sensitivity was 62.0%, and the specificity was 63.6%. Clinical pregnancy rate and proportion of couples with good-quality embryos were lower in the DFI >30 versus DFI ≤30 group with a female age above 30 years for IVF but not for ICSI. Female age has a negative effect and should be considered in predicting the effects of sperm DNA fragmentation on pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Study Question: Is male age associated with the clinical outcomes of IVF/ICSI cycles for idiopathic infertility after adjustment for female age?Summary Answer: Male ageing is negatively associated with clinical IVF/ICSI outcomes in couples with idiopathic infertility independent of female age.What Is Known Already: The effect of male age on the outcomes of infertility treatments is controversial and poorly explored. In contrast, fertility is known to decline significantly with female age beyond the mid-30s, and reduced oocyte quality plays an important role. The negative effect of male age on sperm quality is largely associated with an increasing susceptibility to sperm DNA damage. Although increasing maternal age has been linked with poorer oocyte quality, studies on the effect of male age have disregarded the need to control for female age making it difficult to define clearly the role of male age in infertile couples.Study Design, Size, Duration: This retrospective cohort study analysed 2425 cycles of couples with idiopathic infertility selected from a total of 24 411 IVF/ICSI cycles performed at Monash IVF in Australia between 1992 and 2017. The primary outcome was live birth and secondary outcomes were clinical pregnancy and miscarriage.Participants/materials, Setting, Methods: Couples with primary/secondary infertility who underwent IVF/ICSI cycles with male partners classified as normozoospermic were selected (inclusion criteria). Couples in which the female partner had endometriosis, tubal factors, polycystic ovarian syndrome, ovarian hyperstimulation syndrome, poor responders (≤3 mature oocytes retrieved) and couples with more than 15 cumulus oocyte complexes retrieved or who used cryopreserved gametes were excluded. Binary logistic multilevel modelling was used to identify the effect of male age and female age on clinical outcomes after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: <40, 40-44, 45-49, 50-54, ≥55; female age:<30, 30-34, 35-39, ≥40) predictors.Main Results and the Role Of Chance: There was a negative effect of male age and female age on live birth as odds ratios (OR) with 95% CI for each additional year of age (OR-male age: 0.96 [0.94-0.98]; OR-female age: 0.90 [0.88-0.93] P < 0.001). Potential interactions with male age such as type of treatment (IVF/ICSI), embryo transfer day (Day 3/Day 5) and female age did not have significant associations with outcomes (P > 0.05). Secondary outcomes showed a significant reduction in the odds of clinical pregnancy (OR-male age: 0.97 [0.96-0.99]; OR-female age: 0.92 [0.89-0.94] P < 0.001) and an increase in the odds of miscarriage with older age: male age (OR: 1.05 [1.01-1.08]; P = 0.002); female age (OR: 1.11 [1.05-1.18]; P < 0.001). Worse outcomes were associated with more cycles (clinical pregnancy-OR: 0.96 [0.93-0.99] P = 0.03; live birth-OR: 0.96 [0.92-0.99] P = 0.023) while more inseminated oocytes were associated with better outcomes (clinical pregnancy-OR: 1.06 [1.03-1.06] P < 0.001; live birth-OR: 1.07 [1.04-1.11] P < 0.001). Analyses for age categories showed a gradual worsening of clinical outcomes with increasing male age, with a significantly worse live birth and clinical pregnancy outcomes in males aged older than 50 years compared to males younger than 40 years (P < 0.05).Limitations, Reasons For Caution: This study is limited to the information on confounding factors included. The study may also be limited in its generalizability to a wider population due the strict selection criteria. Age as a category could potentially result in residual confounding due to categorizing a continuous variable.Wider Implications Of the Findings: This study provides information for counselling of couples with idiopathic infertility.Study Funding/competing Interest(s): Funded by the Education Program in Reproduction and Development, Department of Obstetrics and Gynaecology, Monash University. None of the authors has any conflict of interest to report.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Introduction: The OPTIMIST trial revealed that for women starting in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment, no substantial differences exist in first cycle and cumulative live birth rates between an antral follicle count (AFC)-based individualized follicle-stimulating hormone (FSH) dose and a standard dose. Female age and body weight have been suggested to cause heterogeneity in the effect of FSH dose individualization. The objective of the current study is to evaluate whether these patient characteristics modify the effect of AFC-based individualized FSH dosing in IVF/ICSI treatment.Material and Methods: A secondary data-analysis of the OPTIMIST trial. Women initiating IVF/ICSI treatment were classified as predicted poor (AFC 0-7), suboptimal (AFC 8-10) or hyper responders (AFC >15), and randomly allocated to a standard FSH dose (150 IU/d) or an individualized FSH dose (450, 225 or 100 IU/d for predicted poor, suboptimal and hyper responders, respectively). In each predicted response category, logistic regression models with interaction terms were used to evaluate the presence of effect modification. The first cycle was analyzed, and the primary outcomes were first complete cycle live birth rate (including fresh plus frozen-thawed embryo transfers) and ovarian hyperstimulation syndrome (OHSS) risks.Results: No effect modification was revealed in the predicted poor (n = 234) and suboptimal (n = 277) responders. In the predicted hyper responders (n = 521), the effect of the individualized FSH dose on the first cycle live birth rate was modified by female age (P = 0.02) and the effect on OHSS risks was modified by body weight (P = 0.02). A dose reduction from 150 to 100 IU/d generally decreased the OHSS risks in predicted hyper responders, but also reduced the chance of a live birth in young women, and had no beneficial impact on OHSS risks in women with a relatively low body weight.Conclusions: In women with a predicted hyper response undergoing IVF/ICSI treatment, female age and body weight seem to modify the effect of FSH dose individualization. Although a reduced FSH starting dose generally decreases the OHSS risks, it may also reduce the chance of a live birth, specifically for young women. Future studies could consider these findings when investigating the optimal approach to reduce OHSS risks while maintaining the probability of a live birth for predicted hyper responders in IVF/ICSI treatment. [ABSTRACT FROM AUTHOR]

Study Question: What is the number of oocytes where the maximum cumulative live birth rate per aspiration (CLBR) is observed during ART in women of different ages?Summary Answer: The maximum CLBR was observed when around 25 oocytes were retrieved in women between 18-35 years of age, around 9 oocytes in women more than 45 years of age and continued to increase beyond 30 oocytes in women between 36-44 years of age.What Is Known Already: The live birth rate per fresh or frozen/thaw embryo transfer (FET) procedure has traditionally been the main measure of ART success. However, with the introduction of highly efficient embryo cryopreservation methods, CLBR encompassing live delivery outcomes from the fresh and all subsequent FET following a single ovarian stimulation and oocyte collection is increasingly viewed as a more meaningful measure of treatment success. There is evidence suggesting that larger oocyte yields are associated with increased likelihood of cumulative live birth per aspiration. Whether this association is the same across female ages has not yet been properly investigated.Study Design, Size, Duration: This is a large retrospective population-based cohort study using data from the Australian and New Zealand Assisted Reproduction Database (ANZARD). ANZARD contains information from all ART treatment cycles carried out in all fertility centres in Australia and New Zealand. Overall, 221 221 autologous oocyte aspiration cycles carried out between January 2009 to December 2015 were included in the analysis.Participants/materials, Setting, Methods: Cumulative live birth per aspiration was defined as at least one liveborn baby at ≥20 weeks gestation resulting from an ART aspiration cycle, including all fresh and FET resulting from the associated ovarian stimulation, until one live birth occurred or all embryos were used. Cycles where no oocytes were retrieved were excluded from analysis as there is no possibility of live birth. Analyses of data were performed using generalized estimating equations to account for the clustered nature of data (multiple cycles undertaken by a woman). Univariate and multivariable regression analysis was performed to identify and adjust for factors known to independently affect cumulative live birth per aspiration. An interaction term between female age and the number of oocytes retrieved was included to assess whether the age of the women was associated with a different optimal number of oocytes to achieve at least one live birth from an aspiration cycle (i.e. the effect-modifying role of female age). The likelihood of cumulative live birth per aspiration was calculated as odds ratios (ORs) with 95% CI.Main Results and the Role Of Chance: The median number of oocytes retrieved was 7 (interquartile range, 4-12) and median age of patients was 36 (interquartile range, 33-40). The overall CLBR was 32.2%. The results from the multivariable regression analysis showedthat the number of oocytes retrieved remained a significant predictor (P < 0.001) of cumulative live birth per aspiration after adjusting for female age, parity and cycle count. Compared to the reference group of 10-14 oocytes retrieved, the adjusted odds for cumulative live birth per aspiration increased with the number of oocytes retrieved: 1-3 oocytes, 0.21 (95% CI, 0.20-0.22); 4-9 oocytes, 0.56 (95% CI, 0.55-0.58); 15-19 oocytes, 1.38 (95% CI, 1.34-1.43); 20-24 oocytes, 1.75 (95% CI, 1.67-1.84); and 2.10 (95% CI, 1.96-2.25) with more than 25 oocytes. After stratifying by female age group, the rate of increase in CLBR per additional oocyte retrieved was lower in the older age groups, indicating that higher oocyte yields were more beneficial in younger women. CLBR of patients in the <30 years and 30-34 years age groups appeared to reach a plateau (with only minimal increase in CLBR per additional oocyte retrieved) after retrieval of 25 oocytes at 73% and 72%, respectively, while CLBR of patients in the 35-39 years and 40-44 years age groups continued to increase with higher oocyte yields, reaching 68% and 40%, respectively, when 30 or more oocytes were retrieved. CLBR of patients aged 45 years and above remained consistently below 5%. Findings suggest that the number of oocytes retrieved where CLBR appears to be maximized is around 25 in women between 18-35 years, more than 30 in women between 36-44 years and around 9 in women 45 years and older. However, results for women aged 45 years and older may not be as robust due to the relatively small sample size available in this age group.Limitations, Reasons For Caution: As with all large retrospective database studies, there are potential confounders that cannot be accounted for. Despite the current study being based on complete ascertainment of ART cycles across two countries, ovarian stimulation protocols, oocyte quality parameters and a number of important patient characteristics are not collected by ANZARD. Additionally, a small number of cycles were available for women over 45 years yielding more than 15 oocytes, making these estimates unreliable.Wider Implications Of the Findings: The results from this study demonstrate that the number of oocytes retrieved where the maximum CLBR is observed during ART is dependent on female age. This provides information for clinicians and patients to understand the modifying effect of age on the number of oocytes retrieved and the likelihood of success with ART.Study Funding/competing Interest(s): No external funding was used for this study. The Fertility Society of Australia funds the National Perinatal Epidemiology and Statistics Unit to manage ANZARD and conduct national reporting of ART in Australia and New Zealand. Associate Professor Georgina Chambers (G.C.) is employed by the University of New South Wales (UNSW) and is director of the National Perinatal Epidemiology and Statistics Unit at UNSW. G.C. was also a paid member of the Australian governments Medicare Benefits Scheme taskforce on assisted reproductive technologies in 2017. [ABSTRACT FROM AUTHOR]

Aspirated follicular cells (AFCs) from the in vitro fertilization program can express various stem cell markers and are even able to differentiate into different types of cells in vitro. The female reproductive potential decreases with increasing age due to lowered ovarian reserve and oocyte quality, but data on the effect of female age on stem cell characteristics of AFCs are scarce. Therefore, the aim of this study was to elucidate whether female age affects the mesenchymal stem cell (MSC) characteristics of AFCs. Follicular aspirates were collected from 12 patients included in the in vitro fertilization programme with a normal ovarian reserve. Patients were divided into four age groups: Group A ≤ 30 years, Group B 31–35 years, Group C 36–39 years and Group D ≥ 40 years. After removal of the oocytes, AFCs were collected from follicular aspirates using hypo-osmotic technique and cultured in vitro, and their stemness was compared according to female age. The cultured AFCs were analysed for gene expression using the Human Mesenchymal Stem Cell RT2 Profiler™ PCR Array, for their potential for differentiation into adipogenic and osteogenic lineage, and for their expression of MSC-related markers using immunocytochemistry. We found that female age can significantly influence their stemness: expression of pluripotency and MSC-related genes, and their differentiation potential. Despite the relatively high expression of MSC-related genes, the AFCs of the oldest patients had the lowest potential to differentiate into osteogenic and adipogenic lineages in vitro, which may be related to their age and the changed ovarian function. [ABSTRACT FROM AUTHOR]

Study Question: What is the chance of a treatment-independent live birth following IVF (including ICSI) treatment?Summary Answer: Over 5 years of follow-up, the treatment-independent live birth rate was 17% in unsuccessfully treated women and 15% in those who had a live birth after IVF.What Is Known Already: A limited number of studies have investigated the chance of treatment-independent conception following completion of IVF, but most of them have been based on surveys with poor response rates and limited sample sizes.Study Design, Size, Duration: This is a population-based, retrospective cohort study of 2133 women who received IVF treatment between 1998 and 2011 at a single regional IVF Unit and were followed for a minimum of 1 year and maximum of 15 years after their last IVF or ICSI treatment cycle.Participants/materials, Setting, Methods: This study included all women, residing in the north-east of the UK, who attended the Aberdeen Fertility Clinic and received IVF treatment between 1998 and 2011. Clinical and diagnostic information of all women was linked with treatment and pregnancy outcome data. A total of 2133 women were divided into two groups: (i) those who achieved a live birth following successful IVF or ICSI treatment (n = 1060) and (ii) those in whom treatment was unsuccessful i.e. resulted in either no pregnancy or pregnancy loss (n = 1073). The two groups were followed from the date of the last embryo transfer until the first treatment-independent live birth or 31 December 2012, whichever came first. The primary outcome was the treatment-independent live birth rate at 1, 2.5, 5 and 10 years of follow-up. Cox regression was used to determine factors associated with treatment-independent live birth in each group.Main Results and the Role Of Chance: Within 5 years of follow-up, the treatment-independent live birth rate was 17% (95% CI, 15-19%) among women whose IVF or ICSI treatment was unsuccessful and 15% (95% CI, 12-17%) among women whose treatment resulted in live birth. In both groups, shorter duration of infertility, younger female age and IVF as compared to ICSI were associated with a higher chance of achieving treatment-independent live birth. Among unsuccessfully treated women, the chance of post-IVF live birth was reduced in those with tubal factor infertility. Three or more previous IVF or ICSI embryo transfers were associated with a lower chance of treatment-independent live birth among successfully treated women.Limitations, Reasons For Caution: The study was conducted in a single fertility centre, which could compromise the generalizability of the findings. Moreover, data were unavailable on the women's use of contraception or active attempts to get pregnant, both of which could influence treatment-independent live birth rates.Wider Implications Of the Findings: This study provides a better understanding of the long-term prognosis for treatment-independent live birth after completion of IVF or ICSI treatment. The results will inform women of their chances of a treatment-independent live birth following failed or successful treatment and the factors that are associated with it.Study Funding/competing Interest(s): This work was funded by a Chief Scientist Office Postdoctoral Training Fellowship in Health Services Research and Health of the Public Research (Ref PDF/12/06). The views expressed here are those of the authors and not necessarily those of the Chief Scientist Office. The authors have no competing interests.Trial Registration Number: Not applicable. [ABSTRACT FROM AUTHOR]

Objective: To determine the ovarian reserve parameters in patients presenting for IVF and intracytoplasmic sperm injection (ICSI) treatment and its association with the number of follicles retrieved and number of oocyte retrieved and fertilized. Methods: A retrospective cross sectional study was conducted at Australian Concept Infertility Medical Centre from January 2017 to August 2017. Around 120 couples presenting to infertility clinics selected for IVF and ICSI with Females (25-45) had their FSH, AMH and AFC done. After ovulation induction, its response was determined by number of follicles retrieved, quality of oocytes retrieved or fertilized and inseminated. SPSS version 20 was used for the purpose of data analysis. Results: The median age of the patients was 34 (29-38) years. A moderate negative correlation of age and FSH levels was observed with quality of oocytes, Number of oocyte inseminated, number of oocyte fertilized and number of follicle restored. However, a positive correlation of AMH and AFC levels were found with quality of oocytes, Number of oocyte inseminated, number of oocyte fertilized and number of follicle restored. The correlation of AMH levels with number of oocyte inseminated (rho 0.729, p-value <0.001), number of oocyte fertilized (rho 0.721, <0.001) and number of follicle restored (rho 0.723, p-value <0.001) were found strongly correlated. Conclusion: Our study concluded that AMH and AFC have a strong correlation with number of follicles restored and number of oocytes retrieved whereas FSH and age has a weak correlation with the number of follicles restored and number of oocytes retrieved. [ABSTRACT FROM AUTHOR]

Infertility rate documented in Pakistan is 21.9% with only 25% success rate even after procedures like intracytoplasmic sperm injection (ICSI). This rate is further on the decline with enhancement of female age. We aimed to observe the effect of female age on oocyte parameters and reproductive outcome after ICSI. It was done by retrospective analysis of a quasi- experimental design carried out after approval from "Ethical review board of Islamabad clinic serving infertile couples" from July 2010 to August 2011. The response to ovarian stimulation in (282) females was assessed on the basis of groups, A, B, C and D with age ranges up to 25years; 25.1 to 30years; 30.1 to 35years and >35years, respectively. The outcome was assessed as non-pregnant, preclinical abortion and clinical pregnancy groups on the basis of beta hCG and cardiac activity by trans-vaginal scan. We observed that maximum number of pregnancies 32 (38%) occurred in C group, and least 10 (10%) in group A. There was a statistical reduction in the number of mature and fertilized oocytes as the age advanced from group C to D (p<0.05).This shows that reduction in maturity and fertilization of oocytes with advancement of age recommends early referral of couples to assisted reproductive clinics. [ABSTRACT FROM AUTHOR]

Study Question: Do cumulative live birth rates (CLBRs) over multiple IVF/ICSI cycles confirm the low prognosis in women stratified according to the POSEIDON criteria?Summary Answer: The CLBR of low-prognosis women is ~56% over 18 months of IVF/ICSI treatment and varies between the POSEIDON groups, which is primarily attributable to the impact of female age.What Is Known Already: The POSEIDON group recently proposed a new stratification for low-prognosis women in IVF/ICSI treatment, with the aim to define more homogenous populations for clinical trials and stimulate a patient-tailored therapeutic approach. These new criteria combine qualitative and quantitative parameters to create four groups of low-prognosis women with supposedly similar biologic characteristics.Study Design, Size, Duration: This study analyzed the data of a Dutch multicenter observational cohort study including 551 low-prognosis women, aged <44 years, who initiated IVF/ICSI treatment between 2011 and 2014 and were treated with a fixed FSH dose of 150 IU/day in the first treatment cycle.Participants/materials, Setting, Methods: Low-prognosis women were categorized into one of the POSEIDON groups based on their age (younger or older than 35 years), anti-Müllerian hormone (AMH) level (above or below 0.96 ng/ml), and the ovarian response (poor or suboptimal) in their first cycle of standard stimulation. The primary outcome was the CLBR over multiple complete IVF/ICSI cycles, including all subsequent fresh and frozen-thawed embryo transfers, within 18 months of treatment. Cumulative incidence curves were obtained using an optimistic and a conservative analytic approach.Main Results and the Role Of Chance: The CLBR of the low-prognosis women was on average ~56% over 18 months of IVF/ICSI treatment. Younger unexpected poor (n = 38) and suboptimal (n = 179) responders had a CLBR of ~65% and ~68%, respectively, and younger expected poor responders (n = 65) had a CLBR of ~59%. The CLBR of older unexpected poor (n = 41) and suboptimal responders (n = 102) was ~42% and ~54%, respectively, and of older expected poor responders (n = 126) ~39%. For comparison, the CLBR of younger (n = 164) and older (n = 78) normal responders with an adequate ovarian reserve was ~72% and ~58% over 18 months of treatment, respectively. No large differences were observed in the number of fresh treatment cycles between the POSEIDON groups, with an average of two fresh cycles per woman within 18 months of follow-up.Limitations, Reasons For Caution: Small numbers in some (sub)groups reduced the precision of the estimates. However, our findings provide the first relevant indication of the CLBR of low-prognosis women in the POSEIDON groups. Small FSH dose adjustments between cycles were allowed, inducing therapeutic disparity. Yet, this is in accordance with current daily practice and increases the generalizability of our findings.Wider Implications Of the Findings: The CLBRs vary between the POSEIDON groups. This heterogeneity is primarily determined by a woman's age, reflecting the importance of oocyte quality. In younger women, current IVF/ICSI treatment reaches relatively high CLBR over multiple complete cycles, despite reduced quantitative parameters. In older women, the CLBR remains relatively low over multiple complete cycles, due to the co-occurring decline in quantitative and qualitative parameters. As no effective interventions exist to counteract this decline, clinical management currently relies on proper counselling.Study Funding/competing Interest(s): No external funds were obtained for this study. J.A.L. is supported by a Research Fellowship grant and received an unrestricted personal grant from Merck BV. S.C.O., T.C.v.T., and H.L.T. received an unrestricted personal grant from Merck BV. C.B.L. received research grants from Merck, Ferring, and Guerbet. K.F. received unrestricted research grants from Merck Serono, Ferring, and GoodLife. She also received fees for lectures and consultancy from Ferring and GoodLife. A.H. declares that the Department of Obstetrics and Gynaecology, University Medical Centre Groningen received an unrestricted research grant from Ferring Pharmaceuticals BV, the Netherlands. J.S.E.L. has received unrestricted research grants from Ferring, Zon-MW, and The Dutch Heart Association. He also received travel grants and consultancy fees from Danone, Euroscreen, Ferring, AnshLabs, and Titus Healthcare. B.W.J.M. is supported by an National Health and Medical Research Council Practitioner Fellowship (GNT1082548) and reports consultancy work for ObsEva, Merck, and Guerbet. He also received a research grant from Merck BV and travel support from Guerbet. F.J.M.B. received monetary compensation as a member of the external advisory board for Merck Serono (the Netherlands) and Ferring Pharmaceuticals BV (the Netherlands) for advisory work for Gedeon Richter (Belgium) and Roche Diagnostics on automated AMH assay development, and for a research cooperation with Ansh Labs (USA). All other authors have nothing to declare.Trial Registration Number: Not applicable. [ABSTRACT FROM AUTHOR]

The POSEIDON group (P atient- O riented S trategies E ncompassing I ndividualize D O ocyte N umber) has introduced "the ability to retrieve the number of oocytes needed to achieve at least one euploid embryo for transfer" as an intermediate marker of successful outcome in IVF/ICSI cycles. This study aimed to develop a novel calculator to predict the POSEIDON marker. We analyzed clinical and embryonic data of infertile couples who underwent IVF/ICSI with the intention to have trophectoderm biopsy for preimplantation genetic testing for aneuploidy. We used the negative binomial distribution to model the number of euploid blastocysts and the adaptive LASSO (Least Absolute Shrinkage and Selection Operator) method for variable selection. The fitted model selected female age, sperm source used for ICSI, and the number of mature (metaphase II) oocytes as predictors (p < 0.0001). Female age was the most important factor for predicting the probability of a blastocyst being euploid given each mature oocyte (loglikelihood of age [adjusted for sperm source]: 30.9; df = 2; p < 0.0001). The final predictive model was developed using logistic regression analysis, and internally validated by the holdout method. The predictive ability of the model was assessed by the ROC curve, which resulted in an area under the curve of 0.716. Using the final model and mathematical equations, we calculated the individualized probability of blastocyst euploidy per mature retrieved oocyte and the minimum number of mature oocytes required to obtain ≥1 euploid blastocyst—with their 95% confidence interval [CI]—for different probabilities of success. The estimated predicted probabilities of a mature oocyte turn into a euploid blastocyst decreased progressively with female age and was negatively modulated overall by use of testicular sperm across age (p < 0.001). A calculator was developed to make two types of predictions automatically, one using pretreatment information to estimate the minimum number of mature oocytes to achieve ≥1 euploid blastocyst, and another based on the actual number of mature oocytes collected/accumulated to estimate the chances of having a euploid blastocyst using that oocyte cohort for IVF/ICSI. The new ART calculator may assist in clinical counseling and individualized treatment planning regarding the number of oocytes required for at least one euploid blastocyst in IVF/ICSI procedures. [ABSTRACT FROM AUTHOR]

The tendency for self-superparasitism and it's effects on the quality of the parasitoid Ooencyrtus pityocampae (Mercet) (Hymenoptera: Encyrtidae) in parasitizing a new laboratory host, Philosamia ricini (Danovan) (Lepidoptera: Saturniidae), were investigated. In this study, female parasitoids of various ages (1-, 3- and 5-day-old) were tested individually. Parasitoids were provided with 1-day-old P. ricini eggs at ratios of 5, 10, 20, 30 and 40 host eggs per wasp. The tendency to superparasitize was dependent on the female's age and host density. Five-day-old females showed a strong tendency to superparasitize at low host densities. The development time of wasps in superparasitized eggs was longer than that of wasps in singly parasitized eggs. The size and longevity of adult parasitoids decreased significantly with superparasitism. This work contributes to the development of an efficient mass rearing and laboratory rearing of the parasitoid O. pityocampae using a new host.