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Background: Individuals undergoing fertility treatments often experience heightened stress levels compared to the general population. With the increasing number of women facing recurrent failed in vitro fertilization (IVF) cycles, this research aimed to assess the effectiveness of positive thinking counseling and cognitive reconstruction in reducing perceived stress among infertile women. Methods: A randomized controlled clinical trial was conducted with 57 women who had undergone unsuccessful IVF cycles at the Fatemiyeh Infertility Center in Hamadan, Western Iran. Using block randomization, participants were randomly assigned to the control group (29 participants)and the intervention group (28 participants). The intervention group received individual face-to-face positive thinking counseling and cognitive reconstruction in eight sessions, each lasting 45 to 60 min. Stress levels were measured using the Cohen Perceived Stress Scale at the beginning of the study and on the embryo transfer day for both groups. Data were analyzed using Stata-13, with a significance levelof p < 0.05. Results: Both groups' mean perceived stress scores showed no statistically significant differences before the intervention (p = 0.168). However, after the intervention, the mean perceived stress scores in the intervention group were significantly lower than those in the control group (p < 0.001). Conclusions: It appears that the use of these counseling approaches leads to a reduction in perceived stress among infertile women. Trial registration: Registration Number: IRCT20120215009014N474, registered on May15, 2023. [ABSTRACT FROM AUTHOR]

Background: Severe oligoasthenoteratozoospermia (OAT), characterized by a reduced sperm count, motility, and altered morphology, presents a significant challenge in the field of male infertility. Platelet-rich plasma (PRP), renowned for its regenerative capabilities, emerges as a potential intervention for this condition. This study aims to explore the impact of PRP on male infertility, focusing specifically on individuals with severe OAT. Materials and Methods: The clinical trial study involved 88 infertile men diagnosed with OAT and devoid of underlying diseases. These participants were referred to the infertility center and subsequently divided into two cohorts: a control (44 individuals) and an intervention group (44 individuals). Patients in the intervention group received 2 cc of PRP in each testicle, prepared by centrifuging the patients autologous blood samples. Sperm parameters and DNA fragmentation index (DFI) of the patients were measured before and after the procedure. Statistical analysis used SPSS version 16 software, with a significance level set at less than 5%. Results: The statistical analysis revealed a significant difference in concentration (11.32±8.44 vs. 16.06± 15.16, P=0.030), progressive motility (8.86 ± 7.79 vs. 11.97 ± 11.82%, P=0.014) and DNA fragmentation (25.62 ± 12.84 vs. 17.23 ± 9.15%, P<0.001) between the control and intervention groups after PRP injection. However, no significant difference was found in normal morphology (1.63 ± 1.44 vs. 1.81 ± 3.68%, P=0.628) and volume (2.13 ± 0.82 vs. 2.24 ± 1.43, P=0.663) between the control and intervention groups after PRP injection. Conclusion: This study demonstrates the effectiveness of PRP treatment in increasing sperm concentration and motility, while also reducing sperm DNA fragmentation. However, further studies are needed to validate these findings (registration number: IRCT20220317054318N2). [ABSTRACT FROM AUTHOR]

Background: Infertility is one of the most common problems in the world; there is a growing demand for herbal medicines to treat infertility-related problems. Materials and Methods: A randomized controlled trial with three groups was conducted, each with 30 participants. The first group was administered 1.5 grams of Carob daily, the second group was administered 1.5 grams of Ginseng daily, and the third group received a placebo. The treatment was administered for 12 weeks, and before and after the intervention, semen parameters, testosterone, prolactin, luteinizing hormone, follicle-stimulating hormone, thyroid hormones, and sexual function were evaluated. Sexual function was assessed using the International Index of Erectile Function Questionnaire. Results: The mean (SD) age of participants was 34.83 (6.22), 34.60 (5.78), and 33.67 (5.82) years in Carob, Ginseng, and Placebo groups, respectively. The results showed that in the Carob group, the normal volume of semen (Z 133 = 3.05, p = 0.02) and the normal shape of sperm (Z 134 = 2.97, p = 0.01) increased significantly compared to the control group. In the Ginseng group, the normal volume (Z 133 = 3.90, p = 0.001) and the normal viscosity of semen (Z 133 = 2.36, p = 0.01) increased significantly compared to the control group.The Carob group showed a significant increase in normal sperm counts and testosterone hormone levels (Z 131 = 2.81, p = 0.05). The Ginseng group demonstrated a significant improvement in orgasm function (H2 = 6.14, p = 0.04) and the total score of the International Index of Erectile Function (IIEF) (H2 = 5.8, p = 0.05). Conclusions: Carob supplements are suggested to enhance some semen parameters and male sex hormones. For infertile men, Ginseng can be beneficial in improving sexual function. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the effects of the antioxidant supplement of CoQ10 and placebo in the male infertility treatment. Materials and Methods: The randomized controlled trial study was designed as a clinical trial. Samples in each group consisted of 30 members. The first group received 1 daily dose of 100 mg coenzyme Q10 capsules and the second group received a placebo treatment. Treatment in both groups lasted 12 weeks. Before and after the intervention of semen analysis, hormonal measurement of testosterone, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and thyroid stimulating hormone (TSH) were done. Sexual function was assessed before and after the intervention by using the International Index of Erectile Dysfunction questionnare. Results: The mean age of participants was 34.07 (5.26) years in the CoQ10 group and 34.83 (6.22) in the placebo one. Normal volume of semen (P=0.10), viscosity (P=0.55), sperm count (P=0.28), and sperm motility (P=0.33) in the CoQ10 group increased without statistically significant differences. But the normal sperm morphology increased with statistically significant differences in the CoQ10 group (P=0.01). There was an increase in normal FSH levels and testosterone levels in the CoQ10 group compared with the placebo patients, but these differences were not statistically significant (respectively P=0.58, P=0.61). The results also revealed that the scores of erectile function (P=0.95), orgasm (P=0.86), satisfaction with sexual intercourse (P=0.61), overall satisfaction (P=0.69) and the score of the International Index of Erectile Function (IIEF, P=0.82) were greater after the intervention in the CoQ10 group than in the placebo group although the difference was not statistically significant. Conclusion: The use of CoQ10 supplement can improve sperm morphology; however, in other sperm parameters and also in some hormones increased after the intervention, this was not statistically significant and therefore the result is not conclusive (registration number: IRCT20120215009014N322). [ABSTRACT FROM AUTHOR]

Objective: To compare the pregnancy outcomes achieved by in vitro fertilization (IVF) between minimal stimulation and conventional antagonist protocols in poor ovarian responders (PORs). Materials and methods: In this randomized controlled trial, 77 PORs undergoing IVF were selected and divided into two groups. First group was the minimal stimulation group (n = 42) receiving 100 mg/day clomiphene citrate on day 2 of the cycle for 5 day that was followed by 150IU/day human menopausal gonadotropin (hMG) on day 5 of the cycle. Second group was the conventional group (n = 35) receiving at least 300 IU/daygonadotropin on day 2 of the cycle. Gonadotropin-releasing hormone (GnRH) antagonist protocol was applied for both groups according to flexible protocol. Number of retrieved oocytes and chemical pregnancy rate were the main outcomes. Results: There was no difference in number of retrieved oocyte and pregnancy rate (2.79 ± 1.96 vs. 2.20 ± 1.71 and 5.6% vs. 4.1%; p > 0.05) between both groups. The gonadotropin dose used in the minimal stimulation group was lower than conventional group (1046 ± 596 vs. 2806 ± 583). Conclusion: Minimal stimulation protocol with lower gonadotropin used is likely to be considered as a patient- friendly and cost-effective substitute for PORs. [ABSTRACT FROM AUTHOR]

Background: In vitro maturation (IVM) is a promising technique in assisted reproductive technologies, offering benefits such as reducing the risk of ovarian hyperstimulation syndrome. Objective: This study aimed to evaluate the effects of timed follicular fluid meiosis-activating sterol (FF-MAS) supplementation on the IVM of germinal vesicle oocytes using a dynamic microfluidic system. Materials and Methods: In this lab trial study, 266 germinal vesicle oocytes were collected from the Infertility Center of Fatemieh hospital, Hamedan, Iran between June 2023 and January 2024. The oocytes were allocated into 3 groups for dynamic microfluidic culture. Each group received culture medium at a flow rate of 0.36 µL/min for 24 hr through inlet A and FF-MAS supplementation through inlet B for 1, 2, and 6 hr. The study evaluated maturation and fertilization rates, embryo development, and mitochondrial status, which was assessed using the JC-1 mitochondrial membrane potential assay. Results: Maturation rates were significantly higher in the medium-term FF-MAS exposure (MTG) and long-term FF-MAS exposure groups compared to the short-term FF-MAS group (STG) (p < 0.05). Fertilization rates were also higher in the MTG and long-term FF-MAS group compared to the STG (p <0.05). Embryo formation rates and the proportion of good-quality embryos were higher in the MTG compared to the STG (100% vs. 75%; p = 0.03) and (83.3% vs. 33.3%; p = 0.01), respectively. Mitochondrial peripheral distribution was significantly higher in the MTG than in the STG (p = 0.04). Conclusion: Optimizing FF-MAS exposure duration enhances IVM efficiency, offering a promising strategy to increase oocyte utilization in in vitro fertilization programs. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of a microfluidic culture system supplemented with follicular fluid meiosis-activating sterol (FF-MAS) on the maturation of immature oocytes in patients with polycystic ovarian syndrome (PCOS)., Methods: A total of 438 germinal vesicle oocytes from 163 PCOS patients were included. Oocytes were divided into five groups: (1) cultured in static drops without FF-MAS, (2) cultured in static drops with FF-MAS, (3) cultured in a microfluidic device without FF-MAS, (4) cultured in a microfluidic device with FF-MAS for the first 2 h, and (5) cultured in a microfluidic device with FF-MAS for 24 h. Maturation, fertilization, and embryo development rates were assessed, alongside gene expression analysis using quantitative real-time PCR. Ultrastructural analysis was performed using transmission electron microscopy (TEM)., Results: The maturation rates for oocytes in groups 1 to 5 were 36%, 48%, 42%, 64%, and 65%, respectively, with groups 4 and 5 showing significant increases (p < 0.05). Fertilization rates were higher in groups 4 and 5 (p < 0.05). High-quality embryo formation rates were significantly higher in groups 3, 4, and 5. Gene expression analysis indicated enhanced expression of BRCA1 and TP53 in the dynamic culture groups. Ultrastructural analysis showed improved mitochondrial integrity and cytoplasmic maturation in the dynamic groups., Conclusions: The dynamic microfluidic culture system with FF-MAS supplementation significantly enhances oocyte maturation and embryo quality in PCOS patients by closely mimicking the natural in vivo environment. This approach shows promise for optimizing in vitro oocyte maturation and improving fertility outcomes., (© 2025 Japan Society of Obstetrics and Gynecology.)

Human oocyte maturation is a lengthy process that takes place over the course of which oocytes gain the inherent ability to support the next developmental stages in a progressive manner. This process includes intricate and distinct events related to nuclear and cytoplasmic maturation. Nuclear maturation includes mostly chromosome segregation, whereas rearrangement of organelles, storage of mRNAs and transcription factors occur during cytoplasmic maturation.Human oocyte maturation, both in vivo and in vitro, occurs through a process that is not yet fully understood. However, it is believed that the second messenger, cyclic adenosine monophosphate (cAMP), plays a pivotal role in the upkeep of the meiotic blocking of the human oocyte. Relatively high levels of cAMP in the human oocyte are required to maintain meiosis blocked, whereas lower levels of cAMP in the oocyte enable meiosis to resume. Oocyte cAMP concentration is controlled by a balance between adenylate cyclase and phosphodiesterases, the enzymes responsible for cAMP generation and breakdown.In addition to nuclear maturation, the female gamete requires a number of complicated structural and biochemical modifications in the cytoplasmic compartment to be able to fertilize normally. According to ultrastructural studies, during the transition from the germinal vesicle stage to metaphase II (MII), several organelles reorganize their positions. The cytoskeletal microfilaments and microtubules found in the cytoplasm facilitate these movements and regulate chromosomal segregation.The aim of this review is to focus on the nuclear and cytoplasmic maturation by investigating the changes that take place in the process of oocytes being competent for development.