Short insemination during conventional in vitro fertilization increases embryo quality.

Aim: To compare clinical outcomes using short and long co-incubation protocols in sibling oocytes based on embryo morphokinetic outcomes measured by time-lapse incubator with stratification based on a woman's age and sperm quality.

Design: Our study included 72 cycles with >6 oocytes retrieved. Sibling oocytes were distributed for two parallel protocols: short (3 h; n = 421) or long (16-20 h; n = 434) insemination, using the same amount of spermatozoa from the same prepared sample.

Two types of cleavage, from zygote to three cells, result in different clinical outcomes and should be treated differently.

Research Question: What is the utilization rate of embryos that exert inadequate zygote cleavage into three daughter cells?

Design: This study used a retrospective dataset from a single IVF Unit. A total of 3,060 embryos from 1,811 fresh IVF cycles were analyzed. The cleavage pattern, morphokinetics, and outcome were recorded.

Stain-Free Sperm Analysis and Selection for Intracytoplasmic Sperm Injection Complying with WHO Strict Normal Criteria.

This multi-center study evaluated a novel microscope system capable of quantitative phase microscopy (QPM) for label-free sperm-cell selection for intracytoplasmic sperm injection (ICSI). Seventy-three patients were enrolled in four in vitro fertilization (IVF) units, where senior embryologists were asked to select 11 apparently normal and 11 overtly abnormal sperm cells, in accordance with current clinical practice, using a micromanipulator and 60× bright field microscopy. Following sperm selection and imaging via QPM, the individual sperm cell was chemically stained per World Health Organization (WHO) 2021 protocols and imaged via bright field microscopy for subsequent manual measurements by embryologists who were blinded to the QPM measurements.

Standardization of Post-Vitrification Human Blastocyst Expansion as a Tool for Implantation Prediction.

The increased use of vitrified blastocysts has encouraged the development of various criteria for selecting the embryo most likely to implant. Post-thaw assessment methods and timetables vary among investigators. We investigated the predictive value of well-defined measurements of human blastocyst re-expansion, following a fixed incubation period.

Gonadotropin releasing hormone agonist triggering for maturation cycles.

The objective was to evaluate the outcomes of maturation (IVM) cycles using gonadotropin releasing hormone agonist (GnRH-ag) triggering. A retrospective cohort of IVM cycles from January 2015 to December 2019 in a single university-affiliated centre was examined. Main outcome measures were: (i) IVM maturation rate; and (ii) IVM maturation result.

Does stress affect IVF outcomes? A prospective study of physiological and psychological stress in women undergoing IVF.

Research Question: What are the effects of physiological and psychological stress on fertility outcomes for women undergoing IVF?

Design: A prospective cohort study of 72 patients undergoing IVF in 2017 and 2018. Physiological stress was assessed by salivary cortisol measurements: (i) pretreatment, when the patient received the IVF protocol; (ii) before oocyte retrieval (follicular cortisol was also measured); and (iii) before embryo transfer. Emotional stress was evaluated at each assessment with the State-Trait Anxiety Inventory and a 1-10 Visual Analogue Scale (VAS, referred to as the 'Stress Scale'.

A prospective study of C-reactive protein in patients with obesity during IVF.

This prospective cohort pilot study investigated the physiology of C-reactive protein (CRP) during fertilization (IVF) cycles and its effect on outcomes in women with and without obesity. The study was conducted from April to August 2014, in the IVF Unit of a university-affiliated hospital. Women aged 18-42 years were enrolled.

Number of Oocytes Retrieved as a Criterion for "Freeze-All" Strategy versus a Single "Rescue" Bolus of Low-Dose Human Chorionic Gonadotropin Following GnRH Agonist for Ovulation Triggering: A Pilot Study.

Aim: To evaluate the number of oocytes retrieved as a criterion - when to use a "freeze-all" or low-dose "rescue human chorionic gonadotropin (hCG)" strategy.

Methods: A retrospective study. Instead of the classic hCG trigger, an E2 level of ≥3,000 pg/mL was used to trigger ovulation with GnRH agonist.

What we learned from extended culture of 'rejected' day-3 cleavage stage embryos: a prospective cohort study.

Background: To test whether poor quality day-3 embryos can undergo successful blastulation and implantation.

Methods: A prospective cohort study was conducted. Whether or not a good quality embryo was transferred on day-3, poor quality (rejected) embryos were further cultured and followed.

Does the transfer of a poor quality embryo together with a good quality embryo affect the In Vitro Fertilization (IVF) outcome?

Background: IVF cycles which result in only one good quality embryo, and a second poor quality embryo present a dilemma when the decision involves transferring two embryos. The aim of this study was to evaluate whether a poor quality embryo has a negative effect on a good quality embryo when transferred along with a good quality embryo.

Methods: We retrospectively evaluated in vitro fertilization (IVF) cycles involving single embryo transfers (SET) and double embryo transfers (DET).

Time lapse microscopy is useful for elective single-embryo transfer.

The aim of our study was to evaluate time lapse microscopy (TLM) as a selection tool for single-embryo transfer (SET) on day 5, blastocyst stage. An observational cohort study was conducted. Patients who had SET were compared to patients who had double embryo transfer (DET).

What is the best treatment for women with polycystic ovarian syndrome and high LH/FSH ratio? A comparison among in vitro fertilization with GnRH agonist, GnRH antagonist and in vitro maturation.

Purpose: To evaluate whether high LH/FSH ratio has a clinical impact on patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) with GnRH-agonist/antagonist protocols or in vitro maturation (IVM) treatments.

Methods: We retrospectively reviewed all PCOS patients with day 3 LH/FSH ratio ≥1.5 who underwent IVF or IVM.

What are the best predictors for successful GnRH antagonist protocol in in vitro fertilization (IVF) treatment?

Objective: To determine factors that affect the success rate of GnRH antagonist protocol in in vitro fertilization (IVF) treatment.

Design: Retrospective cohort study.

Patients: Patients who underwent IVF cycle with their first GnRH antagonist protocol.

GnRH-antagonist programming versus GnRH agonist protocol: a randomized trial.

Objective: Testing the ability to program IVF GnRH-antagonist cycles to avoid weekend oocyte retrieval.

Study Design: Preliminary randomized clinical trial. Patients presenting an indication for IVF or IVF-ICSI were assigned into either the Treatment Group - GnRH antagonist protocol, programmed to start stimulatory agents on a Friday, with oral 2mg estradiol valerate twice a day from the 2nd day of cycle until the first Friday to follow, or to the Control Group - long luteal GnRH agonist protocol.

Morphological and molecular markers are correlated with maturation-competence of human oocytes.

Study Question: Does the position of the germinal vesicle (GV) in human oocytes correlate with molecular and morphological parameters as well as with maturation-competence?

Summary Answer: The position of GV in human oocytes correlates with density of microtubule (MT) filaments, concentration of Fyn, nucleolus localization and the ability of the oocytes to complete maturation following GV breakdown (GVBD).

What Is Known Already: Our knowledge is confined to oocytes of young mice where maturation-competence is correlated with a central GV and regulated by MTs and the presence of a chromatin ring. Fyn kinase is localized at the spindle and cortex of mouse oocytes and plays a role in both maturation and MT stabilization.

Assessment of sperm hyperactivated motility and acrosome reaction can discriminate the use of spermatozoa for conventional in vitro fertilisation or intracytoplasmic sperm injection: preliminary results.

Basic semen analysis is insufficient for determining the fertility potential. The aim of this study was to determine if hyperactivated motility (HAM) and acrosome reaction (AR) can be useful tests for evaluating semen quality during male infertility evaluations and to help the clinician decide whether regular insemination or intracytoplasmic sperm injection (ICSI) is preferable during in vitro fertilisation. A prospective study was conducted.

Monitoring stimulated cycles during in vitro fertilization treatment with ultrasound only--preliminary results.

Objective: To evaluate if monitoring patients by ultrasound (US) only during in vitro fertilization (IVF) treatment is safe.

Design: Randomized prospective study.

Intervention: Patients undergoing their first IVF treatment were randomized into two groups.

Re-evaluation of post-wash sperm is a helpful tool in the decision to perform in vitro fertilisation or intracytoplasmic sperm injection.

The aim of this study was to find discriminatory parameters, based on sperm characteristics on the day of ovum pickup, that can help guide the decision to perform either intracytoplasmic sperm injection (ICSI) or in vitro fertilisation (IVF). We evaluated 112 cycles fertilised with both regular and ICSI insemination during the same cycle. A total of 112 cycles were analysed.

Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study.

Background: The aim of this study was to evaluate the effect of dehydroepiandrosterone (DHEA) supplementation on in vitro fertilization (IVF) data and outcomes among poor-responder patients.

Methods: A randomized, prospective, controlled study was conducted. All patients received the long-protocol IVF.

Human oocyte cryopreservation and the fate of cortical granules.

Objective: To examine the effect of the commonly used oocyte cryopreservation protocol on the cortical granules (CGs) of human immature germinal vesicle (GV) and mature metaphase II (MII) oocytes.

Design: Laboratory study.

Setting: IVF unit.

The effect of chilling on membrane lipid phase transition in human oocytes and zygotes.

Background: Chilling injury occurs when the cell membrane undergoes a transition from the liquid state to the gel state. Human oocytes and single-cell zygotes are of similar shape and size but the post-thawing survival rate of oocytes is poorer. We set out to investigate the possible difference in membrane lipid phase transition (LPT) temperature between the two cell types.

Cortical granules reaction after intracytoplasmic sperm injection.

The cortical reaction (CR) in mammalian oocytes is induced following sperm-egg membrane fusion. During intracytoplasmic sperm injection (ICSI) the physiological cascade of gamete interaction events is bypassed. The aim of this study was to explore CR occurrence after the ICSI procedure and its correlation with the meiotic status of the oocytes.

The role of a human chorionic gonadotropin burst in in vitro fertilization.

Findings: No oocytes were found during four ovum pickups (OPU), despite a satisfactory ovarian response to controlled ovarian hyperstimulation. After the first attempt failed in the fourth case, five eggs were retrieved, fertilized, and cleaved after cycle rescue with hCG.

Conclusions: Whenever oocytes are not aspirated during OPU due to a lack of hCG administration, the cycle may be rescued if 10,000 IU of hCG is injected immediately and OPU planned for 33-36 hr later.