Fertility outcomes post immune checkpoint inhibitor exposure.

Harrold et al. evaluate the fertility impact of checkpoint inhibitor blockade (ICB), demonstrating that unlike in utero exposure, post-exposure conception appears to result in uncomplicated pregnancies and healthy progeny. They demonstrate contemporaneous monitoring of temporal female hormonal fluctuations before, on, and post ICB exposure and prior to successful embryo implantation.

Live-Birth Outcomes Among Women With Infertility and Anti-Müllerian Hormone Levels of 0.3 ng/mL or Lower.

Objective: To estimate the live-birth rate per in vitro fertilization (IVF) cycle and after cumulative infertility treatment among patients with anti-müllerian hormone (AMH) levels of 0.3 ng/mL or lower.

Methods: We conducted a retrospective cohort study at a single academic center of patients with infertility and AMH levels of 0.

p53 and reproduction.

Tumor protein 53 (TP53) and its related family of p63 and p73 are tumor suppressor genes that regulate cellular activity to enhance longevity. p53 binds to specific response elements in DNA, modulating the transcription of genes that govern the major defenses against tumor growth. Additional members of the p53 family are involved with male and female germ cell survival.

Preimplantation genetic screening: who benefits?

Objective: To compare IVF outcomes between women undergoing frozen transfers of blastocysts verified as euploid by preimplantation genetic screening (PGS) with patients undergoing fresh nonbiopsied blastocyst transfers.

Design: Retrospective cohort study.

Setting: Academic medical center.

The effect of 5α-reductase-2 deficiency on human fertility.

A most interesting and intriguing male disorder of sexual differentiation is due to 5α-reductase-2 isoenzyme deficiency. These male infants are born with ambiguous external genitalia due to a deficiency in their ability to catalyze the conversion of T to dihydrotestosterone. Dihydrotestosterone is a potent androgen responsible for differentiation of the urogenital sinus and genital tubercle into the external genitalia, urethra, and prostate.

Regulation of female reproduction by p53 and its family members.

Tumor suppressor p53 is crucial for embryonic implantation through transcriptional up-regulation of uterine leukemia inhibitory factor (LIF). This article reports that p53 and estrogen receptor α were activated in endometrial tissues during implantation to coordinately regulate LIF production. By using human p53 knockin (Hupki) mice carrying a single nucleotide polymorphism (SNP) at codon 72 (arginine/proline), the arginine allele was demonstrated to produce higher uterine LIF levels during implantation than the proline allele.

The first successful paternity through in vitro fertilization-intracytoplasmic sperm injection with a man homozygous for the 5α-reductase-2 gene mutation.

Objective: To report a case of successful paternity from a male homozygous for 5α-reductase-2 deficiency.

Design: Case report.

Setting: Academic center, division of reproductive endocrinology.

Single-nucleotide polymorphisms in the p53 pathway regulate fertility in humans.

The tumor suppressor protein p53 plays an important role in maternal reproduction in mice through transcriptional regulation of leukemia inhibitory factor (LIF), a cytokine crucial for blastocyst implantation. To determine whether these observations could be extended to humans, a list of single-nucleotide polymorphisms (SNPs) in the p53 pathway that can modify the function of p53 was assembled and used to study their impact on human fertility. The p53 allele encoding proline at codon 72 (P72) was found to be significantly enriched over the allele encoding arginine (R72) among in vitro fertilization (IVF) patients.

Triploidy--the breakdown of monogamy between sperm and egg.

The advent of assisted reproductive technology (ART) has taught us a great deal about human fertilization patterns. Thirty years of experience with IVF and cultivation of early embryos has provided a unique view into the mechanisms of normal and aberrant human fertilization. Here we review the different types of triploidy following conventional in vitro fertilization and intracytoplasmic sperm injection, as well as the mechanisms giving rise to digynic and dispermic fertilization.

An analysis of transfusion practice and the role of intraoperative red blood cell salvage during cesarean delivery.

Background: We sought to determine to what extent intraoperative salvaged red blood cells (RBC) might theoretically reduce exposure to appropriately transfused allogenic erythrocytes in Cesarean delivery patients.

Methods: Medical records of Cesarean delivery patients requiring blood transfusions from January 1, 1992 to June 30, 1996 and June 1, 1998 to June 30, 2003 were reviewed. For each patient, we calculated the number of allogenic RBC units that could have theoretically been avoided had intraoperative autotransfusion been performed, based upon estimated blood loss, preoperative hematocrit, and the amount of retrieved blood needed to yield a single RBC unit.

Simultaneous bilateral ovarian torsion in the follicular phase after gonadotropin stimulation.

Objective: To present and discuss the first report of follicular phase bilateral ovarian torsion following a cancelled IVF cycle.

Design: Case report.

Setting: University-based assisted reproductive technology program.