Limiting the number of fresh donor oocytes inseminated with sperm as a strategy to minimize supernumerary embryos.

Objective: To determine the optimal number of fresh donor oocytes to expose to sperm for patients who want to prioritize reducing surplus embryos while preserving the live birth rate.

Design: Cross-sectional study.

Setting: University.

Association between torquetenovirus in vaginal secretions and infertility: An exploratory metagenomic analysis.

Problem: The association of viruses with infertility remains incompletely evaluated.

Method Of Study: Vaginal secretions from 46 women seeking treatment in the Center for Reproductive Medicine and Infertility at Weill Cornell Medicine were tested for viruses by metagenomic analysis by lab personnel blinded to all clinical data.

Results: Torquetenovirus (TTV) was identified in 16 women, alphapapillomavirus in seven women and most were positive for bacteriophages.

Euploid programmed frozen embryo transfer cycles are associated with a higher live birth rate when estradiol levels more closely mimic physiology.

Objective: To determine whether peak estradiol (E) levels above the usual physiologic range (300-500 pg/mL) will impact programmed frozen embryo transfer (FET) outcomes in an ideal study population of those using good-quality single euploid blastocysts.

Design: Retrospective cohort study.

Setting: University-based clinic.

Embryo ploidy in vitrified versus fresh oocytes: Is there a difference?

Purpose: To evaluate embryo ploidy in a cohort of patients who underwent preimplantation genetic testing for aneuploidy (PGT-A) with vitrified oocytes compared to fresh oocytes.

Methods: Patients who underwent their first autologous oocyte vitrification and warming followed by in vitro fertilization (IVF) and trophectoderm biopsy for PGT-A between 1/1/2017 and 12/31/2021 at a single academic institution were included. Patients were compared 1:3 to age-matched controls who underwent their first IVF cycle with fresh oocytes and subsequent trophectoderm biopsy for PGT-A.

Combining early pregnancy bleeding with ultrasound measurements to assess spontaneous abortion risk among infertile patients.

Background: Approximately 15% of all clinically recognized pregnancies in patients with infertility result in spontaneous abortion. However, despite its potential to have a profound and lasting effect on physical and emotional well-being, the natural history of spontaneous abortion in women with infertility has not been described. Although vaginal bleeding is a common symptom in pregnancies conceived via reproductive technologies, its prognostic value is not well understood.

Antimüllerian hormone is not associated with embryo ploidy in patients with and without infertility undergoing in vitro fertilization with preimplantation genetic testing.

Objective: To assess the association between antimüllerian hormone (AMH) and embryo ploidy rates in 2 cohorts of patients undergoing in vitro fertilization (IVF) with trophectoderm biopsy for preimplantation genetic testing for aneuploidy (PGT-A): the general population of women pursuing IVF with PGT-A (Infertile cohort) and women pursuing IVF with preimplantation genetic testing for monogenic disorders (PGT-M) owing to the risk of hereditary monogenic diseases (Non-infertile cohort).

Design: Retrospective cohort study.

Setting: Academic center.

Pregnancy outcomes after oral and injectable ovulation induction in women with infertility with a low antimüllerian hormone level compared with those with a normal antimüllerian hormone level.

Objective: To determine the ongoing pregnancy rate among patients with infertility with a low antimüllerian (AMH) level compared with those with a normal AMH level after oral and injectable ovulation induction (OI)/intrauterine insemination (IUI).

Design: Retrospective cohort.

Setting: Academic center.

Advancing paternal age does not negatively impact fresh embryo transfer cycle outcomes.

Research Question: What is the impact of advancing paternal age, stratifying for maternal age, on fresh embryo transfer cycle outcomes?

Design: All first autologous fresh embryo transfer cycles between 2013 and 2019 at a single high-volume academic institution were retrospectively reviewed. Female age was dichotomized along the cohort median of (37 years) (Female-Young [F-Y]: <37 years; Female-Old [F-O]: ≥37 years). Male age was stratified along the cohort median (38 years) and 90th centile (48 years) (Male-Young [M-Y]: <38 years; Male-Intermediate [M-I]: ≤38 and >48 years; Male-Old [M-O]: ≥48 years).

The use of fresh compared to frozen ejaculated sperm has no impact on fresh embryo transfer cycle reproductive outcomes.

Purpose: To compare the reproductive outcomes of fresh embryo transfer (ET) cycles utilizing fresh versus frozen ejaculated sperm.

Methods: First autologous fresh embryo transfer cycles at a single high-volume academic institution between 2013 and 2019 were retrospectively reviewed. IVF cycles using ejaculated sperm were included, and cycles using donor or surgically retrieved sperm were excluded.

Medical and mental health implications of gestational surrogacy.

Gestational surrogacy in the United States has quadrupled since 1999, but to date, only a few states explicitly permit compensated gestational surrogacy. Current legal prohibitions are often influenced by outdated and stereotyped understandings of surrogacy. It is increasingly important to understand the current literature about the medical and mental health impacts of surrogacy and how state legislatures have addressed compensated gestational surrogacy in recent years.

Body mass index is not associated with embryo ploidy in patients undergoing in vitro fertilization with preimplantation genetic testing.

Objective: To assess the association between body mass index (BMI) and embryo aneuploidy and mosaicism in a cohort of patients undergoing in vitro fertilization (IVF) with trophectoderm biopsy for preimplantation genetic testing for aneuploidy (PGT-A) using next-generation sequencing technology.

Design: Retrospective cohort study.

Setting: Academic center.

Chronic endometritis in women with suspected retained products of conception and their reproductive outcomes.

Objective: To determine whether women who underwent operative hysteroscopy for suspected retained products of conception (rPOC) have histopathologic evidence of chronic endometritis (CE).

Design: Retrospective cohort.

Setting: Academic center.

Time from oocyte retrieval to frozen embryo transfer in the natural cycle does not impact reproductive or neonatal outcomes.

Objective: To determine if the time from oocyte retrieval to frozen embryo transfer (FET) in the natural cycle affects reproductive or neonatal outcomes.

Design: Retrospective cohort.

Setting: Not applicable.

Detection of early placental hormone production in embryo transfer cycles lacking a corpus luteum.

Purpose: This study sought to identify the initiation of placental hormonal production as defined by the production of endogenous estradiol (E2) and progesterone (P4) in a cohort of patients undergoing programmed endometrial preparation cycles with single embryo transfers resulting in live-born singletons.

Methods: In this retrospective cohort study, patients undergoing either programmed frozen-thawed embryo transfer (FET) with autologous oocytes or donor egg recipient (DER) cycles with fresh embryos were screened for inclusion. Only patients who underwent a single embryo transfer, had a single gestational sac, and a resultant live-born singleton were included.

Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I.

Purpose: The summary presented herein represents Part I of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part I outlines the appropriate evaluation of the male in an infertile couple. Recommendations proceed from obtaining an appropriate history and physical exam (Appendix I), as well as diagnostic testing, where indicated.