To collapse or not to collapse blastocysts before vitrification? A matched case-control study on single vitrified-warmed blastocyst transfers.

Research Question: Does laser-induced artificial blastocoel collapse result in better blastocyst cryopreservation survival and a higher live birth rate (LBR) in comparison with intact counterparts?

Design: Half of the supernumerary blastocysts from IVF cycles were randomly selected before vitrification for laser-induced artificial collapsing or vitrification in intact form. A matched case-control study of first transfers of single blastocysts artificially collapsed (case) or intact (control) before vitrification was conducted. Controls were matched to cases on a 1:1 ratio by female age, parity, fresh and vitrified cycle protocol, blastocyst age and quality, resulting in 309 case-control pairs.

The Maribor consensus: report of an expert meeting on the development of performance indicators for clinical practice in ART.

Study Question: Is it possible to define a set of performance indicators (PIs) for clinical work in ART, which can create competency profiles for clinicians and for specific clinical process steps?

Summary Answer: The current paper recommends six PIs to be used for monitoring clinical work in ovarian stimulation for ART, embryo transfer, and pregnancy achievement: cycle cancellation rate (before oocyte pick-up (OPU)) (%CCR), rate of cycles with moderate/severe ovarian hyperstimulation syndrome (OHSS) (%mosOHSS), the proportion of mature (MII) oocytes at ICSI (%MII), complication rate after OPU (%CoOPU), clinical pregnancy rate (%CPR), and multiple pregnancy rate (%MPR).

What Is Known Already: PIs are objective measures for evaluating critical healthcare domains. In 2017, ART laboratory key PIs (KPIs) were defined.

Health related QoL in celiac disease patients in Slovenia.

Background: Measurements of health-related quality of life (HRQoL) among celiac disease patients using a validated questionnaire have been lacking in Slovenia. This study aims to measure HRQoL in celiac disease (CD) patients using EQ-5D internationally validated questionnaire and comparing it to the HRQoL of the general population.

Methods: In this cross sectional analysis all of the approximately 2000 members of the Slovenian Celiac Society were invited to take part.

Public database for validation of follicle detection algorithms on 3D ultrasound images of ovaries.

Background And Objective: Automated follicle detection in ovarian ultrasound volumes remains a challenging task. An objective comparison of different follicle-detection approaches is only possible when all are tested on the same data. This paper describes the development and structure of the first publicly accessible USOVA3D database of annotated ultrasound volumes with ovarian follicles.

Recommendations for good practice in ultrasound: oocyte pick up.

Study Question: What is good practice in ultrasound (US), and more specifically during the different stages of transvaginal oocyte retrieval, based on evidence in the literature and expert opinion on US practice in ART?

Summary Answer: This document provides good practice recommendations covering technical aspects of US-guided transvaginal oocyte retrieval (oocyte pick up: OPU) formulated by a group of experts after considering the published data, and including the preparatory stage of OPU, the actual procedure and post-procedure care.

What Is Known Already: US-guided transvaginal OPU is a widely performed procedure, but standards for best practice are not available.

Study Design Size Duration: A working group (WG) collaborated on writing recommendations on the practical aspects of transvaginal OPU.

Reproductive complications in celiac disease patients in Slovenia.

Objective: Celiac disease is associated with higher risk of infertility, recurrent abortions, and adverse outcomes in pregnancy and in puerperium. The aim of the study was to analyse the association between celiac disease and reproductive disorders in the group of celiac patients and compare these to healthy controls.

Methods: A retrospective case-control matched study.

Onset of menarche is not delayed in Slovenian patients with celiac disease.

Objective: Celiac disease (CD) is an autoimmune disorder associated with numerous health problems, including reproductive disorders. This study was performed to analyze the association between CD and the menstrual cycle in a group of patients with CD and compare these patients' characteristics with those of healthy women.

Methods: The study included 145 patients with CD (age, 15-51 years) and 162 healthy women (age, 18-55 years).

Could polymorphisms of some hormonal receptor genes, involved in folliculogenesis help in predicting patient response to controlled ovarian stimulation?

Purpose: The aim of this study was to investigate whether single nucleotide polymorphisms (SNPs) in selected genes, responsible for hormonal regulation of folliculogenesis, are associated with response to controlled ovarian hyperstimulation (COH) and clinical characteristics of women enrolled in in vitro fertilization (IVF) programs.

Methods: In a cross-sectional study, 60 (IVF) patients underwent COH by using gonadotropin-releasing hormone (GnRH) antagonist and recombinant follicle-stimulating hormone (rFSH) protocol. Patients were classified into three groups: poor-responders (according to Bologna criteria), normo-responders (≤ 15 oocytes), and hyper-responders (> 15 oocytes).

Artificial blastocoel collapse of human blastocysts before vitrification and its effect on re-expansion after warming - a prospective observational study using time-lapse microscopy.

Vitrified human blastocysts show varied re-expansion capacity after warming. This prospective observational study compared behaviour of artificially collapsed blastocysts (study group patients, n = 69) to that of blastocysts that were vitrified without artificial collapse (control group patients, n = 72). Warmed blastocysts were monitored by time-lapse microscopy and blastocoel re-expansion speed and growth patterns compared between study and control groups.

Cumulative live birth rate after GnRH agonist trigger and elective cryopreservation of all embryos in high responders.

Elective embryo cryopreservation after using gonadotrophin-releasing hormone (GnRH) antagonist protocols and GnRH agonist triggering is becoming an increasingly important part of medically assisted reproduction. We designed a single-centre retrospective study to assess the cumulative probability of achieving a live birth through consecutive transfers of vitrified-warmed blastocysts after elective embryo cryopreservation in high-responding patients. Hence, 123 women identified to be at high risk for developing ovarian hyperstimulation syndrome were included.

What is the value of anti-Müllerian hormone in predicting the response to ovarian stimulation with GnRH agonist and antagonist protocols?

Background: Anti-Müllerian hormone (AMH) is a marker of the ovarian reserve with promising prognostic potential in reproductive medicine. We aimed to evaluate the prognostic ability of AMH for predicting excessive or poor responses to ovarian stimulation using gonadotrophin-releasing hormone (GnRH) agonist and GnRH antagonist protocols in patients undergoing medically assisted reproduction (MAR) procedures.

Methods: This retrospective analysis included 623 women who underwent ovarian stimulation for medically assisted reproduction.

The use of time lapse photography in an in vitro fertilization programme for better selection for embryo transfer.

The time lapse photography is not a new method for assessing the dynamics of early embryo development in vitro. It has been used many times in the past for studying cleavages and blastulation of embryos of various animal species. However, this technique became available for routine use in an human in vitro fertilization (IVF) programme only a couple years ago and it becomes more and more popular today.

Simultaneous determination of phthalates, their metabolites, alkylphenols and bisphenol A using GC-MS in urine of men with fertility problems.

A GC-MS method was successfully applied to measure simultaneously the concentrations of endocrine disrupting compounds (5 dialkyl phthalates, 9 phthalate monoesters, 3 alkylphenols and bisphenol A) in 136 male urine samples. In the present study the method was validated and concentrations of EDCs were determined. The results were compared with results from other studies.

Are urinary bisphenol A levels in men related to semen quality and embryo development after medically assisted reproduction?

Objective: To evaluate whether urinary bisphenol A (BPA) levels in men adversely influence semen quality and embryo development after medically assisted reproduction.

Design: Prospective, cohort study.

Setting: University-based tertiary care center.

Human chorionic gonadotropin levels are equally predictive for pregnancy outcome after fresh and vitrified-warmed blastocyst transfer.

Purpose: The aim of the present study was to evaluate if the live birth predictive values of β-hCG levels differ in fresh and vitrified-warmed blastocyst transfer cycles.

Methods: In the retrospectively designed study, 775 cycles with positive β-hCG values 13 days after fresh blastocyst transfer (fresh ET; n = 568) or vitrified-warmed blastocyst transfer (FET; n = 207) were selected for analysis. Average β-hCG levels stratified according to pregnancy outcome (biochemical pregnancy, spontaneous abortion, ectopic pregnancy, and singleton or twin birth) were compared between fresh ET and FET cycles.

Comparison of embryo transfer strategies and assisted reproduction outcome in Slovenian and cross-border patients.

A reduction in the number of embryos transferred is the most important step in decreasing multiple gestation rates after medically assisted reproduction. Slovenia has implemented insurance company regulations that regulate single-embryo transfer in selected good-prognosis couples. The aim of the present study was to evaluate its effects on the Slovenian population compared with cross-border patients, who are not affected by the insurance company policy.

Are sperm DNA fragmentation, hyperactivation, and hyaluronan-binding ability predictive for fertilization and embryo development in in vitro fertilization and intracytoplasmic sperm injection?

Objective: To determine the diagnostic value of the following sperm function tests in predicting the fertilizing ability of spermatozoa in conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI): hyaluronan-binding assay (HBA), DNA fragmentation (Halosperm), and hyperactivity.

Design: Prospective study.

Setting: University medical center.

Evaluation of coagulation abnormalities among women with vaginal bleeding in the first trimester of pregnancy.

Objective: To compare blood coagulation parameters between pregnant women with vaginal bleeding in the first trimester of pregnancy and pregnant women with normal pregnancy in the first trimester.

Methods: A prospective controlled study of 98 women in the first trimester of vital pregnancy was conducted at the University Medical Centre Maribor, Slovenia. The study group comprised women with vaginal bleeding (n=50) while the control group women with normal pregnancy, admitted for artificial abortion (n=48).

Prediction of human blastocyst development from morulas with delayed and/or incomplete compaction.

Objective: To determine the influence of delayed compaction and fragmentation on the developmental capacity of morulas.

Design: Prospective study.

Setting: University IVF center.

Changes in perifollicular vascularity after administration of human chorionic gonadotropin measured by quantitative three-dimensional power Doppler ultrasound.

Aim: To determine the perifollicular vascular network and blood flow changes of the dominant preovulatory follicle using quantitative three-dimensional (3D) power Doppler analysis.

Methods: A total of 21 cycles were studied in spontaneously ovulating women who underwent folliculometry and 3D power Doppler angiography of perifollicular blood flow of the dominant preovulatory follicle on the day of human chorionic gonadotropin (hCG) administration and 24 h after it.

Results: At 24 h after the administration of hCG, increases were found in the area inside the biggest follicular circumference (8.

An observational study of assisted reproductive technology outcomes in new European Union member states: an overview of protocols used for ovarian stimulation.

Background: The development of new fertility treatment options has facilitated individualized assisted reproductive technology (ART) protocols to improve outcomes. Manufacturing improvements to recombinant human follitropin alfa have allowed precise dosing based on mass (filled-by-mass; FbM) rather than bioactivity (filled-by-bioassay; FbIU). Continued monitoring and reporting of follitropin alfa treatment outcomes in routine clinical practice is essential.

Sperm morphological abnormalities as indicators of DNA fragmentation and fertilization in ICSI.

Purpose: To determine the relationship between sperm morphological abnormalities, DNA fragmentation and fertilization rate in intracytoplasmic sperm injection (ICSI).

Methods: Sperm samples from 20 ICSI cycles were analysed. Morphology was assessed according to strict criteria, and DNA fragmentation was measured by terminal deoxynucleotidyl transferase (TdT)-mediated fluorescein-dUTP nick end labelling (TUNEL) using flow cytometry.

A prospective, randomized trial on the effect of atmospheric versus reduced oxygen concentration on the outcome of intracytoplasmic sperm injection cycles.

Objective: To assess whether the embryo cultivation at different oxygen tensions had any effect on intracytoplasmic sperm injection (ICSI) outcome.

Design: Prospective randomized trial.

Setting: University clinical center.