International Journal of Reproductive BioMedicine
Year:2023 | Volume:21 | Issue:3|Papers Count:8

The decision to use a living or deceased donor to perform uterus transplantation (UTx) is an evaluation of benefit a nd h arm a nd i s b ased o n t he m edical t eam’, s choices. The current study determines the differences between living and deceased donation in human UTx according to determinant factors in choosing the donor type. For this review study, the PubMed database was searched without time, language, and location limitations up to May 2022. From 113 identified a rticles, 4 5 p apers w ere i ncluded i n t he s tudy for review. According to the results, in comparison to living donation, the biggest advantage of deceased donation is the lack of surgical and or psychological risks for the donor. In contrast, a comprehensive pre-transplantation medical assessment is less possible in deceased donation, and preplanned surgery cannot be realized. According to published peer-reviewed clinical trials on UTx, the graft failure rates in living and deceased donor UTx are 21% and 36%, respectively. Supposing all recipients who did not have graft failure underwent embryo transfer, live birth rates in living and deceased donor UTx procedures are almost 63% and 71%, respectively. Currently, considering the occurrence of live births from both donations, particularly from nulliparous deceased donor, increased demand for UTx in the near future, shortage of uterus grafts, and lack of sufficient d ata f or a comprehensive comparison between the 2 types of donation, the use of both donations still seems necessary and rational.

Background: The implantation rate after assisted reproductive technology depends on 2 important factors, good quality embryo and endometrial receptivity. Endometrial receptivity is mainly assessed by ultrasound measurement of endometrial thickness and morphology. Objective: This study aimed to investigate the relationship between uterine artery Doppler indices/endometrial perfusion and pregnancy rate. Materials and Methods: This cohort study was done on 250 women who were candidates for frozen embryo transfer from January to July 2022. For assessing endometrial receptivity, we performed a Doppler ultrasound of the uterus before embryo transfer with apparently desirable endometrium (endometrial thickness ≥,7 mm and 3 line endometrial pattern). In addition, the women were divided into 2 groups according to assisted reproductive technology outcome (clinical pregnancy), group I positive clinical pregnancy, and group II negative clinical pregnancy, and uterine artery indices and endometrial perfusion were compared between these groups. Results: Uterine artery Doppler showed that the pulsatility index was significantly different between positive and negative clinical pregnancy groups, but resistance index and peak systolic velocity (PSV) did not have statistically significant differences. Also, endometrial perfusion was significantly different between the 2 groups of clinical pregnancy. Endometrial perfusion was significantly better in positive clinical pregnancy groups. Conclusion: Doppler ultrasound can help to assess endometrial receptivity.

Background: Mesenchymal stem cells (MSCs) are deemed as potential new therapeutic agents for infertility treatment and adipose tissue (AT) becomes a potential MSCs source. To direct MSCs through the differentiation process properly, an environment comparable to the in vivo niche might be indispensable. Objective: This study aims to differentiate human AT-derived MScs (hAD-MScs) into male germ-like cells in vitro using a combination of rabbit Sertoli cells conditioned medium (SCCM), bone morphogenetic protein 4, and retinoic acid. Materials and Methods: MScs were isolated from human ATs of fertile and infertile donors. The verified MScs were differentiated using a 2-step protocol,the first step included 20 ng/ml bone morphogenetic protein 4 treatment. The second step was performed utilizing 1 μ, M retinoic acid and/or SCCM. The morphological changes and the expression of germ cell (GC)-specific markers: octamer-binding transcription factor, 4,stimulated by retinoic-acid-8, synaptonemal complex protein-3, and protamine-1 were assessed in the treated cells using quantitative polymerase chain reaction. Results: Induction of hAD-MScs resulted in the upregulation of GC-specific genes where SCCM treatment showed the highest expression. The synaptonemal complex protein-3 and protamine-1 gene expression was detected after 19 and 26 days of induction, respectively. PRM1 was detected in hAD-MScs cultured in SCCM earlier than in other treated groups. The treated cells became more elongated-like spindles and formed aggregates. Conclusion: hAD-MScs differentiated to GC lineage exhibited the ability to express GC-specific markers under in vitro conditions, and rabbit’, s Sertoli cells can be used for inducing transdifferentiation of hAD-MScs into germ-like cells.

Background: Male factor infertility is a multifactorial defect, and many of its etiologies are unknown. Teratozoospermia is determined by the existence of over 85% morphologically abnormal spermatozoa in semen which are almost incompetent in fertilization function. One of the most novel issues in genetic alterations studies is the variation of sperm telomere lengths (STL) and its collaboration with male infertility. The present study has been focused on STL alterations in teratozoospermia. Objective: Investigation of differences in telomere length of teratozoospermia specimens and sperms with normal parameters. Materials and Methods: In this case-control study, 60 men referred to Arak Fertility Clinic, Markazi province, Iran from November 2017 to February 2018 were categorized into teratozoospermia and normozoospermic groups. Sperm genomic DNA extraction was conducted, and STL were evaluated using quantitative polymerase chain reaction. Results: Statistical evaluation of relative telomere length was calculated by the ratio of telomere to single-copy gene for teratozoospermia and normal specimens. Results significantly demonstrated that relative telomere length in teratozoospermia samples is nearly 3 times shorter than in normal samples (p >0. 001). Conclusion: Our results represent the reduction of telomeres length in teratozoospermia and suggest that this alteration might be one of the factors contributing to the sperm fertility potential of this kind of specimen. However, defining relevant molecular processes requires further detailed investigations.

Background: Aerva lanata, a herb used as food and also consumed as a tonic by pregnant women to relieve stomach pains and prevent miscarriage. In addition to other characterized properties, it possesses antifertility and anti-implantation activities. Objective: This study investigates the testicular toxicity of the testes of offsprings of Dams treated with crude aqueous extract of Aerva lanata. Materials and Methods: 25 pregnant Wistar rats (Dams) weighing 180-240 gr were randomly earmarked into 5 groups (n = 5/each). Group A served as control,groups B, C, D, and E received 200, 400, 800, and 1000 mg/kg body weight of Aerva lanata extract, respectively, beginning from 12th to 19th day of gestation. The pups (delivered of Dams) were weighed, observed, and sacrificed 6 wk post-parturition. The testes of the male pups were obtained for histological procedures the testis histology was examined. Results: No gross malformation was observed in the treatment groups, the number of pups/litter was significantly reduced in group E (p = 0. 01), pups weight analysis showed a significant reduction in groups C and E (p = 0. 04, and 0. 02 respectively), and the mean pup testes weight was significantly reduced in groups B, C, D, and E (p = 0. 03, 0. 03, 0. 01, and < 0. 001 respectively) when compared with control. Histologically, the treated pup testes tissues showed varying degrees of disruption and distortion of the cellular arrangements of the germinal epithelium in a dose dependent manner compared to the control. Conclusion: The study revealed a testicular toxicity and possibly antifertility role of Aerva lanata in dams’,pups.

Background: The use of frozen embryo transfers (FET) in assisted reproduction has increased worldwide. Controlled ovarian hyperstimulation in a fresh transfer may impair endometrial-embryo synchronicity. However, there is conflicting evidence on live birth rates (LBR) and clinical pregnancy rates (CPR). Objective: To compare LBRs and CPRs between single autologous day 5 fresh vs. vitrified blastocyst transfer cycles, to investigate the impact of controlled ovarian hyperstimulation on embryo-endometrium asynchrony. Materials and Methods: A large cross-sectional analysis of 6002 embryo transfers (ET) comprised 3774 fresh and 2228 FET cycles from 2016 to 2019. Multivariate and subgroup analysis were performed for high responders (> 20 oocytes). Results: Univariate analysis showed no difference in LBR (28. 3% vs. 27. 4%, p = 0. 43) and CPR (32. 2% vs. 30. 9%, p = 0. 30),however, multivariate analysis demonstrated significantly lower LBR (OR 0. 864, p = 0. 046, 95% CI 0. 749-0. 997) and CPR (OR 0. 852, p = 0. 024, 95% CI 0. 742-0. 979) in FET compared to fresh ETs. Younger participant age, previous in vitro fertilization pregnancy, advanced blastocyst expansion, higher trophectoderm quality, and lower cumulative number of ETs all improved the odds of LBR and CPR. Conventional in vitro fertilization, rather than intracytoplasmic sperm injection, improved CPR but not LBR. Body mass index affected neither LBR nor CPR. In the subgroup, multivariate analysis of high responders showed no difference in LBR or CPR. Conclusion: This study demonstrates relatively higher LBR and CPR of nearly 14% for fresh ETs compared to FETs, in multivariate analysis. A universal freeze-all strategy, without appropriate indication, may lead to suboptimal outcomes. In high responders, freeze-all cycles may be beneficial, as outcomes appear similar.

Background: Outcome prediction of participants treated with in-vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) using anti-Mullerian hormone (AMH) concentration has been widely used. According to the patient-oriented strategies encompassing individualized oocyte number (POSEIDON) definition, low prognosis Bologna responders have changed from poor. This definition divides low prognosis into 4 groups. Objective: The purpose of this study was to assess blood AMH levels in the group of women treated with IVF/ICSI who were thought to have a low prognosis. Materials and Methods: A retrospective cohort study among 252 suspected low, prognosis group participants was assessed between January 2016 and December 2019 at Morula IVF, National hospital, Surabaya, Indonesia. Observed AMH serum levels and pregnancy rates were compared among 4 subgroups. Results: The AMH cutoff value was 1. 7 ng/mL with a sensitivity of 86. 7% and a specificity of 70% for diagnosing low-prognosis women using POSEIDON criteria. There was no difference in the pregnancy rate between those groups (p > 0. 05). Conclusion: AMH levels may indicate a poor prognosis for women having IVF/ICSI in accordance with POSEIDON guidelines. To predict the poor prognosis in women, the cutoff value must be identified.

Background: Phenotypic dysmorphism is not rare to be found in the human oocyte, especially in the perivitelline space, which are among the most important aberration of the extra cytoplasmic component. Case Presentation: The case is of a 30-yr-old woman with no previous pregnancy, attempting an in vitro fertilization treatment for the first time. Given the extraordinary quantity of granular particles found in the perivitelline space, visible after the stripping procedure, it was not possible to establish the presence and position of the first polar body to appreciate the correct oocyte maturation (metaphase 2). Nevertheless, all the eggs were injected by the intracytoplasmic sperm injection. A time lapse incubator was used to perform the entire culture. Hence, a record of 6 days culture video was obtained. Only 2 eggs could fertilize correctly and reach the blastocyst stage on day 6. The embryos were frozen and subsequently transferred as frozen embryo transfer following the next menstrual cycle. Conclusion: The exceptional presence of granular particles in the perivitelline space, which reminds us for aspects and behavior of the granulosa cells, seems to affect the fertilization but not the blastocysts quality. As a matter of fact, the woman, after the embryo transfer, achieved a successful twin live birth.