This review addresses the current understanding of In Vitro Maturation (IVM) treatment, including indications and effective treatment protocols influencing oocyte developmental competence. A comprehensive literature search was performed to gather relevant studies, clinical trials, and reviews related to IVM. Databases such as PubMed, MEDLINE, and pertinent medical journals were searched. The selected literature was analyzed and synthesized to offer a comprehensive overview. IVM has emerged as a promising technique for inducing maturation in immature oocytes across various developmental stages. Its applications extend to areas utilizing In Vitro Fertilization (IVF), gaining traction as a treatment option for Polycystic Ovary Syndrome (PCOS) and fertility preservation in cancer patients. Recent advancements have led to improved global pregnancy rates, resulting in successful births. IVM also holds potential in reducing risks associated with conventional IVF, including ovarian hyperstimulation syndrome and multiple pregnancies. Despite these advantages, IVM adoption in clinical practice remains limited. Ongoing research aims to refine therapeutic protocols and expand clinical indications. IVM holds promise in assisted reproductive technology, spanning applications from cancer patient fertility preservation to addressing PCOS. Enhanced pregnancy rates highlight efficacy, while risk reduction compared to IVF underscores its importance. Further research is needed for optimal use across patient groups, emphasizing protocol refinement and expanded applications.

The point of this consideration is to examine the possible influence of progesterone (P4), estradiol (E2), and testosterone (T) concentrations in follicular fluid (FF) on fertilization, implantation, and biochemical pregnancy rates in patients with polycystic ovary (PCO) and normal women during in vitro fertilization (IVF) treatment. 30 normal-ovulatory women between 24-42 years old and 26 women with the PCO, between 21-37 years old under assisted reproductive therapy were recruited from two university hospital IVF centers during this study. The fluid from more than one preovulatory follicle was obtained on the day of ovulation for hormone measurement using the Elisa method. Association between the mentioned steroid levels and fertilization, implantation, and biochemical pregnancy rates were assessed by using spearman, Mann-Whitney, and regression tests. Among the assessed outcomes, in the PCO group, the FF, E2, and T levels appeared to have a noteworthy reverse relationship with fertilization rate (P= 0.050). In both groups, intrafollicular levels of the E2/T ratio correlated positively with implantation rate (P=0.024 in control vs. P= 0.009 in PCO) and biochemical pregnancy (P= 0.020 in control vs. P= 0.012 in PCO). Furthermore, intrafollicular E2/P4 levels showed a positive relationship with both implantation (P= 0.047) and biochemical pregnancy (P= 0.050) rates in the control group. Our results for the first time suggest that high intrafollicular levels of E2 and T may influence reduced fertilization rate. The E2/T ratio would be a good predictor of successful implantation and pregnancy rates regardless of infertility causes. Moreover, the E2/P4 ratio could be a valuable prescient marker for implantation and biochemical pregnancy rates in normal-ovulatory women. Beyond the mentioned results, the underlying pathological processes, and pathways, including hyperandrogenism and interruptions in the hypothalamic-pituitary-ovarian (HPO) axis could be the potent concepts in polycystic ovary syndrome (PCOS) etiology and an alteration in genetic variants of SHBGs and catalytic enzymes responsible in steroidogenesis pathways. Furthermore, possible correlations between the mentioned steroid hormones and the functions of genes related to gonadotropins and steroid hormones in the pathophysiological pathways involved in PCOS were explored.

Background: Preimplantation genetic diagnosis (PGD) is a diagnostic approach in assisted reproductive technology (ART) to detect and select unaffected embryos to be transferred. Obtaining biopsy samples from embryos (polar body, blastomere, or blastocyst) is a key step in preimplantation genetic testing (PGT), which has many technical issues. Objectives: This study aimed to evaluate the effect of biopsies from 3-day embryos (blastomere) on the quality of embryos and implantation success in couples who requested sex selection before embryo transfer. Methods: On the third day after fertilization, 352 high-quality embryos (> six cells on day third with < 10% fragmentation) were collected from 77 women and were tested for sex selection using FISH testing. A laser beam was used to obtain blastomere biopsies by removing a significantly small portion of the zona pellucida. One blastomere was gently biopsied by an aspiration pipette through its hole. After biopsy sampling, the embryo was immediately returned to the embryo scope until transfer. Embryos’ integrity and blastocyst formation were assessed on day 5. Results: A total of 595 embryos were studied, including 352 embryos that were biopsied on day 3 for gender selection (i.e., the intervention group) and 243 intracytoplasmic sperm injection (ICSI) embryos that did not undergo biopsy (i.e., the control group). Overall, 17.1% of the embryos were abnormal for X or Y chromosomes. Biopsy for PGD was performed 67 - 73 hours after ICSI. Blastomere biopsy taking was significantly associated with blastocyst quality and implantation success. Conclusions: In this study, after obtaining blastomere biopsies, we investigated the growth process of the embryos according to morphokinetic parameters. Our results showed that blastomere biopsy taking could affect the blastulation of embryos and decrease the success rate of implantation.

Aim: Evaluation of Primary post partum hemorrhage as a predictor of von Willebrand disease.Case: A 39 years woman with the history of 15 years primary infertility was referred to shahid sadoughi hospital for termination of pregnancy. Due to the history of IVF (Invitro fertilization) golden baby, she was underwent csesarean section. 2 days after this surgery, she had severed vaginal bleeding that could not be controlled by transfusion, prostaglandines, ligation of uterine artry and internal iliac artry and hysterectomy. On evaluation, we had resulted she had a sub normal von willebrand factor and was diagnosed von Willebrand disease.Result and conclusion: In the patients with primary postpartum hemmorrhage whish unanwered to rutine treatments, we must think about inherited bleeding disorders such as von Willebrand disease.

Background: The benefits of frozen embryo transfer (FET) vs. fresh embryo transfer for in vitro fertilization (IVF) have been discussed in previous studies. Objective: To determine and compare the pregnancy outcomes following FET and frozen embryos transfer in women who underwent assisted reproductive techniques. Materials and Methods: In this cross-sectional study, 233 women candidates for IVF/intra cytoplasmic sperm injection who referred to the Kamali Training Medical Center, Karaj, Iran during 2019-2020 were evaluated in 2 groups of fresh (n = 127) and frozen (n = 106) embryo transfers. The rates of pregnancy outcomes including chemical and clinical pregnancy, live birth, preeclampsia, ectopic pregnancy, still birth, and pregnancy loss were compared between groups in 3 age subgroups (< 25, 25-35, and 35-40 yr old). Results: No significant difference in terms of chemical and clinical pregnancy and live birth rates were observed between groups in women aged < 25 yr. Chemical and clinical pregnancy and live birth rates were significantly higher in the FET group compared to fresh group in 25-35-yr-old women (p = 0.01, p = 0.03, and p = 0.01, respectively). In 35-40-yr-old women, no significant differences were observed in terms of chemical and clinical pregnancy rates, but live birth rate was found to be significantly higher in the FET group (p = 0.02). The pregnancy loss was lower in the FET group (p = 0.038). Conclusion: In conclusion, the FET method in women aged 25-35 yr significantly increases the chance of successful IVF/intra cytoplasmic sperm injection.

Background: Based on the laboratory assays, there is no definitive decision about embryo selection with the proper embryogenic stage for successful transfer in the in vitro fertilization (IVF) technique leading to live birth. Objectives: This experimental study critically aimed to evaluate the efficacy of embryo transfer in cleavage and blastocyst stages based on the identical population (IP) concept. Methods: The IP concept was explained based on several critical points, including the strain (Balb/c), weight (30 g), age (six and eight weeks for females and males, respectively), number of previous sexual cycles, and the same generation. All embryos in each group were divided into grades A, B, and C. Finally, the produced embryos were transferred by trans-cervical procedure, and the mortality rate was recorded. Results: The number of implantation sites and live births increased in all grades of the blastocyst stage compared to the cleavage stage. The number and percentage of implantation sites in blastocyst and cleavage stages were: [11 (45.83%) vs. 3 (8.57%), P < 0.05] for grade A, [8 (29.62%) vs. 1 (5.26%), P > 0.05] for grade B, [2 (10%) vs. 0 (0%), P > 0.05] for grade C, and number and percentage of live births in blastocyst and cleavage stages were [5 (20.83%) vs. 1 (2.85%), P < 0.05] grade A, [3 (11.11%) vs. 0 (0%), P > 0.05] grade B, and [1 (5%) vs. 0 (0%), P > 0.05] grade C. Conclusions: Based on the results, the frequency of implantation sites and the live birth was higher in blastocyst transfer than in the cleavage stage in IVF.