Editor's Choice
A meta-analysis of serum lipid profiles in premature ovarian insufficiency
Premature ovarian insufficiency (POI), defined as loss of normal ovarian functions before the age of 40 years, occurs in at least 1% of all women. It affects the reproductive system and causes many health problems and psychological stress. Abnormal serum lipid profile leads to cardiovascular diseases, which are strongly associated with high mortality in patients with POI. To date, several studies have examined the levels of different serum lipids in patients with POI. The results, however, are either inconclusive or inconsistent.Is oxytocin receptor antagonist administration around embryo transfer associated with IVF treatment success? A systematic review and meta-analysis
A systematic literature review and meta-analysis was conducted to evaluate whether the administration of an oxytocin receptor antagonist (OTR-a) around embryo transfer is associated with live birth and pregnancy achievement in IVF treatment. Multiple databases were searched for randomized controlled trials (RCT) comparing the outcome of IVF treatment with administration of an OTR-a before, during or after embryo transfer versus administration of placebo/nil. The literature search identified 11 eligible RCT.Lower risk of adverse perinatal outcomes in natural versus artificial frozen–thawed embryo transfer cycles: a systematic review and meta-analysis
Frozen–thawed embryo transfer (FET) has increased steadily worldwide over the past few years (De Geyter et al., 2020; Zegers-Hochschild et al., 2020). In 2015, FET accounted for about 40% of all IVF cycles in Europe (De Geyter et al., 2020). The freeze-all strategy has reported successful results with higher live birth rates and lower incidence of ovarian hyperstimulation syndrome compared with fresh embryo transfer (Roque et al., 2019; Wei et al., 2019). Some studies have suggested that singletons born after FET also have better neonatal outcomes compared with singletons born after fresh embryo transfer, e.g.Impact of chronic endometritis in infertility: a SWOT analysis
Chronic endometritis is a pathology often associated with reproductive failure, but there are still no clear recommendations on whether its inclusion in the initial study of infertile couples is necessary. In this discussion paper, based on a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis, the different aspects of the repercussions of chronic endometritis in fertility are evaluated. To avoid possible subjectivity in the analysis and results of this study, the researchers followed the Oxford criteria for the evaluation of evidence.Influence of ethnicity on different aspects of polycystic ovary syndrome: a systematic review
This systematic review aimed to assess variations in the clinical presentation and treatment outcomes of patients with polycystic ovary syndrome (PCOS) belonging to different ethnicities. A search was performed for studies comparing various clinical aspects of PCOS in two or more different ethnic groups. After screening 2264 studies, 35 articles were included in the final analysis. In comparison with White women with PCOS (wPCOS), East Asian women with PCOS (eaPCOS) were less hirsute, whereas Hispanic women with PCOS (hPCOS), South Asian women with PCOS (saPCOS) and Middle Eastern women with PCOS (mePCOS) were more hirsute.Cytogenetic testing of pregnancy loss tissue: a meta-analysis
Of all clinically recognized pregnancies, about 15% end in loss (Nybo Andersen et al., 2000; Rai and Regan, 2006). The great majority of pregnancy losses occur within the first trimester of pregnancy (Baird, 2009; Farr et al., 2007). Aneuploidy of the embryo is an important female age-related genetic cause of pregnancy loss and can be tested in pregnancy loss tissue (Hassold and Hunt, 2001; Rai and Regan, 2006). A proportion of couples (1–3%) not only suffer from one ‘sporadic’ pregnancy loss but from recurrent pregnancy loss, meaning two or more pregnancy losses (historically three or more losses) (Ford and Schust, 2009).Controversies in ART: can the IVF laboratory influence preimplantation embryo aneuploidy?
Published reports have indicated that rates of preimplantation embryo aneuploidy in a control donor population may vary between IVF centres. This suggests that location-specific conditions, in the clinic, IVF or genetics laboratory, may be influencing the chromosome dynamics or diagnosis. More recent reports suggest that rates of embryo mosaicism, representing mitotic errors, may vary between IVF centres. This would suggest perhaps a laboratory-controlled variable is influencing mitotic cell division during preimplantation embryo development.Use of progestins to inhibit spontaneous ovulation during ovarian stimulation: the beginning of a new era?
Advances in oocyte and embryo cryopreservation for assisted reproduction prompted new approaches to ovarian stimulation. Attention has been paid to progesterone and its derivatives to block the LH surge, as oocyte vitrification removes possible harmful effects of progestins on endometrial receptivity. This review summarizes the current status of progestin use to inhibit ovulation during ovarian stimulation compared with conventional ovarian stimulation. Progestin-primed ovarian stimulation is shown to effectively inhibit spontaneous ovulation, without affecting the number of retrieved oocytes and embryo quality.Imaging the ovary
Using mainly histological analyses of fixed ovarian tissues and ultrasound imaging of ovaries in vivo, earlier imaging studies have established the basic framework of ovarian folliculogenesis as well as luteal formation and regression. The ovary contains individual follicles as functional structures, together with corpora lutea, interstitial tissues, innermost medulla and the outmost layer of the surface epithelium. Most of the 800,000 primordial follicles found at birth in human females remain at the dormant stage.A search for molecular mechanisms underlying male idiopathic infertility
Infertility affects approximately 15% of the couples wanting to conceive. In 30 − 40% of the cases the aetiology of male infertility remains unknown and is called idiopathic male infertility. When assisted reproductive technologies are used to obtain pregnancy, an adequate (epi)genetic diagnosis of male infertility is of major importance to evaluate if a genetic abnormality will be transmitted to the offspring. In addition, there is need for better diagnostic seminal biomarkers to assess the success rates of these assisted reproductive technologies.Insights from clinical experience in treating IVF poor responders
‘Poor responders’ is a term used to describe a subpopulation of IVF patients who do not respond well to ovarian stimulation with gonadotrophins. While there is no standard definition of a poor responder, these patients tend to be of advanced maternal age (≥40 years), have a history of poor ovarian response with conventional stimulation protocols, and/or have low ovarian reserve. Despite the heterogeneity of this patient group, there are characteristics and needs common to many poor responders that can be addressed through a holistic approach.Anti-Müllerian hormone kinetics in pregnancy and post-partum: a systematic review
The aim of this systematic review is to critically appraise the available evidence regarding the kinetics of anti-Müllerian hormone (AMH) during pregnancy and post-partum. A systematic literature search was conducted in MEDLINE, Embase, CENTRAL, Scopus and Web of Science on 14 December 2015, aiming to identify studies providing data on the serum concentration of AMH in women at various stages of gestation and post-partum. There was a total of 1719 participants across eight studies. Seven out of the eight studies reported a decline in serum AMH concentration with advancing gestational age.Sperm cryopreservation and reproductive outcome in male cancer patients: a systematic review
This systematic review of the literature reports on the use and effectiveness of sperm banking programmes for cancer patients. Thirty studies with 11798 patients were included. The aggregated rate of use of cryopreserved semen was 8% (95% CI 8 to 9%). A statistically significant correlation emerged between the mean and median duration of follow-up and the rate of use (R2 = 0.46; P = 0.03). The rate of patients discarding their frozen sample was reported in 11 studies. The aggregated rate was 16% (95% CI 15 to 17%).GnRH agonist trigger for the induction of oocyte maturation in GnRH antagonist IVF cycles: a SWOT analysis
Gonadotrophin releasing hormone agonist (GnRHa) trigger is effective in the induction of oocyte maturation and prevention of ovarian hyperstimulation syndrome during IVF treatment. This trigger concept, however, results in early corpora lutea demise and consequently luteal phase dysfunction and impaired endometrial receptivity. The aim of this strenghths, weaknesses, opportunities and threats analysis was to summarize the progress made over the past 15 years to optimize ongoing pregnancy rates after GnRHa trigger.The endocrine function of human placenta: an overview
During pregnancy, several tightly coordinated and regulated processes take place to enable proper fetal development and gestational success. The formation and development of the placenta is one of these critical pregnancy events. This organ plays essential roles during gestation, including fetal nourishment, support and protection, gas exchange and production of several hormones and other mediators. Placental hormones are mainly secreted by the syncytiotrophoblast, in a highly and tightly regulated way.Live birth using vitrified–warmed oocytes in invasive ovarian cancer: case report and literature review
This article reports the live birth of a healthy newborn using vitrified–warmed oocytes in a young patient with invasive mucinous ovarian carcinoma (stage Ic). Diagnosis was performed after a laparoscopic left adnexectomy. She underwent two cycles of ovarian stimulation, and 14 oocytes were vitrified before fertility-sparing surgery with uterus preservation went ahead. One year later, a transfer of two embryos was performed after insemination of warmed oocytes. Eighteen days after the transfer, she underwent a laparotomy because of abdominal pain, vaginal bleeding and haemoperitoneum.Bob Edwards and the first decade of Reproductive BioMedicine Online
This review celebrates the achievements of Bob Edwards – Founder of this journal, Editor Emeritus, and 2010 Nobel laureate for Physiology or Medicine. A glance through his life-time’s publications from 1954 to 2008 (Appendix, p. 112) reveals the extraordinary range of Bob’s intellectual curiosity and knowledge, and his at times almost mischievous determination to challenge conventional wisdom. We have selected 14 of his papers from the first decade of Reproductive BioMedicine Online to review here by way of illustration.Oocyte developmental competence and embryo development: impact of lifestyle and environmental risk factors
Oocyte development is the end result of a sophisticated biological process that is hormonally regulated and produced by highly specialized cellular lines that differentiate in early embryo/fetal development. Embryo development is initially regulated by maternal transcripts until replaced by embryonic genomic expression. Then, an assortment of hormones and local environmental factors in various concentrations along the reproductive tract (e.g. fallopian tube, endometrial lining) provide the protection, nutrients and means of communication for the embryo to implant and develop.
