Objective To investigate the embryo retention (ER) rate in embryo transfer (ET) cycles and its effects on reproductive outcomes. Design Matched retrospective cohort study. Setting A tertiary hospital−based reproductive medicine center. Patient(s) A total of 6,089 ET cycles were performed from January 2013 to December 2018 in our unit. Intervention(s) Each woman was matched with two separate control

In humans and other mammals, a hallmark of female reproductive function is the capacity to episodically release fertilizable oocytes under the precise control of a cascade of hormonal regulators that interplay in a cyclic manner within the hypothalamic-pituitary-ovarian (HPO) axis. Although the basic elements of this neurohormonal system were disclosed several decades before, a major breakthrough in

Objective To analyse the published literature in reproductive endocrinology and infertility (REI) to examine the transparency and the use of reproducible research practices of the scientific literature and to identify possible avenues for improvement. Design Meta-epidemiologic study. We examined the first 20 consecutive full-text original articles presenting primary data from five REI-specific journals

Objective To investigate the role(s) of hyaluronan synthase 2 (HAS2) and hyaluronan in disease progression of endometriosis and epidermal growth factor (EGF)−induced motility changes of endometriotic cells. Design A case-control experimental study and in vitro primary cell culture study. Setting University hospital−affiliated research centers. Patients A total of 21 women with stage I/II endometriosis

Advances in medically assisted reproduction led to new understanding of many key facets of reproductive physiology often upending prior dogma. This series of reviews covers unexpected and thought-provoking advances in the hypothalamus and pituitary, folliculogenesis, ovulatory triggering, what triggering misses physiologically, control of follicular growth and in vitro activation, and the relationship

The current ovarian cycle paradigm postulates that ovulation is triggered by a critically sustained elevation of estradiol. However, an in-depth look into the published data reveals considerable uncertainty about the relative roles of progesterone and estradiol in the ovulation process.This review provides compelling evidences that the role of estradiol in ovulation has been misinterpreted and that

Final maturation of follicles has, in connection with ovarian stimulation and infertility treatment, traditionally been achieved by the administration of a human chorionic gonadotropin (hCG) bolus trigger of 5,000 to 10,000 IU. This trigger serves two purposes: induce oocyte maturation; and serve as luteal phase support owing to its long half-life. It now appears that the hCG bolus trigger is unable

Male factor infertility is a significant problem present in up to 50% of infertile couples. The relationship between male infertility and systemic disease is of significant interest, and emerging evidence suggests a relationship between male infertility and male genitourinary (GU) birth defects (cryptorchidism, hypospadias, ambiguous genitalia, and congenital anomalies of the kidney and urinary tract)

Objective To determine the susceptibility of the endometrium to infection by—and thereby potential damage from—SARS-CoV-2. Design Analysis of SARS-Cov-2 infection-related gene expression from endometrial transcriptomic data sets. Setting Infertility research department affiliated with a public hospital. Patient(s) Gene expression data from five studies in 112 patients with normal endometrium collected

Objective To investigate the presence of viral RNA in human semen of patients with severe acute-respiratory syndrome coronavirus 2 (SARS-CoV-2) and to evaluate its presence and relevance in semen parameters. Design Pilot cohort study. Setting University hospital. Patient(s) Thirty-four men were distributed as: 1) patients in convalescence (patients with confirmed SARS-CoV-2 infection in pharyngeal

Intracytoplasmic sperm injection, while typically effective for overcoming low or absent fertilization in couples with a clear abnormality of semen parameters, is frequently used in combination with assisted reproductive technologies for other etiologies of infertility in the presence of semen parameters that meet the World Health Organization 2010 normative reference values. This committee opinion

Since the advent of preimplantation genetic testing for aneuploidy (PGT-A) in the 1990s, substantial changes in test methodology and technology now allow the detection and reporting of intermediate chromosome copy number (commonly referred to as mosaicism) for aneuploidy in a trophectoderm biopsy sample. Clinicians are grappling with how to interpret such findings and how to counsel patients about

The demand for certainty is one which is natural to man, but is nevertheless an intellectual vice —Bertrand Russell

Objective To investigate a possible correlation between chromosomal aberrations and paternal age, analyzing embryos derived from young oocyte donors, with available preimplantation genetic testing for aneuploidy results from day 5/6 trophectoderm biopsy obtained by next-generation sequencing for all 24 chromosomes. Design Retrospective cohort study. Setting Canadian fertility centre. Patient(s) A total

Objective To evaluate a novel micro-straw as an efficient, simple method for freezing a small number of human spermatozoa for intracytoplasmic sperm injection (ICSI). Design Prospective cohort study. Setting Sperm bank. Patient(s) Men with severe oligozoospermia or azoospermia undergoing a total of 143 ICSI cycles at the CITIC-Xiangya Hospital of Reproduction and Genetics from June 1, 2015, to June

Objective To determine relationships between age of men with potential male factor infertility and sperm chromatin structure assay (SCSA) measures of sperm DNA fragmentation (SDF) and high DNA stainable sperm (HDS), and to compare these data with those obtained from healthy donor men without reproductive issues. Design Retrospective study. Setting Infertility clinics and diagnostic laboratory. Patients

Objective To evaluate the effect of coenzyme Q10 (CoQ10) supplementation on oocyte maturation rates and postmeiotic aneuploidy rates during in vitro maturation (IVM) of human oocytes. Design Clinical laboratory observation. Setting Hospital and university laboratories. Patient(s) Forty-five patients aged ≥38 years and 18 patients aged ≤30 years undergoing in vitro fertilization. Intervention(s) The

Objective To determine if transferring a lower-quality embryo with a good-quality blastocyst is detrimental, given that evidence suggests that embryos can signal the endometrium and that embryo quality may affect negatively endometrial receptivity. Design Retrospective cohort study. Setting In vitro fertilization center. Intervention(s) Single- versus double-embryo transfer. Patient(s) Patients with

Objective To describe the outcome of preimplantation genetic testing (PGT-A) using their own oocytes in patients with mosaic Turner Syndrome (MTS). The impact of the assisted reproduction technique (ART) performed (PGT-A or oocyte donation) and the type of absence of the X chromosome (total or partial) were considered. Design Retrospective observational multicenter study. Setting University-affiliated

Objective To assess the level of satisfaction of women undergoing transvaginal oocyte retrieval (TOR) without anesthesia as well as the comfort of the gynecologists. Design Single-center, prospective cohort study of women undergoing TOR from July 2017 to January 2018. Setting This study was conducted in an academic public hospital. Patient(s) Women with ≤15 follicles for retrieval were eligible. Women

Objective To study the use of the aromatase inhibitor letrozole for treatment of ectopic pregnancy compared with methotrexate. Design Nonrandomized prospective cohort study. Setting University hospital. Patient(s) A series of 42 consecutive patients with undisturbed ectopic pregnancy. Intervention(s) Counseling on treatment options, including surgical treatment (control group) versus medical treatment

Objective To evaluate the feasibility of using indocyanine green (ICG) to estimate the vascularization of the resected zone during a laparoscopic rectal shaving. Design Indocyanine green can highlight blood vascularization when injected intravenously. There is no relevant, objective, intraoperative method to assess the vascularity of the resected zone during a laparoscopic rectal shaving for deep infiltrating

Objective To evaluate ovarian stimulation regimens and reproductive outcomes in a cohort of women undergoing ovarian tissue cryopreservation (OTC) and ovarian tissue transplantation (OTT). Design Retrospective cohort study. Setting University hospital and fertility clinics. Patients Twenty-eight women undergoing OTT and in vitro fertilization (IVF) from 2012 to 2017. Intervention OTC, OTT, and IVF

Objective To report ovarian tissue autotransplantation (AT) results and describe the relationship between technical and clinical factors and outcomes. Design Multicenter retrospective cohort study. Setting Tertiary medical centers. Patient(s) Infertile patients who had stored ovarian tissue before sterilizing treatment and returned for AT with the aim of conceiving. Interventions(s) Ovarian tissue

Objective To evaluate whether SOHLH2 intronic variation contributes to the genetic predisposition to male infertility traits, including severe oligospermia (SO) and different nonobstructive azoospermia (NOA) clinical phenotypes. Design Genetic association study. Setting Not applicable. Patient(s) Five hundred five cases (455 infertile patients diagnosed with NOA and 50 with SO) and 1,050 healthy controls

Objective To assess the psychosocial outcomes of recipients and their partners 2 and 3 years after entering this first clinical uterus transplantation study. Design Prospective observational study. Setting University hospital. Patient(s) Nine women with absolute uterine factor infertility and their male partners participated. Intervention(s) Psychosocial evaluations using questionnaires focusing on

Objective To investigate whether endometrial extracellular vesicles (EVs) from patients with recurrent implantation failure (RIF) attenuate the growth and invasion of embryos. Design In vitro experimental study. Setting University-affiliated hospital. Patient(s) Ten RIF patients and seven fertile women. Interventions(s) Endometrial cells isolated from endometrial tissues obtained from patients with

Objective To review the presentation of unicornuate uterus with a functional noncommunicating rudimentary uterine horn and a laparoscopic method of management, highlighting laparoscopic surgical techniques. Design A video review of unicornuate uterus with a functional noncommunicating rudimentary uterine horn and a laparoscopic approach to treatment in a 13-year-old pubertal female with severe menstrual

Objective To present an effective approach to trophectoderm biopsy for blastocysts of different stages and characteristics by mechanical blunt dissection (MBD). Design Stepwise demonstration with still pictures and operational video clips to explain tips and tricks for trophectoderm biopsy. (This demonstration was approved by the Reproductive Study Ethics Committee at Shengjing Hospital of China Medical

Objective To study compliance and effectiveness of the mHealth nutrition and lifestyle coaching program Smarter Pregnancy in couples undergoing in vitro fertilization (IVF) treatment with or without intracytoplasmic sperm injection (ICSI). Design Multicenter, single-blinded, randomized controlled trial, conducted from July 2014 to March 2017. Setting IVF clinics. Patient(s) A total of 626 women undergoing

Objective To evaluate the impact of oral contraceptives (OC) on live birth rate (LBR) following a fresh embryo transfer and cumulative live birth rate (cLBR) in normal ovulatory women undergoing in vitro fertilization (IVF). Design Retrospective cohort study. Setting Reproductive center. Patients A total of 3,110 normo-ovulatory women aged 20–40 years undergoing IVF either using or not using OC pretreatment

Objective To determine whether the presence of focal adenomyosis of the outer myometrium (FAOM) at preoperative magnetic resonance imaging is associated with the severity of deep infiltrating endometriosis. Design Observational cross-sectional study involving 255 symptomatic deep infiltrating endometriosis patients. Comparisons were performed according to the presence of FAOM. Setting University hospital

Objective To assess whether trophectoderm biopsy has any impact on the level of serum β-human chorionic gonadotropin (β-hCG) in early pregnancies. Design Retrospective cohort study. Setting University-affiliated reproductive medical center. Patient(s) Three hundred and eighty-three women undergoing 396 frozen embryo transfer (FET) cycles with preimplantation genetic testing (PGT), and 353 women undergoing

Objective To study the pregnancy, miscarriages, and live birth rates (LBRs) according to maternal killer cell immunoglobulin-like receptor (KIR) genes expressed by uterine natural killer cells and paternal or oocyte donor human leukocyte antigen-C (HLA-C) genes expressed by trophoblast cells in patients with recurrent reproductive failure. Design Prospective observational cohort study. Setting Private

Objective(s) To assess efficacy and safety of self-administered 3 mg dinoprostone vaginally in reducing pain during copper intrauterine device (IUD) insertion in parous women. Design Randomized, double-blinded, placebo-controlled trial. Setting Family planning clinic in a tertiary referral hospital. Patient(s) Multiparous women who were attending a family planning clinic and requesting copper IUD insertion

Objective To identify and treat the gamete responsible for complete fertilization failure with intracytoplasmic sperm injection (ICSI) using a newly proposed assisted gamete treatment (AGT). Design Prospective cohort study. Setting Center for reproductive medicine. Patient(s) One-hundred and fourteen couples with an adequate number of spermatozoa for ICSI and a fertilization rate of ≤10%, after controlling

Objective To investigate the associations between dietary patterns and antral follicle count (AFC), a marker of ovarian reserve. Design Prospective cohort study. Setting Fertility center at an academic hospital. Patient(s) A total of 363 women seeking preconception evaluation and infertility care at the Massachusetts General Hospital who participated in the Environment and Reproductive Health Study

Objective To study the global DNA methylation pattern in spermatozoa of patients with varicocele as well as investigate their semen quality. Design Prospective observational case-control study. Setting University-affiliated hospital. Patient(s) A total of 26 men with varicocele and 26 fertile men without the disorder. Interventions Analysis of semen quality and sperm DNA methylation patterns. Main

Objective To evaluate the association between in vitro fertilization (IVF) and ischemic placental disease (IPD), stratified by gestational age. Design We performed a secondary analysis of a retrospective cohort study of deliveries. Setting Deliveries were performed over 15 years at a single tertiary hospital. Patient(s) We included all parturients who had a live born infant or an intrauterine fetal

Objective To evaluate the effect of embryo stage at transfer on placental histopathology and perinatal outcome in singleton live births resulting from fresh embryo transfers (ETs). Design Retrospective cohort study. Setting Not applicable. Patient(s) The study population included all live births after fresh ETs during the period from 2009 to 2017. Intervention(s) None. Main Outcome Measure(s) Primary

Objective To test whether in vitro maturation (IVM) of oocytes is an option for preserving the fertility of women diagnosed with premature ovarian insufficiency (POI). Design Case report. Setting University hospital. Patient(s) A 36-year-old amenorrheic patient was referred for fertility preservation (FP) counseling with a diagnosis of autoimmune POI. Serum follicle-stimulating hormone (21.0 and 36

Objective To study the effect of frozen embryo transfer (FET) preparation protocol on incidence of subchorionic hematoma (SCH) and serum hormone levels. Design Retrospective cohort study. Setting University-affiliated fertility center. Patient(s) Patients who underwent FET at the New York University Langone Fertility Center. Intervention(s) None. Main Outcome Measure(s) The primary outcome was incidence

Objective To investigate the current evidence that correlates impaired male fertility with the risk of developing male-related malignancies. Design Systematic review and meta-analysis of population-based retrospective cohort studies. Setting Not applicable. Patient(s) Men diagnosed with impaired fertility status and subsequently observed to determine incidence risk in developing testicular cancer (TCa)

Objective To examine whether F2-isoprostanes, a marker of systematic oxidative stress, are associated with antimüllerian hormone (AMH), an indicator of ovarian reserve, in a population-based cohort of women of black and white ethnicities. Design Cross-sectional analysis. Setting Not applicable. Patients The CARDIA Women’s Study, a population-based cohort. Black (n = 398) and white (n = 432) late reproductive−aged

Objective To demonstrate techniques for successful donor-to-recipient vaginal anastomosis in uterine transplantation including illustration of a tension-free technique. Design This video uses live-action footage from surgery, detailed animations, and illustrations to review the step-by-step technique we use for vaginal anastomosis in uterine transplantation. Institutional Review Board approval was

Objective To prospectively evaluate the association between dietary fat intake and risk of uterine fibroids; and to evaluate the association between erythrocyte membrane fatty acid (FA) levels and fibroid risk. Design Prospective cohort study. Cox proportional hazard models were used to calculate hazard ratios and 95% confidence interval (CI). In a subset of participants 34 individual FAs were measured

Objectives To assess trends, predictors, and perinatal outcomes of ovarian hyperstimulation syndrome (OHSS) associated with in vitro fertilization (IVF) cycles in the United States. Design Retrospective cohort study using National Assisted Reproductive Technology Surveillance System (NASS) data. Setting Not applicable. Patient(s) Fresh autologous and embryo-banking cycles performed from 2000 to 2015

Objective To study whether intrauterine application of auto-crosslinked polymers of hyaluronic acid (ACP) gel after dilation and curettage (D&C) improves reproductive outcomes. Design Follow-up of a prospective randomized trial. Setting University and university-affiliated teaching hospitals. Patient(s) Women with a miscarriage at <14 weeks’ gestation with at least one previous D&C were randomized

Objective To describe our simplified two-step technique for transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and to demonstrate the application of the technique. Design Step-by-step description of the technique and demonstration of its application using surgical video footage from two different cases. Setting Tertiary university hospital. Patient(s) Patient 1 was a 27-year-old

Objective To assess reproductive endocrinology and infertility (REI) physicians’ basic knowledge of compassionate embryo transfer, current practices, and perceived barriers to offering compassionate transfer. Design Cross-sectional survey study. Setting Not applicable. Patients Not applicable. Intervention None. Main Outcome Measures Number of physicians offering and performing compassionate transfer

Objective To study how adult offspring in planned lesbian-parent families relate to their unknown or known donors. Design Qualitative analyses of the sixth wave of online surveys from a longitudinal study of adult offspring in planned lesbian families, enrolled at conception. Setting Community-based United States national study. Patient(s) The 76 participants were 25-year-old donor insemination (DI)

Objective To determine the maternal demographic, health, and fertility variables underlying prematurity. Design Retrospective: Society for Assisted Reproductive Technology Clinic Outcome Reporting System data linked to Massachusetts birth certificates and hospital stays. Setting Not applicable. Patients We included 166,963 privately insured, singleton, first births to women ≥18 years of age between

Objective To investigate the relative contribution of genetic and environmental components to subfertility. Design Twin design using a quantitative genetic liability threshold model that splits the variation of subfertility into additive genetic effects, common environmental effects, and unique environmental effects. Setting Not applicable. Patients A total of 9053 Danish monozygotic and dizygotic

Randomized controlled trials (RCTs) and meta-analyses are the pinnacle of evidence-based medicine, enabling identification of the best available diagnostic, interventional, and therapeutic options. These tools help clinicians and policy makers to set clinical guidelines, but they also represent a double-edged sword: The meaningfulness of RCTs and meta-analyses relies on their quality, performance,

Objective To investigate clinic-specific risk factors for monozygotic twinning (MZT) using a large, electronic database. Design Retrospective case-control study. Setting Infertility clinics. Patient(s) Using an electronic medical record system, viable clinical pregnancy (confirmation of a gestational sac(s) and presence of at least one fetal pole with a heartbeat on first trimester ultrasound), data

Assisted reproductive technology (ART) has been so widely deployed across the world that over 1% of all births are now ART babies, with even higher percentages in the Nordic countries. As pregnancy rates are limited by technical, population, and inherent limitations of human reproduction, key performance indicators should be defined for all the different facets of ART to measure the efficacy of the

Describing clinical outcomes from assisted reproduction technology (ART) treatment cycles has been an evolving challenge throughout the world. Three simple metrics provide a transparent and highly accurate summary of ART outcomes. The first metric is the probability of having no embryos available to transfer. This metric incorporates all causes of failure from initiation of the treatment cycle up to

The laboratory is the heart of an in vitro fertilization (IVF) clinic, and a quality management system is critical for its administration. We review the main structural, process, and outcome key performance indicators (KPIs) to provide laboratory managers with concrete tools aimed at enhancing the quality of their work. Three concepts must be stressed when dealing with KPIs in IVF: [1] always consider

Embryo diagnostics are somewhat controversial in clinical assisted reproduction technology (ART) practice and remain an active area of investigation. Application of embryo diagnostics holds great potential to raise the standard of clinical care by eliminating futile transfers, allowing highly effective single-embryo transfer, and reducing the probability of clinical loss and ongoing abnormal gestations

Like all industries, fertility clinics should identify and follow reference markers of its activity—key performance indicators (KPI)—to allow assisted reproductive technology outcomes to be monitored and compared. Clinical KPIs revolve around following set parameters of the patient population, procedures, and outcome data. Moreover, KPIs should also include identified protocols and standard operating