Assisted Reproduction

El objetivo de este trabajo es analizar, a partir de un corpus de testimonios procedentes de foros, chats y blogs sobre reproducción asistida elaborado ad hoc, las expresiones metafóricas que sirven a las mujeres participantes para comunicar lo que pasa en sus cuerpos y lo que transcurre en sus pensamientos y emociones. A partir de la metáfora bélica el cuerpo como campo de batalla se analizan cinco grupos de expresiones metafóricas en las que los dominios fuente evidencian que, frente a la presentación optimista de las clínicas, el proceso por el que pasan las pacientes está marcado por el dolor y la impotencia.

Purpose Repeated pregnancy loss (RPL) occurs in 1 out of 300 couples, and the cause of about 50% of them remains idiopathic. Mitochondria have an important role in human development through ATP production and their involvement in apoptosis. Methods 96 RPL and 96 control females were used to investigate the frequency of deletions and point mutations in the displacement loop (D-loop) on mitochondria. Multiplex PCR and DNA sequencing methods were used to detect possible variations in the mitochondrial DNA (mtDNA). Results No deletions but a high frequency of point mutations were found in RPL females; among 129 variations observed in RPL, 22 mutations were significant (P<0.05) and the insertion of C in nucleotide 114 was novel. Conclusion High rate of mutations in D-loop of mtDNA was observed in maternal blood, a fact that may have a direct or indirect role in inducing RPL. The results can be used in the assessment of RPL and designing possible treatments for improving assisted reproduction. Keywords Mitochondrial DNA . Deletion . Mutation . Repeated pregnancy loss Recently, it has been hypothesized that mitochondria may be directly involved in human reproduction, this has taken attentions within the scientific and medical community . Human mitochondrial DNA (mtDNA) contains a 16569-base pair double strand circular genome which encodes 13 proteins (from 37 genes) of the respiratory chain, 2 rRNAs and 22 tRNAs needed for mitochondrial protein synthesis . The double strand consists of heavy (Hstrand that is Guanine-rich) and light strands (L-strand, that is cytosine-rich). This genome also includes a non-coding displacement region (D-loop) which consists of 1122 base pairs (bp) (16024-577 nt of mtDNA) , acting as a promoter of mtDNA and containing essential transcription and replication elements. D-loop contains two hypervariable Capsule No deletions but a high rate of D-loop point mutations were observed in mtDNA of RPL women. This condition may have a role in inducing RPL.

Introduction Assisted reproductive technologies are increasingly more present in our everyday life: from classical sperm/egg donation or in vitro fertilization to newer, more controversial methods such as surrogate motherhood, male pregnancies or posthumous sperm procurement. Every year, new concepts are emerging in this field and the medical world is not always prepared to deal with them. Material and method The greatest problem of using posthumous sperm procurement as an assisted reproductive method resides in analyzing consent related. An extensive research of the scientific literature revealed eight possible situations which we will present and analyze in this article. Results By analyzing consent related issues we present a decision making algorithm for posthumous sperm procurement.

Banu Kumbak received her MD degree in 1996 from Hacettepe University, School of Medicine, and an Obstetrics and Gynaecology speciality degree in 2001 from Istanbul University Cerrahpasa Medical School, Turkey. She has been working in the area of assisted reproductive treatments since 2002. Her special interests are poor responder patients, ovarian stimulation protocols for assisted reproduction cycles and reproductive surgery.

Objective: This study aimed to determine the impact of endometriosis on oocyte maturation in stimulated In-vitro Fertilization/Intra Cytoplasmic Sperm Injection (IVF/ICSI) outcomes. This retrospective study was conducted at Hameed Latif Hospital, Lahore from March 2021 to March 2023. Methodology: About 180 women were included in this study. All the study subjects were categorized into two groups in equal, where Group A presented with ovarian endometriosis and Group B presented women without endometriosis. Infertility parameters in both groups were same like age, body mass index (BMI), and infertility duration. Outcome parameters (ovarian reserve, fertilization rate, embryo quality, implantation rate and pregnancy outcomes) were compared in both groups. Results: The mean age was 38 years in both groups. In group A, BMI and the Antral Follicle Count was lower as compared to group B. (p-value =0.04) The number of oocytes retrieved, matured, and fertilized was higher in group B (14±5.31, 13±4.60, 12.5±4.79) as compared to group A (5±2.52, 4.83±2.40, 3.66±1.03). All the variables were statistically significant with the p-value <0.05. The pregnancy rate in Group A was 30% and in Group B, it was 29%. Conclusion: Oocyte number and quality are affected by endometriosis. However, ovarian endometrioma does not affect the embryo quality and the outcome of pregnancy.

Spermatogenesis is the fundamental process by which sperm are produced in the male testes. This mini-review provides a comprehensive overview of spermatogenesis and its clinical relevance to infertility treatment, with an emphasis on in vitro fertilization (IVF). We outline the duration, location, and hormonal regulation of spermatogenesis, and describe the stages of cellular development from spermatogonia to mature spermatozoa. A detailed examination of spermiogenesis-the final transformation of spermatids into motile sperm-is included, highlighting how this process underlies sperm morphology and motility characteristics. Hormonal regulation by the hypothalamic-pituitary-gonadal axis is discussed in the context of male fertility and IVF planning. We also review the contributions of accessory glands (seminal vesicles, prostate, bulbourethral glands) to semen composition and their impact on sperm function. The concept of sperm DNA fragmentation index (DFI) is explored, including its causes, assessment methods, and clinical significance for fertility outcomes. Finally, we consider key clinical implications for IVF, such as the management of azoospermia (obstructive vs. non-obstructive), techniques for sperm selection, the role of hormonal therapies, and emerging experimental approaches. Taken together, these topics bridge basic science and clinical practice, aiming to equip clinicians and researchers with a concise, clinically oriented guide to spermatogenesis in the context of assisted reproduction.

While procreation through copulation has remained the conventional means for pregnancy and beginning the human family, advances in medical technology has now demonstrated that coitus is no more the absolute process for childbearing. Individuals like infertile couples, single persons, lesbians and gay partners have now resorted to assisted reproductive technology (ART) and surrogacy arrangements in order to start a family. Transcending the hope and joy it offers to these groups of individuals who may have been incapable of having children of their own, this new procreative technology has stirred up a number of ethical and legal questions. The focal aim of the article was to investigate the state of the law for ascertaining the legal parentage and nationality of a child born through ART. Determination of these sensitive issues is vital because of the possibility of a child conceived through ART having more than two parents, especially where surrogacy, donor sperm and donor eggs are involved. The article adopted desk-based and comparative research methods by relying on both primary and secondary sources of information. The various sources of information were appraised and deductions derived from them were presented descriptively. The article revealed inter alia, that in some of the countries examined, ART practice is regulated and the courts, in a number of instances, have been engaged to resolve controversies pertaining to the legal parentage and nationality of children born through ART procedure. But in Nigeria, the practice is unregulated by law and there is dearth of decided cases on the subject. The authors therefore, recommended that in view of the increasing number of individuals turning to ART in Nigeria, including cross-border surrogacy, to build families, there is need for definite ART legislation in Nigeria so as to assist in resolving these problems and other related ones. Nigerian lawmakers could examine similar laws from other foreign jurisdictions and use them as potential guide to fashion out a domestic legislation in Nigeria. The Nigerian courts could also learn from decisions from other jurisdictions so as to know how to determine related cases as they occur in Nigeria.

As infecções pelo vírus da imunodeficiência humana (HIV) estão aumentando nas últimas décadas, mesmo com as terapias antirretrovirais e com a publicidade realizada para que as relações sexuais ocorram com proteção. Diante do cenário de maior perda do medo de aquisição da infecção sexualmente transmissíveis -  IST, associado a uma conjuntura de pesquisas sobre a possibilidade quase remota de transmissão do vírus estando o portador com carga viral indetectável, o sexo desprotegido passou a não ser combatido e culminou em práticas de exposição mais frequentes. O presente trabalho busca discutir e refletir sobre as controvérsias a respeito da não transmissão ainda que a carga viral no sangue esteja indetectável, especialmente porque apesar de haver uma correlação com a carga viral no sêmen, inúmeros fatores podem contribuir para que ela esteja detectável. Portanto, segundo os estudos, a possibilidade, ainda que ínfima, de se transmitir, e, por isso, independente do resultado da carga vi...

BACKGROUND: Ovarian stimulation gives rise to supraphysiological estradiol levels, which may affect oocyte quality. This study aims to investigate whether ovarian stimulation deranges the homocysteine pathway thereby affecting the pre-ovulatory follicle. METHODS: Blood samples were collected on cycle day 2 and the day of hCG administration in 181 women undergoing ovarian stimulation for IVF. In each subject, the diameter of the two leading follicles was measured and the corresponding follicular fluids were collected. In blood and follicular fluid samples, total homocysteine (tHcy), folate, cobalamin and pyridoxal'5-phosphate (PLP) were determined. According to the blood folate levels, women were classified as either folic acid supplemented (n 5 113) or non-supplemented (n 5 32). RESULTS: Ovarian stimulation resulted in a significant decrease in blood tHcy and cobalamin levels (both P 0.001). The blood concentrations of tHcy, folate, cobalamin and PLP were significantly correlated with the corresponding follicular fluid concentrations (all P 0.001). Follicular fluid tHcy concentrations were inversely correlated with follicular diameter (P 0.05). In folic acid supplemented women, follicular fluid folate was inversely correlated with follicular diameter (P 0.05). CONCLUSIONS: Ovarian stimulation deranges blood and follicular fluid biomarkers of the homocysteine pathway. High ovarian follicular fluid tHcy and folate levels may have detrimental effects on follicular development.

BACKGROUND: During IVF or ICSI cycles, ovarian hyperstimulation syndrome (OHSS) is a major problem. The aim of this prospective, multicentre, comparative study (using historical controls) was to assess the efficacy of a GnRH antagonist protocol in preventing OHSS in selected patients who had experienced OHSS or had been at risk of OHSS in their previous IVF/ICSI attempt. METHODS AND RESULTS: Patients underwent a new cycle where the same gonadotrophin protocol was used [same dose of recombinant FSH (rFSH)] but a different protocol was used for pituitary desensitization: cetrorelix 0.25 mg multiple-dose antagonist instead of GnRH agonist long protocol. Cetrorelix 0.25 mg was administered daily, starting when the leading follicle reached a diameter of 14 mm. In other words, rFSH was administered in the new cycle according to the dosage and the step-up or stepdown modalities used during the previous cycle, independently of ultrasound findings and serum estradiol (E 2 ) levels. Eighty-seven patients entered the study. Out of the 87 cycles involving GnRH agonists, 49 (56.3%) were cancelled and out of the 87 involving GnRH antagonists 28 (32.2%) were cancelled [McNemar's test; 95% confidence interval (CI) 235.8% to 211.2%; P < 0.001]. After GnRH agonist cycles, we recorded 24 cases of OHSS (18 moderate and six severe; 27.6%), whereas after the GnRH antagonist cycles there were 10 cases of OHSS (nine moderate and one severe; 11.5%) (95% CI -26.4% to 25.7%; P 5 0.006). There was a statistically significant reduction in the total number of follicles with a diameter > 10 mm (Wilcoxon's test; Z 5 6.1; P < 0.001) and of E 2 levels on the day of HCG administration (2538 versus 4322.4 pg/ml; P < 0.001) in the GnRH antagonist cycles versus GnRH agonist cycles. Twenty-nine patients had an embryo transfer in the first cycle (76.3% of oocyte retrievals) and 57 in the cycle using GnRH antagonist (96.6%). This 20.3% difference was also significant (Z-test; 95% CI 6.8-36.0%; P 5 0.003). After the antagonist cycles, 18 pregnancies (20.7 per initiated cycle; 31.6% per embryo transfer) were obtained. CONCLUSIONS: Although this study presents some limitations owing to the use of historical controls, our data show a favourable effect of GnRH antagonists in reducing the incidence of OHSS and the number of assisted fertilization cycles cancelled because of the risk of OHSS in high responder patients. As a consequence, GnRH antagonist plus gonadotrophin administration could also increase the percentage of oocyte retrievals and embryo transfers in this high risk group of patients.

Born in Milan, Italy in 1965, Walter Vegetti obtained his MD in 1991 and the speciality degree in Obstetrics and Gynaecology in 1995 at the University of Milan. His fi elds of interest since the beginning of his professional activity are reproductive endocrinology and assisted reproduction. He currently works in Milan, at the Infertility Unit of the

and head of the day surgery unit in the Department of Clinical and Experimental Biomedical Sciences. She conducts collaborative research/training in the IVF centre AZ free Universitet Brusselles, the Ultrasonic Institute University in Zagreb, Croatia and the Endoscopic Centre of Clermont-Ferrant, France. She is a member of the Ministerial Committee for the Guidelines on Assisted Reproduction Techniques and Law 40/2004 and an adviser of the 12th Permanent Committee on Hygiene and Healthcare in the Italian Senate for the investigation into endometriosis as a social disease.

One of the most revolutionary advances in science and technology has been the advancement in in vitro fertilization to treat infertility. Increased demand for in vitro fertilization as a result of socio-demographic trends, with new technologies facilitating supply. Technology is used in conjunction with IVF to improve the outcome by facilitating each step of the process. IVF advancements are likely the most exciting scientific developments in infertility treatment. In the past years, the field of in vitro fertilization has undergone technological advancements that were unimaginable including endometrial receptivity array (ERA), in vitro gametogenesis, mitoscore, microfluidic technology, cryopreservation of surplus embryos and ovarian tissues, intracytoplasmic sperm injection (ICSI), testicular sperm extraction (TESE), chromosomal screening through preimplantation genetic diagnosis (PGD), mitochondrial manipulation methods (MMT), autologous germline mitochondrial transfer (AUGMENT), uterine transplantation, laser assisted hatching, embryoscope, endometrial coculture, intrauterine insemination (IUI), gamete intrafallopian transfer (GIFT), fallopian tube sperm perfusion (FSP), surrogacy motherhood, bovine somatic cell nuclear transfer (SCNT), frozen-thawed embryo (FET), organ culture systems, embryonic stem cells (ESC), induced pluripotent stem cells (iPSC), spermatogonial stem cells, micromanipulation and many different methods to improve the quality of infertility treatments. Current breakthroughs in IVF technology, such as controlled ovarian hyperstimulation, luteal phase support and improved culture media were completed quickly. Reproductive medicine, particularly IVF is fast changing how people reproduce, and as a result, it will always be crucial to science and society. The goal of this article is to provide an overview of emerging technologies that have the potential to significantly increase IVF utilization.

Η ραγδαία εξέλιξη των τεχνικών υποβοηθούμενης αναπαραγωγής έχει επιφέρει σημαντικές επιπτώσεις στο δίκαιο της οικογένειας, στην ερμηνεία της έννοιας της γονεϊκής ιδιότητας και στη σχέση δικαίου και βιοηθικής. Η εδραίωση πρακτικών όπως η δωρεά γαμετών, η εξωσωματική γονιμοποίηση και η κατάψυξη γενετικού υλικού (ωαρίων, σπέρματος και εμβρύων), εγείρει σειρά νομικών αντιρρήσεων που αφορούν την αναγνώριση της γονικής ιδιότητας, την προστασία του παιδιού, την ιδιωτικότητα του βίου και την ανθρώπινη αξιοπρέπεια.

Augmentation of labour with oxytocin is still a common practice in our environment, but remains a high-risk molecule. The purpose of this study was to describe the practice of augmentation of labour with oxytocin in Goma. It was a retrospective study about 412 cases stimulated over a period of 6 month period in three reference hospitals in Goma, eastern Democratic Republic of Congo. The usual descriptive statistics were measured according to whether the variable was qualitative or quantitative. The results reveal an augmentation rate of 54%. The protocol of augmentation of labour with oxytocin protocol was not respected in the majority of cases: the bishop score not evaluated in 56.8% of the stimuli with 91.3% of cases stimulated by a dose of 10 IU diluted in 500 ml and a high flow rate ≥ 9 drops per minute in 15.4% of cases, short intervals of increase ≤ 29 minutes in 18.5% of cases and 90.6% of stimulations were not monitored by tococardiography. Augmentation of labour was more indicated by general practitioners and was monitored by more than half of midwives. Hypokinesia was the main indication. In more than one third of the cases, the increase intervals and the increased drops were not reported. The practice of augmentation of labour with oxytocin in the city of Goma do not meet the standards of the World Health Organization and a study on the maternal-neonatal prognosis after the augmentation of labour with oxytocin proves essential.

The aim of this study was to determine the correlation between ultrastructural studies for pinopodes expression after ovarian hyperstimulation and progesterone injection in mice. Materials and Methods: Adult NMRI mice were superovulated using human menopasual gonadotropic (hMG) and human chorionic gonadotropic (hCG) hormones; after that, daily injection of progesterone (1 mg/mouse) was performed. Animals were sacrificed by cervical dislocation 3.5 and 4.5 days after hCG injection. Tissues of uterine horns were obtained and processed for scanning (SEM) and transmission (TEM) electron microscopy studies. The pseudopregnant control samples were studied same as experimental groups. Results: The SEM and TEM observations showed that in control groups on 3.5 days of pregnancy, there were some pinopodes. All apical cell surfaces expressed these projections on the forth day. In progestrone-injected group, well developed pinopods were expressed 3.5 days after hCG injection and they were transformed to small projections on the fourth day following hCG injection. Also, the life span of pinopods was limited to a short time. At the TEM levels, the pinopods were seen as swelling process on the apical surface, which were more pronounced on day 3.5 of hCG injection in hyperstimulated and progestrone injection. The progestrone may cause premature expression of pinopodes and the implantation failure after ovarian induction may be due to these timing changes.

Objective To evaluate the benefit of Metfomin added to Clomiphene Citrate in a primary ovulation induction protocol in PCOS patients Design Prospective randomised controlled study Setting Tygerberg Academic Hospital, Stellenbosch University and the Institute of Reproductive Medicine at Vincent Pallotti Hospital, Cape Town Patients 107 patients presenting with PCOS Study Group A was pre-treated with metformin 850 mg twice a day for at least 6 weeks before clomiphene was added and the metformin was used throughout the study period. Group B received clomiphene without pre-treatment with metformin. In both groups clomiphene was given at a starting dose of 50 mg day 4-8 and increase with increments of 50 mg to a maximum of 150 mg if no response was achieved. The ovulation rate achieved in women in the M+C/C arm was 34/52 (65.4%) compared to 36/55 (65.5%) in the C/C arm. The treatment effect ((M+C/C) -C/C) is 0% with 95% confidence interval of -18.1% to 18%. The per protocol ovulation results were 34/42 (81%) in the M+C/C arm compared to 36/48 (75%) in the C/C arm. The ovulation rate difference was 6% with 95% confidence interval -11% to 22%. In a comparison of successful ovulating versus nonovulating women from the trial the following were significant baseline determinants: lower median weight in the ovulating group (77 kg versus 86 kg, p=.021), lower median bmi (29.0 versus 32.9, p=.009), lower median DHEAS at baseline (4.6 compared to 7.0, p=.049), lower median 17OH-progesterone (2.2 versus 4.6, p=.027) and higher baseline median SHBG ( 37.8 compared to 28.5, p=.036). Conclusion Although identical ovulation rates were observed in both arms equivalence could not be concluded with respect to the specified criteria.

Objective To evaluate the benefit of Metfomin added to Clomiphene Citrate in a primary ovulation induction protocol in PCOS patients Design Prospective randomised controlled study Setting Tygerberg Academic Hospital, Stellenbosch University and the Institute of Reproductive Medicine at Vincent Pallotti Hospital, Cape Town Patients 107 patients presenting with PCOS Study Group A was pre-treated with metformin 850 mg twice a day for at least 6 weeks before clomiphene was added and the metformin was used throughout the study period. Group B received clomiphene without pre-treatment with metformin. In both groups clomiphene was given at a starting dose of 50 mg day 4-8 and increase with increments of 50 mg to a maximum of 150 mg if no response was achieved. The ovulation rate achieved in women in the M+C/C arm was 34/52 (65.4%) compared to 36/55 (65.5%) in the C/C arm. The treatment effect ((M+C/C) -C/C) is 0% with 95% confidence interval of -18.1% to 18%. The per protocol ovulation results were 34/42 (81%) in the M+C/C arm compared to 36/48 (75%) in the C/C arm. The ovulation rate difference was 6% with 95% confidence interval -11% to 22%. In a comparison of successful ovulating versus nonovulating women from the trial the following were significant baseline determinants: lower median weight in the ovulating group (77 kg versus 86 kg, p=.021), lower median bmi (29.0 versus 32.9, p=.009), lower median DHEAS at baseline (4.6 compared to 7.0, p=.049), lower median 17OH-progesterone (2.2 versus 4.6, p=.027) and higher baseline median SHBG ( 37.8 compared to 28.5, p=.036). Conclusion Although identical ovulation rates were observed in both arms equivalence could not be concluded with respect to the specified criteria.

The most frequent pregnancy issue is a miscarriage, which is defined as the spontaneous end of pregnancy before the fetus reaches viability. The current research aims to identify the potential significance of selenium (Se) and vitamin E (VE) as predictive diagnostic biomarkers in recurrent pregnancy loss (RPL). Methods: A case control study that included three study groups; 35 women with RPL, 30 non-aborted pregnant (NAP) women, and 25 healthy women. After rigorously applying the eligibility requirements, patients were chosen from those visiting Bint Al-Huda Teaching Hospital and Suq Al-Shuyukh General Hospital in Thi-Qar Province (Iraq). Serum VE and serum Se levels were determined using the ELISA and atomic absorption spectrophotometer techniques, respectively. Results: The outcomes showed that the RPL group's serum VE and Se below normal levels were (88.6% and 62.9% respectively) lower than in the healthy control group (28% and 24% respectively). The level of VE was depleted in NAP group (93.3%) compared to HC group (28%) with significant differences, whereas the level of Se was significantly lower in RPL group (62.9%) compared NAP group (13.3%). Conclusions: A significant positive association of VE and Se in RPL and a significant negative association of VE and Se in NAP and HC.

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Feed takes 60% of production cost. Corn herbage can give high quality feed especially young forage because it contains high protein and it low lignification content. The objectives of this research are to get a methods of high quality forage production to increase cost feed efficiency, and to get an alternative concentrate for calves. This research is divided into three steps of experiment. The first experiment, analyzing production and nutrient corn herbage in 15 days ages; in the second, production of corn herbage and observe the effect of corn herbage on the calves; and third, analyzing forage production cost and compared it to concentrate cost. The Factorial Randomized Complete Design was selected for these experiments. The parameter including dry matter, nutrient contains, organic matter coefficient, palatability, and economic analyzis. The results showed that corn herbage production can did in small box. A tretment by soil medium and hydrophonic nutrient give dry matter production is 136 g DM/m 2 , protein contained i.e: 18,30% and organic matter coefficient is 68%, fresh forage is very palatable and feed cost is Rp 858,-. It makes the corn herbage available to use as alternative concentrate.

CONCLUSION: Although previous studies have suggested that cervical dilatation at the time of ET has a detrimental effect, our results do not support this. The observed difference from pervious studies may be a result of (1) Cervical dilatation being performed using ultrasound guidance to assure that the tip of the dilator does not extend beyond the internal cervical os; (2) Cervical dilatation using tappered graduated flexible teflon dilators of a smaller size are less traumatic than the traditional plastic or metal cervical dilators; (3) The performance of a trial or mock transfer just prior to the acutal transfer; (4) The largest teflon dilator used is marginally greater in diameter than the outside diameter of the Wallace catheter and this avoids overzealous dilatation. Our data suggests that a time period between cervical dilatation and ET is not necessary. Cervical dilatation to overcome cervical stenosis at the time of ET in an IVF does not alter the clinical pregnancy outcome of an IVF cycle.

BACKGROUND: Intrauterine insemination (IUI) is the oldest and most practised form of assisted reproduction worldwide. We systematically reviewed the literature so that we could evaluate the use of soft versus firm catheters in subfertile women undergoing IUI. METHODS: Extensive searches were conducted for full-text manuscripts, conference abstracts, ongoing and unpublished trials. Primary outcomes were clinical pregnancy (CPR) and ongoing pregnancy (OPR)/live birth rates (LBRs) per woman. Secondary outcomes were multiple pregnancy rate (MPR) per clinical pregnancy, difficulty cannulating the cervix, bleeding and patient discomfort. Meta-analysis was performed using the Peto-modified Mantel-Haenszel fixed-effect model. RESULTS: Seven randomized trials were identified, and four were excluded. No significant differences were noted for CPR and LBR per woman [OR = 0.96, 95% CI = 0.70-1.32 and OR = 0.82, 95% CI = 0.43-1.58, respectively]. As for the secondary outcomes, MPRs per cycle were also not significantly different. More difficulty was noted with soft catheters and more patient discomfort with firm catheters. Bleeding following the procedure was similar between the two groups. CONCLUSIONS: Catheter choice during IUI does not seem to be a detrimental factor for success, as in other assisted reproduction techniques (ART). More studies are warranted to draw definitive conclusions and support the results of this systematic review.

Submitted by Kristen Rebecca Jule to the University of Exeter as a thesis for the degree of Doctor of Philosophy in Animal Behaviour, May 2008. ... This thesis is available for Library use on the understanding that it is copyright material and that no quotation from the thesis may be ...

It has been suggested that there is an increased risk of congenital malformations in association with assisted reproduction techniques. We herein report a case of in utero diagnosis of caudal regression syndrome after intracytoplasmic sperm injection. The couple was referred for assisted reproduction due to advanced maternal age and pregnancy was achieved in the first cycle. Evaluation after 3 weeks showed single topic pregnancy. Ultra-sound scans performed at 19 and 21 weeks of gestation showed absence of sacral and lombar segments, suggesting caudal regression syndrome. Necropsy revealed absence of thoraxic and lumbosacral vertebrae, hypoplastic bladder and bilateral hydroureternephrosis.

This article presents an analytical approach to the reality of couples with children born in Spain who descend from at least one Romanian parent. It was carried out with the official data included in the Childbirth Statistical Bulletin of the National Statistics Institute. The Romanian community represents the largest contingent of foreign residents in Spain, showing a steady growth since 2000 to the present. For this reason, it is important to learn about the processes of settlement and integration of this population. Romanian immigrants in Spain are usually young people who also marry young people (especially if it's between people of the same nationality) and who reside mainly in Madrid, Valencia, Andalusia and Catalonia. The results show that Romanian-only couples reveal different patterns from couples with only one Romanian member.

Assisted reproduction in a global world produces not only new babies and new parents but also new citizens and raises new bioethical concerns (e.g., Campbell 2007;. This essay outlines an interdisciplinary theoretical perspective in understanding how fertility travel and transnational reproduction unfold from the perspectives of the different actors involved. Three theoretical pairs-care and engineering, reproscapes and reproflows, and gifts and commodities-are suggested as theoretical frameworks for understanding transnationalized reproduction. The authors conclude that reproductive movements and fragmentary bodies confront legal and administrative systems in interesting and often highly complex ways.

Objective: In this qualitative study, we investigate how lesbian couples experience and deal with the difference in genetic relatedness in their family. Background: Previous research showed that lesbian couples handle the difference with regard to genetic relatedness by, for instance, creating a narrative about physical resemblances or by focusing on the social bond and its influence on children. Methods: The findings are based on qualitative in-depth interviews with 10 lesbian couples who had at least one donor-conceived child aged 7-10. The difference with regard to the genetic link brought up complex and contextspecific experiences for these parents. Generally, the genetic link was described as irrelevant: equality between both parents was presented as a given. However, some experiences of difference due to the presence of one genetic link were found. In these accounts, the genetic link was described as a valuable extra that created an inequality between them as parents. Conclusion: The findings show that these mothers have a complex attitude towards genetic relatedness.

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Seminal plasma contains a wide range of biomolecules—including inorganic elements—that may significantly influence male reproductive function. Historically, semen analysis has focused on sperm count and motility, while overlooking the diagnostic potential of this acellular fraction. This narrative review synthesizes historical perspectives on seminal plasma metallomics, elucidates the biological functions of its diverse elemental constituents, and critically evaluates methodological advancements in their detection. Furthermore, it examines future clinical and research directions by addressing key topics, including the evolution of multi-element analyses in seminal plasma, the interplay between metal exposure and male reproductive health, and the application of omics-based and machine-learning approaches in characterizing male infertility. Progress in analytical chemistry, particularly inductively coupled plasma mass spectrometry, now enables high-precision multi-element measurements in seminal plasma. The “metallomic” profiles reveal both essential elements—such as calcium, magnesium, potassium, sodium, zinc and selenium—and potentially toxic metals, including cadmium and lead, that reflect environmental exposures and may impair fertility. Seminal plasma metallomics also underscores fraction-specific differences between prostatic and seminal vesicular secretions, suggesting that certain chemicals may rise in seminal plasma before shifts appear in blood, thereby making it a promising biomarker for infertility risk assessment. Machine-learning approaches, such as clustering based on seminal plasma-to-serum ratios, offer new diagnostic insights by identifying subtypes of male infertility. By complementing traditional semen parameters and advanced biomarkers (e.g., DNA fragmentation index), these integrative tools can refine diagnoses and guide interventions, including nutritional supplementation and avoidance of specific toxicants, potentially improving pregnancy outcomes. However, significant challenges remain: standardized protocols, validated reference ranges, and larger prospective studies are needed for clinical translation. Addressing these gaps is crucial for integrating metallomic analyses into routine evaluations of male infertility. As this field continues to evolve, it has the potential to reshape infertility assessments and foster more personalized and effective management strategies.

En los procesos de reproducción asistida ya no nos vale con conseguir espermatozoides, debemos conseguir los mejores espermatozoides. Dentro de los parámetros que hasta ahora se estudiaban estaba la concentración, la movilidad y la forma. Se observan diferencias en las tasas de éxito reproductivo, a pesar de sémenes con parámetros clásicos similares, por lo que se buscan otros marcadores de calidad seminal. Uno de ellos es el grado de fragmentación de ADN espermático. Se han visto claras relaciones entre valores de ADN elevados y dificultades reproductivas. Tradicionalmente, y de una manera empírica, el uso de vitaminas como la E y la C se han usado para mejorar la calidad espermática. La relación entre los grados de fragmentación de ADN de espermatozoides y el exceso de radicales libres o el déficit de antioxidantes ha planteado que el suplemento de complejos o sustancias antioxidantes en varones infértiles puede mejorar su capacidad reproductiva al reducir los grados de fragmentación de ADN de los espermatozoides. En este trabajo pretendemos valorar la utilidad de un complejo de antioxidantes (Androferti ® Laboratorio Q-Pharma) para reducir los niveles de fragmentación de ADN espermático. Palabras clave: ROS. Espermatozoides. Infertilidad. Antioxidantes. Fragmentación de ADN de espermatozoides. Técnicas de reproducción asistida (TRA).

Cytotoxic drugs and immunosuppressive therapies are used to treat patients with nonmalignant, nontesticular systemic diseases. These therapies can permanently suppress spermatogenesis. Sperm cryopreservation before treatment theoretically could give these men the opportunity to achieve a pregnancy with a woman later in life when the couple decides to do so. However, it is not known whether pretreatment sperm quality in these men is good enough to be used for assisted reproductive techniques. The main objective of this study was to determine the usefulness of cryopreservation in this patient population by: 1) assessing their pretreatment semen quality (eg, count, motility, and motion kinetics) and comparing it with that of healthy donors before and after cryopreservation; 2) comparing patients' pretreatment semen characteristics with World Health Organization reference values for normal sperm; and 3) examining the differences in semen parameters among patient groups. Semen specimens were obtained from 25 healthy donors and from 23 patients with a variety of disorders (12 had autoimmune disorders, 4 had kidney disorders, 3 had diabetes, 2 had ulcerative colitis, and 2 had heart transplants). All patients, except those with diabetes, required immunosuppressive or cytotoxic therapy. Although the pretreatment quality of the semen of these patients was not as good as that of donors, semen samples were within the normal reference range of the World Health Organization. No statistically significant differences in sperm parameters were found within the 4 patient groups except for those with diabetes (n ϭ 3), who showed poorer sperm counts (P Ͻ .04). However, no conclusive evidence can be reached due to the small sample size. Our results indicate that pretreatment semen quality in these patients is adequate for reproductive techniques. We believe that cryopreservation should be offered to patients of reproductive age with disease or treatment regimens that may cause infertility.

Cytotoxic drugs and immunosuppressive therapies are used to treat patients with nonmalignant, nontesticular systemic diseases. These therapies can permanently suppress spermatogenesis. Sperm cryopreservation before treatment theoretically could give these men the opportunity to achieve a pregnancy with a woman later in life when the couple decides to do so. However, it is not known whether pretreatment sperm quality in these men is good enough to be used for assisted reproductive techniques. The main objective of this study was to determine the usefulness of cryopreservation in this patient population by: 1) assessing their pretreatment semen quality (eg, count, motility, and motion kinetics) and comparing it with that of healthy donors before and after cryopreservation; 2) comparing patients&#39; pretreatment semen characteristics with World Health Organization reference values for normal sperm; and 3) examining the differences in semen parameters among patient groups. Semen specim...

This study evaluated prefreeze and postthaw semen quality before treatment in patients with different types of sarcomas and carcinomas to determine whether cryopreservation would be of value for these patients. Semen specimens were obtained from 50 normal donors and from 21 patients with carcinoma and from 14 patients with sarcoma. The specimens were cryopreserved by a standard freezing procedure using TEST-Yolk buffer. Prefreeze and postthaw sperm motion characteristics were measured. Prefreeze total motile sperm count was significantly higher in donors (median: 129.6 x 10(6)/ml) than in men with carcinoma (46.9 x 10(6)/ml, P &lt; .001) or sarcoma (66.3 10(6)/ml, P = .04). The percent motility and percent linearity were significantly lower in patients with carcinoma. In postthaw specimens, total motile sperm count, curvilinear velocity, and linearity were significantly lower in patients with carcinoma. The two patient groups in this study had poor semen quality when compared with h...

This study compared the pretreatment semen quality in patients with Hodgkin&#39;s disease and non-Hodgkin&#39;s lymphoma with a group of healthy donors. We also examined the differences in prefreeze and postthaw semen quality among the different stages of Hodgkin&#39;s disease. The study included 89 patients with Hodgkin&#39;s disease, 18 with non-Hodgkin&#39;s lymphoma, and 50 healthy sperm donors. In patients with Hodgkin&#39;s disease, the prefreeze and postthaw semen characteristics were significantly lower than those of the healthy donors. Similar results also were seen in patients with non-Hodgkin&#39;s lymphoma. No significant differences in the prefreeze semen quality were seen in patients with different stages of cancer. Patients with Hodgkin&#39;s disease and non-Hodgkin&#39;s lymphoma in our study had poor semen quality when compared with healthy donors both before and after cryopreservation. As cancer therapy significantly impairs reproductive potential, sperm banking sh...

The East Flanders Prospective Twin Survey (EFPTS) is a prospective, population-based registry of multiple births in the province of East-Flanders, Belgium. EFPTS has several unique features: it is population-based and prospective, with the possibility of long-term follow-up; the twins (and higher order multiple births) are recruited at birth; basic perinatal data recorded; chorion type and zygosity established; and since 1969 placental biopsies have been taken and frozen at −20 °C for later determination of genetic markers. The EFPTS is the only large register that includes placental data and allows differentiation of three subtypes of monozygotic (MZ) twins based on the time of the initial zygotic division: the dichorionic–diamnionic pairs (early, with splitting before the fourth day after fertilization), the monochorionic–diamnionic pairs (intermediate, splitting between the fourth and the seventh day post-fertilization), and the monochorionic–monoamnionic pairs (late, splitting a...

with both ovaries clearly visible on TVS were included. Women who volume/transvaginal ultrasound had had a previous unilateral oophorectomy or partial oophorectomy were excluded. If either ovary contained a follicle or a cyst Ͼ10 mm in diameter it was not possible to measure accurately the net ovarian

Purpose The objective of this study was to evaluate the effect of men and recipient age on the reproductive outcome of our oocyte donation program. Methods We retrospectively analyzed 915 cycles, taking into account men and recipient age, separately and together. The significant cut off value for men and recipients age with incidence in the reproductive outcome was 39 years. Recipient older than 38 years presented a significantly lower pregnancy and implantation rates than others (44.92 vs. 55.75±1.53%, 25.66 vs. 32.79±1.64%). If men age was older than 38, a significant reduction in pregnancy and implantation rates was observed, too (46.0 vs. 54.65%, 26.00±1.52 vs. 32.43±1.65%). When men and recipient age was analyzed together, a reduction in pregnancy and implantation was detected only if both were older than 38. Conclusions Present study suggests that age has a detrimental effect on the reproductive outcome of oocyte donation cycles when both men and recipient are ≥ 39 years old.

Objective: To report a case of conjoined twins conceived through assisted reproduction after intracytoplasmic sperm injection (ICSI) and the transfer of three eight-cell embryos on day 3. Design: Case report. Setting: Assisted reproduction unit of a private hospital. Patient(s): A 32-year-old patient underwent ICSI and received three embryos. Intervention(s): Ovarian stimulation and ICSI. Main Outcome Measure(s): Images of the embryos and ultrasound images of the fetuses. Result(s): One embryo measuring 7 weeks, relatively big in size and bizarre in appearance with one heartbeat, was detected on transvaginal ultrasound at 6 weeks, 4 days of pregnancy. Two weeks later, another ultrasound was performed; two fetuses with a common heart were observed. In 10th week of pregnancy, two fetuses with two hearts and an attached thorax were observed. A diagnosis of thoracopagus was made, and the pregnancy was terminated. Conclusion(s): Conjoined twins conceived through assisted reproduction are extremely rare. This case, which occurred after transfer of cleavage-stage embryos, suggests that ovulation induction, ICSI, and assisted hatching may also play roles in addition to other factors commonly proposed to be responsible for conjoined twining, such as in vitro culture condition, culture time, and blastocyst-stage transfer. (Fertil Steril Ò 2011;96:e111-4.

In recent decades, ethicists have engaged with new developments in human reproductive technologies from a variety of angles. Yet there has been relatively little effort to problematize the concept of reproduction itself. In this paper, we examine the question of what reproduction is and its relationship with biology. We show that reproduction is commonly assumed to entail biological parenthood-an assumption that we term "the biological reproduction paradigm." Drawing on Sally Haslanger's analysis of the biological/ social division between sex and gender, we suggest that the concept of reproduction is socially constructed, despite its apparently biological nature. In turn, we argue that the supposed necessity of the relationship between reproduction and biological parenthood leads to a situation in which access to a variety of medical, legal, and social goods is constrained on the basis of spurious, inconsistent, and undertheorized assumptions. Finally, we note that, given the socially constructed nature of reproduction, we cannot take it for granted that the term "reproduction" signifies the same thing among different interlocutors and in different contexts.

Do we owe anything to our genetic relatives qua genetic relatives? The philosophical literature has primarily addressed this question in the context of procreation. But genetic matching databases raise the question of whether we owe anything to previously unknown genetic relatives. This article argues that influential philosophical arguments regarding moral claims to know one's genetic origins (sometimes referred to as a 'right to know') in the context of gamete donation have implications for a broader set of claims. First, these arguments imply more than a claim to know the identity of a genetic relative; the interests which they invoke can only be satisfied through a relationship. Second, the scope of the claims is broader than tends to be acknowledged: even if procreators have special obligations towards their offspring, these arguments imply that weighty moral claims can be made against other genetic relatives in many different contexts.

Assisted reproductive technology (ART) with washed semen can achieve pregnancy with minimal risk of horizontal and vertical transmission of chronic viral diseases (CVD) such as human immunodeficiency virus (HIV), hepati- tis C virus (HCV) and hepatitis B virus (HBV) among serodiscordant couples. How- ever, few studies have been made of the use made by these couples of ARTs or of the obstetric results achieved. In this retrospective study, 93 men who were seropositive for HIV, HCV or HBV and who underwent assisted reproduction treatment at our centre (Hospital Universitario Virgen de las Nieves, Granada, Spain) were included. Washed semen was tested to detect viral particles. Non-infected women were tested before and after each treatment, as were the neonates at birth and after three months. A total of 62 sperm samples were washed, and none were positive for the detec- tion of viral molecules. Semen samples from 34 HBV positive males were not washed since the female partner had immun...

We examined the effect of flushing ewes (feeding extra protein and energy just prior to breeding to increase ovulation) on a rangeland operation near Lyman, WY. Rambouillet, Rambouillet x Finn, and commercial wool sheep were supplemented in two studies. In study one, ewes and rams were fed 1.11 lbs/day of supplement in an open-range setting for 35 days, beginning a week before breeding. Lambing rate was determined at docking. In study two, a pen study, ewes were fed grass hay and supplement at the same rate as range ewes. Lambing rate was determined at birth. Supplementation can increase lambing rate and profits. INTRODUCTION Ewes in poor body condition and/or malnourished often have lower ovulation and pregnancy rates than ewes in good body condition and on a good plane of nutrition (Gunn and Doney, 1975). Poor or severe lack of nutrition is a primary cause of embryo loss (Smith, 1991). Flushing or supplementing ewes just prior to, and during the breeding season can improve the ovu...

OBJECTIVE: To confirm that HcG levels in follicular fluid and serum after intramuscular (IM) or subcutaneous(SC) administration of purified (p)HcG and SC administration of recombinant(r)HcG and their associations with body mass index (BMI) and oocytes maturation in ICSI cyle. STUDY DESIGN: We used pHcG or rHcG for triggering ovulation of all patients . Group1(n:56) received IMpHcG and Group2(n:57) received SCpHcG and Group3( n:47) received rHcG . Serum and follicular fluid HcG levels were measured on the day of oocytes retrieved as primary outcome. RESULT: There was a significant difference on serum and follicular fluid HcG levels among three groups. No correlation was found between BMI and oocytes maturation for Group1 and Group2. But there was a significantly negative correlation between BMI and oocytes maturation in Group3. CONCLUSION: When comparing the different administration routes of HcG , the S.C. route of HcG seems to be safer and useful for obese patients.