Time-lapse imaging of preimplantation embryos is increasingly being employed in assisted reproduction treatment. This technique has facilitated the use of objective algorithms based on embryo morphokinetic variables for embryo selection. A recent study has detailed the use of time-lapse imaging using defined morphokinetic data for detecting embryos at risk of having aneuploid chromosome structure, without the need to perform preimplantation genetic screening.
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Several investigators have evaluated the significance of stress in assisted reproduction cycles. A recent prospective cohort pilot study highlights that stress and anxiety levels in women undergoing in vitro fertilization (IVF) therapy remain significantly high throughout the treatment. Accordingly, researchers underscore the need to explore various modalities to reduce stress experienced by women during IVF cycles.
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The standard overnight co-incubation of spermatozoa and oocytes has been compared with the brief co-incubation insemination protocol by numerous investigators in the past. However, it remains unclear whether reduction in the sperm-oocyte co-incubation time improves or negatively affects the outcomes of in vitro fertilization (IVF) therapy. According to a recent Cochrane review, the brief gamete co-incubation insemination protocol may improve the rates of ongoing as well as clinical pregnancy in infertile women undergoing IVF therapy.
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It has been a routine practice to transfer multiple embryos in most IVF patients to overcome low implantation rates and achieve satisfactory pregnancy rates. Consequently, the risk of multiple pregnancies is greater in IVF patients with associated adverse impact on mother and child. Single embryo transfers (SETs) have been promoted as the only efficient way to prevent multiple pregnancies in IVF. Several trials have compared SETs with double embryo transfers (DETs), and a recent study has demonstrated that transfer of a single, chromosomally normal embryo offers pregnancy rates comparable to a DET.
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Opinions vary on the importance of polar body morphology in predicting fertilization and embryo development. Most contemporary publications propose that fragmented polar body is not prognostic for oocyte fertilization or embryo development. However, a recent study demonstrates that the fertilization probability of an oocyte with fragmented polar bodies is far less compared to an oocyte with normal polar bodies.
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The prognosis of successful IVF outcomes in women with low ovarian response fulfilling the Bologna criteria is very poor. A recent retrospective pilot trial reports that corifollitropin alfa followed by highly purified human menopausal gonadotrophin (hp-HMG) in a GnRH antagonist protocol results in promising pregnancy rates in poor ovarian responders fulfilling the Bologna criteria. However, these results were seen only in poor ovarian responders <40 years of age.
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Microbial colonization of the female upper genital tract even in the absence of symptomatic infection has been well documented in previous trials. A recent study demonstrates that the presence of microbes in the follicular fluid collected at the time of transvaginal oocyte retrieval adversely affects the outcomes of in vitro fertilization (IVF) therapy.
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A recent retrospective study demonstrates that use of oral contraceptives with high androgenic progestin suppresses functional ovarian reserve and oocyte yields in young oocyte donors. Accordingly, researchers highlight the need for reevaluating the routine practice of using oral contraceptives prior to in vitro fertilization (IVF) cycles.
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An imbalance in the ratio of the polyunsaturated fatty acids (PUFAs), arachidonic acid and docosahexaenoic acid (AA/DHA) has been implicated in male infertility. A recent study highlights that treatment with lycopene significantly improves the AA/DHA ratio in the seminal plasma of infertile males and facilitates spontaneous as well as assisted conception among infertile couples. The study is claimed to be the first to report the efficacy of lycopene therapy in altering the AA/DHA ratio in seminal plasma and its ability to restore fertility in infertile couples.
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Recurrent implantation failure post in vitro fertilization (IVF) therapy has been attributed to numerous maternal and embryonic factors. A recent study, published in the European Review for Medical and Pharmacological Sciences, indicates that fibroblast growth factor-1 (FGF-1) may play a crucial role as a maternal factor influencing implantation.
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