The signs and symptoms of ovarian hyperstimulation syndrome (OHSS) is attributed to elevated vascular permeability, resulting in fluid shift from capillaries to the third space. Vascular endothelial growth factor (VEGF) is linked to this increase in vascular permeability, and hence its suppression may potentially prevent or reduce the severity of OHSS. Dopamine agonists, which block VEGF receptor 2 phosphorylation, have been suggested to decrease the incidence and severity of OHSS in IVF/ICSI cycles. A new systematic review and meta-analysis highlights the prophylactic action of dopamine agonists, such as cabergoline, in lowering the incidence of OHSS. The study findings have been published in the journal, Human Reproduction Update. Continue Reading

The prevalence of subclinical hypothyroidism (SH) is reported to be high in infertile women. Despite this, its management remains controversial owing to the lack of proven treatment benefits. Now, a recent prospective, randomized trial has highlighted the importance of levothyroxine (LT4) supplementation for achieving clinical pregnancies in women with SH opting for IVF-ICSI. The findings of the study have been published in the recent issue of Endocrine Practice. Continue Reading

Intracytoplasmic morphologically selected sperm injection (IMSI), a modification of ICSI procedure, evaluates motile sperm organellar morphology by magnifying the sample >6000 times with a high power microscope, enhanced by digital imaging. Several studies have demonstrated that IMSI, compared to ICSI, improves treatment outcomes, including the rate of implantation, pregnancy, and live birth. Now, a Brazilian research team reports similar outcomes, in terms of fertilization rate, embryo cleavage rate, and day 2 embryo quality, with both the conventional and modified ICSI procedures. However, the scientists did not rule out the possibility of IMSI positively influencing the late paternal effects. The study results have been published online in the European Journal of Obstetrics, Gynecology, and Reproductive Biology. Continue Reading

In a recent prospective cohort study, a team of Danish researchers have reported that singleton IVF/ICSI pregnancies have a >4-fold enhanced risk of stillbirths compared to spontaneous conceptions. The results have been published in the recent issue of Human Reproduction. Continue Reading

In recent years, preimplantation genetic diagnosis (PGD) has emerged as a potential alternative to and compliments prenatal genetic diagnosis in preventing the birth of children with genetic/chromosomal abnormalities. Apart from congenital chromosomal and genetic abnormalities, PGD is currently used for the screening of late-onset diseases having a genetic predisposition, as well as preimplantation human leukocyte antigen (HLA) typing for the generation of savior siblings. However, certain researchers speculate that the technique is associated with adverse health effects including increased neurological defects in the offspring; probably due to the biopsy conducted in early stage embryos. Now, a recent prospective study published in the journal Human Reproduction rules out the risk for increased birth defects in singletons born after PGD. Continue Reading

A recent randomized controlled study highlights the increase in implantation and live birth rates with mid-follicular recombinant human luteinizing hormone (r-HLH) supplementation in women aged 35 to 39 years who were subjected to ovarian stimulation for intracytoplasmic sperm injection (ICSI) cycles. The findings have been published in the recent issue of the journal, Reproductive BioMedicine Online. Continue Reading

The molecular interaction of the sperm with the zona pellucida (ZP) is an important event that precedes fertilization, and also relates to various sperm functions, such as capacitation completion and ligand-induced acrosome reaction. In clinical practice, defective sperm-ZP interactions are a relatively common cause of fertilization disorders. Sperm-ZP binding tests help in detecting subtle abnormalities in the sperm, which cannot be identified by semen analyses. A recent prospective study provided further credence to the effectiveness of such tests in selecting competent sperm for improved ICSI outcome. The findings of the study have been published in the recent issue of the journal, Reproductive BioMedicine Online. Continue Reading

Blastogenesis denotes the development that occurs in the first 28 days after conception, wherein the basic body plan, gene expression domains, and the embryo’s developmental fate are established. The defects or malformations arising at this stage are generally severe and lethal, owing to several reasons such as the embryo’s small size, interdependent nature of its development, and proximity of the organ rudiments. Now, a recent study published in the journal, Human Reproduction highlights the link between IVF/ICSI procedures and blastogenesis birth defects, with the probability of the specific risk being lower with frozen-thawed embryo transfer. Continue Reading

Several assisted hatching (AH) techniques, such as mechanical dissection, zona thinning with acidified Tyrode’s solution or proteolytic enzymes, and laser energy, have been evaluated with varying reports on their clinical efficacy. Now a new method of hatching, in which the zona pellucida (ZP) is mechanically expanded using hydrostatic pressure has been developed, helping to increase the implantation rates of day-3 frozen-thawed embryos in IVF/ICSI cycles. The findings of this prospective study have been published in the latest issue of Fertility and Sterility. Continue Reading

Polycystic ovary syndrome (PCOS), affecting around 5-10% of all reproductive-aged women, is one of the most common causes of anovulation. The identification of the role of insulin resistance in women with PCOS, who are also commonly resistant to clomiphene citrate (CC), resulted in the use of insulin sensitizers. The use of metformin, an insulin-sensitizing agent, in PCOS patients undergoing IVF or ovulation induction has been extensively researched, but with divergent results. Now, a new study reports that metformin significantly reduces the incidence of ovarian hyperstimulation syndrome (OHSS) and miscarriage, while positively affecting the oocyte and embryo quality in CC-resistant PCOS women undergoing IVF. The results of the randomized controlled study have been published in the Journal of Obstetrics and Gynecology. Continue Reading