New Hope Fertility Center

Background Preimplantation genetic testing for aneuploidy (PGT-A) is used principally to identify embryos with whole chromosome aneuploidy, which are generally considered non-viable. Reports of healthy live births following transfer of embryos classified as fully aneuploid are therefore extraordinary and require rigorous verification. Methods This commentary evaluates how claims of live births from embryos diagnosed as fully aneuploid by PGT-A are generated, interpreted and reported. We examine prevailing evidentiary standards and highlight key sources of potential error, including lack of genetic identity confirmation, natural conception, laboratory or clerical error and misclassification of mosaic or segmental aneuploid embryos. Results To date, no published report has included DNA-based confirmation demonstrating that a healthy child originated from an embryo diagnosed as fully aneuploid. Failure to clearly distinguish whole chromosome aneuploidy from mosaic or segmental aneuploidy, which retain the potential to result in live birth, further complicates interpretation and risks overstating the implications of such reports. Conclusion In the absence of genetic identity confirmation, claims of live births from embryos classified as fully aneuploid cannot be considered evidentiary. As interest in this topic grows, rigorous genetic validation and standardised reporting should be required to ensure scientific credibility, support accurate patient counseling and guide responsible interpretation of these reports.

Plastics are used broadly for various applications, and their degradation and fragmentation have led to widespread accumulation of nanoplastics in the environment. Although nanoplastics are ubiquitous and intractable in the environment and in organisms, their potential health impacts remain unclear. Emerging evidence showed that nanoplastics can cross the blood-brain barrier and accumulate in the brain. However, the effects of nanoplastics on neuronal health and functions in the brain are poorly understood. Here, we examined the effects of nanoplastic exposure on neurotransmitter release by measuring FM 4-64 (a lipophilic styryl dye) release from synaptic vesicles during electrical stimulation after exposing rat hippocampal neurons to 1-10 μg/mL of fluorescent polystyrene nanoplastics with an average diameter of 42 nm. We found that nanoplastics accumulated in the presynaptic terminal of hippocampal neurons and reduced stimulation-induced FM 4-64 release in a dose-dependent manner. Furthermore, nanoplastics decreased Ca2+ elevation in the presynaptic terminal of hippocampal neurons during electrical stimulation. Our results suggest that accumulated nanoplastics in the brain can impair neuronal functions by disrupting neurotransmitter release and Ca2+ dynamics in the presynaptic terminal of neurons, which could eventually lead to neurodegeneration.

Heavy menstrual bleeding (HMB) is a common complication of anticoagulant therapy in menstruating women with venous thromboembolism (VTE). Direct oral anticoagulants (DOAC) used for VTE treatment may differ in their menstrual bleeding profiles. Therefore, the prospective multicenter noninterventional investigator-initiated HEMBLED registry (HE: avy M: enstrual BLE: eding in patients treated with D: OAC) was performed to analyze spontaneous menstrual bleeding in women treated with therapeutic DOAC doses.A modified pictorial blood assessment chart (PBAC) score was used to define the severity of menstrual bleeding. Patients were only included when they did not use hormonal or intrauterine contraception methods. The prospective follow-up was 4 months. The primary endpoint was the comparison of the PBAC scores between the individual DOAC groups.Overall, 73 patients with 213 monthly assessments of the PBAC scores were analyzed. Patients were on average 35 years old and were anticoagulated with apixaban (62%), rivaroxaban (26%), edoxaban (7%), or dabigatran (6%). The PBAC scores of the rivaroxaban group (mean: 145 points) were significantly increased by 54% compared with the apixaban group (mean: 93 points, p = 0.0193). HMB (PBAC score > 100 points) at least once was detected in 53% of the apixaban group compared with 79% of the rivaroxaban group (p = 0.0913). The duration of menstrual bleeding was numerically shorter in the apixaban group compared with the rivaroxaban group (p = 0.1894).DOAC differ in their influence on the intensity of spontaneous menstrual bleeding. This should be taken into account when advising young women with VTE who need an oral anticoagulant.

Numerous publications have questioned the lack of analytical reliability and clinical relevance of sperm morphology assessment for infertility workup and before use of assisted reproductive techniques (ART). There is a huge variability in the performance and interpretation of this test. It has become necessary to evaluate its true medical service rendered to the patient. To develop clinical guidelines for use of spermatozoa morphology assessment during male fertility check-up and before ART. These guidelines were produced following a pre-defined standard methodology for narrative and Patient Intervention Comparison Outcomes (PICO) questions. The French Working Group (WG) on Sperm Morphology Assessment consisted of 15 members including an expert in statistics. R1: WG does not recommend systematic detailed analysis of abnormalities (or groups of abnormalities) during sperm morphology assessment. R2: WG recommends that the laboratory should use a qualitative or quantitative method for detection of a monomorphic abnormality (globozoospermia, macrocephalic spermatozoa syndrome, pinhead spermatozoa syndrome, multiple flagellar abnormalities). The result may be given as an interpretative commentary or as a numerical report of the percentage of detailed abnormalities. R3: There is insufficient evidence to demonstrate the clinical value of indexes of multiple sperm defects (TZI, SDI, MAI) in investigation of infertility and before ART. Accordingly, the working group does not recommend the use of sperm abnormality indexes (TZI, SDI, MAI) in sperm morphology assessment. R4: WG gives a positive opinion on the use of automated systems based on cytological analysis after staining after qualification of the operators, and validation of the analytical performance within their own laboratory. R5: WG does not recommend using the percentage of spermatozoa with normal morphology as a prognostic criterion before IUI, IVF, or ICSI, or as a tool for selecting the ART procedure. This article examines the clinical interest of sperm morphology assessment during fertility check-up and before ART. The overall level of evidence from studies is low, challenging current practices regarding sperm morphology assessment. These guidelines suggest a significant simplification of sperm morphology assessment in the light of the examined publications while maintaining the detection of monomorphic sperm abnormalities.

Infertility poses a significant global health burden, especially in cases where diminished ovarian reserve and endometrial injury limit the success of standard assisted reproductive technology treatments. Platelet-Rich Plasma (PRP) have gained attention as novel regenerative tool and adipose-derived stem cells (ADSCs) has recently gained lots of interest owing to their easy availability, multipotent characteristics, and paracrine activity. The combination of PRP and ADSCs acts better than each one individually and acts synergistically to promote tissue regeneration. This review addresses studies on the application of PRP and ADSCs in reproductive medicine, specifically targeting ovaries and uterus. In ovaries, ADSCs and PRP demonstrated potential for functional recovery in premature ovarian insufficiency, early menopause, and chemotherapy-induced ovarian damage, showing menstrual restoration, hormonal normalization, and stimulation of follicle growth. ADSC-derived exosomes and conditioned medium promoted oocyte maturation, lowered oxidative stress, improved blastocyst development, and increased embryo survival. Additionally, findings indicate that intrauterine delivery of ADSCs and PRP enhances endometrial thickness, angiogenesis, and receptivity, with reports of improved implantation and pregnancy outcomes in women with thin endometrial lining or Asherman’s syndrome. Collectively, these results underscore the regenerative promise of ADSCs and PRP in overcoming various infertility causes.

Mammalian fertilization involves the migration of spermatozoa through the female reproductive system. Early embryonic development is a consequence of several steps and signaling pathways being activated, as well as biochemical and morphological modifications of spermatozoa that enable them to penetrate the membrane of mature oocytes. There are some crucial steps known to clearly explain the process of fertilization, starting with hyperactivation of spermatozoa, mutual recognition, and binding of gametes mediated by receptors located on the surface membranes of both gametes. The final step is followed by oocyte activation, which is primarily triggered via sperm-derived factors, inducing a sharp increase in intracellular calcium levels, eventually leading to polyspermy block. This review integrates current knowledge of the molecular and physiological events governing fertilization, emphasizing how ion regulation and signaling pathways converge to enable sperm function and oocyte activation. Special attention is given to sperm-derived factors such as phospholipase C zeta (PLCζ) and post-acrosomal sheath WW domain-binding protein (PAWP), which play essential roles in triggering calcium release and supporting early embryonic development.