Reproductive Biology Associates

ObjectiveTo evaluate the association between prior mode of delivery (cesarean vs. vaginal) and endometrial thickness in the subsequent frozen embryo transfer (FET) cycle. The secondary aim was to evaluate FET cycle outcomes.DesignRetrospective cohort study.SubjectsThis multicenter study included patients with one previous live birth who initiated a subsequent, autologous FET cycle from January 2012 to December 2024. Patients were grouped by mode of prior delivery: cesarean or vaginal.ExposureCesarean or vaginal delivery.Main Outcome MeasuresThe primary outcome was endometrial thickness at final lining assessment. Secondary outcomes included FET cycle cancellation rate due to thin or fluid-filled endometrium, pregnancy, and live birth rates. Subgroup analyses evaluated outcomes of euploid FET cycles only.ResultsA total of 11,131 FET cycles consisting of 5,149 from patients with prior cesarean and 5,982 from patients with prior vaginal delivery were included. Endometrial thickness in the subsequent FET cycle was similar between cohorts (cesarean: 10.4 mm [10.3–10.5 mm]; vaginal: 10.4 mm [10.3–10.4 mm]). The FET cycle cancellation rate due to thin endometrium was comparable (cesarean: 1.3%, vaginal: 1.2%; adjusted relative risk [aRR] 1.02 [0.72–1.43]); cancellation due to endometrial fluid accumulation was higher in the cesarean cohort (1.0% vs. 0.5%; aRR 2.22 [1.40–3.58]). Cesarean delivery was associated with lower live birth (49.5% vs. 53.0%; aRR 0.95 [0.90–0.98]) and clinical pregnancy (60.5% vs. 64.1%; aRR 0.95 [0.90–0.99]), with similar rates of clinical pregnancy loss (cesarean: 10.6%, vaginal: 10.6%; aRR 0.95 [0.84–1.07]). Similar trends were observed in patients undergoing euploid FET, with lower live birth demonstrated in those with a prior cesarean (55.3% vs. 60.3%; aRR 0.91 [0.84–0.98]), but similar chance of clinical pregnancy loss (cesarean: 9.1%, vaginal: 9.4%; aRR 0.95 [0.77–1.17]).ConclusionAlthough patients can be reassured that a prior cesarean does not appear to be associated with reduced endometrial thickness, receptivity in FET cycles may be diminished, as reflected by lower subsequent live birth rates. One possible explanation is an altered endometrial environment, given the increased risk of cycle cancellation due to endometrial fluid accumulation in patients with prior cesarean delivery.

To evaluate clinical outcomes for patients undergoing IVF treatment where an arti cial intelligence (AI) platform was utilized by clinicians to help determine the optimal starting dose of FSH and timing of trigger injection. Prospective clinical trial with historical control arm Setting Four physicians from two assisted reproductive technology treatment centers in the United States participated in the study. The treatment arm included patients undergoing autologous IVF cycles between December 2022 -April 2023 where the physician use AI to help select starting dose of follicle stimulating hormone (FSH) and trigger injection timing (N = 246). The control arm included historical patients treated where the same doctor did not use AI between September 2021 -September 2022. None. Total FSH used and average number of mature metaphase II (MII)oocytes. There was a non-signi cant trend towards improved patient outcomes and a reduction in FSH with physician use of AI. Overall, the average number of MIIs in the treatment vs. control arm was 12.20 vs 11.24 (improvement = 0.96, p=0.16). The average number of oocytes retrieved in the treatment vs. control arm was 16.01 vs 14.54 (improvement = 1.47, p = 0.08). The average total FSH in the treatment arm was 3671.95 IUs and the average in the control arm was p=0.13). There was a trend towards improved laboratory outcomes with physician use of AI.. Together, this suggests that AI can safely assist in re ning the starting dose of FSH while narrowing down the timing of the trigger injection during ovarian stimulation, bene ting the patient in optimizing the count of MII oocytes retrieved,

In contemporary society, socially active women are increasingly planning their fertility for later in life. The fertility outcomes for advanced-age patients, even with egg donation, are often suboptimal due to endometrial aging. Recurrent implantation failure (RIF) is one of the core problems for assisted reproductive technology (ART), especially for advanced-age patients. High-quality, euploid embryos and synchronization between the embryonic stage and the uterine endometrial lining are crucial for positive outcomes. The study aims to improve ART outcomes with personalized embryo transfer (pET) according to endometrial receptivity analysis (ERA) in advanced-age patients with challenging reproductive histories, and RIF by utilizing, donor oocytes andpreimplantation genetic testing for aneuploidy (PGT-A) for embryo testing. A randomized, controlled observational follow-up study was conducted from2020 to 2023. After obtaining informed consent, 320 patients with RIF were selected. Patients were allocated into the study group and control group 1 based on consistent application of randomization principles, while control group 2 was selected separately. The study group included patients undergoing PGT-A and ERA, aged 35-45 years, with a mean age of 40.5±3.7 years. Control group 1 comprised patients undergoing PGT-A, aged 35-45 years, with a mean age of 40±4.2 years. Control group 2 consisted of patients undergoing PGT-A and ERA, aged less than 35 years, with a mean age of 31.6±2.2 years. Results suggestthat ERA may improve implantation and pregnancy outcomes in advanced-age patients, particularly those withRIFs. The pregnancy rate was significantly higher in the study group (77.9%), compared to control group 1 (57.6%) (p=0.0007), and no significant difference compared to control group 2(77.3%) (p=0.94). The implantation rate was higher in the study group (54.1%) than in control group 1 (39.4%) (p=0.0009), and there wasno significant difference between the study group and control group 2(50%, p=0.87). The live birth rate was also higher in the study group (71.3%), compared to control group 1 (39.4%) (p<0.0001). There were no significant differences between the study group and control group 2 (65.9%, p=0.50). pETguided by ERAsignificantly improves pregnancy, implantation, and live birth rates in advanced-age patients with challenging reproductive histories. pET providesART outcomes with no significant difference between advanced-age patients and younger patients with pET guided by ERA.

Abstract The COVID-19 has affected millions of people across the world and worsened the socio-economic conditions that have sound reasons to discuss about the impact of COVID-19 on the progress of achieving the target level of sustainable development. The stagflation due to COVID-19 has a possibility to push a large section of population back under the critical level of income. The economic restriction and lockdown has impacted on the supply of food and essential requirements for decent living. The health services and education have been jeopardised. So the possible impact to achieving the Sustainable Development Goals of no poverty (SDG1), zero hunger (SDG2), good health and wellbeing (SDG3), education (SDG4), decent work and economic growth (SDG8), income inequality (SDG10) are examined in this chapter. This chapter also discusses about the proper implementation and stress on SDGs as the possible instruments on the way out of recession. Difference-in-difference analysis is used to explain the impact of COVID-19 with the data in global context in respect of before COVID and after COVID.

Benthic macroinvertebrate taxa vary in their sensitivities to water quality and habitat conditions, contributing to their extensive use as ecological indicators. As climate change and landscape alteration increasingly impact stream temperatures, interest is growing in expanding our knowledge of how macroinvertebrates are affected by current and future thermal conditions. Using samples from 3501 sites, we evaluated relationships between macroinvertebrate taxa and modeled stream temperatures across Oregon and Washington, in the U.S. Pacific Northwest. We used Maximum Weekly Maximum Temperature (MWMT) values from the NorWeST temperature dataset, which is the same metric used for numeric water temperature standards in Oregon and Washington. MWMT captures peak thermal stress, when cold-water adapted aquatic biota are closest to their upper physiological limits. For each macroinvertebrate taxon, we characterized relationships between MWMT and their distributions with three measures: 1) central thermal tendency, based on weighted average (WA) optima calculations and relative abundance data; 2) lower and upper thermal limits, based on the 10th and 90th percentiles of taxon occurrence, using presence data; and 3) thermal sensitivity curve shape, based on Generalized Additive Model (GAM) plots. We assigned 521 taxa, from species to phyla, to seven thermal preference categories, ranging from cold and warm stenotherms (narrow range) to eurythermal (wide range). Thermal sensitivity and variability within each taxonomic group were identified for establishing taxonomic targets for regional monitoring programs. We also developed the Macroinvertebrate Thermal Tolerance Index (MTTI) to represent the assemblage-level response to available thermal habitats, using WA optima and relative abundances for 324 taxa. The MTTI model had a strong relationship with modeled temperatures (R2 = 0.68) and a root-mean-square-error of 2.5 °C. Our work builds on previous regional and national efforts to identify thermal indicator taxa by using modeled stream network temperatures and a thermal metric that corresponds directly to regional water temperature standards. Both the taxa thermal preferences and the MTTI can be used to help identify causes of biological impairment, prioritize restoration and protection actions, and monitor assemblage-wide changes in thermal tolerance over time.

Preimplantation genetic testing commonly employs simplistic copy-number analyses to screen for aneuploidy in blastocyst trophectoderm biopsies. Interpreting intermediate copy number alone as evidence of mosaicism has led to suboptimal estimation of its prevalence. Because mosaicism originates from mitotic nondisjunction, utilizing SNP microarray technology to identify the cell-division origins of aneuploidy might provide a more accurate estimation of its prevalence. The present study develops and validates a method of determining the cell-division origin of aneuploidy in the human blastocyst by using both genotyping and copy-number data in parallel. The concordance of predicted origins with expected results was demonstrated in a series of truth models (99%-100%). This included determination of X chromosome origins from a subset of normal male embryos, determination of the origins of translocation chromosome-related imbalances via embryos from couples with structural rearrangements, and prediction of either mitotic or meiotic origins via multiple rebiopsies of embryos with aneuploidy. In a cohort of blastocysts with parental DNA (n= 2,277), 71% were euploid, 27% were meiotic aneuploid, and 2% were mitotic aneuploid, indicating a low frequency of bona fide mosaicism in the human blastocyst (mean maternal age: 34.4). Chromosome-specific trisomies in the blastocyst were also consistent with observations previously established in products of conception. The ability to accurately identify mitotic-origin aneuploidy in the blastocyst could benefit and better inform individuals whose IVF cycle results in all aneuploid embryos. Clinical trials with this methodology might also help provide a definitive answer regarding the reproductive potential of bona fide mosaic embryos.