Reproductive Medicine Institute

BackgroundPer- and poly-fluoroalkyl substances (PFASs) are a group of synthetized industrial pollutants which have been detected worldwide in both environment and humans and gradually raised public health concerns. Previous studies suggested that PFASs had reproductive toxicity and may do harm to pregnancy and children. However, it is still uncertain that whether effect of PFAS exposure on offsprings begins from embryo quality or post-implantation pregnancy outcomes. This study explores the association between exposure to PFASs and embryo quality or pregnancy outcomes to promote maternal–infant health.MethodsThis study included 246 women who underwent their first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles from July 2017 to August 2018 and measured concentrations of 23 PFAS congeners of follicular fluid samples. Generalized linear regression model with ln-transformed concentration values was performed to evaluate the association between individual PFAS congener and embryo quality and pregnancy outcomes. Weight quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were used to estimate mixed effect of PFAS exposure on the above outcomes.ResultsPFAS exposure had no significant association with high-quality blastocyst rate. Whereas, PFAS exposure had significantly adverse effect on miscarriage and live birth rate with the predominant risk of perfluoro-n-butanoic acid (PFBA) (For miscarriage, Q4 vs. Q1 OR: 6.44 (95%CI: 1.47, 33.72), Adjusted p = 0.03; For live birth, Q4 vs. Q1 OR: 0.35 (95%CI: 0.14, 0.82), Adjusted p = 0.04). BKMR model also suggested that there was potential joint effect between mixed PFAS chemicals and miscarriage or live birth.ConclusionFor women undergoing IVF/ICSI, exposure to PFASs was associated with higher miscarriage and lower live birth rate but had no adverse effect on embryo quality.

ABSTRACT Recent James Webb Space Telescope (JWST) observations have revealed a growing population of galaxies at $z>4$ with elevated nitrogen-to-oxygen ratios. These ‘N/O-enhanced’ galaxies (NOEGs) exhibit near to supersolar N/O at sub-solar O/H, clearly deviating from the well-established scaling relation between N/O and O/H observed in local galaxies. The origin of this abundance anomaly is unclear. Interestingly, local globular clusters also exhibit anomalous light-element abundances, whose origin remains debated. In this work, we compare the chemical abundance patterns of 22 known NOEGs at $0\lesssim z\lesssim 12$ – primarily discovered with JWST – to those observed in local globular clusters. We find similarities in the abundances of C, N, O, Fe, and He between the two populations. The similar abundance patterns support the scenario in which globular cluster stars formed within proto-cluster environments – similar to those traced by NOEGs – that were self-enriched. Indeed, the enhancement in N/O in early galaxies appears to be only found in dense stellar environments with $\Sigma _{\star }\gtrsim 10^{2.5}~M_\odot ~{\rm pc^{-2}}$, as expected for the progenitors of globular clusters in the Milky Way, and similar to those of star clusters identified in strongly lensed high-redshift galaxies. Furthermore, we find a tentative positive correlation between N/O ratios and stellar mass among NOEGs. The apparent high occurrence rate of NOEGs at high redshift is consistent with the picture of cluster-dominated star formation during the early stages of galaxy evolution. Measuring chemical abundances across diverse stellar environments in high-redshift galaxies will be crucial for elucidating the connection between NOEGs and globular clusters.

Abstract Human endometrial receptivity is a critical determinant of pregnancy success; however, in vivo studies of its features and regulation are particularly challenging due to ethical restriction. Recently, the development of human endometrial assembloids has provided a powerful model to examine this intricate biological process. In this study, we established a specialized human window-of-implantation (WOI) endometrial assembloid system that mimics the in vivo receptive endometrium. It recapitulates not only the structural attributes of pinopodes and cilia, but also molecular characteristics of mid secretory endometrium. Furthermore, the WOI endometrial assembloid exhibits hormone responsiveness, energy metabolism with larger and enhanced functional mitochondria, increased ciliary assembly and motility, and epithelial-mesenchymal transition (EMT), as well as promising potential for embryo implantation. As such, WOI assembloids hold great promise as a platform to unravel the intricate mechanisms governing endometrial receptivity regulation, maternal-fetal interactions, and associated diseases, ultimately driving impactful advancements in the field.

Human endometrial receptivity is a critical determinant of pregnancy success; however, in vivo studies of its features and regulation are particularly challenging due to ethical restriction. Recently, the development of human endometrial organoids has provided a powerful model to examine this intricate biological process. In this study, we established a specialized human window-of-implantation (WOI) endometrial organoid system that mimics the in vivo receptive endometrium. The endometrial organoid recapitulates not only the structural attributes of glands and stroma, but also the in vivo endometrium's cell types at the single-cell level. Furthermore, the WOI endometrial organoid exhibits the features of in vivo implantation endometrium such as hormone responsiveness, secretory functions, and distinctive implantation window hallmarks, including decidualization, extracellular matrix (ECM) remodeling, pinopode formation, cilia generation and metabolism. This in vitro model also effectively demonstrates the process of proliferation-secretory transformation, ciliary epithelium differentiation, and epithelial-mesenchymal transition (EMT). As such, WOI organoids hold great promise as an alternative platform to unravel the intricate mechanisms governing endometrial receptivity regulation, maternal-fetal interactions, and associated diseases, ultimately driving impactful advancements in the field.

Abstract Study question What are the current recommended criteria for morphological assessment of oocytes, zygotes and embryos? Summary answer The present ESHRE/Alpha Scientists in Reproductive Medicine consensus document provides several novel recommendations to assess oocyte and embryo morphology and rank embryos for transfer. What is known already A previous Alpha Scientists in Reproductive Medicine / ESHRE consensus on oocyte and embryo morphological assessment was published in 2011. After more than a decade, a thorough review and update was needed. Study design, size, duration A working group consisting of Alpha Scientists in Reproductive Medicine executive board members and ESHRE Special interest group of Embryology members formulated recommendations on oocyte and embryo morphological assessment. Participants/materials, setting, methods The working group included 17 internationally recognized experts with extensive experience in clinical embryology. Seven members represented Alpha Scientists in Reproductive Medicine and 8 members represented ESHRE, in addition to two methodological experts from the ESHRE central office. Based on a systematic literature search and discussion of existing evidence, the recommendations of the Istanbul Consensus (2011) were reassessed and, where appropriate, updated based on consensus within the working group. After stakeholder review, the final version will be approved by the working group, the Alpha executive board and the ESHRE Executive Committee. Main results and the role of chance This updated consensus paper provides 20 recommendations focused on the timeline of preimplantation developmental events and morphological criteria for oocyte, zygote, and embryo assessment. Based on duration of embryo culture, recommendations are given on the frequency and timing of assessments to ensure safety and effectiveness. Limitations, reasons for caution Several criteria relevant to oocyte and embryo morphology have not been well studied, leading to either a recommendation against their use for grading or for use in ranking rather than grading. Future updates may require further revision of these recommendations. Wider implications of the findings This document provides embryologists with clear advice on best practices when assessing oocyte and embryo quality based on the most recent evidence.

Roux-en-Y gastric bypass (RYGB) has consistently demonstrated excellent weight loss and comorbidity resolution. However, outcomes vary based on patient's BMI. Single anastomosis duodeno-ileostomy with sleeve (SADI-S) is a novel procedure with promising short-term results. The long-term outcomes of SADI-S in patients with BMI ≥ 50kg/m2 are not well described. We aim to compare the safety and efficacy of SADI-S with RYGB in this patient population. We performed a multicenter retrospective study of patients with a BMI ≥ 50kg/m2 who underwent RYGB or SADI-S between 2008 and 2023. Patient demographics, peri- and post-operative characteristics were collected. Complication rates were reported at 6, 12, 24, and 60months postoperatively. A multivariate linear regression was used to evaluate and compare weight loss outcomes between both procedures. A total of 968 patients (343 RYGB and 625 SADI-S; 68.3% female, age 42.9 ± 12.1years; BMI 57.3 ± 6.7kg/m2) with a mean follow-up of 3.6 ± 3.6years were included. Patients who underwent RYGB were older, more likely to be female, and have a higher rate of sleep apnea (p < 0.001), hypertension (p = 0.015), dyslipidemia (p < 0.001), and type 2 diabetes (p = 0.016) at baseline. The rate of bariatric surgery-specific complications was lower after SADI-S compared to RYGB. We reported no bariatric surgery related deaths after 1 year following both procedures. SADI-S demonstrated statistically higher and sustained weight loss at each time interval compared to RYGB (p < 0.001) even after controlling for multiple confounders. Lastly, the rate of surgical non-responders was lower in the SADI-S cohort. In our cohort, SADI-S was associated with higher and sustained weight-loss results compared to RYGB. Comorbidity resolution was also higher after SADI-S. Both procedures demonstrate a similar safety profile. Further studies are required to validate the long-term safety of SADI-S compared to other bariatric procedures.

The purpose of the study was to study the effectiveness of antioxidant complexes «I’ll be a dad. At 40 as at 20» and «I’ll be a dad forte. At 40 as at 20» (KorolevPharm LLC, Russia) in men with pathospermia. Material and methods. An open, randomized, placebo-controlled, prospective study was conducted with the inclusion of 72 patients with pathospermia, who, as part of their routine practice, were prescribed a biologically active supplement (BAS) «I’ll be a dad. At 40 as in 20», or dietary supplement «I’ll be a dad forte. At 40 like at 20», or placebo for 4 weeks. Patients aged 18 to 45 years with impaired reproductive function in the form of oligo- and/or astheno- and/or teratozoospermia were included. A spermogram was performed before and after treatment, the dynamics of indicators was assessed using the Wilcoxon test. Results. During therapy in the main group, there was a significant increase in the volume of ejaculate (from 2.7 ml to 3.2 ml, p=0.006), a decrease in the frequency of viscosipathy (from 28% to 6%), a decrease in the concentration of spermatozoa (from 38.5 million/ml to 35 million/ml, p=0.01), an increase in the proportion of progressively motile spermatozoa (from 20% to 23.5%, p=0.0002), an increase in the proportion of morphologically normal spermatozoa (from 1% to 1.5%, p=0.02). In the control group, there were no statistically significant improvements in spermogram parameters. Conclusion. BAS «I’ll be a dad. At 40 as at 20» and BAS «I’ll be a dad forte. At 40 as at 20» have a positive effect on all indicators of spermiological tests in patients with pathospermia. It is advisable to recommend these drugs as part of complex therapy for a period of at least 30 days.

ResumoApresenta-se uma revisão sistemática sobre interseccionalidade no ambiente rural.O conceito "rural" considera a multifuncionalidade dos territórios além do espaço de produção agrícola.Foram incluídos resumos que discutiram o ambiente rural e interseccionalidade, totalizando 67 artigos.Através do software Iramuteq, na análise de similitude, as palavras 'rural' , 'woman' , 'gender' , 'social' e 'health' aparecem como importantes conectores.Evidenciou-se que as investigações avaliadas podem compor uma práxis com movimentos sociais do campo.Conclui-se que diferentes eixos de opressões são analisados sob a ótica da interseccionalidade no rural, especialmente gênero, classe, etnia e raça, dialogando com diferentes expressões dos movimentos sociais do campo.

Human endometrial receptivity is a critical determinant of pregnancy success; however, in vivo studies of its features and regulation are particularly challenging due to ethical restrictions. Recently, the development of human endometrial assembloids has provided a powerful model to investigate this intricate biological process. In this study, we established a specialized human window-of-implantation (WOI) endometrial assembloid system that mimics the in vivo receptive endometrium. It not only reproduces the structural attributes of pinopodes and cilia, but also molecular characteristics of mid-secretory endometrium. Furthermore, the WOI endometrial assembloid exhibits hormone responsiveness, an energy metabolism profile characterized by larger and functionally enhanced mitochondria, increased ciliary assembly and motility, and epithelial-mesenchymal transition (EMT), as well as promising potential for embryo implantation. As such, WOI assembloids hold great promise as a platform to unravel the intricate mechanisms governing the regulation of endometrial receptivity, maternal-fetal interactions, and associated pathologies, ultimately driving impactful advancements in the field.