To evaluate the impact of a history of gestational trophoblastic disease on pregnancy outcomes in in vitro fertilization-embryo transfer procedures(IVF-ET) and to utilize logistic regression to analyze potential risk factors influencing re-pregnancy outcomes among women with GTD histories undergoing IVF-ET. This retrospective cohort study collected data from patients with a history of GTD who underwent IVF-ET at the hospital from January 2018 to January 2023. The study group comprised 27 women with a history of GTD. A control group of 54 women, matched at a 1:2 ratio, without a GTD history, was selected from those who underwent IVF-ET during the same period at the same hospital. Statistical analyses were employed to compare baseline characteristics, embryological parameters, and pregnancy outcomes between the two groups. The study group exhibited significantly lower endometrial thickness (EMT) during the mid-luteal phase of the natural menstrual cycle, reduced EMT on the day of embryo transfer (ET), and a decreased blastocyst formation rate compared to the control group (p < 0.05). Furthermore, the study group had a higher number of uterine curettages prior to transfer, an increased rate of discarded embryos, and higher total sperm motility (PR + NP) in their spouses (p < 0.05). Logistic regression analysis revealed that a history of GTD does not significantly affect pregnancy outcomes post-IVF-ET. A history of GTD does not significantly influence pregnancy outcomes following IVF-ET. Therefore, patients with a GTD history and their physicians can approach the IVF-ET process with less anxiety and adopt a more positive and rational outlook.

To investigate the distribution of ABO blood groups among infertile couples in Southern China (Ganzhou region) and to explore the association between blood types and male reproductive parameters. This single-center retrospective study analyzed data from 696 infertile couples who sought treatment at a tertiary reproductive medicine center in Southern China between 2016 and 2024. ABO blood group distributions in infertile men and women were compared with those of a large-scale reference population from Southern China (n ≈ 14.41 million). Chi-square tests, Cramér's V effect size, and the observed-to-expected ratio (O/E) were used to evaluate associations between couple blood type combinations and semen parameters, including sperm concentration, total sperm count, progressive motility, and normal morphology. Blood group O was significantly overrepresented in infertile men (39.51% vs. 34.21%, P = 0.008) and women (41.67% vs. 34.19%, P < 0.001), whereas blood group AB was underrepresented (men: 6.18% vs. 8.91%, P = 0.008; women: 6.47% vs. 8.91%, P = 0.008). The O/O couple blood type combination showed a significantly higher prevalence among infertile couples (16.81% vs. 11.70%, O/E = 1.44, P < 0.001), while combinations involving A/B and B/AB occurred less frequently (O/E = 0.57-0.78, P < 0.05). Male blood type was associated with sperm normal morphology (O < A < B < AB, P = 0.02), but not with sperm concentration or progressive motility. Blood group O-particularly the O/O couple combination-may be associated with an increased risk of infertility, whereas combinations involving B or AB blood groups may confer a potential protective effect. The ABO blood group type may influence male fertility, partly through its association with sperm morphology. These findings provide region-specific evidence and underscore the need for large-scale, multi-center studies to further validate the observed associations.

To evaluate whether a micronutrients supplement combined with probiotics improves oocyte retrieval outcomes in normoresponder women undergoing controlled ovarian hyperstimulation for oocyte donation. A multicenter, prospective, randomized, double-blind, controlled clinical trial was conducted between July 2022 and July 2024 with 196 normoresponder oocyte donors at three fertility centers in Spain. Participants received either study supplement or a placebo for at least 30days before and during controlled ovarian hyperstimulation. The intention-to-treat analysis showed a significant increase in the total number of follicles (28.01 ± 10.4 vs. 24.7 ± 7.1; p = 0.0314) and follicles ≥ 16mm (19.3 ± 8.6 vs. 15.8 ± 6.1; p = 0.0065) in the study group compared to the placebo group. Regarding the quality of MII oocytes, the mean number of good-quality oocytes showed no differences between groups (17.0 ± 7.7 (84.1%) vs. 15.4 ± 8.2 (81.4%); p = 0.2187). The per-protocol analysis (participants who completed the study and adhered fully to the supplement regimen, n = 79) revealed significantly higher total oocytes retrieved (27.7 ± 10.4 vs. 21.2 ± 7.9; p = 0.0045), MII oocytes (22.5 ± 8.89 vs. 17.3 ± 7.25; p = 0.0092), and good-quality MII oocytes (18.97 ± 7.7 vs. 13.42 ± 6.5; p = 0.0019) in the study group. Probiotic micronutrients supplementation improved follicular development and oocyte yield, in normoresponder oocyte donors, especially when administered according to the recommended protocol. These findings suggest potential benefits for oocyte donation programs; however, further research is needed to establish definitive recommendations. The study protocol was registered at ClinicalTrials.gov (TRN: NCT05473039) on June 27, 2022.

To study reproductive outcomes of transferring embryos with mosaic chromosomal aneuploidies unrelated to target loci in preimplantation genetic testing for structural rearrangement (PGT-SR). A retrospective analysis of 1712 PGT-SR cycles (involving 1373 couples) from a single center was conducted. Comprehensive chromosomal analysis was performed on trophectoderm biopsy samples using whole-genome amplification combined with next-generation sequencing. Clinical outcomes after single embryo transfer, including clinical pregnancy rate, miscarriage rate, live birth rate, and ectopic pregnancy rate, were compared between mosaic embryo transfers and completely euploid embryo transfers. In PGT-SR cycles, euploid embryo transfers (1338 cycles) demonstrated a clinical pregnancy rate of 65.17%, live birth rate of 58.67%, miscarriage rate of 6.05%, and ectopic pregnancy rate of 0.45%, whereas mosaic embryo transfers (165 cycles) exhibited comparable outcomes with 58.18%, 54.55%, 3.64%, and 0%, respectively. The subgroup analysis by mosaic degree which revealed low-level mosaicism (20%-29% and 30%-49%) had outcomes similar to euploid embryos. High-level mosaicism (50%-69%) demonstrated significantly reduced clinical pregnancy (OR = 0.20, 95% CI 0.06-0.54) and live birth rates (OR = 0.20, 95% CI 0.06-0.56), though miscarriage remained comparable. No significant outcome variations were observed across chromosomal types. In PGT-SR cycles, embryos with low-level mosaicism (20%-49%) unrelated to target loci demonstrate equivalent clinical pregnancy and live birth outcomes to completely euploid embryos. Although high-level mosaicism (50%-69%) is likely associated with reduced live birth rates, these embryos still retain potential for healthy live births.

To identify novel pathogenic genes and variants responsible for oocyte degeneration and death. Whole-exome sequencing was conducted in 78 individuals with primary infertility characterized with oocyte degeneration and death, followed by Sanger sequencing of candidate variants. Pathogenicity of identified COX15 variants was characterized through morphological assessment, AlphaFold3-based structural modeling and functional validation including Western blotting and immunofluorescence. We identified a compound-heterozygous COX15 variants and a homozygous COX15 variant in two affected individuals with oocyte degeneration. The variants c.C664T [p.R222C] was a previously reported recurrent pathogenic variant. The clinical records showed that majority of oocytes retrieved from affected individuals were immature and degenerated. Structural modeling assay showed that all the COX15 variants affected the binding pocket with heme o. The compound-heterozygous COX15 variants c.C905T [p.P302L] and c.C664T [p.R222C] in family 1 significantly decreased COX15 protein level in HeLa cells. While the homozygous variant c.C647T [p.P216L] decreased the COX1 protein level in oocytes from family 2 (II-1), implying the disruption of respiratory complex IV (COXIV) assembly. Our study identified two novel variants in COX15, and functional analysis confirmed the pathogenicity of the variants. Our findings expand the mutational spectrum of COX15 and making it a potential genetic diagnostic marker for those suffering from female infertility causing by oocyte degeneration.

We describe a 26-year-old IVF patient, with primary infertility, who underwent oocyte retrieval following ovarian stimulation. During the procedure, we encountered premature follicular luteinization confined to large follicles in the right ovary, while the smaller follicles in the left ovary were not affected. Repeated blood tests in the late follicular phase ruled out premature LH rise and showed an abnormal progesterone rise. We maintain that ovarian tissue mechanical pressure may lead to abnormal follicular luteinization, independent of the LH surge.

Ovarian stimulation (OS) is a critical component of assisted reproduction techniques (ART), in which gonadotropins are administered to induce follicular development and maturation to improve the chances of conception. It has been reported that ovarian response to OS can be affected by certain genetic factors. This study explores the relationship among SNVs of AMHR2 (c.-482A > G/rs2002555 and c.1749C > T/rs2071558), basal FSH and estradiol levels, gonadotropin dosage, and ovarian response to identify predictive indicators. Oocytes were retrieved from 684 infertile Chinese women treated with ART. All patients were divided into three groups: low (< 6 oocytes), normal (6-14 oocytes), high response (> 14 oocytes). Genotyping of c.-482A > G and c.1749C > T were detected on the Sequenom iPlexMassARRAY platform. Transcriptional function of c.-482A > G variant in AMHR2 promoter was validated by Luciferase Reporter Assay in 293T cells. Our results indicated that both c.-482A > G and c.1749C > T SNVs were associated with basal FSH levels (p = 0.047 and 0.023, respectively). Genotype and allele distribution frequencies of AMHR2 c.-482A > G were significantly different among the three ovarian response groups (p = 0.007 and 0.009, respectively). AMHR2 c.-482A > G was associated with the number of total oocytes retrieved (p = 0.011). FSH was associated with the ovarian response (p < 0.001). Validation by Luciferase Assay indicated AMHR2 c.-482A > G mutation in the promoter region affect the promoter activity. AMHR2 c.-482A > G SNVs may be involved in the mechanism of the ovarian response to OS. AMHR2 c.-482A > G SNVs can interact with basal FSH levels, and jointly serve as predictor of the ovarian response to OS.

PurposeThe economics of IVF operations remain opaque despite growing prevalence and substantial investment in fertility services. Traditional accounting methods often fall short by failing to capture the complex relationship between biological inputs (number of eggs and embryos processed), skilled labor, and equipment utilization, creating a distorted view across different procedures and patient characteristics.MethodsThis paper presents Activity-Based Costing (ABC) as a methodological framework for understanding true IVF laboratory costs. We demonstrate a use case with an analysis of data from five IVF laboratories (600–2200 annual egg retrieval cycles) across different US regions including time studies of 500 + procedures at each site, with theoretical projections to 4000 annual egg retrieval cycles based on queuing theory.ResultsWe identify significant cost elasticity with biological inputs; costs increase by 55% for egg freezing when the number of eggs per patient triples, and by 30% for complex IVF procedures (such as those requiring embryo biopsy) when egg count per patient doubles. We also describe substantial scale effects, with marginal lab costs 40% higher in centers performing 500 yearly egg retrieval cycles versus 2000-cycle centers, and 4000-cycle centers estimated to achieve 13–40% lower costs per procedure than operations performing 500 retrieval cycles annually. Finally, we show labor efficiency increases by 30% between centers performing 500 and 2000 annual egg retrieval cycles, an observation supported by a queuing rule of thumb (QROT) analysis, with capital utilization also improving dramatically.ConclusionsABC enables evidence-based pricing, capacity planning, technology assessment, and consolidation strategizing. ABC is intended to inform operational efficiency, not clinical treatment, ensuring that quality of care and patient outcomes remain the primary considerations in fertility services.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10815-025-03715-y.