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Clinical Advancements in Infertility Treatments and Assisted Reproductive Technology (ART)
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Clinical Advancements in Infertility Treatments and Assisted Reproductive Technology (ART)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 25 May 2024 | Viewed by 1090

Special Issue Editor

Dr. Diana Alecsandru

E-Mail Website
Guest Editor
1. Department of Immunology, IVI RMA Madrid, Madrid, Spain
2. IVI Foundation, Health Research Institute La Fe, Valencia, Spain
Interests: reproductive disorders; immunology; IVF clinical; female fertility; pre-implantation genetics

Special Issue Information

Dear Colleagues,

Infertility is a significant health problem, affecting 8–15% of people worldwide.  Decades ago, assisted reproductive technology (ART) emerged as a tool in the fight against infertility. Though the number of patients undergoing ART has grown substantially and the process itself has been subjected to numerous advancements since its inception, most ART cycles do not result in a live birth. Even when chromosomally normal embryos are transferred, only about 50% gets implanted. Apart from ageing, which is the primary issue affecting fertility in today's society, other underlying conditions such as male factor, endometriosis, ovulation disorders, tubal disease, uterine factor, metabolic, immune and inflammatory disorders also affect negatively fertility and ART outcomes.

Pregnancy involves the coexistence of two genetically different identities in a suitable environment. This exceptional situation requires specific changes in the uterine microenvironment, at the morphological, metabolic, immunological, vascular, biochemical and even genetic levels. Research in this field is concerned with  preventive procedures (fertility preservation at a young age), shortening the diagnosis time, as well as improving the diagnostic techniques and treatment measures.

This Special Issue aims to collate both original research and review articles that highlight the clinical advancements in infertility and ART. Some potential topics include artificial intelligence, diagnosis and treatment of maternal environment, and the maternal–fetal cross-talk.

Dr. Diana Alecsandru
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infertility
  • ART
  • implantation failure
  • endometrial factor
  • decidualization
  • early placentation
  • maternal–fetal cross-talk
  • maternal immune tolerance
  • maternal–fetal match
  • artificial intelligence

Published Papers (2 papers)

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Research

13 pages, 1306 KiB  
Article
Advancing Age May Decrease Mitochondrial Activity in Cumulus Cells
by Suwichaya Jitngamsujarit, Lingling Salang, Charupong Saengboonmee, Supannika Sorin, Kanyarat Thithuan, Thanida Pongsritasana and Sineenart Sukkasame
J. Clin. Med. 2024, 13(10), 2800; https://doi.org/10.3390/jcm13102800 - 9 May 2024
Viewed by 256
Abstract
Background: The goal of this study was to compare mitochondrial activity in cumulus cells (CCs) between young and advancing-aged women, the factors that affect mitochondrial activity, and their association with blastocyst quality. Materials and methods: This prospective study included 80 infertile women who [...] Read more.
Background: The goal of this study was to compare mitochondrial activity in cumulus cells (CCs) between young and advancing-aged women, the factors that affect mitochondrial activity, and their association with blastocyst quality. Materials and methods: This prospective study included 80 infertile women who underwent ICSI between May and October 2023. Participants were divided into two groups: older and younger than 38. The oocyte mitochondrial activity from CCs was evaluated using MitoTracker, and the mean fluorescence intensity (MFI) was also evaluated. Results: The univariate and multivariate analyses revealed a significant difference in the MFI between the woman ≥ 38 age group and the lower age group (162.68 ± 79.87 vs. 228.39 ± 121.38; p-value = 0.005; 95%CI 19.97, 111.45). The factors that affected the MFI were women ≥ 38 years of age (p-value = 0.005; 95%CI −111.45, −19.91), total gonadotropin dosages (p-value = 0.006; 95%CI −0.08, 0.01), and gonadotropin-releasing hormone agonist (GnRHa) triggering (p-value = 0.006; 95%CI 36.46, 210.06). However, only women aged ≥38 years remained statistically significant after a multivariable regression analysis (p-value = 0.014; 95%CI −121.00, −14.30). In addition, only male age (mean age ± SD = 38.26 ± 5.13) was associated with high blastocyst quality in univariate and mixed multivariate analyses (OR 0.91; 95%CI 0.56, 3.04). The chemical pregnancy rate was not significantly different between the two age groups (34.5% vs. 56.7%; p-value = 0.162; 95%CI 0.2, 1.30). Conclusion: Advancing age decreased mitochondrial activity in CCs but did not affect blastocyst quality. By contrast, male age may be a predictor of high-grade blastocyst quality. Full article
(This article belongs to the Special Issue Clinical Advancements in Infertility Treatments and Assisted Reproductive Technology (ART))
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12 pages, 668 KiB  
Article
Time-Lapse Incubation for Embryo Culture-Morphokinetics and Environmental Stability May Not Be Enough: Results from a Pilot Randomized Controlled Trial
by Gilat C. Sacks, Henny Mozes, Ruth Ronn, Talia Elder-Geva, Oshrat Schonberger, Ido Ben-Ami and Naama Srebnik
J. Clin. Med. 2024, 13(6), 1701; https://doi.org/10.3390/jcm13061701 - 15 Mar 2024
Viewed by 540
Abstract
Background: Does the Time-lapse Incubator (TLI) add value to reproductive outcomes when its two components, undisturbed culturing and morphokinetic embryo grading, are separated. Methods: A prospective pilot, randomized, controlled, double-blinded, single-center study was conducted during the years 2016–2020. In total, 102 patients were [...] Read more.
Background: Does the Time-lapse Incubator (TLI) add value to reproductive outcomes when its two components, undisturbed culturing and morphokinetic embryo grading, are separated. Methods: A prospective pilot, randomized, controlled, double-blinded, single-center study was conducted during the years 2016–2020. In total, 102 patients were randomized into three groups: (1) conventional incubation with morphological evaluation only (n = 34), (2) TLI with both morphological and morphokinetic evaluations (n = 32), and (3) TLI with morphological evaluation only (n = 36). All arms were cultured in ESCO-MIRI® incubators. A total of 1061 injected mature oocytes were evaluated (420 in arm 1, 285 in arm 2, and 356 in arm 3). The primary outcome was live birth rates. Secondary outcomes included clinical and cumulative pregnancy rates as well as embryo quality. Embryos in arm 3 were retrospectively evaluated for their morphokinetic score. Results: No significant difference was found in the live birth rate for single embryo transfer cycles (SET) (35% vs. 31.6% vs. 24%, p = 0.708) or double embryo transfer (DET) cycles (41.7% vs. 38.5% vs. 36.4%, p = 0.966). Comparable pregnancy rates, clinical pregnancy rates, and cumulative pregnancy were found for similar top-quality embryos for days 2, 3, and blastocyst stages across groups. A similar number of embryos were suitable for either transfer or cryopreservation within the different groups. For 62.8% of the embryos in arm 3, the morphokinetic and morphologic evaluations were similar. In only 2/36 (5.6%) treatment cycles, the use of morphokinetic scoring may have helped the patient avoid undergoing an additional treatment cycle. In the other cases, morphokinetic scoring would not have changed the end point of pregnancy. Conclusions: The two components of the TLI system—undisturbed culturing and morphokinetic embryo grading—do not appear to have a significant additional value in reproductive outcome, although these results should be validated by an RCT. Full article
(This article belongs to the Special Issue Clinical Advancements in Infertility Treatments and Assisted Reproductive Technology (ART))
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