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 610

Special Issue Editor


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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

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Keywords

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

Published Papers (1 paper)

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Research

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 396
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
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