Jornal Brasileiro de Reproducao Assistida最新文献

{"title":"Anti-Müllerian hormone as a predictor of the number of oocytes obtained during in vitro fertilization treatments.","authors":"Ana Braga Reis, Carla Leal, Márcia Barreiro, António Tomé, Emídio Vale-Fernandes","doi":"10.5935/1518-0557.20240049","DOIUrl":"https://doi.org/10.5935/1518-0557.20240049","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the correlation between serum anti-Müllerian hormone (AMH) and the number of oocytes retrieved after controlled ovarian stimulation for in vitro fertilization treatments and determine cut-off values predictive of poor and high response to stimulation.</p><p><strong>Methods: </strong>It was performed a retrospective observational study that included 1003 cycles of controlled ovarian stimulation carried between February 2017 and December 2023 at a Medically Assisted Procreation Centre. The exclusion criteria were the following: serum AMH levels obtained more than 6 months prior to the start of the ovarian stimulation, the presence of a single ovary, non-Caucasian ethnicity, a controlled ovarian stimulation cycle performed for the purpose of oocyte donation or fertility preservation, a documented diagnosis of endometriosis, a documented history of ovarian surgery and the absence of essential data for the study in the medical records (absence of the number of oocytes obtained or the AMH value). Poor response to stimulation was defined as ≤ 3 oocytes retrieved, and high response was defined as > 15 oocytes. The correlation between variables was calculated using Spearman's correlation test and cut-off values were determined using ROC (Receiver Operating Characteristic) curves.</p><p><strong>Results: </strong>AMH exhibited a significantly positive correlation with the number of oocytes retrieved (Spearman's correlation coefficient = 0.60, p<0.01). The predictive cut-off for poor ovarian response was 0.72 ng/mL (specificity of 95.13%, sensitivity of 43.23%), and the predictive cut-off for high ovarian response was 4.77 ng/mL (specificity of 89.86%, sensitivity of 38.22%).</p><p><strong>Conclusions: </strong>Serum AMH proved to be a good predictor of the ovarian response to controlled ovarian stimulation for in vitro fertilization treatments, which makes it useful in supporting clinical decision-making. However, it should not be used as an absolute discriminator of poor or high ovarian response.</p>","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Previous Use of Combined Oral Contraception in High Complexity Assisted Reproduction Treatments in Protocol with Oral Progestin - Previous use of COC and ART.","authors":"Daniel Henrique Braga Vidal, Fabiana Lanoli Gentil, Erik Montagna, Caio Parente Barbosa, Renato de Oliveira","doi":"10.5935/1518-0557.20240058","DOIUrl":"https://doi.org/10.5935/1518-0557.20240058","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of prior use of combined oral contraceptives in assisted reproduction techniques with ovulation blockade by oral progestin.</p><p><strong>Methods: </strong>Retrospective cohort study with a single-center convenience sample of patients treated between 2018 and 2021. Two groups were compared: with and without a history of combined oral contraceptives (comparator). The clinical variables were age, body mass index, type of infertility and smoking. Regarding treatment, antral follicle count; follicles >14 mm; oocytes in metaphase I and II; number of embryos; days of treatment; total dose of medication, chemical and clinical pregnancy rate and delivery after 1st embryo transfer. Absolute and relative frequencies were used for the qualitative variables; means, medians and t-test for the quantitative ones. Association between qualitative variables used the Chi-square test and, for quantitative variables, the Mann-Whitney test (p<0.05). The statistical program used was Stata 16.0.</p><p><strong>Results: </strong>Among 407 medical records, 351 were included (combined oral contraceptive=243 and comparator=108). The combined oral contraceptive and the comparator groups had, respectively, mean (SD±) age 38.2 (4.5) and 38.2 (4.5) years; chemical pregnancy rates of 30.5% and 29.6% (p=0.281); clinical pregnancy rates of 24.8% and 24.1% (p=0.313) and abortion, 5% and 4.6% (p=0.544). The median time on combined oral contraceptives was 6 years.</p><p><strong>Conclusions: </strong>Previous use of combined oral contraceptives did not impact reproductive results in relation to the comparator group in patients undergoing assisted reproduction techniques in protocols with oral progestin.</p>","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in assisted reproduction: psycho-emotional repercussions.","authors":"Rose M Massaro Melamed","doi":"10.5935/1518-0557.20240065","DOIUrl":"https://doi.org/10.5935/1518-0557.20240065","url":null,"abstract":"","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poster Presentations - Abstracts of the 28th Annual Congress of the SBRA. Florianópolis/SC - Brazil, 2024.","authors":"","doi":"10.5935/1518-0557.20240063","DOIUrl":"https://doi.org/10.5935/1518-0557.20240063","url":null,"abstract":"","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential impacts of ambient PM2.5 exposure on sperm quality in northern Thailand.","authors":"Aram Thapsamuthdechakorn, Tawiwan Pantasri, Usanee Sanmee, Tanarat Muangmool, Pareeya Somsak, Pannarai Somboonchai, Jamjit Doungpunta","doi":"10.5935/1518-0557.20240051","DOIUrl":"https://doi.org/10.5935/1518-0557.20240051","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the correlation between ambient particulate matter 2.5 (PM2.5) concentration and sperm quality among northern Thai men exposed to the seasonal air pollution from the agricultural burning process.</p><p><strong>Methods: </strong>The demographic data and semen analysis of Thai men living in Chiang Mai, Thailand, who visited the infertile clinic were collected. The correlation test between the monthly amount of PM2.5 and sperm quality was carried out.</p><p><strong>Results: </strong>From 2017 to 2021, 1,109 Thai men visited the Infertile Clinic. The correlation test between PM2.5 and sperm quality in years with a better climate revealed a weak positive correlation between the mean PM2.5 and percentage of progressive motile sperm and normal morphology (r=0.08, p=0.05 and r=0.1, p=0.02). However, there was a negative correlation between the mean PM2.5 and sperm concentration, progressive motility and normal sperm morphology during the years with a higher amount of ambient PM2.5, and especially PM2.5 exposure 3 months before semen collection (r=-0.12, p=0.01, r=-0.11, p=0.003, r=-0.15, p=0.004).</p><p><strong>Conclusions: </strong>Exposure to a high amount of PM2.5 air pollution negatively affects sperm quality.</p>","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of COVID-19 on the male reproductive system.","authors":"Abzal Kystaubayev, Askhan Abzalbekov, Bakyt Ramazanova, Vyacheslav Lokshin, Muhammed Iskakov","doi":"10.5935/1518-0557.20240048","DOIUrl":"https://doi.org/10.5935/1518-0557.20240048","url":null,"abstract":"<p><strong>Objective: </strong>The relevance of the study is determined by the deepening understanding of the global consequences of the coronavirus pandemic, which affect not only lung health but also a wide range of other body systems. In light of new data on the long-term effects of coronavirus infection, this study is highly significant. The purpose of this study is to investigate the impact of coronavirus infection on the male reproductive system and assess its potential influence on male fertility to refine the mechanisms of damage and provide recommendations for medical care.</p><p><strong>Methods: </strong>The study utilised a combination of methods, including a meta-analysis of medical organisation databases, analysis of clinical cases, representative sample method, and quantitative survey method. These approaches allowed for a comprehensive and multifaceted view of the problem.</p><p><strong>Results: </strong>The samples of sperm showed a noticeable decrease in progressive motility, sperm concentration, and volume, especially in patients with moderate and severe symptoms of COVID-19, whereas patients with mild symptoms only experienced a decrease in progressive motility and overall sperm motility. The survey identified symptoms of male reproductive system dysfunction after recovering from COVID-19. Predominant symptoms included decreased libido (15%), impotence (13%), and infections of the genital organs (12%). Most surveyed men lacked sufficient awareness of other aspects of male reproductive health, including infections, genetic defects, chronic diseases, and available medical services.</p><p><strong>Conclusions: </strong>As a result of the study, it was concluded that coronavirus infection can have a negative impact on the male reproductive system. The practical value of this study lies in improving approaches to medical care for men who have recovered from COVID-19 and creating preventive programmes.</p>","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Artificial Intelligence (AI) currently able to provide evidence-based scientific responses on methods that can improve the outcomes of embryo transfers? No.","authors":"Argyrios Kolokythas, Michael H Dahan","doi":"10.5935/1518-0557.20240050","DOIUrl":"https://doi.org/10.5935/1518-0557.20240050","url":null,"abstract":"<p><strong>Objective: </strong>The rapid development of Artificial Intelligence (AI) has raised questions about its potential uses in different sectors of everyday life. Specifically in medicine, the question arose whether chatbots could be used as tools for clinical decision-making or patients' and physicians' education. To answer this question in the context of fertility, we conducted a test to determine whether current AI platforms can provide evidence-based responses regarding methods that can improve the outcomes of embryo transfers.</p><p><strong>Methods: </strong>We asked nine popular chatbots to write a 300-word scientific essay, outlining scientific methods that improve embryo transfer outcomes. We then gathered the responses and extracted the methods suggested by each chatbot.</p><p><strong>Results: </strong>Out of a total of 43 recommendations, which could be grouped into 19 similar categories, only 3/19 (15.8%) were evidence-based practices, those being \"ultrasound-guided embryo transfer\" in 7/9 (77.8%) chatbots, \"single embryo transfer\" in 4/9 (44.4%) and \"use of a soft catheter\" in 2/9 (22.2%), whereas some controversial responses like \"preimplantation genetic testing\" appeared frequently (6/9 chatbots; 66.7%), along with other debatable recommendations like \"endometrial receptivity assay\", \"assisted hatching\" and \"time-lapse incubator\".</p><p><strong>Conclusions: </strong>Our results suggest that AI is not yet in a position to give evidence-based recommendations in the field of fertility, particularly concerning embryo transfer, since the vast majority of responses consisted of scientifically unsupported recommendations. As such, both patients and physicians should be wary of guiding care based on chatbot recommendations in infertility. Chatbot results might improve with time especially if trained from validated medical databases; however, this will have to be scientifically checked.</p>","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of advanced paternal age on the live birth rate in patients undergoing Assisted Reproduction treatment: Findings from an analysis at a public reproductive center in Brazil.","authors":"Vanessa B M Maia, Aline Q Rodrigues, Victor E T Sousa, Mariana F R Barcelos, Jair T Goulart, Fernanda Paulini, Natalia I Z Tierno","doi":"10.5935/1518-0557.20240053","DOIUrl":"https://doi.org/10.5935/1518-0557.20240053","url":null,"abstract":"<p><strong>Objective: </strong>Human reproduction presents a challenge for our species, as evidenced by the escalating rates of infertility. This trend has prompted inquiries into diverse strategies aimed at mitigating infertility and enhancing conception rates. Despite the extensive research on advanced maternal age as a risk factor for reproductive outcomes, paternal age has historically garnered comparatively less attention. The aim of this study was to assess the impact of paternal age on embryos and its subsequent repercussions on fertilization rate, biochemical pregnancy, clinical pregnancy, and live birth rate in individuals undergoing assisted reproductive treatment in a public reproductive center located in Brazil.</p><p><strong>Methods: </strong>This investigation adopted a retrospective cohort, cross-sectional, analytical design, utilizing the analysis of secondary data, covering the period from July 2015 to July 2021.</p><p><strong>Results: </strong>A total of 350 couples grappling with infertility and undergoing intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) were included in the analysis. Examination of age groups revealed a notable correlation between the ages of women and men (correlation coefficient R=0.12, p<0.0001). In the analysis of IVF techniques, a discernible trend towards a negative correlation with paternal age was observed, signifying that higher paternal age was linked to lower fertilization rates (p=0.004).</p><p><strong>Conclusions: </strong>Advanced paternal age significantly impacts full-term birth rates in IVF procedures, emphasizing the need for preconception public health advisories that underscore the risks associated with delaying parenthood for both men and women, particularly among those necessitating assisted reproductive techniques.</p>","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Link between Premature Ovarian Insufficiency, Insomnia and Circadian Pathways.","authors":"Anna K Kloster, Luana N G Adami, Mariana Moysés-Oliveira, Helena Hachul, Monica L Andersen, Sergio Tufik","doi":"10.5935/1518-0557.20240052","DOIUrl":"https://doi.org/10.5935/1518-0557.20240052","url":null,"abstract":"<p><strong>Objective: </strong>To establish an interaction network for genes related to premature ovarian insufficiency (POI) and insomnia, and to identify biological processes that connect POI to the physiological clock.</p><p><strong>Methods: </strong>Previously reported lists of genes associated to POI and insomnia were contrasted and their intersection was used as input on protein-protein interaction analyses. POI-associated genes were contrasted with gene expression markers for neural circadian control and enriched pathways among their shared content were dissected.</p><p><strong>Results: </strong>The functional network generated from the intersection between POI and insomnia gene lists pointed to the central nervous system as the most relevant cellular context for this connection. After identifying POI-associated genes that play a role in neural circadian patterns, we observed the disruption of pathways related to the hypothalamic-pituitary-gonadal axis as the major genetic link between ovarian function and circadian neural circuits.</p><p><strong>Conclusions: </strong>These findings highlight neurological mechanisms that support the POI-insomnia interplay.</p>","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraovarian platelet-rich plasma injection in poor responders.","authors":"Luciana María Devenutto, Gastón Rey Valzacchi, Marianela Ercolano, Orlando Etchegoyen","doi":"10.5935/1518-0557.20240031","DOIUrl":"10.5935/1518-0557.20240031","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate if it possible to improve ovarian reserve parameters and oocyte retrieval in poor responders who undergo intraovarian injection of platelet-rich plasma (PRP).</p><p><strong>Methods: </strong>Prospective cohort study. We included 148 poor responders who underwent PRP injection between October 2021 and December 2022 in our institution, comparing pre and post PRP ovarian function. In addition, the IVF outcomes of a subgroup of patients was studied after the intervention in contrast with the previous treatment.</p><p><strong>Results: </strong>An improvement in ovarian reserve was observed in relation to previous values: FSH (13.57 vs. 11.32, p=0.11), AMH (0.39 vs. 0.48, p=0.06), antral follicle count (3.98 vs. 5.75, p<0.001); as well as a higher number of oocytes retrieved (2.63 vs. 3.65, p=0.01) and produced embryos (1.64 vs. 2.22, p=0.03); without a great impact on pregnancy rates.</p><p><strong>Conclusions: </strong>Although experimental, intraovarian PRP could restore ovarian function and be postulated as an alternative to oocyte donation in patients with low ovarian reserve who do not accept this treatment. There is a lack of randomized controlled trials to support these findings.</p>","PeriodicalId":46364,"journal":{"name":"Jornal Brasileiro de Reproducao Assistida","volume":" ","pages":"450-456"},"PeriodicalIF":1.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}