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Recent advancements in assisted reproductive technology (ART) have enabled couples to achieve pregnancy, who were previously unable to conceive. However, recurrent implantation failure (RIF) remains a significant challenge. This case study exhibits the effective use of hysteroscopic-guided platelet-rich plasma (PRP) instillation in the treatment of a female patient aged 33 who was nulliparous and diagnosed with RIF and a thin endometrium, which resulted in primary infertility. The couple had a history of 10 years of infertility and had previously undergone ART procedures, including intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI), which failed. The female partner was diagnosed with a thin endometrium (<7 mm) and underwent hysteroscopy, revealing no other significant intrauterine pathologies. Following hormonal treatment and ovum pick-up, hysteroscopic PRP was administered, resulting in improved endometrial thickness (ET) and successful embryo implantation, as evidenced by a positive serum ß-hCG level of 1470 mIU/mL. This case demonstrates the hysteroscopic injection of PRP's potential for increasing endometrial receptivity and enhancing ART outcomes in women with RIF due to thin endometrium, making it a promising alternative to conventional therapies.
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This case-control study investigated the correlation between male infertility in India and the methylenetetrahydrofolate reductase (MTHFR) C677T variant. Infertile males were utilized as the case group in the study, whereas fertile individuals served as the control group. The C677T polymorphism was genotyped using PCR-RFLP analysis (polymerase chain reaction-restriction fragment length polymorphism). The Chi-square test and odds ratio calculation were implemented in the statistical analysis method for assessing the correlation between the C677T mutation and infertility. The results of this study revealed that the case group (9.4%) had a substantially greater prevalence of the C677T variation than the control group (1.6%). The C677T variation is significantly associated with male infertility by the Chi-square test (P value: 0.006). According to these results, the MTHFR gene>s C677T variation may increase the incidence of male infertility in the Indian population. Additional evaluations were also conducted to investigate the association between the C677T variation and particular infertility indicators. The C677T variation has been demonstrated to have been significantly correlated with a low or missing sperm count (p 0.05). These findings highlight the potential function of the MTHFR gene in reproductive health and advance our understanding of the genetic underpinnings of male infertility. It is encouraged to investigate the underlying mechanisms and additional investigation of the underlying mechanisms and to support the creation of individualized approaches to diagnosing and managing male infertility.
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Sperm morphology significantly influences the fertilization capacity of male germ cells. Morphological abnormalities are frequently associated with an overproduction of reactive oxygen species (ROS), leading to further sperm damage and subsequent infertility. This case study examines a couple facing infertility, with male factor infertility identified as the primary issue, characterized by teratozoospermia and a high DNA fragmentation index (DFI). The objective was to assess the efficacy of zeta potential (ZP) as a sperm sorting technique for intracytoplasmic sperm injection (ICSI) in patients showing high DNA fragmentation. A 34-year-old male with abnormal sperm parameters underwent ICSI using the ZP technique for sperm separation, while his 28-year-old female partner received ovarian stimulation. This intervention resulted in the development of two good-quality blastocysts, resulting in a successful embryo transfer (ET) and a positive pregnancy outcome. Previous attempts using conventional assisted reproductive technologies (ART), including in vitro fertilization (IVF), followed by ICSI and ET, as well as other sperm selection methods, were not successful. The ZP-based approach demonstrated significant benefits by selecting spermatozoa with optimal parameters, such as negative membrane potential, thereby enhancing the success rate. This case emphasizes the advantages of personalized treatment strategies in managing male infertility and highlights the potential of advanced sperm sorting techniques in improving fertility outcomes.
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Infertility affects millions globally, with advanced parental age posing a significant risk. This case report details a couple who experienced secondary infertility for 12 years. Following multiple unsuccessful attempts at assisted reproductive technology (ART), a personalized treatment regimen involving platelet-rich plasma (PRP) perfusion and laser-assisted hatching (LAH) resulted in a successful pregnancy. Diagnostic evaluations identified specific reproductive challenges, leading to tailored interventions. A positive pregnancy outcome was achieved after PRP treatment enhanced endometrial thickness and LAH facilitated embryo implantation. This case highlights the importance of individualized treatment strategies in infertility management and proves the potential efficacy of PRP and LAH in overcoming recurrent implantation failure. Further research is needed to explain the roles of PRP and LAH in improving pregnancy outcomes, especially in older parents and couples with a history of failed in vitro fertilization (IVF) treatments.
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Low sperm count and motility in oligoasthenozoospermia present significant challenges to conception. This case report involves a couple, a 28-year-old female and a 35-year-old male, experiencing secondary infertility for four years. The male partner's habits of alcohol consumption and smoking were potential infertility factors. Semen analysis revealed a total sperm count of 10 million/mL, with total motility at 30% and progressive motility at 5%. The couple underwent intracytoplasmic sperm injection (ICSI), using advanced sperm separation techniques to isolate motile and morphologically normal sperm. Despite the suboptimal sperm parameters, this approach resulted in successful fertilization and pregnancy. The female partner's preparation involved a short antagonist treatment, leading to the retrieval of eight oocytes, seven of which were mature. A positive urine pregnancy test and ultrasound confirmed the pregnancy, with ß-hCG at 798 mIU/mL. This case highlights the potential of individualized treatments in managing oligoasthenozoospermia, emphasizing their promise in improving assisted reproductive outcomes despite mixed research results.
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Male infertility is significantly affected by bacteriospermia, defined by the presence of bacteria in semen. This case report aims to address the effects of bacteriospermia and its correlation with semen characteristics, sperm DNA fragmentation (SDF), and reproductive outcomes. The 33-year-old male was diagnosed with bacteriospermia caused by two gram-negative bacteria: Escherichia coli and Klebsiella pneumoniae. It was found that sperm parameters such as mobility, number, and morphology were compromised in sperm, indicating poor fertility. In addition, SDF analysis has revealed a high DNA fragmentation index (DFI), emphasizing the detrimental effects of bacteriospermia on the integrity of sperm. Antibiotic therapy and antioxidant supplements have been used as therapeutic measures to reduce the impact of bacterial infections and DNA damage caused by oxidative stress (OS). Follow-up assessments showed significant improvements in the integrity of the sperm DNA and the resolution of microbial colonization, which ultimately led to successful in vitro fertilization (IVF) and embryo transfer (ET), leading to a positive pregnancy outcome.
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Polycystic ovary syndrome (PCOS) is an endocrinological disorder affecting women of reproductive age, characterized by hormonal imbalance leading to metabolic and reproductive dysregulations. This case report revolves around a 30-year-old husband and his 27-year-old partner. The male partner had normozoospermia, and the female spouse had PCOS, according to the couple's diagnostic evaluations. The female patient received ovarian stimulation specifically to assist with PCOS, and the retrieved oocytes were then matured in vitro. After intracytoplasmic sperm injection (ICSI), fertilization and embryonic development were successful. Treatment of PCOS-related infertility presents many challenges, and in vitro maturation (IVM) and its potential as an effective assisted fertility method are discussed. To optimize treatment outcomes, the conclusion shows the importance of IVM and other assisted reproductive techniques for infertility. It also focuses on the necessary continuous research and clinical experience. Clinical pregnancy was confirmed by measuring serum beta-human chorionic gonadotropin (ß-hCG) levels followed by ultrasound sonography (USG), which showed a normal growth rate of the fetus.
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Factors, including exposure to substances like organophosphorus compounds (OPCs), have been linked to fertility issues, which are a growing concern. In this case study, a 29-year-old farmer and his 26-year-old wife, married for the past five years, faced challenges conceiving despite several attempts. It was found that the husband's exposure to OPCs like chlorpyrifos, malathion, diazinon, etc., had impacted the quality of his sperm. However, after undergoing treatments and making lifestyle changes such as panchakarma therapy and taking Shilajit supplements, there was an improvement in sperm quality. Through in vitro fertilization using physiological intracytoplasmic sperm injection, successful fertilization and the development of high-quality blastocysts were achieved. This case demonstrates the potential for addressing infertility caused by toxins through a blend of traditional medicinal practices and modern reproductive technologies. It underscores the need for research into strategies that can reduce the effects of OPC exposure on male fertility.
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This case report describes the use of smooth endoplasmic reticulum aggregates-positive (SERa+) oocytes along with intracytoplasmic sperm injection (ICSI), supplemented with granulocyte-macrophage colony-stimulating factor (GM-CSF), aiming to enhance fertilization rates and reproductive outcomes. A 39-year-old woman, facing primary infertility for the past seven years, received assisted reproductive treatment (ART), which included adding GM-CSF to the culture medium and culture SERa+ oocytes before ICSI. Clinical results, embryo quality, fertilization rates, and other fertility parameters were used to track the patient's progress toward this individualized approach that led to a positive twin pregnancy and healthy twin babies.
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This report documents the case of a 36-year-old female diagnosed with stage I invasive ductal carcinoma of the left breast who, alongside her 39-year-old husband, sought fertility assistance at our center due to primary infertility. Having survived cancer twice in the span of their seven-year marriage, the couple faced the challenge of overcoming both the repercussions of cancer treatment and difficulties in conceiving. Initial attempts through three intrauterine insemination (IUI) cycles proved unsuccessful, leading the couple to opt for in vitro fertilization (IVF). The fertility assessment of the husband revealed the presence of several pus cells and a high sperm DNA fragmentation index (DFI). To address this, a medication regimen was administered to improve sperm quality. Concurrently, the female underwent controlled ovarian stimulation (COS) with the anti-estrogen agent letrozole to mitigate the risk of estrogen surges that could compromise her health. Subsequently, oocytes were retrieved from the female, and intracytoplasmic sperm injection (ICSI) was used to facilitate fertilization with her husband's sperm. Following successful embryo development, the patient underwent embryo transfer (ET), resulting in a positive beta-human chorionic gonadotropin (beta-hCG) result, signifying a successful conception. This case report highlights the intricate challenges faced by individuals with a history of breast cancer, emphasizing the delicate balance required in managing infertility in such circumstances. The described approach, involving personalized treatments and meticulous care, underscores the possibility of achieving successful conception for females struggling with fertility issues post-cancer survival. The documented journey serves as a testament to the resilience of individuals facing the dual challenges of cancer survival and infertility, offering insights into the complexities of their reproductive healthcare.
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The human vascular system exhibits a remarkable degree of anatomical variability, with deviations from conventional arterial branching patterns occasionally encountered. Among these variations, the atypical bifurcation has drawn attention for its infrequent occurrence and potential clinical implications. This study investigates the rare anatomical variation of high bifurcation seen during cadaver dissection in the brachial artery. It emphasizes the relevance of understanding such variations in established vascular anatomy and their clinical implications. Detailed findings from the dissection of the upper limbs, which reveal a high bifurcation in a 40-year-old male cadaver, are presented. The report highlights unique anatomical variations, including a superficial path. The conclusion underscores the rarity of this high bifurcation and its potential impact on medical procedures. It stresses the importance of healthcare professionals being aware of and prepared for such anatomical variations for optimal patient care. In order to manage potential difficulties during medical operations affecting the circulatory system and eventually enhance patient outcomes, it is necessary to understand these deviations.
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Infertility affects couples worldwide. Among these, obstructive azoospermia (OA) is a common cause. In some cases, the lack of spermatozoa in ejaculation results from blockages in the male reproductive tract. In this case study, we discuss an infertile male diagnosed with OA following three years of unsuccessful attempts at conception. The male had a history of bilateral inguinal hernia repair due to congenital bilateral absence of the vas deferens. Diagnostic assessments confirmed azoospermia. Microscopic epididymal sperm aspiration (MESA) was performed for sperm retrieval due to its efficacy and reduced postoperative pain, testicular atrophy, and decreased testosterone levels. The retrieved sperm was processed using SpermMobil media for intracytoplasmic sperm injection. Following successful fertilization, embryo transfers resulted in a positive pregnancy test. This case highlights the significance of specific treatment approaches for OA, specifically the effectiveness of MESA and SpermMobil in achieving successful outcomes in assisted reproduction technology for male infertility.
RESUMEN
Endometriosis and infertility are clinically associated. The therapeutic approaches for endometriosis, whether medical or surgical, yield distinct outcomes for a woman's potential for achieving conception, whether through natural means or with the aid of assisted reproductive technology (ART). In this case report, a 29-year-old female and her 32-year-old partner, married for the last five years, sought assistance at our fertility clinic after having one failed in vitro fertilization (IVF) cycle. The patient had a history of dysmenorrhea and deep dyspareunia, suggesting the presence of an ovarian cyst. Transabdominal ultrasound and laparoscopy confirmed the existence of ovaries with adhesions and a chocolate cyst measuring 8 cm × 6 cm in dimensions. Cystectomy of ovarian endometriomas enhances the rate of spontaneous conception and reduces pain. Moreover, it has the potential to enhance the outcome of IVF. The successful outcome achieved through ART, specifically the intracytoplasmic sperm injection cycle, underscores the importance of technological advancements in overcoming infertile barriers. This case report exemplifies the personalized and innovative approaches available to couples undergoing fertility treatment.
RESUMEN
The issue of infertility affects couples all over the world. Recurrent implantation failure (RIF) is caused by immunology, thrombophilias, endometrial receptivity, microbiota, anatomical anomalies, male factors, and embryo aneuploidy. An accurate evaluation of endometrial receptivity (ER) in cases of RIF during in-vitro fertilization (IVF) treatments is crucial to improve reproductive outcomes. To find her accurate window of implantation (WOI), a 34-year-old woman with unexplained RIF underwent an endometrial receptivity array (ERA) test. This case study examines her inexplicable RIF and reproductive results. The ERA test examined gene expression patterns in endometrial tissue to determine the receptive phase for proper embryo transfer. Primary infertility, ineffective intrauterine insemination (IUI), and several unsuccessful IVF rounds were all part of the patient's medical history. Her WOI determined the embryo transfer timing after getting the ERA test results. The patient's clinical pregnancy was successful. This particular case focuses on the potential of the ERA test to improve reproductive outcomes. However, when using this strategy, it is essential to consider difficulties, including invasiveness and related expenses. In this case, the positive results urge future research to apply customized WOI determination using the ERA test to improve the effectiveness of IVF therapies in patients with recurrent implantation failure. More extensive investigations and controlled trials are required to confirm these results and the broader applicability of this strategy. The ERA test is promising, but to provide a holistic approach to infertility care, it should be taken into account together with endometrial changes and elements of embryo-endometrial interaction that impact the success of implantation.
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This case report explores the application of mechanical hatching as a successful intervention in the treatment of primary infertility for a couple with a consanguineous marriage history and recurrent implantation failure. A 32-year-old female patient and her 37-year-old spouse, after six years of unsuccessful attempts to conceive, underwent multiple intrauterine insemination (IUI) and in vitro fertilization (IVF) and embryo transfer (ET) cycles without success. Normal parameters were observed in semen analysis and hormone tests for the male and female partners, respectively. Despite a series of failed assisted reproductive technology (ART) procedures, the implementation of mechanical hatching using partial zona dissection (PZD) pipettes led to a positive pregnancy outcome. The case underscores the potential efficacy of individualized approaches, specifically mechanical hatching, in addressing challenges associated with implantation failure, offering hope to couples facing infertility issues.
RESUMEN
This case report presents an illustrative account of a couple experiencing secondary infertility attributed to the fragmentation of DNA in sperm. Secondary infertility, the inability to conceive after having previously successfully conceived a child, can be due to various factors, including male infertility issues. Sperm DNA fragmentation (SDF) has emerged as a major factor influencing male fertility, resulting in poor embryo development and lower pregnancy rates. This case is about the use of advanced assisted reproductive technologies, specifically physiological intracytoplasmic sperm injection (PICSI) and intracytoplasmic sperm injection (ICSI), to treat secondary infertility caused by fragmentation of sperm DNA. PICSI enables the identification and selection of spermatozoa with optimal functional integrity using hyaluronan, a natural binding substance. Preparing a PICSI dish requires skill and precision. Sperm exhibiting a high DNA fragmentation index were excluded from the selection process to enhance embryo development potential. The couple underwent controlled ovarian stimulation, egg retrieval, and ICSI with PICSI. The treatment resulted in the successful conception of a singleton pregnancy. Subsequent prenatal monitoring indicated a healthy pregnancy progression, ultimately culminating in the delivery of a healthy baby girl at term. This case report highlights the efficacy of integrating PICSI as a sperm selection method preceding ICSI, specifically in cases of secondary infertility related to SDF. Further research and larger-scale studies are warranted to approve the findings of this case report and establish the broader applicability of this treatment approach.
RESUMEN
The 29-year-old participant in the case study has been grappling with infertility for the last six years. Following an assessment of her symptoms, hormone profile, and ultrasound results, she received a diagnosis of polycystic ovarian syndrome (PCOS). PCOS is a multifaceted endocrine and metabolic disorder characterized by symptoms such as obesity, insulin resistance, anovulation, and polycystic ovaries. Various factors, including heredity, intestinal dysbiosis, obesity, environmental pollutants, lifestyle choices, and neuroendocrine abnormalities, contribute to the susceptibility of women to PCOS. In planning polycystic ovarian stimulation, it is crucial to consider parameters such as antral follicle count (AFC), luteinizing hormone (LH), and anti-Müllerian hormone (AMH). Careful planning of the gonadotrophin dose is essential to achieve an optimal response during a gonadotropin-releasing hormone antagonist (GnRH-ant) cycle. In our case, the brief antagonist protocol was used, resulting in a favorable outcome with minimal risk of ovarian hyperstimulation syndrome (OHSS). Despite multiple unsuccessful attempts at natural conception, the patient successfully conceived with the help of intracytoplasmic sperm injection (ICSI), leading to a positive pregnancy outcome. In addition to incorporating mechanical hatching to promote implantation, we diligently selected the most beneficial medications for the patient.
RESUMEN
A 33-year-old woman with secondary infertility and polycystic ovarian syndrome (PCOS) is profiled in this case report. In 2020, an in-vitro fertilization/intracytoplasmic sperm injection pregnancy resulted in a missed abortion, which is part of the patient's medical history. In order to enhance fertility outcomes, this case report seeks to give an overall perspective on the treatment and medical care strategy for people with PCOS and previous cases of infertility. One of the physical characteristics of PCOS, bilateral polycystic ovaries, was seen in the patient. Treatments included long-term gonadotropin-releasing hormone agonist treatment, medications, and optimizing endometrial preparation. The patient was regularly monitored with routine ultrasound evaluations, hormone profiling, and psychological support. For patients with PCOS and secondary infertility, the case report emphasizes the value of individualized treatment strategies, close monitoring, and supportive care to enhance pregnancy outcomes. Clinicians handling situations similar to this one will greatly benefit from the conclusions and treatment plans offered in this case study, which emphasizes the need for a multifaceted strategy to deal with the complexity of PCOS-related infertility.
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In this report, we present the clinical management of a male patient diagnosed with non-obstructive azoospermia (NOA), a condition characterized by the absence of sperm in the ejaculate due to impaired spermatogenesis. A 37-year-old patient underwent two surgical procedures: testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA). Surprisingly, the beta-human chorionic gonadotropins (ß-HCG) testing that followed produced promising findings suggesting NOA syndrome may be reversible. Theophylline and pentoxifylline, phosphodiesterase inhibitors with immunomodulatory effects, were creatively used in this case study to increase sperm viability and activation after PESA. Hyaluronic acid was also used as an additional therapy because it is well known for aiding in sperm development and binding to oocytes. The patient underwent hyaluronic acid, which can potentially increase the fertilization rate and improve the selection of sperm. This in-depth case study offers insightful information on the effective management of NOA by combining theophylline, pentoxifylline, and hyaluronic acid. The results highlight the ability of these therapies to revive spermatogenesis, offering a cutting-edge method of treating male infertility. More research is required to clarify the underlying processes and confirm the effectiveness of this strategy in more successful reproductive medicine therapies.