ABSTRACT
Key clinical message: In in vitro fertilization (IVF), laser offers several advantages. In this study, we employed laser to eliminate the zona pellucida of a contaminated embryo. This approach helps to rescue embryo with bacterial contamination, and improve embryo-endometrium interaction. Abstract: To present a case report on the removal of a contaminated zona pellucida from an embryo of patient with a history of recurrent implantation failure (RIF), which was followed by a successful live birth. We present the case of a 34-year-old patient with a history of 3 years of infertility who underwent in vitro fertilization. During the culture process, the embryos became contaminated, leading to three failed implantations. Despite the aneuploidy of the embryo and the implementation of a washing technique, the contamination persisted. In the final attempt, the contaminated zona pellucida was successfully removed using laser, followed by embryo transfer, resulting in a live birth. We provided detailed clinical information, including patient demographics, infertility history, ovarian response, evidence of bacterial contamination, embryo development, treatment protocols, and outcomes. Laser excision of the zona pellucida is a safe and effective method for addressing bacterial infection in embryos.
ABSTRACT
Objective Recurrent implantation failure (RIF) is a significant challenge in assisted reproduction. Genratest has emerged as a potential tool to identify the displaced window of implantation (WOI). This study aimed to evaluate the impact of this test on the pregnancy outcomes of RIF patients. Methods A retrospective analysis was conducted on 143 RIF patients who were categorized into two groups: the personalized embryo transfer (pET, n=69) group and standard embryo transfer (sET, n=74) group. The main measured outcomes were clinical pregnancy, ongoing pregnancy, miscarriage, and live birth rates. Results Genratest effectively diagnoses the displaced WOI in 90% of RIF patients. The pET group exhibited a higher rate of clinical pregnancy (n=36/69, 52.2%) compared to the sET group (n=35/74, 47.3%), but this difference was not statistically significant (p=0.679). Ongoing pregnancy rates were comparable between the pET (n=28/69, 40.6%) and the sET (n=30/74, 40.5%) groups (p=0.996). Live birth rates showed no statistically significant difference between the two groups (n=26/69, 37.7% versus n=22/74, 29.7%, p=0.407). Miscarriage rates were similar in both groups (n=9/69, 13% versus n=11/74, 14.9%, p=0.942). Conclusions pET based on the results of the Genratest did not show a significant improvement in pregnancy outcomes, including clinical pregnancy, ongoing pregnancy, live birth, or miscarriage rates. Further research is needed to identify the role of Genratest in RIF patients.
ABSTRACT
[This corrects the article DOI: 10.7759/cureus.52256.].
ABSTRACT
Several previous studies in the field of assisted reproduction have focused on the use of blood gel derivatives, such as platelet-rich fibrin (PRF), as a treatment for endometrial rehabilitation. However, the ability to release growth factors and the gel form of this product led to the evolution of platelet lysates. In this study, blood gel derivatives, including PRF lysate, which was in liquid form, and PRF gel, were collected and evaluated for growth factors. It was shown to be effective in endometrial wound healing and regeneration in mouse injured uterine tissue models through structure and function (pinopode expression, embryo implantation) evaluation. The results demonstrated that the concentrations of growth factors, including PDGF-AB and VEGF-A, were higher in the PRF lysate compared to the PRF gel (p < 0.05). PRF lysate could release these growth factors for 8 days. Furthermore, both PRF gel and PRF lysate restored the morphology of injured endometrial tissues in terms of luminal and glandular epithelia, as well as uterine gland secretory activity. However, the presence of pinopodes and embryonic implantation were only observed in the PRF lysate group. It can be concluded that PRF lysate promotes wound healing in mouse injured tissue models in vitro, which can act as healing products in tissue repair.
ABSTRACT
The lack of standardized clinical practice impeding the optimal management of iron deficiency (ID) and iron deficiency anemia (IDA) in women is a global concern, particularly in the Asia-Pacific region. The aim of this study was to determine best practices through a Delphi consensus process. In Round 1, panelists were asked to rate their level of agreement with 99 statements across four domains: identification, diagnosis and assessment, prevention, and treatment of ID/IDA in women. In Round 2, panelists reappraised their ratings in view of the collective feedback and responses to Round 1. After two rounds, consensus (≥85% agreement) was reached for 84% of the Delphi statements. Experts agreed on the role of presenting symptoms and risk factors in prompting assessments of anemia and iron status in women. Experts repeatedly called for prevention, recommending preventive iron supplementation for pregnant women irrespective of anemia prevalence levels, and for non-pregnant adult women, adolescent girls, and perimenopausal women living in areas with a high prevalence of anemia. Experts unanimously agreed to prescribing oral ferrous iron as first-line therapy for uncomplicated ID/IDA. The recommendations and clinical pathway algorithms generated should be used to inform clinical practice and standardize the care of women at risk or presenting with ID/IDA in the Asia-Pacific region.
