Impact of Hysteroscopic Instillation of Autologous Platelet-Rich Plasma on Pregnancy Outcomes in Patient With Recurrent Implantation Failure: A Case Report.

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.

Optimizing IVF Success: A Case Study of Melatonin-Assisted Frozen Embryo Transfer for Poor Oocyte Quality and Endometriosis.

The case study investigates the journey of a couple facing infertility. It intensifies the challenges, including poor oocyte quality and endometriosis. In spite of two failed in vitro fertilization cycles, the decision for ovum pickup (OPU) was made, followed by intra-cytoplasmic sperm injection (ICSI), embryo treatment with melatonin, and frozen embryo transfer (FET) to optimize the chances of a successful pregnancy. The couple opted for this approach. OPU yielded four poor-quality oocytes, prompting ICSI and melatonin treatment to enhance embryo quality. The embryos were exposed to culture supplementation with melatonin for 72 hours before being transferred to conventional media. After 5 days or 120 hours, the embryos developed into 3BB quality blastocysts, indicative of developmental stage and morphology. The blastocysts were then cryopreserved, and after 2 months, FET was conducted, resulting in the transfer of two embryos, which subsequently led to a positive pregnancy indication, as indicated by a ß-hCG level of 233 mUI/ml measured 14 days post transfer. This approach highlights the effectiveness of melatonin supplementation in improving embryo quality and ultimately facilitating successful pregnancy in complex scenarios like endometriosis-related infertility.

Effect of Platelet-Rich Plasma (PRP) in Combination with Endometrial Scratching for Patients Undergoing Assisted Reproductive Technology Treatment.

Endometrium scratching is a process of intentionally injuring the endometrium, and after scratching the endometrium, platelet-rich plasma (PRP) is inserted into the endometrial wall to improve pregnancy outcome. This case report revolves around a 33-year-old woman and her 38-year-old husband, who have been married for 3 years and were seeking treatment for their secondary infertility. The female had a history of hypothyroidism, and after the investigation, she was diagnosed with hyperprolactinemia. She also had a history of failure in vitro fertilization (IVF) cycles and two recurrent miscarriages upon investigation. The husband was found to have asthanozoospermia. After diagnosis of the female, we started treatment of cabergoline for hyperprolactinemia, a history of unsuccessful IVF cycles, and two recurrent miscarriages upon investigation. After the treatment of hyperprolactinemia in our clinic, we scheduled ovum pick-up and started the stimulation and performed intra-cytoplasmic sperm injection. After 1 month, we scheduled embryo transfer. On day 1, the progesterone scratched the endometrium wall and loaded the PRP to enhance the endometrial wall, and after an interval of 14 days, we checked the ß-hCG level in the blood, and the result was positive, that is, the level was 1020 mIU/mL. The successful result of endometrial scratching with PRP improves pregnancy outcomes.

A Case Study Based on a Complementary and Alternative Medicine Approach on an Oligoasthenoteratozoospermic Patient and its Effect on Assisted Reproductive Technology Outcome.

A couple visited the IVF clinic to seek treatment for primary infertility. A 45-year-old quadragenarian female and her 49-year-old male partner were recommended infertility treatment after 2 years of unsuccessful attempts to conceive. The woman had a recent history of dengue and chickenpox. The male partner was advised to do a semen analysis. The report showed asthenoteratozoospermia and the semen sample viscous. On the other hand, the female was diagnosed with hypothyroidism. The male patient was given a 3-month medication treatment that included probiotic supplements and cranberry juice to treat bacterial infections and urinary tract infections. The male partner also advised medication, and regular semen analysis was performed after every 3 months. The treatment plan included intrauterine insemination (IUI), which increased the possibility of pregnancy. Fourteen days following the IUI and pregnancy test, the outcomes were positive. The case illustrates the difficulties in treating primary infertility by combining reproductive procedures, medication, and lifestyle modifications. Regularly monitoring semen quality and hormonal levels is crucial in assessing treatment success. The positive outcome of IUI suggests the effectiveness of the fertility treatment plan.

Varicocele and Interventional Radiology: A Comprehensive Case Study on Diagnosis, Therapeutic Intervention, and Implications for Reproductive Health.

Male infertility is known to be influenced by varicocele, a common vascular aberration marked by aberrant dilatation of the pampiniform plexus veins within the scrotum. In this instance, a 38-year-old man showed up with scrotal discomfort and swelling, which are clinical signs of varicocele. Scrotal ultrasonography provided diagnostic confirmation, confirming the existence of varicocele and identifying a concomitant minor hemorrhage in the left scrotal sac. Despite the initiation of conservative measures, such as bed rest, cryotherapy, and analgesics, the patient's clinical course was marked by persistent scrotal swelling and hematoma formation. Subsequently, interventional radiological techniques were employed, specifically coil deployment and varicocele embolization. These interventions demonstrated significant efficacy, leading to a notable reduction in the presenting symptoms. Follow-up assessments, conducted post intervention, indicated a complete resolution of both pain and hematoma. This clinical trajectory underscores the pivotal role of interventional radiology in managing varicocele-related complications. The multi-faceted nature of this case highlights the necessity of a comprehensive, inter-disciplinary approach integrating radiological interventions for the effective management of varicocele-associated symptoms, potentially optimizing reproductive health outcomes.

Correlation of MTHFR C677T Polymorphism with Male Infertility among Indian Population: Case-Control Study.

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.

A Successful Pregnancy Outcome Using Laser-Assisted Hatching and Platelet-Rich Plasma Perfusion in Advanced Maternal and Paternal Age: A Case Report.

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.

Enhancing Endometrial Health in Assisted Reproductive Technology (ART): Evaluating Autologous Endometrial Cells and Platelets-Rich Plasma (PRP) via Hysteroscopic Injections.

This review article examines the effectiveness of incorporating autologous endometrial cells and platelet-rich plasma (PRP) through hysteroscopic injections within the field of assisted reproductive technology (ART). This study assesses the outcomes of these injections on the susceptibility of the endometrium, the dynamics of the uterus, and the frequencies of pregnancy in individuals with refractory thin endometrium. Based on a complete examination of several trials, it becomes apparent that autologous PRP injections provide encouraging turnouts in augmenting endometrial thickness, raising endometrial receptivity, and, in the end, raising chances of being pregnant and successful delivery. The research highlights the promise of autologous PRP and minimally changed endometrial cellular treatments in enhancing outcomes in ART, especially for people who have had problems with implantation. This article gives a whole evaluation of the medical use of and upgrades regarding the utilization of infusions of PRP and autologous endometrial cells under hysteroscopic control to deal with infertility issues related to endometrial health through the synthesis of contemporary studies.

Enhancing Intracytoplasmic Sperm Injection Outcomes With Zeta Sperm Selection: A Case Report.

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.

Investigation of the Effect of Dehydroepiandrosterone (DHEA) on In Vitro Fertilization (IVF) Outcomes in a Patient With Poor Ovarian Reserve: A Case Report.

This study represents a case of a 42-year-old female patient who had a history of infertility, undergoing treatment at the in vitro fertilization (IVF) centre in Sawangi, India. The patient presented with a medical history marked by recurrent medical termination of pregnancies, a small uterus diagnosed through metroplasty, and a significant impediment to fertility treatment attributed to poor ovarian reserve. Clinical assessment revealed the male partner's history of alcohol consumption and cigarette smoking, along with benazepril usage for hypertension (5 mg/day). Despite normal semen parameters, intrauterine insemination (IUI) proved unsuccessful, prompting a recommendation for IVF utilizing the intracytoplasmic sperm injection (ICSI) procedure. The patient displayed low anti-Mullerian hormone (AMH) levels, indicative of insufficient ovarian reserve. Dehydroepiandrosterone (DHEA) supplementation was advised orally for a period of one month to enhance ovarian function. Subsequent evaluation demonstrated a notable increase in AMH levels, facilitating the retrieval of six oocytes, comprising average-quality metaphase II (MII) oocytes and one dysmorphic metaphase I (MI) oocyte. Following ICSI, successful fresh embryo transfer ensued, resulting in a positive beta-human chorionic gonadotropin (ß-hCG) test with serum ß-hCG levels measuring 1676 mIU/mL, confirming the successful implantation of one of the two transplanted embryos. This case underscores the significance of DHEA supplementation in augmenting ovarian reserve and achieving favorable IVF-ICSI outcomes in patients with primary infertility. The holistic approach, encompassing lifestyle modifications and tailored medication, contributed to a positive pregnancy outcome. Further research is warranted to explore the broader implications of DHEA therapy in the management of infertility.

A Review of Semen Analysis: Updates From the WHO Sixth Edition Manual and Advances in Male Fertility Assessment.

Semen analysis is essentially used to check the fertility of a man, especially when couples are having difficulties conceiving. Studies concerning male fertility, testicular factors, and seminal characteristics have been under investigation for the last few decades. In 1980, the World Health Organization (WHO) started reaching out to scientists in order to set standards for high-quality semen and develop a semen manual. From this point to the present, six editions of this manual have been produced, delineating the characteristics of semen and reporting protocols for semen analysis. Sperm morphology is analyzed as per WHO norms to measure the biological capacity of a male for reproduction. Both national and international manuals have been developed, with the latest, the sixth edition, produced in July 2021. This review paper conveys the current WHO publication's updates and identifies the clinical recommendations for proper evaluations. The publication considers the characteristics of semen in order to discuss the content of the previous editions of the WHO. It is also utilized to assess the method applied to determine the DNA presence of sperm fragmentation.

Integrative Approach to Address Male Infertility: A Case Study on Organophosphorus Compound Exposure and Traditional Medicinal Interventions.

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.

Unlocking the Potential of Assisted Hatching in Assisted Reproductive Technology: A Narrative Review.

The present study is set in the broad field of assisted reproductive technologies (ARTs) and examines various procedures under assisted hatching (AH). It also reviews their effects on implantation success rates. The primary emphasis is on explaining who has benefited and how many have benefited from these interventions. The most important factor determining the success rate of ART is implantation. To increase these rates, we use AH in our clinics to enhance each embryo's chances at life and substantially improve overall results. This comprehensive review includes various approaches, such as chemical-based measures (such as applying Tyrode's solution) and mechanical techniques (such as zona drilling and partial zona dissection). The individual techniques are carefully scrutinized, considering their mechanical detailing, methods of applying therapeutic effects, and the appropriateness of matching present social circumstances. The review begins by analyzing the basic nature of AH as a medium for embryo implantation and then focuses on how this detailed view reveals the advantages and drawbacks of various methods. Moreover, the articles discuss improvements in AH technology and many of the most modern technological developments that can help fine-tune ART issues. A major problem with these methodologies is that they involve serious risks and legal complications. However, a broad assessment of these topics allows us to understand their impact on fertility treatments. This review is written as a guidebook for physicians and researchers working in reproductive medicine. It compiles all current knowledge, providing literature to build on successes that will make breakthroughs possible in ART. Indeed, this is a valuable reference for guiding us in navigating complex AH procedures. It advances ARTs step by step toward perfection.

Platelet-Rich Plasma (PRP) for Endometrial Treatment Efficacy and Safety in Assisted Reproductive Technology: A Comprehensive Review.

Platelet-rich plasma (PRP) is among the new ground-breaking methods called for endometrial disorders detected in assisted reproductive technology (ART). This research work takes account of both a systematic literature review and an exploration of the molecular connections. The report aims to present the capabilities and benefits of the PRP in ART and the nonconformance and dangers involved in its use in ART. However, all these stages of ART need conducive endometrium, live micro embryo, and coordinated interaction between the blastocyst and the uterus. Despite all ART has achieved, implantation failure still exists as a problem having one quarter being attributed to the absence of the endometrial receptivity level. The review points to a corresponding increase in the role of autologous PRP in promoting cell proliferation, neo-angiogenesis, and anti-inflammatory effects to facilitate effective endometrial receptivity. The outcome of prior trials with the PRP approach proved to be positive for women with adenomyosis, thin endometrial lining, recurring implantation failure, chronic endometritis, and Asherman's syndrome. Challenges still exist in the proper placement of PRP for all women with infertility problems as well as how it works for individuals with blood disorders and infections. This study will look into the safest number of doses, the time of acting, and the possible future health hazards that both mother and child may face.

Success in Parenthood: The In Vitro Maturation Breakthrough in Infertility.

This case report revolves around a 37-year-old woman and her 39-year-old husband, who have been married for seven years and were seeking treatment for infertility. The husband has been diagnosed with asthenozoospermia for the past six years and has been on continued medication, and the woman has been diagnosed with polycystic ovarian syndrome (PCOS). To improve fertility outcomes, this case report enlightens the treatment and medical strategy for people with PCOS. Treatment included low-dose ovarian stimulation for the removal of immature eggs, and then in vitro maturation (IVM) of those oocytes was done. Later, intracytoplasmic sperm injection (ICSI) was performed to form the blast. The formed blasts were later cryopreserved till embryo transfer. This case report highlights the importance of preventing the risk of ovarian hyperstimulation syndrome (OHSS) in patients with PCOS.

Managing Primary Infertility in a Woman With Uterine Fibroids Utilizing Myomectomy and In Vitro Maturation (IVM) of Oocytes.

This case report demonstrates the management of primary infertility in a couple: the male was 37 years old and the female was 32 years old. The female had a submucosal uterine fibroid. Later, the female underwent a myomectomy to remove submucosal fibroids in the uterus after two failed intrauterine insemination (IUI) cycles. After six months of her recovery period, she underwent ovum pickup for an in vitro fertilization (IVF) cycle. During the process of ovum pickup (OPU), four oocytes were retrieved: three in the metaphase one (M1) stage and one in the metaphase two (M2) stage. Subsequently, the couple underwent in vitro maturation (IVM) of oocytes, where the M1 stage oocytes were cultured for six hours. The M1 stage oocytes progressed to the M2 stage. These oocytes were then injected with sperm, which resulted in the formation of two blastocysts. These blastocysts were then cryopreserved for three months, and after three months, these frozen embryos were then transferred, leading to the successful conception. The case study evaluates a couple who suffered from infertility. This study includes a treatment of myomectomy and in vitro maturation.

Enhancing Fertility: A Case Report of the Frozen Platelet-Rich Plasma Therapy for Thin Endometrium and Poor Ovarian Reserve.

A 33-year-old female patient was assessed for primary infertility due to thin endometrium and poor ovarian reserve (POR). The effectiveness of platelet-rich plasma (PRP) therapy was evaluated in terms of thickening the endometrium and enhancing implantation. The patient also had a history of four intrauterine inseminations and one intracytoplasmic sperm injection (ICSI), along with low anti-Müllerian hormone (AMH) and high follicle-stimulating hormone levels which showed POR. Gonadotropins are given to enhance follicular growth, while agonists and antagonists are given to prevent premature luteinizing hormone surge and suppress the top axis. During the first oocyte pick-up (OPU), five oocytes were retrieved. ICSI was done to make fertilization easier. On day 5, the embryos had degraded from their initial high quality. The patient was advised to undergo treatment with PRP. The endometrial thickness was significantly thicker, raising the chance of implantation. The second OPU was scheduled, resulting in the retrieval of 14 oocytes on the same day ICSI was performed. High-quality blastocysts (4AA) were produced and transferred during embryo transfer, and the patient tolerated the procedure well. The clinical success of the pregnancy outcome was confirmed by another beta-human chorionic gonadotropin test.

Infertility Challenge in a Cryptozoospermic Patient With Y Chromosome Microdeletion.

A couple is usually diagnosed with infertility if they have regular, unprotected sexual activity for a year or longer and are unable to conceive. Male infertility can be categorised into three types: obstructive infertility, non-obstructive infertility, and coital infertility. A major contributing factor for infertility in men is Y chromosome microdeletion, which is a non-obstructive infertility that involves problems related to sperm production. Deletions in the azoospermia factor region known as azoospermia factor a (AZFa), azoospermia factor b (AZFb), and azoospermia factor c (AZFc) loci independently or together which are situated on the Y chromosome cause a disturbance and alteration that are linked to either a reduction in sperm count, known as oligozoospermia, or the absence of sperm cells in the semen sample, referred to as azoospermia. Observations indicate that individuals with AZFc microdeletion may display irregularities in endocrine hormones. Men experiencing hormonal abnormalities affecting sperm production may receive treatment with clomiphene citrate. In cases of azoospermia and numerous cryptozoospermic patients, intracytoplasmic sperm injection is frequently considered the primary therapeutic approach.

The Implications of the Meiotic Spindle Visualization Technique on In Vitro Fertilization (IVF) Outcome in a Perimenopausal Patient.

An infertile couple visited an in vitro fertilization center situated in Maharashtra, India, seeking treatment for primary infertility. The 39-year-old premenopausal woman had a history of two intrauterine inseminations and intracytoplasmic sperm injections (ICSI), along with a history of tuberculosis from six years, and a normal hormonal range. The male was normozoospermic. The patient was given a gonadotropin-releasing hormone antagonist treatment and triggered before 36 hours of ovum pickup (OPU), but the cycle failed. Due to normal blood parameters, it was decided to use an optimal microscope using a polarizing filter to check the timing of meiotic spindle (MS) formation in the oocytes. The patient was triggered again for OPU, and during the procedure, 14 oocytes were retrieved. It was decided to perform ICSI after seven and a half hours of OPU post-observation of MS formation around the same hour. On day 21, the patient was suggested for embryo transfer (ET), where two blastocysts (4AA and 3AA) were transferred into the uterus. After a successful ET, the patient was discharged from the hospital. On day 14, a beta-human chronic gonadotrophin report revealed a positive pregnancy (910 mIU/mL).

Overcoming Male Factor Infertility: A Journey Through Assisted Reproductive Technology With Platelet-Rich Plasma Therapy.

This case study presents a couple's journey through assisted reproductive technology (ART) experiencing two failed in vitro fertilization cycles. The couple underwent a comprehensive examination, revealing the normal parameters for the female, but asthenoteratozoospermia in the male indicating high morphological defects and reduced sperm motility. Subsequently, intracytoplasmic sperm injection (ICSI) was planned. Despite retrieving six oocytes during ovum pickup (OPU), all blastocysts stopped growth on the second day, prompting a sperm chromatin test disclosing highly DNA-fragmented sperm. Platelet-rich plasma (PRP) therapy was initiated to improve sperm quality, along with frozen embryo transfer (FET). Sperm were incubated with PRP, yielding improved sperm motility and reduced sperm DNA fragmentation. OPU yielded five good-quality metaphase II (MII) oocytes, which were successfully fertilized with PRP-treated sperm, resulting in the formation of four blastocysts. These blastocysts were frozen and later used for FET, resulting in a positive pregnancy outcome and successful conception. This case highlights the importance of personalized intervention in addressing the infertility factor in males and achieving successful ART outcomes.