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.

Fertility Challenges: The Complexities of Retrograde Ejaculation and Cornual Block in Reproductive Health.

Infertility, a complicated reproductive health issue that affects both men and women, can have a variety of causes, from anatomical abnormalities to hormone imbalances. This research addresses a couple who have been struggling with infertility for the past four years: a 31-year-old woman with bilateral tubal blockage and her 34-year-old spouse who suffered from primary infertility due to retrograde ejaculation (RE) for the same period. Analyzing the male's semen sample, it was discovered that there were dead sperm and urine, indicating RE. A hysterosalpingography indicated bilateral tubal obstruction in the female partner. Pelvic factors were examined via laparoscopy, which played a crucial role in addressing further issues. The procedure of treatment included testicular sperm aspiration for sperm extraction and intracytoplasmic sperm injection. Hormonal support was involved in the follow-up, and on the 14th day, the ß-hCG test came back positive. The intricate procedures of RE and cornual block are discussed, with a focus on how they affect reproductive health.

A Successful Pregnancy Following Intracytoplasmic Sperm Injection in a Breast Cancer Survivor: A Case Report.

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.

Integrative Yoga and Ayurvedic Approach to Oligoasthenozoospermia: A Holistic Case Study on Fertility Enhancement.

Infertility is the failure to conceive after one or more years of regular, unprotected life for a fertile female. Around 45% of males are responsible for infertility worldwide. Research shows that nearly 50% of infertility in India is related to male reproductive factors or diseases. The male-carrying pathology in semen production includes low sperm count, volume, motility, abnormal forms, and sperm functional tests. This case presents a 31-year-old male with complaints of wanting issues after a complete year of regular, unprotected intercourse. He had undergone all the routine diagnostic investigations on his wife, which reported no issues and recorded regular ovulatory cycles with patent tubes. Then, progressing in the diagnosis, a semen analysis revealed a semen volume of 2 mL, a sperm concentration of 4 million/mL, progressive motility of 8%, non-progressive motility of 3%, and immotile sperm of 89%, with normal sperm morphology. Based on clinical examination, semen analysis, and investigation, the case was diagnosed as oligoasthenozoospermia. Oligozoospermia means low sperm count, and asthenozoospermia means low sperm motility. Oligoasthenozoospermia can be correlated to the Shukra Kshaya Lakshanas mentioned in Ashta Shukra Dushti. There is no satisfactory treatment in modern medicine for these conditions. Yoga and Ayurvedic intervention are the better options for these conditions. This case report focuses on the management of oligoasthenozoospermia through yoga and Ayurvedic medicines, Youvanamrit Vati and Shilajitrasayan Vati, given to the patient for four months.

Optimizing In Vitro Fertilization (IVF) Success in Hypergonadotropic Hypogonadism: A Case Study on the Impact of the Shanghai Protocol.

This article evaluated the effect of the Shanghai protocol on a hypergonadotropic hypogonadism patient undergoing in vitro fertilization (IVF) treatment. Hypergonadotropic hypogonadism was characterized by low sex hormone levels and elevated gonadotropins, leading to infertility. Poor ovarian response and failed pregnancy outcomes were the results of previous IVF treatments using conventional stimulation methods. The 37-year-old female patient was advised to follow the Shanghai protocol, which involved gonadotropin stimulation following pituitary suppression with a long-acting gonadotropin-releasing hormone agonist (GnRH-a). The Shanghai protocol significantly improved the ovarian response. Two oocytes were retrieved, and one 4AA grade (number 4 represents an expanded blastocyst, the embryo is large, and the zona is thin; first A represents the inner cell mass of numerous and tightly packed cells; second A represents trophectoderm, with many cells organized in epithelium) embryo was formed. According to her previous result, the patient with hypergonadotropic hypogonadism who had one unsuccessful IVF cycle after visiting our infertility center was advised of the Shanghai protocol. Establishing these results and enhancing the Shanghai protocol's implementation to this specific patient treatment, clinical pregnancy was achieved.

Assessment of Reproductive Health Knowledge Among College Students in Northwestern India: A Cross-Sectional Study.

Background Reproductive health knowledge is a critical aspect of overall well-being, particularly among college students who represent a demographic transitioning into adulthood. In northwestern India, where cultural nuances and societal perceptions play a significant role, understanding the factors influencing reproductive health knowledge becomes imperative. This cross-sectional study explores the interplay between demographic factors and awareness of reproductive health and infertility treatment among college students in northwestern India. Methods A diverse sample of 564 college students in northwestern India participated in the study, providing information on key demographic variables, including age, gender, marital status, degree, field of study, and college year. Statistical analysis, including the calculation of p-values, was employed to determine the significance of associations between these demographic factors and the participants' knowledge of reproductive health. Descriptive statistics, including percentages and numbers, were calculated to present a comprehensive overview of the data. To evaluate the significance of associations, chi-square tests were conducted for categorical variables such as age, gender, marital status, degree, field of study, and college year. The p-values were computed to determine the statistical significance of observed relationships, with a significance level set at 0.05. Results The study uncovered notable findings with implications for targeted interventions. Among age groups, participants aged 23-25 exhibited the highest knowledge percentage at 43.22% (51/564), and this association was statistically significant (p = 0.042). Gender disparities were evident, with females showing higher awareness (46.52% (127/564)) compared to males, and this difference was statistically significant (p = 0.001). Marital status revealed significant differences (p = 0.0012), particularly in single individuals who demonstrated a knowledge percentage of 46.52% (127/564). Significant variations were observed based on the degree held, with doctorate holders having the highest awareness at 49.15% (58/564) (p = 0.01). Field of study significantly influenced knowledge (p = 0.0001), particularly in medical and engineering disciplines. College year also exhibited significance (p = 0.003), with the first-year students demonstrating a knowledge percentage of 42.20% (73/564). Conclusions These findings underscore the importance of tailored educational interventions and targeted awareness campaigns. Recognizing the influence of demographic factors on reproductive health knowledge is crucial for developing effective strategies that address the specific needs of college students in northwestern India, promoting a more informed approach to reproductive health and infertility treatment.

The Influence of Abstinence Interval on Semen Quality and Its Effect on an Assisted Reproductive Technology (ART) Pregnancy: A Case Report.

This case report focuses on a couple facing primary infertility, where the male partner exhibited asthenoteratozoospermia and high DNA fragmentation. The treatment approach involved three cycles of intracytoplasmic sperm injection (ICSI), an assisted reproductive technology (ART), to indicate and address the specific challenges posed by male factor infertility. The initial two attempts failed as DNA fragmentation was high, which was observed on days 4 and 3 of abstinence, respectively. In the third cycle, DNA fragmentation was low on day 2 of the abstinence period, resulting in the successful formation and cryopreservation of embryos. Subsequently, three months later, frozen embryo transfer (ET) was done. This was followed by a positive ß-human chorionic gonadotropin (hCG) test after 14 days that confirmed biochemical pregnancy, and successful conception was determined by ultrasound detection of the visible sac with fetal pole. This report underscores the critical importance of treatment plans for individual patients, especially considering the impact of abstinence periods on sperm DNA fragmentation. The findings promote a personalized approach to assisted reproductive techniques, enhancing the success rate. It is recommended that further comprehensive studies be conducted to validate and anticipate these observations.

Characteristics of Polycystic Ovary Syndrome: A Case Report Investigating the Role of Kapha and Pitta Doshas.

Polycystic ovary syndrome (PCOS) presents complex challenges in diagnosis and treatment due to its multifactorial nature. This case study focuses on a 31-year-old woman exhibiting symptoms of weight gain, irregular menstruation cycles, and hirsutism, leading to a diagnosis of PCOS. Conventional diagnostic criteria and ultrasound confirmation of multiple ovarian cysts supported the diagnosis. By integrating Ayurvedic principles alongside Western medical techniques, this study sought to address imbalances in the Kapha and Pitta doshas, fundamental energies according to Ayurveda, believed to contribute to PCOS symptoms. Clinical findings emphasized the role of Pitta dosha imbalance in inflammation, hormonal irregularities, and excessive body heat, while Kapha dosha imbalance manifested in fluid retention, weight gain, and increased mucus production. A holistic treatment approach was devised, aiming to restore doshic balance while addressing hormonal and metabolic dysregulation. The treatment protocol comprised lifestyle modifications, advocating for a regular exercise regimen focusing on activities enhancing insulin sensitivity and promoting weight loss. Swimming, yoga, and brisk walking were recommended to achieve these goals. Dietary interventions tailored to balance Kapha and Pitta doshas were prescribed, emphasizing nourishing, warming foods low in carbohydrates to prevent weight gain and boost metabolism. Anti-inflammatory foods, such as turmeric and ginger, were incorporated to mitigate inflammation. The integration of Ayurvedic principles alongside Western medicine offered a comprehensive approach to PCOS management, addressing both the root causes and symptoms of the condition. This personalized treatment strategy aimed not only to alleviate immediate symptoms but also to promote long-term health and well-being by restoring doshic equilibrium and optimizing hormonal and metabolic functions. In conclusion, this case study highlights the potential efficacy of combining Ayurvedic and Western medical approaches in the management of PCOS, offering a tailored and holistic treatment paradigm for patients seeking comprehensive care.

A Comprehensive Approach to Polycystic Ovarian Syndrome: A Case Report of Successful Intracytoplasmic Sperm Injection Treatment Utilizing the Short Antagonist Protocol and Hatching.

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.

Combination Therapy With Platelet-Rich Plasma (PRP) and Granulocyte Colony-Stimulating Factor (G-CSF) for Thin Endometrium: A Case Report.

This case study highlights the challenges faced by a couple with a history of two failed in-vitro fertilization (IVF) attempts, including miscarriage and ectopic pregnancy. After treating the female partner for pelvic inflammatory disease (PID) with ceftriaxone and doxycycline, the decision was made to proceed with intra-cytoplasmic sperm injection (ICSI) and fresh embryo transfer. Despite the transfer of two good-quality (4AB and 3AA) day five embryos, the human chorionic gonadotropin (ß-hCG) test yielded a negative result. Upon re-examination, a thin endometrium measuring 6.5mm was identified, prompting the implementation of the protocol for improvement of endometrial receptivity (PRIMER) protocol, which involves a combination of platelet-rich plasma (PRP) and granulocyte colony-stimulating factor (G-CSF). Following PRP administration and G-CSF injection, significant improvement was observed in the endometrial thickness. Subsequently, frozen embryo transfer (FET) was performed on day six of progesterone, resulting in a positive pregnancy outcome with a ß-hCG level of 234 mIU/ml. Continuous adherence to instructions and ongoing administration of G-CSF until the 12th week of gestation remains important. This case underscores the efficacy of the PRIMER protocol in overcoming obstacles such as recurrent implantation failure (RIF) and achieving positive outcomes in assisted reproductive technology (ART).

A Case Study on the Efficacy of Hypo-Osmotic Swelling Test and Assisted Hatching in Overcoming Necrozoospermia Challenges.

This case report examines the difficulties faced by a couple with 11 years of primary infertility. Based on the diagnostic evaluation, it was determined that the male was a necrozoospermia patient, while the female had unilateral cornual blockage and polycystic ovarian syndrome (PCOS) with diabetes mellitus (DM) symptoms identified. A comprehensive approach was used in the treatment for the female patient, which included a gonadotropin-releasing hormone (GnRH) short antagonist protocol, a GnRH agonist (GnRHa) trigger, assisted hatching (AH), and the use of the hypo-osmotic swelling test (HOST) to gauge the viability of the sperm. The successful outcome, as evidenced by the increasing levels of beta-human chorionic gonadotropin (ß-hCG) and a successful embryo transfer, highlights the effectiveness of a customized and multifaceted approach in managing intricate infertility problems. This instance offers insightful information about the way modern reproductive technologies can be successfully integrated with specialized treatment plans to achieve successful outcomes in difficult cases of infertility.

A Case Report on Endometrial Receptivity Array Test for Infertile Patient to Enhance Reproductive Outcomes.

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.

Improving Semen Quality in a Male Partner With Abnormal Seminal Parameters Through Yoga and Yoga Nidra: A Case Report.

This research presents a case study involving a 39-year-old male and his 34-year-old female partner seeking fertility consultation in Maharashtra, India, after struggling to conceive for over three years. Despite the male participant's lack of discernible medical conditions and typical lifestyle, semen analysis revealed severe oligozoospermia attributed to elevated stress levels from his physically demanding occupation and infertility-related emotional strain. The female partner exhibited normal blood parameters, including anti-Müllerian hormone (AMH). Embracing holistic approaches, the couple integrated yoga and Yoga Nidra into their daily routine to address stress-induced hormonal imbalances. The customized yoga regimen is aimed at stress reduction and overall well-being, incorporating physical postures, breathing exercises, and meditation. Yoga Nidra, a guided relaxation technique, was employed to induce profound rest and alleviate stress. Over a 12-week period, the male participant diligently adhered to the regimen, reporting heightened relaxation, improved sleep quality, and reduced stress levels. Semen analysis before and after intervention showed significant improvements in sperm count and motility alongside diminished morphological abnormalities. In parallel, the female partner underwent intrauterine insemination (IUI), resulting in a positive beta-human chorionic gonadotropin (ß-hCG) analysis. Weekly follow-ups monitored progress, with supplementation administered as needed. While promising, further research with larger sample sizes and controlled trials is warranted to establish definitive efficacy. Overall, yoga and Yoga Nidra offer noninvasive adjuncts to conventional therapies for male infertility, underscoring the importance of integrating holistic practices into comprehensive fertility management strategies.

Mechanical Hatching as a Therapeutic Intervention for Improving Implantation Rate in a 32-Year-Old Female With Recurrent Implantation Failures: A Case Report.

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.

Implications of Progestin-Primed Ovarian Stimulation (PPOS) in a Patient With Diminished Ovarian Reserve (DOR) and Its In Vitro Fertilization (IVF) Outcome.

In this case study, a 39-year-old woman pursuing treatment for secondary infertility at our infertility clinic was visited by her 42-year-old husband. The couple had a history of failed attempts, including two intrauterine insemination (IUI), two intracytoplasmic sperm injection (ICSI) cycles, and two miscarriages. Diminished ovarian reserve (DOR) was noted in the patient's medical profile. A gonadotropin-releasing hormone (GnRH) antagonist, cetrorelix acetate, was given to the patient at a daily dosage of 0.25 mg to treat their condition once the maturing follicle had grown to a diameter of 10 mm. Following the administration of the GnRH antagonist, the first oocyte pick-up (OPU) procedure was conducted. During this process, two oocytes were successfully retrieved. Subsequently, ICSI was performed to facilitate fertilization. However, during the fertilization check, it was observed that no pronuclear fertilization (PN) formations occurred, leading to a cessation of development. Following the initial failure, an ovarian stimulation strategy based on progestin priming was implemented. Progestin is administered using this technique to ready the endometrium for the implantation of the embryo. After the modified ovarian stimulation protocol, an additional beta-human chorionic gonadotropin (ß-hCG) test was verified as a successful clinical pregnancy outcome.

Exploring the Association Between Age Groups and Success Patterns in Platelet-Rich Plasma Therapy: A Cohort Study.

Objective This study aimed to comprehensively examine the correlation between success trends in platelet-rich plasma (PRP) therapy and the advancing age of patients undergoing fertility interventions. Methods Female participants were categorized randomly into five age groups undergoing PRP or conventional hormone replacement therapy. Procedures included controlled ovarian stimulation, escalating estrogen dosage, gonadotrophin injections, and embryo transfer post-ovulation trigger. A pivotal PRP intervention was provided to half of the age sub-groups, and endometrial thickness was assessed 24 hours prior to embryo transfer. Statistical analysis employed SPSS 26.0 for Windows Student Version (IBM Inc., Armonk, New York), incorporating descriptive statistics, one-way analysis of variance (ANOVA), Tukey's honestly significant difference (HSD) test to explore age-PRP success relationships (p<0.05). Results The study, involving 60 participants, revealed a balanced patient distribution across age groups, with 20-30 age groups contributing 23.33% each. Baseline characteristics showed no significant differences between PRP and hormone replacement therapy (HRT) groups. Post-intervention, PRP demonstrated consistently higher endometrial thickness (p<0.001) and clinical pregnancy rates (63.33%) compared to HRT (40%). These findings suggest a positive association between PRP therapy and improved outcomes, particularly in younger age cohorts. Conclusion The study challenges traditional perspectives on hormonal influences in fertility, highlighting a potential link between PRP therapy and favorable outcomes among younger age groups. Improved endometrial thickness and clinical pregnancy rates in the PRP group emphasize the need for further exploration of PRP's mechanisms and applications in reproductive medicine.

Application of Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) on a Teratozoospermic Patient and Its Effect on the In-Vitro Fertilization (IVF) Outcome.

Infertility, defined as the inability to conceive after 12 months of unprotected sexual activity, affects millions globally. Approximately 80% of cases have identifiable causes, including endometriosis, tubal obstruction, ovulatory dysfunction, and male sperm abnormalities. Lifestyle factors, such as smoking and obesity, also impact fertility. Sperm morphology, a key factor in male infertility, often presents as teratozoospermia, with defects in the head, midpiece, or tail. Poor ovarian reserve, indicated by low anti-mullerine hormone (AMH) and antra-follicular count (AFC) values, contributes to female infertility, often exacerbated by age-related factors. Elevated follicle-stimulating hormone (FSH) levels further diminish oocyte quantity and quality. Intracytoplasmic Sperm Injection (ICSI), a micromanipulation technique aiding infertile couples, may face challenges in detecting subtle sperm morphology defects. Advanced methods like Motile Sperm Organelle Morphological Examination (MSOME) and Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) under high magnification enhance sperm selection accuracy. We present the case of a 36-year-old woman and her 42-year-old husband who sought assistance after seven years of infertility. Previous Intrauterine injection (IUI) and ICSI attempts failed due to the wife's low ovarian reserve and elevated FSH, compounded by the husband's teratozoospermia. Their earlier In-Vitro Fertilization (IVF) experience yielded a single poor-quality oocyte, hindering blastocyst formation. Investigations revealed the wife's poor AFC, AMH of 0.033ng/ml, and FSH at 24IU/L. Her medical history included hypertension and gallbladder removal. The husband exhibited 98% defective sperm, devoid of a substance abuse history. The wife's family had a polycystic ovarian syndrome (PCOS) history, and her low AMH and AFC yielded only three poor-quality oocytes during the current assessment. Oocytes were retrieved, and sperm were selected with the help of IMSI. After ICSI, the patient successfully conceived.

A Case Series Based on the Mixed Double-Embryo Transfer (MDET) Outcome in Patients With Recurrent Implantation Failure.

Successful implantation of embryos depends on the synchronous cross-talks between the endometrial wall and the competent blastocyst within the window of implantation (WOI). Hence, the WOI has a major significance in assisted reproductive technology (ART). However, in some cases, women do not have fixed WOI in ART cycles in order to enhance the rate of successful clinical pregnancy. However, there have been stances where women do not have a fixed WOI, and it shifts in subsequent menstrual periods. This contributes to the chances of recurrent implantation failure (RIF). Another factor that contributes to RIF is erratic endometrial receptivity, which hinders the chances of successful implantation of the conceptus in the endometrium. This case series consists of four case studies where the patients were believed to be suffering from RIF due to variable WOI or erratic endometrial receptivity and the routine protocol followed nowadays failed to make them conceive. In order to resolve the condition, we proposed a novel strategy in an attempt to improve pregnancy rates in these cases. An innovative method of embryo transfer known as mixed double-embryo transfer (MDET), which involved the transfer of one day 3 embryo and one day 5 blastocyst on day 6 of progesterone, led to possible pregnancy outcomes. A viable pregnancy was validated based on the human chorionic gonadotropin (ß-hCG) test report, and two of the cases delivered healthy babies. Thus, this case series provides a unique approach to addressing the issues of RIF. However, larger studies are required to validate the possible use of this technique.

Enhancement of Ovarian Reserve and Oocyte Quality After Platelet-Rich Plasma Instillation in a Woman With Diminished Anti-Müllerian Hormone.

Platelet-rich plasma (PRP) is a concentrated platelet preparation known for its regenerative properties due to the various growth factors it contains. Its application in the medical field, including dentistry, gynecology, and plastic surgery, has surged. In obstetrics and gynecology, PRP has shown promise in improving low libido, vaginal rejuvenation, ovarian reserve, and endometrial receptivity. This study presents a 29-year-old woman experiencing primary infertility attributed to low levels of anti-Müllerian hormone alongside the presence of asthenozoospermia in her husband's semen. After failed intrauterine insemination as well as in vitro fertilization (IVF), attempts at laparoscopic PRP treatment were administered before the second IVF cycle to enhance ovarian reserve and quality. The PRP treatment led to an increased follicle count, improved oocyte quality, and a successful pregnancy outcome in the second IVF cycle. PRP treatment promises to be effective in fertility treatments, potentially increasing ovarian reserve, improving oocyte quality, and enhancing successful pregnancy outcomes. This case report highlights its beneficial impact on a couple facing primary infertility, providing hope for patients with similar reproductive challenges.