The type of COVID-19 vaccination does not affect reproductive function and pregnancy outcomes in infertile couples.

Introduction: Studies on the effect of vaccine type and two other vaccines other than inactivated vaccines approved in China on in vitro fertilization (IVF) pregnancy outcomes are rare. To complement and confirm the existing findings, this research aimed to investigate whether there are adverse effects of different vaccine types in females and males on reproductive function and clinical pregnancy. Methods: This retrospective study enrolled 6,455 fresh embryo transfer cycles at the First Affiliated Hospital of Zhengzhou University between May 1, 2021, and October 31, 2022. The primary outcome is the clinical pregnancy rate (CPR). At the same time, the secondary results are the number of oocytes retrieved, two pronuclei (2PN) rate, blastocyst formation rate, high-quality blastocyst rate, and semen parameters (volume, density, sperm count, forward motility rate, total motility rate, immobility rate, and DNA fragment index (DFI) rate). Results: In the comparison of ovarian stimulation indicators, no statistically significant differences (P > 0.05) were found in Gn days, endometrial thickness, 2PN rate, metaphase 2 (MII) rate, high-quality embryo rate, and blastocyst formation rate. No significant differences (P>0.05) were found in age, body mass index (BMI), education level, and semen parameters (volume, density, sperm count, forward motility rate, total motility rate, immobility rate, and DFI rate) in these four groups. The multivariate regression model showed that neither the types of vaccines nor the vaccination status of both infertile couples significantly affected clinical pregnancy. Discussion: The type of vaccine does not appear to have an unfavorable effect on ovarian stimulation, embryo development, semen parameters, and clinical pregnancy.

Legal and ethical challenges in assisted reproductive technology practice in Ghana.

Objective: Infertility remains a global challenge, with assisted reproductive technology (ART) progressively gaining relevance in developing countries, including Ghana. However, associated ethico-legal challenges have not received the needed policy attention. This study explored the legal and ethical challenges of ART practice in Ghana. Design: The study employed an exploratory phenomenological approach to examine ART in Ghana, focusing on ethics and law governing this practice. Participants: Respondents were ART practitioners, managers, facility owners, representatives of surrogacy/gamete donor agencies, and regulatory body representatives. Methods: A semi-structured interview guide was used to collect data.The in-depth interviews were audiotaped, and responses transcribed for analysis through coding, followed by generation of themes and sub-themes, supported with direct quotes. Results: It emerged that there are no ethical and legal frameworks for ART practice in Ghana, and this adversely affects ART practice. Ethical challenges identified border on informed consent, clients' privacy and clinical data protection, gamete donation issues, multiple gestations, single parenting, and social and religious issues. The legal challenges identified include the non-existence of a legal regime for regulating ART practice and the absence of a professional body with clear-cut guidelines on ART practice. In the absence of legal and ethical frameworks in Ghana, practitioners intimated they do comply with internationally accepted principles and general ethics in medical practice. Conclusion: There are no regulations on ART in Ghana. Legal and ethical guidelines are essential to the provision of safe and successful ART practices to protect providers and users. Governmental efforts to regulate Ghana need to be prioritized. Funding: This study had no external funding support. It was funded privately from researchers' contributions.

Psychological, sociocultural, and coping experiences of women with infertility using traditional healthcare services in Harare urban, Zimbabwe: A qualitative study.

This study focused on the psychological, social, and cultural dimensions of infertility among women with infertility in Harare Urban who have utilised traditional healthcare systems to address their infertility problem. It also emphasises their coping strategies for dealing with the challenges encountered along the infertile journey. This was a qualitative study using a phenomenological approach, focusing on the experiences of five women. Data from the interviews was analysed using a simplified version of Hycner's (1985) five-step explication process. The study produced three main themes: psychological experiences, socio-cultural experiences, and coping experiences, along with seven sub-themes. The results showed that women experienced intense distress, sorrow, and self-blame because of their inability to have children, further compounded by the stigma they faced from their families and communities. Women with infertility are subjected to derogatory labels, social contempt, ridicule, and being undervalued, which leads them to develop coping strategies to endure the adverse encounters. These coping mechanisms can have either positive or negative effects on their overall welfare. The exploration of psychological, socio-cultural factors, and coping mechanisms of women with infertility problems' presents a chance to co-create interventions that empower them.

Cette étude s'est concentrée sur les dimensions psychologiques, sociales et culturelles de l'infertilité chez les femmes infertiles de Harare Urban qui ont utilisé les systèmes de santé traditionnels pour résoudre leur problème d'infertilité. Il met également l'accent sur leurs stratégies d'adaptation pour faire face aux défis rencontrés tout au long du parcours stérile. Il s'agissait d'une étude qualitative utilisant une approche phénoménologique, axée sur les expériences de cinq femmes. Les données des entretiens ont été analysées à l'aide d'une version simplifiée du processus d'explication en cinq étapes de Hycner (1985). L'étude a produit trois thèmes principaux : les expériences psychologiques, les expériences socioculturelles et les expériences d'adaptation, ainsi que sept sous-thèmes. Les résultats ont montré que les femmes éprouvaient une détresse, un chagrin et une culpabilité intenses en raison de leur incapacité à avoir des enfants, encore aggravés par la stigmatisation à laquelle elles étaient confrontées de la part de leur famille et de leur communauté. Les femmes infertiles sont soumises à des étiquettes désobligeantes, au mépris social, au ridicule et à la sous-évaluation, ce qui les amène à développer des stratégies d'adaptation pour supporter les rencontres défavorables. Ces mécanismes d'adaptation peuvent avoir des effets positifs ou négatifs sur leur bien-être global. L'exploration des facteurs psychologiques, socioculturels et des mécanismes d'adaptation des femmes souffrant de problèmes d'infertilité présente une opportunité de co-créer des interventions qui les autonomisent.

Infertility problems in the context of reproductive ageing.

The article evaluates the prevalence of infertility problems in the Czech population, identifies methods used by individuals or couples attempting to achieve pregnancy and evaluates in more detail the use of assisted reproduction technology (ART) in contemporary Czech society. The results show that 27% of women and men in their forties declare they have experienced a time when they were trying to get pregnant but did not conceive within at least 12 months. In the general population of reproductive age, one in five declares experience with methods helping to get pregnant. Methods that do not require a doctor's visit are the most frequently used (one in ten declare monitoring ovulation), and 5% of the general population have experience of ART. Among those who have experienced some period of infertility, the experience of methods to assist conception is significantly higher (3/4 of men and 2/3 of women), and the use of medically assisted reproduction is also higher (a quarter have experience of taking medication and a quarter of assisted reproduction).

Coping Strategies Associated with Emotional Adjustment during the Dyadic Experience of Infertility and Its Treatment: A Systematic Review.

BACKGROUND: The aim of this systematic review was to reveal which of the coping strategies used by one partner are protective of and which pose a risk to the other partner's psychological adjustment during the treatment of infertility. MATERIAL AND METHODS: A systematic search of four electronic databases (PubMed, APA PsycINFO, SCOPUS, ScienceDirect), as well as the references of the retrieved articles, was performed between May and September 2023 for studies published from 1990 until 2023, using appropriate MeSH terms and associated text words. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Using an a priori developed pilot data extraction form, authors performed an independent extraction of articles. Information on participants, coping mechanisms, and psychological adjustment was extracted from each study. Relevant articles were critically appraised, and a narrative synthesis was conducted based on the different designs and outcome measures among the included studies. RESULTS: A total of 194 articles were retrieved, and 187 were excluded for not meeting the inclusion criteria. After duplicates had been removed, five studies were included in the review. The results revealed that the psychological adaptation of infertile couples at an interpersonal level may be correlated with both the type of coping and the stage of the stressor (infertility treatment or in vitro fertilisation - IVF). CONCLUSION: This systematic review suggests that health professionals could design and apply interventions based on modifying the coping mechanisms of infertile spouses to increase levels of well-being and decrease levels of distress.

Son Preference among Infertile Couples at the Fertility Clinic of Two Tertiary Hospitals in Enugu, Nigeria.

BACKGROUND: Son preference is known to be prevalent in developing countries and has dire consequences for the family, particularly girls and women. It is speculated that the prevalence of son preference may be high among fertility clinic attendees, and that son preference may be the reason for seeking fertility care in Nigeria. OBJECTIVES: To determine the prevalence and risk factors for son preference among fertility seekers in Enugu, Nigeria. MATERIALS AND METHODS: Questionnaire-based cross-sectional study of fertility clinic attendees from the University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and the Pink Petals Fertility Clinic Enugu from April 1 to September 30, 2023. Eligible and consenting participants were interviewed. Data collection was with a pretested interviewer-administered questionnaire, which contained three sections: biodata, obstetrics and gynecological data and 3-point son preference questions. The proportion of those who scored 3 (son preference) was documented. The analysis was both descriptive and inferential using IBM SPSS statistics for Windows, version 22.0 Armonk, NY, USA: IBM Corp. RESULTS: Of the 422 participants interviewed, 416 (98.6%) completed the study with a nonresponse rate of 6 (1.4%). The overall prevalence of son preference was 10.1% (42/416) and all 42 (10.1%) were in the clinic to have a male baby. The risk factors for son preference were less than tertiary education (P < 0.001, adjusted odds ratio [AOR] = 6.46, confidence interval [CI] 2.79-14.98) and family pressure to have a male baby (P = 0.03, AOR = 3.41, CI 1.72-7.13). CONCLUSIONS: One in 10 couples who attend an infertility clinic in Enugu, Nigeria, has a preference for son, and having a male child is the sole purpose of such a visit. Being under family pressure and not having tertiary education were the predictive risk factors for son preference in the study population.

Résumé Contexte:La préférence pour les garçons est connue pour être répandue dans les pays en développement et a des conséquences désastreuses sur la famille, en particulier sur les filles. et les femmes. On suppose que la prévalence de la préférence pour les garçons pourrait être élevée parmi les prestataires des cliniques de fertilité, et que la préférence pour les garçons pourrait être élevée. être la raison pour laquelle vous recherchez des soins de fertilité au Nigeria.Objectifs:Déterminer la prévalence et les facteurs de risque de préférence pour les garçons parmi les facteurs de fécondité. chercheurs à Enugu, au Nigeria.Matériels et méthodes:Étude transversale basée sur un questionnaire auprès de participantes aux cliniques de fertilité de l'Université de l'hôpital universitaire du Nigeria Ituku Ozalla Enugu et de la clinique de fertilité Pink Petals Enugu du 1er avril au 30 septembre 2023. Éligible et les participants consentants ont été interrogés. La collecte des données s'est faite à l'aide d'un questionnaire pré-testé administré par l'intervieweur, qui contenait trois sections: données biologiques, données obstétricales et gynécologiques et questions de préférence pour les fils en 3 points. La proportion de ceux qui ont obtenu un score de 3 (fils préférence) a été documentée. L'analyse était à la fois descriptive et inférentielle à l'aide des statistiques IBM SPSS pour Windows, version 22.0 Armonk, NY, États-Unis: IBM Corp.Résultats:Sur les 422 participants interrogés, 416 (98.6 %) ont terminé l'étude avec un taux de non-réponse de 6 (1.4 %). La prévalence globale de la préférence pour les garçons était de 10.1 % (42/416) et les 42 (10.1 %) étaient toutes à la clinique pour avoir un bébé de sexe masculin. Les facteurs de risque pour la préférence pour les garçons étaient inférieures à l'enseignement supérieur ( P < 0.001, rapport de cotes ajusté [AOR] = 6.46, intervalle de confiance [CI] 2.79­14.98) et pression familiale pour avoir un bébé de sexe masculin ( P = 0.03, AOR = 3.41, CI 1.72­7.13).Conclusions:un couple sur 10 qui fréquente une clinique d'infertilité à Enugu, au Nigeria, a une préférence pour les fils, et avoir un enfant de sexe masculin est le seul objectif d'une telle visite. Être sous la pression familiale et non avoir fait des études supérieures était le facteur de risque prédictif de la préférence pour les garçons dans la population étudiée.

Prevalence and help-seeking for infertility in a population with a low fertility rate.

BACKGROUND: In Taiwan there has been limited research of epidemiological surveys on prevalence of infertility. This study aimed to provide the updated prevalence of primary infertility and of help-seeking among residents in Taiwan. METHODS: Between February and March 2023, we conducted a cross-sectional population-based telephone survey of 1,297 men and women aged 20-49 years who were residing in Taiwan. We used computer-assisted telephone interviewing techniques to collect data regarding sociodemographic and reproductive characteristics. Using two approaches to defining infertility, we estimated the prevalence of infertility and the prevalence of help-seeking behaviors. Our analyses accounted for survey weighting. RESULTS: The response rate was 27.9%. Among 1,297 respondents, 829 (63.9%) were married or cohabiting, including 404 men and 425 women. The prevalence of primary infertility using definition 1 was 5.6% (95% confidence interval [CI]: 4.2% - 7.4%); the prevalence of primary infertility using definition 2 was 6.7% (5.1% - 8.6%). Regarding professional help-seeking, 11.1% (9.2%-13.5%) had ever consulted a doctor about getting pregnant; 9.9% (8.1%-12.2%) had ever received diagnostic tests/treatment to help with conceiving; 2.6% (1.6% - 4.0%) were currently receiving diagnostic tests/treatment to help with conceiving. CONCLUSION: Our nationwide survey of the prevalence of primary infertility in Taiwan suggests that the prevalence was not as high as what is often seen in the news reports (about 14%). These findings also suggest there may be a gap between those who are currently experiencing infertility and those who are currently being treated; hence, we call for raising awareness of infertility and improving access to infertility healthcare.

Fertility preservation service for children and young adults at high risk of infertility; the hub and spoke model.

PURPOSE: To evaluate the evolution of fertility preservation surgery in children and young adults at high risk of infertility from a single centre to a networked 'Hub and Spoke' service. METHODS: A case note review of patients referred for ovarian or testicular cryopreservation between Jan 2013 and Dec 2023. Demographic data, procurement numbers, and site of procurement were collected. Specialist feedback was obtained to identify the challenges faced. RESULTS: Over time, the number of referrals increased from 4 to 349 patients per year with the number of Spoke centres rising to 36 ovarian and 16 testicular. In 2013-2014; 100% of procurement was ovarian as compared to 2023; 51% ovarian, 49% testicular. Of the 395 referrals in 2021, 81% (n = 319) went on to have procurement and storage of tissue. Between 2013 and 2016, 96% of cases were performed at the Hub. In 2023, 53/349 (15%) cases were performed at the Hub with the remaining 296 (85%) procured at Spoke sites. Surgical issues such as access to theatre, variation and availability of surgical equipment, thermal injury to ovarian tissue and variation in the size of the testicular specimen were identified. CONCLUSION: The Hub and Spoke model successfully delivers treatment to patients close to home as safely possible within their local treatment centre.

Associations of Nutrients and Dietary Preferences with Recurrent Pregnancy Loss and Infertility.

This review examines associations of nutrients and dietary preferences with recurrent pregnancy loss (RPL), miscarriage, and infertility. Research articles, reviews, and meta-analyses of RPL and infertility that focused on nutrition, meals, and lifestyle were reviewed, and associations of nutrients and dietary preferences with pregnancy are discussed in relation to recent research findings. Studies related to RPL were given the highest priority, followed by those dealing with miscarriage and infertility. Multivitamin supplements-even when lacking folic acid or vitamin A-reduced total fetal loss. High-dose folic acid supplementation before conception reduced the risk of miscarriage and stillbirth. A meta-analysis revealed a strong association of vitamin D deficiency/insufficiency with miscarriage. Another meta-analysis revealed that seafood and dairy products reduced the risk of miscarriage, whereas a caffeine intake of 300 mg/day or more was associated with miscarriage. A balanced diet that included nutrients with antioxidant properties helped prevent miscarriage, whereas a diet that included processed foods and nutrients with proinflammatory effects increased the risk of miscarriage. Associations of nutrients with RPL warrant further research.

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Assisted reproductive technologies (ARTs) are core components of the field of reproductive medicine, encompassing multiple pivotal stages of early development from gamete maturation and fertilization to embryo development. Against the backdrop of a deteriorating trend of global decline in fertility rates, patients with infertility problems increasingly turn to ARTs to realize their dreams of parenthood. However, concomitant with this trend is a growing apprehension regarding the potential adverse effects of ARTs. Herein, we endeavor to discuss several common ARTs procedures utilized in clinical settings and the relevant cutting-edge advancements. The ARTs discussed in the article include in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), biphasic in vitro maturation (biphasic IVM), frozen embryo transfer (FET), preimplantation genetic testing (PGT), non-invasive PGT (niPGT), etc. In addition, we reevaluated their roles within the broader context of assisted reproduction aimed at promoting reproductive health. Additionally, we will delve into the impact of ARTs on the reproductive health of the offspring. By prioritizing the reproductive well-being of both patients and their offspring, the ongoing development and improvement of ARTs to enhance their efficacy and safety will contribute significantly to the advancement of human reproductive health.

Local Government Initiatives: A Comprehensive Analysis of Infertility Diagnostic and Treatment Programs in Poland (2009-2020).

BACKGROUND Infertility is an increasingly significant public health problem. However, thanks to the achievements of modern medicine, it is possible to take steps to treat it. The objective of this study was to present data about programs for the diagnosis and treatment of infertility that were developed, implemented, and financed by local governments at all levels in Poland in 2009-2020. MATERIAL AND METHODS The study was conducted based on the analysis of existing data from the Minister of Health. We present data on infertility diagnostics and treatment programs, the number of programs in particular years, the number of programs implemented by individual levels of local governments, the number of people participating in the programs, and the total cost of the programs in EUR. RESULTS Programs aimed at diagnosing/treating infertility began to be implemented in 2012 (most were implemented in 2019 and 2020, 18 each). Twenty-three local governments of various levels, including 5 communes, 13 cities with poviat rights, 1 poviat, and 4 voivodeships, participated in the implementation of these programs. A total of 22 379 people were covered by infertility diagnosis and treatment programs in the years 2012-2020. The cost of all implemented programs was over EUR 10.7 million. CONCLUSIONS The legal situation in Poland caused the vast majority of infertile couples who wanted to have children to have to self-finance in vitro fertilization procedures. A small number of local governments undertook actions aimed at co-financing in vitro fertilization procedures.

Testing the efficacy of a narrative short film in educating the public about providing emotional support to individuals with fertility problems.

BACKGROUND: To educate the public on how best to support people with fertility problems, a narrative short film "Ten Things Not to Say to Someone Struggling with Infertility" was created, depicting the impact that helpful versus unhelpful dialogue has on someone with fertility problems. METHODS: Before and after watching the video, 419 participants from the public were presented with a hypothetical vignette describing a woman experiencing fertility problems and asked about the likelihood that they would endorse a series of helpful and unhelpful statements when communicating with the protagonist. Pre and post endorsement of helpful versus unhelpful statements were compared, as were self-perceived knowledge about the mental health aspects of fertility problems, confidence in providing emotional support to someone with fertility problems, and empathy for the protagonist. RESULTS: Participants endorsed fewer unhelpful statements after the video relative to before (M(SD) = 2.2(2.3) vs. 1.3(2.3), p < .001) and fewer participants endorsed at least one unhelpful statement (72% to 47%, p < .001). Self-perceived knowledge of fertility problems, confidence in providing support, and empathy increased at post-test (ps < .001; Cohen's d = .56-.83) indicating medium-large effects. CONCLUSIONS: A narrative short film appears to be an effective dissemination strategy for sensitizing the public to the emotional struggles of individuals experiencing fertility problems.

Association between depression and infertility based on the PHQ-9 score: Analyses of NHANES 2013-2018.

BACKGROUND: Over the past decade, nationally representative research elucidating the association between depression and infertility has been notably lacking. Our study aimed to investigate the association between depression and infertility among women of childbearing age. METHODS: Our study encompassed 3,654 women aged 18 to 45 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2018. Infertility was defined as a positive response to the query: "Have you attempted to conceive for a minimum of one year without achieving pregnancy?" Depression was evaluated by the Patient Health Questionnaire (PHQ-9) score (range, 0-27). Multiple logistic regression analyses and subgroup analyses stratified by age and race/ethnicity were conducted to investigate the association between depression and infertility. Furthermore, fitted smoothing curves and threshold effect analysis were utilized to depict the nonlinear relationship. RESULTS: Total PHQ-9 score was associated with infertility in the fully adjusted model (OR 1.04, 95% CI 1.01-1.07, P = 0.010), and this relationship exhibited a non-linear pattern, reaching a saturation point at 13, as substantiated by the fitting of smoothed curves. Additionally, the association remained robust when stratified by age but not by race/ethnicity. LIMITATIONS: Cross-sectional design and recall biases. CONCLUSIONS: In this cross-sectional study, depression was associated with infertility among women of childbearing age in the fully adjusted models. This observed association holds potential relevance for clinicians tasked with enhancing psychological well-being during infertility management strategies.

Association between indicators of visceral lipid accumulation and infertility: a cross-sectional study based on U.S. women.

BACKGROUND: Evidence on the association between visceral lipid accumulation and infertility remains limited and controversial. Therefore, the current investigation is the first investigation to unveil this correlation by utilizing novel indicators of visceral lipid accumulation. METHODS: The present study utilized the NHANES 2013-2020 dataset. Researchers utilized multiple logistic regression, smoothed curve fitting, and subgroup analysis to investigate the associations of waist circumference (WC), metabolic score for visceral fat (METS-VF), lipid accumulation product (LAP), visceral adiposity index (VAI) with infertility. Additionally, the eXtreme Gradient Boosting (XGBoost) algorithm model was utilized to evaluate the relative importance of the factors. RESULTS: After adjusting for potential factors that could influence the results, researchers discovered that all these four indicators of visceral lipid accumulation exhibited strong positive correlations with the probability of infertility. The subgroup analysis demonstrated that the correlations remained consistent in the majority of subgroups (P for interaction > 0.05). The results of XGBoost algorithm model indicate that METS-VF is the most meaningful factor in infertility. The ROC curve research revealed that while METS-VF had the greatest AUC values, there was no variation in the AUC value of different markers of visceral fat accumulation (P > 0.05). CONCLUSIONS: The present investigation discovered that increased WC, METS-VF, LAP, and VAI were associated with a heightened prevalence of infertility.

Do Popular Diets Impact Fertility?

Infertility affects 15% of the population in developed countries, and its prevalence is increasing. Fertility can be influenced by different factors. Although key factors like maternal age cannot be changed, there is growing evidence that other modifiable factors, such as diet, can have an impact on fertility. Diet has become increasingly important in recent years for a number of reasons: the new trend toward a healthy lifestyle, the higher prevalence of certain digestive disorders, a lack of time that leads people to consume more prepared and processed food, and personal choice to not eat meat, among others. To meet these needs, several diets have recently become popular, such as the Mediterranean diet, known as the gold standard of health; the DASH diet, known for preventing hypertension; the Western diet, characterized by processed food; the ketogenic diet, characterized by low carbohydrate intake; and the vegetarian diet, which is the choice for people who do not eat meat or animal by-products. Diets present a unique composition characterized by the presence or absence of specific nutrients, which have also been associated with male and female fertility individually. This review assesses the impact of these diets and of macro- and micronutrients on both female and male fertility.

Pharmacogenomic studies of fertility outcomes in pediatric cancer survivors - A systematic review.

For the same age, sex, and dosage, there can be significant variation in fertility outcomes in childhood cancer survivors. Genetics may explain this variation. This study aims to: (i) review the genetic contributions to infertility, (ii) search for pharmacogenomic studies looking at interactions of cancer treatment, genetic predisposition and fertility-related outcomes. Systematic searches in MEDLINE Ovid, Embase Classic+Embase, and PubMed were conducted using the following selection criteria: (i) pediatric, adolescent, and young adult cancer survivors, below 25 years old at the time of diagnosis, (ii) fertility outcome measures after cancer therapy, (iii) genetic considerations. Studies were excluded if they were (i) conducted in animal models, (ii) were not published in English, (iii) editorial letters, (iv) theses. Articles were screened in Covidence by at least two independent reviewers, followed by data extraction and a risk of bias assessment using the Quality in Prognostic Studies tool. Eight articles were reviewed with a total of 29 genes. Outcome measures included sperm concentration, azoospermia, AMH levels, assessment of premature menopause, ever being pregnant or siring a pregnancy. Three studies included replication cohorts, which attempted replication of SNP findings for NPY2R, BRSK1, FANCI, CYP2C19, CYP3A4, and CYP2B6. Six studies were rated with a high risk of bias. Differing methods may explain a lack of replication, and small cohorts may have contributed to few significant findings. Larger, prospective longitudinal studies with an unbiased genome-wide focus will be important to replicate significant results, which can be applied clinically.

The Role of Total Oxidant and Antioxidant Levels in Follicular Fluid in Unexplained Infertility.

BACKGROUND: Unexplained infertility is defined as the absence of any pathology in the basic evaluation performed in couples who cannot achieve pregnancy after 1 year of unprotected sexual intercourse. The results of tests examining the causes of infertility show no identifiable cause in almost 15% of couples. AIM: The aim of this study was to investigate the effects of reactive oxygen species (ROS) on pregnancy and embryos. METHODS: This study included 200 patients, aged between 20-44 years, with unexplained infertility, who had recurrent intrauterine inseminations failures and hence started in vitro fertilization (IVF)/intracytoplasmic sperm injection treatment. Some amounts of waste follicular fluid samples were collected by embryologists from the oocytes of these patients during the ovum pick-up procedure. Next, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values were calculated in the biochemistry laboratory. RESULTS: In terms of pregnancy status, both follicular TOS and OSI values were not significantly different in patients with biochemical and clinical pregnancy, whereas TAS values were significantly higher in patients with pregnancy (P < 0.05). In terms of embryo quality, no significant difference was observed in TAS, TOS, and OSI values between grade 1 and 2 embryos, whereas pregnancy rates were significantly higher in patients who received grade 1 embryo transfer (P < 0.05). However, the follicular fluid TAS levels were significantly lower in smoking patients than in those who did not smoke; TOS and OSI levels were significantly higher. CONCLUSION: This study showed that exposure to oxidative stress might be a causative factor for infertility. In addition, ROS decreased the level of TAS by increasing OSI in the follicular fluid; thus, antioxidant supplementation might be a necessity.