Russian Collaborative Development of Reproduction Technologies for the Sustainable Management of Amphibian Biodiversity

Reproduction technologies(RTs)can provide for the reliable reproduction of amphibians,as well as perpetuation of species genetic variation with the use of biobanks.In 1982,in anticipation of the biodiversity conservation crisis,major Russian institutions collaborated in a dynamic program to develop and implement RTs for the sustainable management of amphibian biodiversity.An initial primary focus was the captive breeding of threatened Russian endemic anuran and caudate species,using RTs that varied from environmental manipulation to the use of exogenous gonadotropic hormones to stimulate reproduction.These species were mostly from Palearctic or cool mountain regions,but also included a wide range of species from warm regions.Other early achievements included the successful cryopreservation of anuran spermatozoa and anuran diploid pluripotent cell nuclei,in order to store both the matrilineal and patrilineal genomes in biobanks,with their subsequent development to the blastula stage after implantation into enucleated oocytes.After the turn of the 21st Century,in support of the priorities of the Amphibian Conservation Action Plan(2007),we developed RTs for the refrigerated storage of testicular or urinary spermatozoa for days to weeks at 4℃,the cryopreservation of urinary spermatozoa using anovel cryoprotectant,the in vitro fertilisation of hormonally induced oocytes either fresh or after refrigerated ex situ or in situ storage,and the artificial insemination of salamanders with fresh spermatozoa.In this article,we describe previously unpublished techniques and techniques from obscure Russian sources.

Gestational Diabetes and Infertility

Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications which affect the mother and offspring. In addition to adverse perinatal outcomes, it may lead to permanent health problems for the mother, such as type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), while increasing the risk of future obesity, CVD, T2DM and GDM in the child. Approximately 15% of women seek fertility treatment. Over the last decade, it has come to attention that patients with an infertility history are more prone to having GDM during their pregnancies, and this review examines the relationship between GDM and infertility. The elevated estrogen, progesterone, leptin, placental lactogen and growth hormone are the main reasons for increased insulin resistance during pregnancy. Despite some confounding factors in the mechanism of GDM in patients with an infertility history, infertility treatment increases the risk, according to numerous studies. The obesity epidemic and associated disorders have become a significant public health concern worldwide. Lifestyle modification for weight loss before pregnancy is encouraged, but there is no strong evidence for improvement in perinatal results. GDM, infertility and infertility treatment have a potential risk of alteration in the embryo’s environment and cause epigenetic reprogramming, which may be inherited to the next generation. The fertility treatment impacts the patient’s and offspring’s health. Patients should be informed about the risks so that they consent and get involved in the decision. Infertility treatment may be accepted as a reason for high-risk pregnancy, and patients can be screened for GDM in early pregnancy.

Hepatitis B virus infection, infertility, and assisted reproduction

Background:Hepatitis B virus(HBV)is one of the most widespread viruses worldwide and a major cause of hepatitis,cirrhosis,and hepatocellular carcinoma.Previous studies have revealed the impacts of HBV infection on fertility.An increasing number of infertile couples with chronic hepatitis B(CHB)virus infection choose assisted reproductive technology(ART)to meet their fertility needs.Despite the high prevalence of HBV,the effects of HBV infection on assisted reproduction treatment remain limited and contradictory.Objective:The aim of this study was to provide a comprehensive overview of the effect of HBV infection on fertility and discuss its effects on pregnancy outcomes,vertical transmission,pregnancy complications,and viral activity during ART treatment.Methods:We conducted a literature search in PubMed for studies on HBV infection and ART published from 1996 to 2022.Results:HBV infection negatively affected fertility in both males and females.Existing research shows that HBV infection may increase the risk of pregnancy complications in couples undergoing assisted reproduction treatment.The impact of HBV infection on the pregnancy outcomes of ART is still controversial.Current evidence does not support that ART increases the risk of vertical transmission of HBV,while relevant studies are limited.With the development of ART,the risk of HBV reactivation(HBVr)is increasing,especially due to the wide application of immunosuppressive therapy.Conclusions:Regular HBV infection screening and HBVr risk stratification and management are essential to prevent HBVr during ART.The determination of optimal strategy and timing of prophylactic anti-HBV therapy during ART still needs further investigation.

Preservation of sperm of cancer patients： extent of use and pregnancy outcome in a tertiary infertility center

Sperm cryopreservation is the best modality to ensure future fertility for males diagnosed with cancer. The extent to which cryopreserved sperm is actually used for impregnation, the fertility treatment options that are available and the success rates of these treatments have not been investigated in depth. The medical records of 682 patients who cryopreserved sperm cells due to cancer treatment were analyzed. Seventy of these patients withdrew their frozen sperm for fertility treatments over a 20-year period （most within the first 4 years after cryopreservation）. Sperm quality of different malignancies and outcomes of assisted reproduction treatment （ART） for pregnancy achievement in relation to the type of treatment and the type of malignancy were evaluated. The results showed that the rate of using cryo-thawed sperm from cancer patients for fertility treatments in our unit was 10.3%. Sperm quality indices differed between different types of malignancies, with the poorest quality measured in testicular cancer. Conception was achieved in 46 of the 184 ART cycles （25%）, and resulted in 36 deliveries. The use of intracytoplasmic sperm injection （ICSI） methodology yielded a significantly higher pregnancy rate （37.4%） than intrauterine insemination （IUI; 11.5%） and was similar to other groups of infertile couples using these modalities. In vitro fertilization （IVF） failed to produce pregnancies. In conclusion, the rate of use of cryopresseved sperm in cancer patients is relatively low （10.3%）. Achievement of pregnancies by ICSI presents the best option but when there are enough stored sperm samples and adequate quality, I UI can be employed. Cryopreservation is nevertheless the best option to preserve future fertility potential and hope for cancer patients.

Assisted Reproductive Technology for HIV-1 Serodiscordant Couples: A Review of Current Controversies

Since 1992, assisted reproductive technology （ART） has been reported as a viable means of helping HIV-1 serodiscordant couples achieve pregnancy while theoretically reducing the risk for viral transmission. While the sum of the evidence suggests that ART is effective and safe, numerous controversies still exist, The follow- ing review addresses several of the important issues involved in the use of ART for HIV-serodiscordant couples, including patient selection, semen processing techniques, post-process HIV testing, the use of lUI vs IVF-ICSI.

Use of Anti-Mullerian Hormone (AMH) for Testing of Ovarian Reserve: A Survey of Fifteen (15) Fertility Centres in Ghana

Anti-Mullerian Hormone (AMH) is a dimeric glycoprotein with a molecular weight of 140 kD, encoded by a gene on the short arm of chromosome and a member of the transforming growth factor-beta (TGF-β) superfamily. The expression of AMH is markedly different in males and females, both in concentration and temporality. In males, Sertoli cells maintain a high concentration of AMH in utero which peaks shortly after birth and then drops precipitously at puberty. In females, granulosa cells produce very low levels of AMH in utero followed by a transient spike in the neonatal period. Concentrations of the hormone then rise steadily through adolescence to a peak in the mid-twenties and subsequently decline until becoming undetectable in menopause. The study aimed to understand how Clinicians and Clinical Embryologists used anti-mullerian hormone (AMH) test to assess ovarian reserve, direct patient selection and treatment regimens and guide in vitro fertilization (IVF) cycle management in all registered fertility hospitals in a West African country, Ghana. A web-based survey (questionnaire) using google forms was performed to solicit responses from all IVF hospitals that are registered with the Fertility Society of Ghana (FERSOG). This questionnaire consisted of fifteen (15) broader questions, ten (10) of which assessed the clinics’ use of AMH. Responses were screened for quality to verify that only one (1) survey was completed by each IVF centre. The study was conducted during May and June 2020 at the In Vitro Fertilization (IVF) Department of the Airport Women’s Hospital (AWH) in Accra, Ghana. Results are reported as the proportion of IVF cycles represented by a particular answer choice. Survey responses were completed from 15 IVF centres, representing 2504 IVF cycles performed annually. A good majority (73.3%) [1835 IVF cycles] of the respondent IVF hospitals reported to use AMH as a first line test and 93.3% reported it as the best test for evaluating ovarian reserve. Another 66.7% reported that AMH results were extremely relevant to clinical practice. However, in contrast, for predicting live birth rate, 60% reported age as the best predictor in their practice. Overall, our results indicate that AMH is considered a first line test for assessing ovarian reserve and is relevant to the clinical practice of majority of Assisted Reproductive Technologies (ART) providers in Ghana.

Impact of COVID-19 pandemic on the pregnancy outcomes of women undergoing assisted reproductive techniques(ARTs):a systematic review and meta-analysis

The global outbreak of the coronavirus disease 2019(COVID-19) led to the suspension of most treatments with assisted reproductive technique(ART). However, with the recent successful control of the pandemic in China, there is an urgent public need to resume full reproductive care. To determine whether the COVID-19 pandemic had any adverse effects on female fertility and the pregnancy outcomes of women undergoing ART, a systematic review and meta-analysis was conducted using the electronic Chinese and English databases. Dichotomous outcomes were summarized as prevalence, and odds ratios(ORs)and continuous outcomes as standardized mean difference(SMD) with 95% confidence interval(CI). The risk of bias and subgroup analyses were assessed using Stata/SE 15.1 and R 4.1.2. The results showed that compared with women treated by ART in the pre-COVID-19 time frame, women undergoing ART after the COVID-19 pandemic exhibited no significant difference in the clinical pregnancy rate(OR 1.07, 95% CI 0.97 to 1.19;I^(2)=0.0%), miscarriage rate(OR 0.95, 95% CI 0.79 to1.14;I^(2)=38.4%), embryo cryopreservation rate(OR 2.90, 95% CI 0.17 to 48.13;I^(2)=85.4%), and oocyte cryopreservation rate(OR 0.30, 95% CI 0.03 to 3.65;I^(2)=81.6%). This review provided additional evidence for gynecologists to guide the management of women undergoing ART treatment during the COVID-19 pandemic timeframe.

Effects of Growth Hormone Supplementation in Patients Undergoing IVF/ICSI-ET with Poor Ovarian Response to Gonadotropin

Objective To analyze the effects of growth hormone （GH） supplementation during IVF/ ICSI-ET in Chinese patients who had prior IVF cycle with poor response to gonadot- ropin （Gn）. Methods Ovulation was stimulated in 389 consecutive patients who all had poor ovarian response, among them, 102 patients （GH cycle） received 4 IU GH and the other 287 patients （non-GH cycle） underwent IVF without GH. Fisher＇s exact test, Chi square test and Student＇s t-test were used to analyze IVF/ICSI-ET outcomes. Results After GH treatment, 102 patients had significantly more large- and medium- sized follicles, oocytes retrieved, 2 pronucleus oocytes, metaphase H stage （M^I） oocytes, and high-quality embryos than in previous cycles without GH. However, the number of embryos transferred, clinical pregnancy rate, transfer rate and biochemical pregnancy rate were not significantly different. Furthermore, the 102 patients given GH had significantly lower luteinizing hormone levels and biochemical pregnancy rates; thicker endometrium and more Gn administration days; and more large- and medium-sized follicles and M^I oocytes than 287 other patients undergoing IVF/ICSI-ET without GH. However, these groups did not differ significantly in clinical pregnancies, high-quality embryos, Mn oocytes, and embryo implantation rates. Conclusion GH may improve some IVF/ICSI-ET outcomes for women with poor ovarian response.

Long-term follow-up of children conceived through assisted reproductive technology

Children conceived via assisted reproductive technologies (ART) are nowadays a substantial proportion of the population. It is important to follow up these children and evaluate whether they have elevated health risks compared to naturally conceived (NC) children. In recent years there has been a lot of work in this field. This review will summarize what is known about the health of ART-conceived children, encompassing neonatal outcomes, birth defects, growth and gonadal developments, physical health, neurological and neurodevelopmental outcomes, psychosocial developments, risk for cancer, and epigenetic abnormalities. Most of the children conceived after ART are normal. However, there is increasing evidence that ART-conceived children are at higher risk of poor perinatal outcome, birth defects, and epigenetic disorders, and the mechanism(s) leading to these changes have not been elucidated. Continuous follow-up of children after ART is of great importance as they progress through adolescence into adulthood, and new ART techniques are constantly being introduced.

Imprinting methylation and assisted reproductive technology

Assisted reproductive technology （ART） is an important treatment for infertile people of reproductive age and is also known as fertility treatment. The processes of ART involves the isolation, handling and culture of early embryos, which may result in alterations in genomic methylation at specific loci and influence the proper establishment and maintenance of genomic imprints. Recent studies have identified an increased incidence of imprinting disorders via ART. In this article, we reviewed that the ART may be prone to induction of imprinting methylation errors during embryonic development. Further studies are necessary to elucidate the safety of ART in this field.

Birth Defects in Assisted Reproductive Technology and Spontaneously Conceived Children:A Meta-analysis

Objective To evaluate the risk of birth defects in children born following assisted reproductive technology （ART） and spontaneous conceptions. Methods This study carried out an updated systematic review to identify papers published by August 2013 with data relating to birth defects of children conceived using ART （IVF and for ICSI） compared with those spontaneously conceived and also compared birth defects between subgroups of lVF and ICSI. Results Totally 76 studies were identified for review. The individual relative risk （RR） estimated for these studies ranged from 0.44 to 5.51, a signifieantly increased risk of birth defects was observed （RR=l.36, 95%CI=1.25-1.47） in ART compared with the spontaneously conceived group, which was also evident in the subgroup analysis. Among these studies, 16 studies simultaneously gave data of birth defects comparing IVF and ICSI children, which showed no difference in risk of combined effects （RR=0.90, 95%CI=0.80 1.02）, but ICSI had a higher risk in subgroups of clinical research （RR=O. 76, 95%CI=0.65-0.89） and crude RR value （RR=O. 78, 95%CI=0.67 0.91）. Conclusion Pooled results from all suitable published studies suggested that children born following ART were at increased risk of birth defects compared with spontaneous conceptions. There is no difference in birth defect risk between children conceived by IVF or 1CS1 using a summative analysis, however, 1CS1 had a significant higher risk in birth defect risk comparing with 1VF when using subgroup analyses of sample size and RR value.