Laboratory and Clinical Outcomes of Single Sperm Cryopreservation in Patients Underwent Micro-TESE

For men with severe oligozoospermia, sperm cryopreservation can preserve surgically obtained sperm. How to cryopreserve single sperm in men is still a hot topic in assisted reproduction technology. Aim to analyze the laboratory and pregnancy outcomes of single sperm cryopreservation group, we retrospectively selected 38 cycles underwent single sperm cryopreservation and thawing as the study group and 618 cycles underwent conventional sperm cryopreservation and thawing as the control group, which were performed in the reproductive medicine center of the Sixth Affiliated Hospital, Sun Yatsen University, from April 2014 to October 2023. All the sperm came from microdissection testicular sperm extraction (micro-TESE), and performed intracytoplasmic sperm injection (ICSI) for fertilization. Zygotes were cultured to Day 3 embryo, which were freshly transferred to female uterus. Surplus embryos were cultured to blastosphere and cryopreserved. There was no statistical difference in female/male age, female BMI, infertility duration and female basal sex hormone (FSH, LH E2, AMH), No. of oocytes retrieved per cycle, No. of ICSI oocytes per cycle and No. of embryos transferred per cycle between the two groups (P > 0.05). No significant difference was found in two-pronuclear oocyte fertilization rate (59.23% VS 58.84%), Day 3 available embryo rate (61.81% VS 63.55%), Day 3 good-quality embryo rate (45.73% VS 50.27%), blastocyst formation rate (47.83% VS 49.46%), the implantation rate (47.37% VS 52.16%), clinical pregnancy rate (36.84% VS 47.18%), miscarriage rate (14.29% VS 12.68%) and live birth rate (85.71% VS 81.70%) between two groups (P > 0.05). In conclusion, single-sperm cryopreservation was the optimal method to preserve sperm after micro-TESE. It can increase the utilization of each sperm and lead to clinical pregnancy.

The Clinical Outcomes of Mosaic Embryo Transfer in Preimplantation Genetic Testing Cycles

Purpose: We aimed to analyze the pregnancy outcomes and perinatal follow-up of mosaic embryo transfer in the preimplantation genetic testing (PGT) cycles. Method: We retrospectively selected 27 mosaic embryo transfer cycles as the study group and 97 euploid embryo transfer cycles as the control group after propensity score matching, which were performed in the reproductive medicine center of the Sixth Affiliated Hospital, Sun Yat-sen University, from March 2019 to September 2023. The biopsy cells from blastocyst were undertaken next generation sequencing (NGS). Results: No significant difference in pregnancy outcomes compared between the two groups. According to the size of aneuploid, fragment the level of mosaicism or blastocyst morphological gradings, there were no significant difference in mosaic embryo transfers. Conclusion: Mosaic embryo detected in the PGT cycle can lead to clinical pregnancy and live birth of healthy offspring, which can be considerate suitable for transfer.

Clinical application of the endometrial microbiota test combined with personalized treatment in patients with repeated implantation failure

Objective:The objective of this study was to investigate the clinical value of the endometrial microbiota test(EMT)combined with personalized treatment in patients with repeated implantation failure(RIF).Methods:From March 2019 to August 2022,the clinical data of patients with RIF at the Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed.A total of 356 patients underwent the EMT using 16S rRNA sequencing and were included in the EMT group.The SPSS statistical software propensity score was set at 1:1 to match the age,anti-Müllerian hormone(AMH),antral follicle count(AFC),years of infertility,and body mass index(BMI)of the women who had not undergone the EMT;subsequently,354 patients were classified in the non-EMT group.We compared the clinical characteristics of the two groups and analyzed the clinical pregnancy outcomes after personalized treatment.Results:The clinical pregnancy rate(CPR)of the EMT group was significantly higher than that of the non-EMT group(47.81%vs.13.38%,P<0.05).Among 356 patients who underwent the EMT,55 patients(15.45%)in group A with normal endometrial microbiota composition did not test positive for the pathogenic bacteria causing chronic endometritis,34 patients(9.55%)in group B with abnormal endometrial microbiota composition did not test positive for the pathogenic bacteria causing chronic endometritis,35 patients(9.83%)in group C with normal endometrial microbiota composition tested positive for the pathogenic bacteria causing chronic endometritis,and 232 patients(65.17%)in group D with abnormal endometrial microbiota composition tested positive for the pathogenic bacteria causing chronic endometritis.After administration of probiotics or antibiotic plus probiotics treatment,the pregnancy rates of groups C and D were higher than those of group A(44.00%vs.20.00%and 55.03%vs.20.00%,respectively;bothP<0.05).Conclusion:The EMT combined with personalized treatment in patients with RIF has solid clinical value as a new treatment strategy.

Advances in the genetic etiology of premature ovarian insufficiency

Premature ovarian insufficiency(POI),defined as the loss of ovarian function in women before the age of 40 years,is a challenging reproductive issue that affects hundreds of millions of people globally with compromised fertility and a higher risk of cardiovascular disease.POI is highly heterogeneous in etiology,including genetic,infectious,metabolic,environmental,iatrogenic,and immunological factors.