Contained morcellation of uterine tissue is readily accomplished via a laparoscopic approach within an insufflated endoscopic pouch, or via ultraminilaparotomy using a flexible, self-retaining retractor.
All the papers from the April 2015 issue of Fertility and Sterility.
Surgical anatomy of supraumbilical port placement Implications for robotic and advanced laparoscopic surgery
This video describes the surgical anatomy of the supraumbilical region and the distances of the port sites at 1-cm increments from the umbilicus in relation to the great vessels.
Berberine inhibits proliferation of leiomyoma cells and may serve as a potential therapeutic agent for the medical treatment of uterine leiomyomas.
Increased expression of p21 activated kinase 4 in adenomyosis and its regulation of matrix metalloproteinase 2 and 9 in endometrial cells
The present study showed that increased Pak4 expression can lead to the development of adenomyosis by enhancing the invasiveness of endometrial cells through regulating MMP-2 and -9 activities.
Follicle stimulating hormone receptor polymorphism affects the outcome of ovulation induction in normogonadotropic World Health Organization class 2 anovulatory subfertility
An FSH receptor polymorphism (rs6166) affects the outcome of ovulation induction in normogonadotropic anovulatory subfertility. The minor allele (680Ser) is associated with Clomiphene-resistant anovulation during treatment with clomiphene citrate.
Prospective study into the value of the automated Elecsys antimüllerian hormone assay for the assessment of the ovarian growing follicle pool
An automated antimullerian hormone assay showed good correlations with age and antral follicle count and is a reproducible measure of the growing follicle pool.
In this registry-based cohort study, we found positive associations between prospectively measured time to pregnancy and several adverse birth outcomes, including preterm birth, low birth weight, placental disorders, gestational diabetes, and cesarean section.
The present study reveals that blood and tissue levels of Mucin 1 and Glycodelin A are much lower in women with recurrent implantation failure than in fertile women.
Cumulative incidence of infertility in a New Zealand birth cohort to age 38 by sex and the relationship with family formation
In this birth cohort, 21.8% of men and 26.0% of women had ever tried to conceive for 12 months or more or sought medical help to conceive by age 38.
Women with chronic endometritis show altered uterine motility in both the periovulatory and midluteal phases.
Women with a time interval from LEEP to pregnancy of
Pregnancy outcomes following 24 chromosome preimplantation genetic diagnosis in couples with balanced reciprocal or Robertsonian translocations
Twenty-four–chromosome preimplantation genetic diagnosis in translocation carriers yields a live birth rate of 52% per embryo transfer and 38% per biopsy cycle. Thirty percent of cycles had no euploid embryos.
Routine use of next generation sequencing for preimplantation genetic diagnosis of blastomeres obtained from embryos on day 3 in fresh in vitro fertilization cycles
In a prospective trial, use of semiconductor-based NGS for PGD was found to provide a significant advantage in improving pregnancy rate.
Additional congenital abnormalities and regions of genomic imbalance are common in women with mullerian disorders, including Mayer-Rokitanksy-Kuster-Hauser syndrome. These women should be thoroughly investigated, and array comparative genomic hybridization should be considered.
Female exposure to phenols and phthalates and time to pregnancy: the Maternal-Infant Research on Environmental
Elevated TCS exposure may be associated with diminished fecundity. BPA and phthalates showed no negative impact; on the contrary, some phthalates might be associated with a shorter time to pregnancy. A major limitation of the study was that only one measurement of exposure was available for each woman after conception. Further research is necessary to test these findings.
Congenital anomalies in offspring of subfertile couples A registry based study in the northern Netherlands
This registry-based study suggests that the associations between IVF/ICSI and penoscrotal hypospadia and imprinting disorders reported in the literature are better explained by the underlying subfertility than by IVF/ICSI treatment.
P-selectin deficiency significantly retarded the development of endometriosis in a mouse model, and soluble P-selectin treatment markedly reduced lesion size in mice through decreased platelet aggregation and angiogenesis, resulting in reduced fibrotic tissue content.
MicroRNA expression profiles were significantly altered between miscarriage and normal pregnancy deciduas. MicroRNA-199b-5p and SGK1 were detected to determine their interaction in pregnancy maintenance in vivo and in vitro.
Singletons born to primiparous women using assisted reproductive technology had increased risk for preterm birth compared with those conceived spontaneously. The increased risk was observed along the gestational age continuum.
Assessment of multiple intrauterine gestations from ovarian stimulation AMIGOS trial Baseline characteristics
The baseline characteristics are provided for women with unexplained infertility who participated in the AMIGOS trial examining ovarian stimulation with gonadotropins, CC, and letrozole.
Embryo transfer practices and multiple births resulting from assisted reproductive technology An opportunity for prevention
Almost half of ART-related multiple births result from transferring two fresh blastocysts to favorable or average-prognosis patients
Changing ovarian stimulation parameters in a subsequent cycle does not increase the number of euploid embryos
Euploidy outcomes were compared in patients that underwent two ovarian stimulation cycles with preimplantation genetic screening; no specific intervention increased the number of euploid embryos within the same patient any more than simply repeating a similar stimulation cycle.
Initiation of progesterone for luteal support may impact pregnancy rates (PRs). Starting progesterone before oocyte retrieval or 6 days after retrieval likely decreases PRs.
Association of number of retrieved oocytes with live birth rate and birth weight An analysis of 231815 cycles of in vitro fertilization
A higher number of retrieved oocytes was associated with an increased incidence of low birth weight in autologous, but not donor, oocyte cycles with fresh transfer of two embryos.
Comparison of antimüllerian hormone levels and antral follicle count as predictor of ovarian response to controlled ovarian stimulation in good prognosis patients at individual fertility clinics in two multicenter trials
Antimullerian hormone was a stronger predictor of ovarian response to controlled ovarian stimulation than AFC in both GnRH agonist and antagonist cycles, also when data were evaluated at the study center level.
This external validation study failed to replicate the performance of the time-lapse published prediction model, but it should inspire each center to build its own prediction model.
Effect of sperm DNA fragmentation on the clinical outcomes for in vitro fertilization and intracytoplasmic sperm injection in women with different ovarian reserves
The negative effect of sperm DNA fragmentation on clinical outcomes of IVF and ICSI is greater in women with reduced ovarian reserve compared with those with normal ovarian reserve.
Fluorescence in situ hybridization detects increased sperm aneuploidy in men with recurrent pregnancy loss
Men with recurrent pregnancy loss and normal semen parameters exhibit increased sperm aneuploidy detected by fluorescence in situ hybridization.
Reflections on “Loop electrosurgical excision procedure and risk of miscarriage” by Ciavattini et al.
Reflections on “Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) Trial: baseline characteristics” by Diamond et al.
Unraveling the fertility knot in World Health Organization type 2 anovulatory women Another step toward a pharmacogenetic treatment choice
Reflections on “FSH receptor polymorphism affects the outcome of ovulation induction in normogonadotropic (WHO2) anovulatory infertility” by Valkenburg et al.
Reflections on “Embryo transfer practices and multiple births resulting from assisted reproductive technology: an opportunity for prevention” by Kissin et al.
How do we explain the association between assisted reproductive technologies and perinatal morbidity
Reflections on “Perinatal outcomes associated with assisted reproductive technology: the Massachusetts Outcomes Study of Assisted Reproductive Technologies (MOSART)” by Declercq et al.
This committee opinion addresses controversies regarding the diagnosis and potential treatment of luteal phase inadequacy.
Perinatal outcomes associated with assisted reproductive technology The Massachusetts Outcomes Study of Assisted Reproductive Technologies MOSART
Comparing assisted reproductive technology (ART) singleton births with subfertile births found significantly higher rates of preterm birth and low birth weight in the ART cohort. Among twins, ART births had significantly lower perinatal death rates.
Endometriosis is a benign inflammatory disease defined by the presence of endometrial glands and stroma in areas outside the uterus. It is estimated to affect 5%–15% of women of reproductive age and is even more prevalent among women with chronic pelvic pain and infertility. Endometriotic implants may be located anywhere within the pelvis, including the ovaries, ovarian fossa, pelvic peritoneum, rectovaginal septum, uterosacral ligaments, and cul-de sac. In some cases, ovarian endometriotic cysts (endometriomas) may be observed by ultrasound imaging.
Luteal phase supplementation after gonadotropin-releasing hormone agonist trigger in fresh embryo transfer: the American versus European approaches
We describe two luteal phase support protocols after gonadotropin-releasing hormone agonist trigger: the European and the American approaches. Both concepts facilitate fresh embryo transfer with excellent reproductive outcomes in the ovarian hyperstimulation syndrome–risk patient.
Major drawbacks and additional benefits of agonist trigger Not ovarian hyperstimulation syndrome related
High responders and oocyte donors may now be stimulated and triggered with reasonable safety. This paradigm shift confers certain advantages and potential new risks.
Avoiding ovarian hyperstimulation syndrome with the use of gonadotropin releasing hormone agonist trigger
This paper describes the pathophysiology of ovarian hyperstimulation syndrome (OHSS), focusing specifically on the luteolytic benefits of the use of GnRH agonist to decrease OHSS and the possible rescue modalities available.
A bolus of GnRH agonist induces a midcycle gonadotropin surge that is more physiologic in duration and quality compared with a bolus dose of human chorionic gonadotropin for oocyte maturation and ovulation.