We discuss whether efficient transduction and subsequent elimination of fibroid tumor-initiating stem cells during debulking of tumor cells will aid in completely eradicating the tumor as well as decreasing the likelihood of recurrence.

Adhesion fibroblasts manifested an altered metabolic profile as compared with normal peritoneal fibroblasts, which favors the glycolytic pathway, and is further altered by hypoxia.

This study discusses the expression of gonadotropin-releasing hormone (GnRH) and its receptor at tubal ectopic pregnancy implantation sites, and investigates the role of GnRH and a GnRH antagonist in regulating trophoblastic BeWo cell viability.

P450c17 deficiency due to inactivating CYP17A1 mutation in 46,XX patients is associated with primary or secondary amenorrhea, absent/sparse pubic hair, hypertension, and high prevalence of ovarian macrocysts with a risk of torsion. In patients with hypergonadotropic hypogonadism, high basal progesterone level is a hallmark for this diagnosis.

Among obese girls with polycystic ovary syndrome, 27% who are metabolically healthy have a more favorable risk profile for type 2 diabetes, atherogenesis, inflammation, and androgenemia compared with the 73% who are metabolically unhealthy.

A diagnosis of depression, anxiety, or treatment with antidepressants before an in vitro fertilization cycle had a slight negative association with pregnancy and live birth but not miscarriage.

Gonadotropin-releasing hormone antagonist used with multifollicular stimulation allows high delivery rates in intrauterine insemination.

Women experience a significant reduction in fecundity and an increase in the probability of infertility in the late thirties. At any age >30 years, women, who have never conceived before, have a lower probability of conception.

Age, duration of infertility, income, and a history of prior pregnancy loss were significantly associated with the probability of live birth in women with unexplained infertility undergoing ovarian stimulation–intrauterine insemination.

The available literature on the treatment of unexplained infertility reflects the heterogeneity of clinical practice. Adequately powered, randomized trials are needed to directly compare the efficacy of these treatments.

Recurrent adnexal torsion is more common when the first torsion episode occurs in the premenarchal period and involves otherwise normal adnexa.

We investigated a biracial cohort of women at the end of their reproductive life. Carrying the apolipoprotein E*2 allele was a risk factor for pregnancy loss only in white women.

This study of the hypothalamus-hypophysis-gonad axis in children and adolescents with nonmosaic triple X syndrome found that Triple X patients showed premature activation of the gonadotropin-releasing hormone pulse generator and reduced gonadal function.

FMR1 CGG repeat lengths within the normal range were not independently associated with ovarian stimulation response or assisted reproduction outcomes.

Our study validated multiple annealing and looping-based amplification cycle next-generation sequencing for 24-chromosome aneuploidy screening of blastocysts.

The histology, ultrastructure, and viability of follicles and stromal cells are better preserved after vitrification of human ovarian cortical strips with slush nitrogen compared with liquid nitrogen.

Inequities exist within state insurance laws that mandate coverage for infertility care. Only 8 of 15 state laws include coverage for male partners, placing undue burden on the female partner.

The study found that cancerous tissues of female reproductive tissues, uterine polyps, and those collected from women with a history of smoking are characterized by altered metals status.

Higher pretreatment whole grain intake was related to a higher probability of live birth among women undergoing in vitro fertilization.

Expression of hypoxia inducible factor 1a and vascularization status in peri-implantation endometrium is altered in the nonconception cycles of women with a history of recurrent miscarriage.

Follicular and luteal phase stimulations show similar in vitro fertilization performance which may lead to a novel strategy to increase the chances of pregnancy in reduced ovarian reserve patient populations.

In vitro fertilization outcomes among South Asian women are similar to Caucasian women in frozen embryo transfer cycles and significantly lower in fresh in vitro fertilization cycles.

Blastocyst collapse observed by time-lapse monitoring is not independently associated with a decreased chance of live birth; rather it is confounded by morphokinetic parameters that are stronger predictors of reproductive outcome.

Among cryptozoospermic men, use of testicular sperm for intracytoplasmic sperm injection offers no advantages in fertilization or pregnancy rates when compared with ejaculated sperm.

In addition to female factors, a low percentage of morphologically normal spermatozoa and moderate number of inseminated motile spermatozoa have a positive predictive value for successful intrauterine insemination, albeit low.

Reflections on “The impact of female age and nulligravidity on fecundity in an older reproductive age cohort” by Steiner et al.

Reflections on “Predictors of pregnancy and live-birth in couples with unexplained infertility following ovarian stimulation-intrauterine insemination” by Hansen et al.

Reflections on “An evidence-based approach to unexplained infertility: a systematic review” by Gunn et al.

We conducted a systematic review of the use of long acting versus daily follicle-stimulating hormone for women undergoing assisted reproduction.

The management of patients with impaired or poor ovarian response (POR) remains a controversial and complex clinical issue. A systematic review of 47 randomized controlled trials revealed 41 different definitions of POR (1). Notably, the number of oocytes retrieved was adopted as a criterion of POR in 40% of the trials, although the threshold number differed considerably among studies (1). To standardize the definition of POR, Ferraretti et al. (2) proposed new criteria, known as the “Bologna criteria,” based on three conditions: 1) advanced maternal age (≥40 years) or any other POR risk factor; 2) a previous incident of POR; and 3) a low ovarian reserve test in terms of antimüllerian hormone (AMH) and antral follicle count (AFC).

We now have the ability to store sperm, oocytes, embryos, and testicular and ovarian tissue in the frozen state for future use with varying degrees of success. Although sperm cryopreservation has been available for well over 60 years, other technologies have only recently been developed and are still being refined. These technological advances have raised multiple questions and issues as to when and how such technologies should be used. The initial intent was to utilize these tissues for individuals who had somehow lost their ability to reproduce.

Many women with Turner syndrome (TS) are eager to become pregnant. A small number (5%–10%) will have a spontaneous pregnancy, an outcome thought to be more likely in women with mosaicism (1). The increased availability of oocyte donation (OD) through assisted reproductive technology (ART) has enabled an unknown number of women with TS to achieve a pregnancy. A gathering body of evidence, however, suggests that pregnancy is high risk, secondary to potential aortic dissection and rupture and a significant risk of developing hypertensive disorders of pregnancy.

Why is surrogacy so highly debated as a pertinent solution for women with infertility caused by uterine factors? Surrogacy implies that a woman becomes pregnant and gives birth to a child with the intention of giving away this child to another person or couple who intends to raise the child.

Another patient in her 40s came to see me for a second opinion last week. Her story is quite typical, and it is easy to summarize in general terms. The patient is aged 42 years and has undergone three IVF cycles without success. More accurately, she has undergone three IVF retrievals but did not have an ET. This is because she was told that all of her embryos were found to be chromosomally abnormal. She was further advised that she seems to only be producing abnormal embryos and that she should now pursue oocyte donation.

Ultrasound imaging and angiography techniques play a crucial role in the diagnosis and treatment of men with subfertility.

The magnetic resonance structured report in infertility defines and proposes a standardized magnetic resonance imaging structured report in patients with infertility to have clinical completeness regarding possible diagnosis and severity.

Noninvasive imaging techniques play an important role in the female infertility diagnostic algorithm. Computerized tomographic and magnetic resonance virtual hysterosalpingography techniques allow a comprehensive assessment of the female reproductive system.

Ultrasound offers descriptive and physiologic assessment of the endometrium. Current prediction of pregnancy by endometrial ultrasound is not satisfactory. Future integration of multiple variables may lead to better prediction.

The concept of “one-stop shopping” for evaluating female infertility is a comprehensive ultrasound evaluating the uterus and ovaries, including the shape of the cavity, serosal surface, and tubal patency.

Advanced imaging technologies have an indispensable role in our ability to noninvasively evaluate and treat couples with reproductive difficulties. Understanding the range of possibilities enables an individually tailored approach.