Clinical Practice in Assisted Reproduction: Reporting Back to the Practitioner on Established Practices and Novel Approaches

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 18958

Special Issue Editor

Associate Professor of Physiology-Embryology, Sr. Clinical Embryologist/Geneticist, School of Medicine, National & Kapodistrian University of Athens, 15452 Athens, Greece
Interests: clinical embryology; preimplantation embryo; IVF; ICSI; PGT-A; infertility; ovarian insufficiency; andrology

Special Issue Information

Dear Colleagues,

Assisted reproduction is identified as one of the “youngest” and highly individualized fields in medicine. In the era of personalized and precision medicine, IVF practice strives to provide patients with state-of-the-art approaches, methods, and strategies in treatment and management. The continued efforts focusing on defining optimal practice and providing the scientific community with guidelines have set the tone for an IVF practice of excellence in the not too distant future.

 In the midst of rethinking established methods and approaches to employing cutting-edge novel strategies, this Special Issue dedicated to assisted reproduction aims to assist the practitioner by providing significant contributions on an array of crucial topics. This special issue aspires to target multifaceted issues that are of interest to the all-inclusive team providing IVF services, from the andrologist to the clinical embryologist, nursing coordinator, psychologist,  and the  reproductive endocrinology and infertility specialist. The rational fueling submissions is encouraged to have as an endpoint reporting back to the practitioners and assisting them in delineating issues that are represented by different schools of thought, ultimately targeting decision-making. This Special Issue shall welcome contributions of original articles, namely, basic research projects, observational studies, prospective intervention studies, RCTs, studies investigating diagnostic tools, case series, systematic reviews, meta-analysis, along with narrative reviews on a highly compelling medical field. From revisiting, rethinking, and reporting on established practices to providing insight regarding novel approaches or raising bioethical issues, we cordially invite you to submit your work.

Our aim is to synthesize an issue supporting our interest towards assisting the practitioner. It is this that will bring us one step closer to understanding, organizing, and practicing optimal management.

Dr. Mara Simopoulou
Guest Editor

Manuscript Submission Information

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Keywords

  • Assisted Reproduction
  • Reproductive Endocrinology and Infertility
  • IVF/ICSI
  • Cryopreservation/Vitrification
  • Male Infertility
  • PGT-A, PGT-M, PGT-SR
  • Stimulation protocols
  • Natural Cycles
  • Poor responders
  • Endometriosis and IVF treatment
  • Premature Ovarian Insufficiency
  • Bioethics in Assisted Reproduction
  • Novel approaches in IVF

Published Papers (3 papers)

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Research

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17 pages, 6159 KiB  
Article
Slow-Freezing Cryopreservation Ensures High Ovarian Tissue Quality Followed by In Vivo and In Vitro Methods and Is Safe for Fertility Preservation
by Živilė Gudlevičienė, Kastytis Žilinskas, Gabrielis Kundrotas, Monika Grubliauskaitė, Daiva Baltriukienė and Virginija Bukelskienė
Medicina 2020, 56(10), 547; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56100547 - 19 Oct 2020
Cited by 5 | Viewed by 2961
Abstract
Background and objectives: Cancer incidence is growing with younger patients diagnosed with this disease every year. Improved cancer diagnostics and treatment lead to better survival of cancer patients. However, after aggressive chemo- or radiotherapy, cancer survivors suffer from various degrees of subfertility or [...] Read more.
Background and objectives: Cancer incidence is growing with younger patients diagnosed with this disease every year. Improved cancer diagnostics and treatment lead to better survival of cancer patients. However, after aggressive chemo- or radiotherapy, cancer survivors suffer from various degrees of subfertility or infertility. Several fertility preservation technologies have been developed for young cancer patients: cryopreservation of germ cells, embryos, or reproductive tissues. The best results have been shown by cryopreservation of sperm and embryos. Yet the success of using cryopreserved oocytes or reproductive tissues (ovarian and testicular) is still insufficient. Therefore, this study was designed to assess the vitality, viability, general quality, and safety of frozen–thawed human ovarian tissue for retransplantation using modern molecular tests. Materials and Methods: The new miRNA array test was used to evaluate miRNA expression in thawed ovarian tissue in combination with standard xenotransplantation and pathological examination of microslides. Results: Our results demonstrated that slow freezing is an efficient way (80%) to cryopreserve ovarian tissue with no structural damage afterwards. We have shown that xenotransplantation into immunodeficient mice, histology, and immunohistochemistry could be potentially replaced by more recent molecular methods. Conclusions: The latter method has shown that altered expression of miRNAs might be used as identifiers of normal/damaged tissue after further analysis. Newer, safer, and more specific approaches need to be developed in order to eliminate the risk of disease reoccurrence. Full article
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10 pages, 1012 KiB  
Article
Could the Age Difference of a Single Calendar Year between Patients Undergoing IVF at 34, 35 or at 36 Years Old Affect the IVF Outcome? A Retrospective Data Analysis
by Konstantinos Pantos, Konstantinos Sfakianoudis, Sokratis Grigoriadis, Evangelos Maziotis, Petroula Tsioulou, Anna Rapani, Polina Giannelou, Anastasios Atzampos, Sevasti Koulouraki, Michael Koutsilieris, Nikolaos Vlahos, George Mastorakos and Mara Simopoulou
Medicina 2020, 56(2), 92; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56020092 - 24 Feb 2020
Cited by 6 | Viewed by 3114
Abstract
Background and Objectives: Clinicians are called to overcome age-related challenges in decision making during In Vitro Fertilization (IVF) treatment. The aim of this study was to investigate the possible impact of a single calendar year difference among patients aged 34, 35 and 36 [...] Read more.
Background and Objectives: Clinicians are called to overcome age-related challenges in decision making during In Vitro Fertilization (IVF) treatment. The aim of this study was to investigate the possible impact of a single calendar year difference among patients aged 34, 35 and 36 on IVF outcomes. Materials and Methods: Medical records between 2008 and 2019 were analyzed retrospectively. The study group consisted of women diagnosed with tubal factor infertility. Sample size was divided in three categories at 34, 35 and 36 years of age. Embryo transfer including two blastocysts was performed for every patient. Comparisons were performed regarding hormonal profile, response to stimulation, quality of transferred embryos, positive hCG test and clinical pregnancy rate. Results: A total of 706 women were eligible to participate. Two-hundred and forty-eight women were 34, 226 were 35 while the remaining 232 were 36 years old. Regarding the hormonal profile, the number of accumulated oocytes and the quality of embryos transferred, no statistically significant difference was documented between the three age groups. Women aged 34 and 35 years old indicated a significantly increased positive hCG rate in comparison to women aged 36 years old (p-value = 0.009, p-value = 0.023, respectively). Women aged 34 and 35 years old presented with a higher clinical pregnancy rate in comparison to those aged 36 years old (p-value = 0.04, p-value = 0.05, respectively). Conclusion: A calendar year difference between patients undergoing IVF treatment at 34 or 35 years of age does not appear to exert any influence regarding outcome. When treatment involves patients above the age of 35, then a single calendar year may exert considerable impact on IVF outcome. This observation indicates that age 35 may serve as a valid cut-off point regarding IVF outcome. Full article
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Review

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23 pages, 685 KiB  
Review
Endometriosis Associated Infertility: A Critical Review and Analysis on Etiopathogenesis and Therapeutic Approaches
by Lidia Filip, Florentina Duică, Alina Prădatu, Dragoș Crețoiu, Nicolae Suciu, Sanda Maria Crețoiu, Dragoș-Valentin Predescu, Valentin Nicolae Varlas and Silviu-Cristian Voinea
Medicina 2020, 56(9), 460; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56090460 - 09 Sep 2020
Cited by 39 | Viewed by 12338
Abstract
Endometriosis represents a frequently diagnosed gynecological affliction in the reproductive timespan of women, defined by symptoms ranging from pelvic pain to infertility. A complex interplay between the genetic profile, hormonal activity, menstrual cyclicity, inflammation status, and immunological factors define the phenotypic presentation of [...] Read more.
Endometriosis represents a frequently diagnosed gynecological affliction in the reproductive timespan of women, defined by symptoms ranging from pelvic pain to infertility. A complex interplay between the genetic profile, hormonal activity, menstrual cyclicity, inflammation status, and immunological factors define the phenotypic presentation of endometriosis. To date, imaging techniques represent the gold standard in diagnosing endometriosis, of which transvaginal ultrasonography and magnetic resonance imaging bring the most value to the diagnostic step. Current medical treatment options for endometriosis-associated infertility focus on either stimulating the follicular development and ovulation or on inhibiting the growth and development of endometriotic lesions. Techniques of assisted reproduction consisting of superovulation with in vitro fertilization or intrauterine insemination represent effective treatment alternatives that improve fertility in patients suffering from endometriosis. Emerging therapies such as the usage of antioxidant molecules and stem cells still need future research to prove the therapeutic efficacy in this pathology. Full article
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