Revista Reproducción

Quality of life and treatment satisfaction assesment in patients with infertility

Fri, 01 Aug 2025 00:00:00 +0000

Study question: Do people undergoing study or treatment for infertility perceive alterations in their quality of life? Summary response: A good perception of quality of life was found in the studied population. What is already known: infertility and its treatment can have negative effects on the quality of life, affecting the emotional and social well-being of patients. FertiQuol is an internationally validated psychometric test to measure quality of life in people experiencing infertility. Study design: prospective, descriptive and cross-sectional. Materials and methods: All people who consulted during a period of 6 months were given the FertiQuol questionnaire, printed version in Spanish. The responses were uploaded to the page https://www.fertistat.com/fertiqol/ by team members, to obtain the corresponding psychometric score. The total FertiQuol score, core subscales and treatment were analyzed with their different areas according to gender and in 3 age groups: up to 34 years, 35 to 39 and 40 or more. The responses corresponding to satisfaction with the treatment were analyzed separately. Results: 89 people were included. Total FertiQuol was 75 in women (core subscale 75.4 and treatment 74) and79 in men (core subscale 79 and treatment 75). The differences were not significant when analyzed according to gender and age groups, except for the group of men aged 40 years or older, which was slightly higher. Satisfaction with treatments predominated, and the services offered for emotional care could be improved. Limitations: there could be differences between patients according to diagnosis,number or type of treatment; study carried out in a single private center. Implications of the findings: knowing the perception of quality of life in patients with infertility and their satisfaction with care allows us to develop strategies to improve their well-being.

Ovarian associated immune microenvironment and Its Modulation During Aging

Thu, 31 Jul 2025 00:00:00 +0000

For a long time, ovarian research has been focused on the follicle, the functional unit of the ovary. However, recent scientific evidence remarks the relevance of the immune response in ovarian function. In this sense, it has been proposed the concept of “Reproductive Immune Microenvironment” that studies the microenvironment associated with reproductive tissues, such as testicular interstitial spaces, ovarian stroma and the endometrium, and its relationship with the resident immune cells. Particularly in the ovary, multiple evidences prove the key role of the immune cells in the ovarian physiology. Among the present cells we can find macrophages, T cells, dendritic cells, NK cells and mastocytes, that contribute to the regulation of the immune response, estrogen synthesis and oogenesis among other processes. Of these populations, macrophages are of special interest since, due to their ability to integrate information from the nervous, immune and endocrine systems together with their functional plasticity and ability to secrete multiple factors, results in them being involved in practically all ovarian physiology. Another concept that has recently been proposed is the Inflammaging, which refers to the inflammation associated to aging. This inflammation is systemic, chronic and low-grade associated with an increase in proinflammatory mediators, different from the local acute inflammation due to lesions and infections. Besides being part of the normal aging process, the inflammaging has been associated with different pathologies. In the ovaries, several reports relate the inflammatory response and fibrosis characteristic of ovarian aging with inflammaging. In this work, we discuss these new concepts of reproductive immune microenvironment and inflammaging, and how they impact on ovarian aging as well as in oocyte quality.

Differences in Pregnancy Outcomes Between Euploid Embryos Biopsied on Day 5 Versus Day 6

Fri, 01 Aug 2025 00:00:00 +0000

Study question: Does embryo expansión time influence reproductive outcomes of euploid embryos? Summary answer: Patients who transferred euploid blastocysts biopsied on day 5 had an 80% higher clinical pregnancy rate than those with euploid blastocysts biopsied on day 6. What is already known: Pregnancy rates in fresh cycle transfers were significantly higher when day 5 expanded blastocysts were transferred compared to slower developing day 6 blastocysts. In thawed embryo transfers, some authors reported higher pregnancy rates with Day 5 blastocysts compared to Day 6, while other authors found no difference. Not all euploid embryos would implant equally with the same development. Study design: Retrospective analytical cohort study. Materials and Methods: We analyzed 125 cycles of euploid embryo transfers performed between May 2018 and April 2023, ordering them according to the day of biopsy. The biopsy day was selected based on the degree of embryonic expansion. The expanded embryos were biopsied on day 5, while those with a lower expansion degree were expected until day 6 to perform the biopsy. Regardless of the biopsy day, all endometrial preparation was performed in the same way for embryos trans-fer. Embryo biopsy transfers (EBT) were divided into two groups according to the day of biopsy: day 5 (EBT5) (n=84) and day 6 (EBT6) (n=41). Main results: Patients who transferred euploid day 5 blastocysts showed a higher clinical pregnancy rate compared with euploid day 6 blastocysts (47.6% vs. 26.8%), this difference was statistically significant with an RR of 1.78 (1.02- 3.08). The miscarriage rate did not show significant differ-ences. Limitations: In order to make our study more robust, it would be relevant to increase the number of cases and, in addition to embryonic development stages, evaluate other embryonic parameters. Wider implications of the findings: Our work is consistent with literature and encourages informed decision when choosing be-tween two or more euploid embryos.

PGT-A of criopreserved embryos: Affects the clinical outcomes?

Fri, 01 Aug 2025 00:00:00 +0000

Study question: Are clinical outcomes compromised when performing preimplantation genetic testing for aneuploidies (PGT-A) on previously cryopreserved embryos compared to fresh biopsied ones? Summary answer: Embryo thawing for subsequent biopsy and re-cryopreservation would be a safe technique that can be used in patients who require PGT-A on embryos from previous procedures. What is already known: The use of PGT-A is becoming increasingly common with the aim of improving the chances of achieving a successful pregnancy after the first blastocyst transfer. Embryo biopsy is routinely performed in fresh cycle procedure; then the embryo is cryopreserved and, if it is an aceptable embryo, will be ransfered in a subsequent cycle. However, there are patients for whom PGT-A is recommended on already frozen embryos. Therefore, these embryos would be cryopreserved twice. The impact of this successive cryopreservations, thawings, and biopsy is controversial. Study design: cross-sectional, analytical. Materials and Methods: 283 fresh embyos biopsied and 31 post-thaw embryos biopsied, between January 2016 and July 2024, were analysed. The biopsies were performed at the blastocyst stage, with assisted hatching done on day 3 or prior to biopsy. The genetic analysis was conducted by NSG using the Illimina platform. Embryo survival rate, genetic and clinical results (clinical pregnancy rate, ongoing pregnancy rate and implantation rate) were compared between both groups using the Chi-square test with a significance level of 5%. Main results: No significant differences were found in embryo survival rate neither clinical results when comparing the two groups, but there are differences in the aneuploidy percentage. Limitations: Small sample size. Wider implications of the findings: Performing two vitrification-thawing cycles on embryos would not affect their survival or clinical outcomes.

First Argentinean experience to validate the ultra-rapid vitrification protocol in human oocytes.

Maria Agustina Meneghini — Fri, 01 Aug 2025 00:00:00 +0000

Study question: What can be concluded from the first experience of using ultrafast vitrification compared to the conventional method? Summary answer: Ultra-rapid vitrification techniques reduce the procedure time with optimal oocyte survival rates. What is already known: Oocyte vitrification is an effective strategy for fertility preservation; however this is one of the most time-consuming techniques in routine laboratory practice. Recent research has suggested the possibility of successful oocyte cryopreservation using an ultra-fast vitrification technique. Study design: Cross-sectional, experimental, descriptive. Materials and Methods: 96 Metaphase II oocytes from our oocyte donation programme were used. They were divided into 3 groups according to the cryopreservation techniques used. Group I: Conventional vitrification - conventionalheating; Group II: Conventional vitrification - ultra-fast heating adapted for conventionally vitrified oocytes; Group III: Ultra-fast vitrification - ultra-fast heating. One hour after heating, oocyte survival was assessed, and the run times for each group were recorded. Results were expressed as a percentage per group. Main results: Thirty-two oocytes were assigned to each experimental group. Survival was 90.6 % (29/32), 100 % (32/32) and 100 % (32/32) and processing time for cryopreservation of 32 oocytes was 68 min, 54 min and 49 min for groups I, II and III, respectively. Limitations: Increasing the sample size and diversifying the study population is required to generalize its application. Wider implications of the findings: Our results obtained in this first Argentinean experience confirm that vitrification of oocytes with ultra-rapid techniques (i) are equal or superior to the conventional method in terms of survival rate, (ii) imply a notable reduction in working times, (iii) can be incorporated into the laboratory routine as they can be applied to conventionally vitrified oocytes.

Del Destello Mental a la Realidad Científica: Neurociencia de la Creatividad en la Investigación

Laura Sícaro — Fri, 01 Aug 2025 00:00:00 +0000

En el corazón de cada avance científico, antes de la técnica, el experimento o la publicación, hay algo intangible: una idea. Ese momento casi fugaz en que la mente, estimulada por una observación, una duda o una intuición, enciende una chispa que puede cambiar paradigmas. En esta edición de nuestra revista, queremos explorar no solo los resultados de este grupo de trabajos, sino el origen de la investigación: el proceso que convierte la curiosidad en conocimiento. Desde la neurociencia sabemos que la generación de ideas involucra un complejo entramado de redes neuronales. La red por defecto activa durante la introspección, imaginación y divagación, juega un papel clave en la gestación creativa. Allí, el cerebro ensambla recuerdos, experiencias pasadas y conocimientos previos para generar nuevas conexiones. Este “caos ordenado” da paso a una idea incipiente. Es decir que “lo nuevo”, no es más que una asociación de “cosas viejas”, ya conocidas y que mutan gracias a una chispa creadora dándole un nuevo significado. A este nivel, el más básico del pensamiento creativo, se somete la vivencia y lo que tomamos del medio como materia prima para un nuevo modelo. Como la exposición al veneno de una araña para Spaiderman, o una Del Destello Mental a la Realidad Científica: Neurociencia de la Creatividad en la Investigación tormenta de radiación cósmica para los 4 Fantásticos, las inquietudes de los que autores de estos trabajos, fueron el gatillo para generar ese superpoder, la creatividad. Y donde interviene, por ejemplo, la dopamina, como el martillo Mjolnir de Thor, la fuente de poder para la plasticidad neuronal, y la flexibilidad sináptica. Pero la creatividad por sí sola no basta. Para que una idea se transforme en proyecto, entra en juego la red ejecutiva central, asociada con la planificación, toma de decisiones y regulación cognitiva. Es aquí donde la idea se somete a un proceso de validación interna: ¿es viable?, ¿es relevante?, ¿cómo se puede probar? En esta etapa, la emoción se alía con la lógica; el sistema límbico y la corteza prefrontal trabajan en conjunto para impulsar la motivación y sostener el esfuerzo. Como el lazo de la verdad de la Mujer Maravilla, necesitamos un sistema autenticador que nos ayude a concretar el proceso. La ciencia, después de todo, no es sólo racionalidad. Es también perseverancia, intuición y pasión. El paso de una idea creativa a un protocolo experimental exige estructura, pero también valentía para explorar lo incierto, como nuestros superhéroes. En el campo de la reproducción humana, donde la ética, la tecnología y la biología convergen, este proceso es especialmente exigente y revelador. Hoy celebramos no solo los resultados, sino los procesos mentales que los hacen posibles. Cada artículo que presentamos en esta edición comenzó como una chispa, una sinapsis, un valiente y desafiante “¿y si...?”. Quizás esta presentación mueva a nuestros lectores a desarrollar también, sus superpoderes de autor.

Comparison between the use of hCG vs. hCG + triptorelin acetate (DUAL TRIGGER) in patients normor-responders

Fri, 01 Aug 2025 00:00:00 +0000

Study question: Does the use of dual triggering for final oocyte maturation improve reproductive outcomes in normal responders? Summary answer: Dual triggering resulted in a higher proportion of retrieved oocytes, MII oocytes per patient, and cryopreserved embryos for future transfers. What is already known: There are conflicting results regarding whether hCG + GnRH analogues increase the number MII oocytes and good embryos. Study design: Retrospective, case-control study. Study group of 54 patients and 108 in the control group. Study period from June 2021 to April 2024. Materials and Methods: Patients under 40 years of age who underwent ICSI with AMH [1.2–3.5] ng/ml and/or FSH <10 IU/ml were included. The study group underwent final oocyte maturation with hCG + GnRH analogue, and the control group with hCG. Patients were matched 2:1 with the study group to match age, final antral follicles, and gonadotropin doses used. Retrieved oocytes, MII, embryos obtained, goodquality embryos, clinical pregnancy per patient, implantation rate, and available cryopreserved embryos were analyzed. Averages, t-tests, Mann-Whitney tests, and chi-square tests were used. A p <0.05 was considered statistically significant. Results: The study group obtained a higher percentage of retrieved oocytes/final follicles (82% vs. 77% - p = 0.0027) and a higher number of MII oocytes (9.4 ± 4.2 vs.8.0 ± 4.2 - p = 0.0412). There were no differences in the number of embryos retrieved, embryos with Good morphology, and cumulative clinical pregnancy per patient (61% vs. 66% - NS). To achieve cumulative results, the Dual Trigger patients transferred fewer embryos (1.4 ± 0.5 vs. 1.7 ± 0.9 - NS), leaving 62% vs. 42% of the embryos retrieved available for future transfers (p < 0.0001). Implications of the findings: In line with previous studies, a higher rate of mature oocytes was found in dual trigger patients who responded normally. The higher proportion of cryopreserved embryos in the dual trigger group would allow for more opportunities for embryo transfers without performing a repeat ICSI.