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PubMed2003

Assisted reproduction in patients with early-stage ovarian malignancies.

OBJECTIVE: To determine the outcome of women with early-stage ovarian malignancies who subsequently underwent assisted reproductive technologies (ART). DESIGN: Retrospective study. SETTING: Academic assisted reproductive technology program. PATIENT(S): Four infertile women who were previously diagnosed with early-stage ovarian malignancies. INTERVENTION(S): Controlled ovulation hyperstimulation, IVF, and/or gamete intrafallopian transfer treatments using clomiphene citrate and/or gonadotropins. MAIN OUTCOME MEASURE(S): Development of tumor recurrence and disease-free interval. RESULT(S): All four women remain free of disease for up to 15 years after treatment. Three of the four women achieved pregnancy. CONCLUSION(S): In patients with early-stage ovarian malignancies, conservative therapy followed by ovarian stimulation for assisted reproduction is an acceptable strategy.

Adult↗
PubMed2006

[Characteristics of IGF-II gene imprinting in twin placentas].

OBJECTIVE: To compare insulin-like growth factor II (IGF-II) gene imprinting in twin placentas with singleton ones and to determine whether imprinting was influenced by assisted reproductive technology, zygosity and fetal sex. METHODS: One hundred and sixty cases of twin placentas and 42 cases of singleton ones were recruited. Allele-specific IGF-II expression was determined by reverse transcription-PCR combined with analysis of an Apa I-sensitive restriction fragment length polymorphism. RESULTS: Although the incidence of IGF-II imprinting loss was higher in normal twin placentas than in singleton ones (20.6% vs 8.7%), there was no statistical significance. There were no significant differences between twins conceived by assisted reproductive technology and those conceived spontaneously (17.9% vs 24.4%), and between dizygotic and monozygotic twins (22.4% vs 16.7%). The incidence of IGF-II imprinting loss in placenta of female twins was statistically higher than that of male ones (26.4% vs 9.8%). CONCLUSION: The risk of IGF-II gene imprinting loss is higher in female twins and has no relationship with assisted reproductive technology and zygosity.

Adult↗
PubMed2003

Retrieval and cryopreservation of sperm from spermatocele fluid.

OBJECTIVES: To evaluate the amount, motility, and viability of sperm in fluid aspirated from naturally occurring spermatoceles and to investigate the effect of cryopreservation of sperm retrieved from spermatoceles. Assisted reproductive technologies have led to successful pregnancies and deliveries using sperm harvested from the epididymis and/or testis of infertile men. METHODS: Aspiration of spermatocele fluid and analysis of the fluid obtained was performed on 20 patients before elective spermatocelectomy. Randomly selected samples (n = 5) were washed using a 70% Percoll gradient, and repeated semen analysis was performed. The washed specimens were cryopreserved in liquid nitrogen, and repeated semen analysis was performed on the thawed specimens. RESULTS: All spermatoceles (n = 20) had viable sperm present (count range 54 x 10(4) to 326 x 10(6)) and 16 (80%) of 20 contained motile sperm. The average percentage of motile sperm was 5%. The average sperm motility and average percent viability of sperm recovered after Percoll gradient improved compared with sperm in the initial spermatocele aspirates (motility 5%, range 0% to 25% and viability 36%, range 2% to 91% before Percoll vs. motility 13%, range 2% to 38% and viability 39%, range 10% to 92% after Percoll). Sperm retrieved after cryopreservation demonstrated reduced motility and viability; however, motile and viable sperm were recovered from all washed and cryopreserved samples. CONCLUSIONS: Our results suggest that spermatocele fluid may contain sufficient numbers of sperm for use with assisted reproductive technologies. Motile and viable sperm can be recovered after cryopreservation and storage of sperm obtained from a spermatocele. Spermatocele fluid may be an additional source of sperm for assisted reproductive technologies.

Cryopreservation↗
PubMed1998

Blastocyst transfer after enzymatic treatment of the zona pellucida: improving in-vitro fertilization and understanding implantation.

It has been shown recently that delayed transfers improve implantation rates in assisted reproductive technology programmes. In a prospective study, the pregnancy rates and safety of outcome were evaluated in a group of patients after the transfer of day 5 blastocysts with enzymatic treatment of the zona pellucida. Nineteen women with a mean age of 32.6+/-5.2 years and mean 2.1+/-2.2 repeated attempts had blastocyst transfers with a mean number of 2.5+/-0.7 embryos replaced per patient. The clinical pregnancy rates per cycle/transfer and implantation rate were 53% and 33%, respectively. The multiple pregnancy rate was 40% (two pregnancies were triplets). The pregnancy and implantation rates were very much higher than observed for most assisted reproduction technology centres. The 'in-vitro implantation' rates of zona-free blastocysts on a variety of feeder monolayers was 92%, offering some thoughts as to the role of the zona and interaction of the inner cell mass and trophoectoderm with the endometrium in implantation. Based on the in-vitro studies and the high multiple pregnancy rates, it appears that zona-manipulated blastocysts implant relatively well and there would be a need to reduce the number of transferred embryos to one or two, thus reducing multiple pregnancies and having spare blastocysts available for cryopreservation. The results also suggest that using the embryo culture protocol and method of transfer in the present study offers encouraging improvements to assisted reproduction technology, and enzymatic treatment of the zona may allow better anchorage and dialogue of the embryo with the endometrium, helping us to improve and understand implantation.

Adult↗
PubMed2006

Infertility, assisted reproduction and rights.

The rights to reproduce and found a family are recognized as basic human rights. Infertile couples should enjoy the same right to reproduce as those who have the ability to do so without assistance. Both positive and negative rights to access to assisted reproductive technologies are required in order to fully realize the reproductive rights. However, there is a limit to such a claim. The positive right of individuals to have state-funded assisted reproductive treatments has to be balanced against the provision of other societal goods and healthcare rationing. The negative right to acquire access to assisted reproductive technologies by individuals' own resources is also restrained. The barrier to such access is often of a moral nature, the standard of which depends on the values of the society.

Female↗
PubMed2003

Risk of death in pregnancy achieved through oocyte donation in patients with Turner syndrome: a national survey.

UNLABELLED: To determine the risk of death in pregnant women with Turner syndrome who were treated with oocyte donation, and to ascertain the prevalence of preconception cardiac screening in these patients. DESIGN: Survey and literature review. SETTING: Academic infertility center. PARTICIPANT(S): All 258 donor-egg programs in the 1997 Assisted Reproductive Technology Success Rates publication from the Society for Artificial Reproductive Technology were surveyed by fax or telephone. MAIN OUTCOME MEASURE(S): Death in pregnancy conceived through oocyte donation and proportion of patients prescreened with echocardiography. RESULTS: One hundred thirty-four (52%) programs reported 146 Turner patients treated, resulting in 101 pregnancies. One patient died from aortic rupture while awaiting treatment; 72 (49.3%) patients were pre- screened with echocardiography. No deaths in pregnancy were reported. A literature review identified four case reports of Turner patients who died during pregnancy in the United States during the same time period. CONCLUSION(S): The maternal risk of death from rupture or dissection of the aorta in pregnancy may be 2% or higher. Patients with Turner syndrome have not been adequately screened with echocardiography before treatment. Specialists who treat patients with Turner syndrome need to be aware of their cardiac risk and its potential exacerbation from the increased cardiac demands of pregnancy.

Aortic Dissection↗
PubMed2004

Early and midluteal phase blood estradiol levels after ovum pickup and pregnancy rates after ICSI cycles.

OBJECTIVE: To examine whether blood estradiol level tendencies during the late follicular and early luteal phases and the 11 days after embryo transfer have any association with the outcome of intracytoplasmic sperm injection-embryo transfer (ICSI-ET) cycles. STUDY DESIGN: This prospective study involved 38 assisted reproductive technology cycles in 35 infertile patients treated with assisted reproductive technologies in which blood samples taken on the 4th, 7th, 9th and 11th days following ET were tested for progesterone, estradiol and hCG levels using an enzyme-linked immunoassay. The estradiol blood levels were compared with the maximal follicular phase blood estradiol. The data were analyzed using Microsoft Excel (Redmond, Washington) and SPSS 10.0 (Chicago, Illinois). The chi2, Mann-Whitney U, Wilcoxon and Pearson tests were usedfor statistical analysis. RESULTS: Average maximum estradiol blood level, number of oocytes produced,fertilization rates and cleavage rates did not show any significant difference between pregnant and nonpregnant cycles. The lower the ratios of estradiol levels measured on posttransfer days 4, 7 and 9 to the maximumfollicular phase level, the lower the probability of pregnancy (P < .01, P < .01 and P < .01, respectively). CONCLUSION: The steeper the decline in blood estradiol levels (affecting the periimplantation period) following ovum pickup relative to the maximum follicular phase estradiol levels, the lower the chance of pregnancy in ICSI-ET cycles.

Biomarkers↗
PubMed2002

Use of technology in reproductive health information designed for communities in South Africa.

The need to change sexual behavior to reduce the spread of the HIV/AIDS epidemic has highlighted the critical need for dissemination of effective reproductive health information. A wide range of media, including visual technologies, is used to provide health information to communities in South Africa. However, little is known about the ability of the technology used in communicating intended messages or on the comprehension of messages by the target audience. The study determined the ability of the technology to convey intended messages and the level of understanding of the information disseminated among the community members. A survey of both rural and urban communities of Umtata district in the Eastern Cape province was conducted to examine the readability and understanding of reproductive health information. The study revealed that urban communities understood disseminated reproductive health information better than rural. The findings also indicated that visual communication is much more problematic for older people. Frequency and consistency of reproductive health information improved the level of comprehension.

Adolescent↗
PubMed2006

Major advances associated with reproduction in dairy cattle.

The purpose of this overview is to review some of the major advances in reproductive technologies, and how they may be applied to meet the challenge of enhancing reproductive efficiency in the high-producing dairy cow of the 21st century. The current population of high-producing dairy cows is considered to be subfertile, as characterized by low pregnancy rates and high rates of embryonic mortality. Coordinated systems of reproductive management have been developed based upon a thorough understanding of the endocrine, cellular, and molecular factors controlling ovarian and uterine function. These systems will partially restore herd reproductive performance. Advances in other reproductive technologies offer possibilities for wider use of superior germplasm. Technologies such as sexed semen, cloning, transgenesis, and preimplantation genetic diagnosis offer the potential to enhance the influence of superior animals on production of food for human consumption. However, at this time, additional research is needed to counteract the higher rates of embryonic and fetal mortality associated with some of these technologies. Furthermore, use of genomics, proteomics, and bioinformatics in the study of reproduction will undoubtedly provide investigators with a greater understanding of the limitations to efficient reproductive processes in the subfertile lactating dairy cow.

Animals↗
PubMed2006

World collaborative report on in vitro fertilization, 2000.

The International Committee for Monitoring Assisted Reproductive Technology's 7th World Report for the year 2000 analyzes wide variations in live and multiple birth rates from 49 countries and six regions by type of assisted reproductive technology, age, number of embryos transferred, and multiple births. More than 460,157 procedures resulted in delivery rate per aspiration for conventional in vitro fertilization (IVF) of 18.6%; for intracytoplasmic sperm injection (ICSI), 20.4%; for egg donation, 32.3% per transfer; and for frozen ET, 12.0% per transfer. Conventional IVF and ICSI twin rates were 26.9% and 26.2%, respectively, and triplet rates were 2.8% and 2.9%, respectively, for an estimated total of approximately 197,000 to 220,000 babies worldwide.

Adult↗
PubMed2026

Clinical applications of digital twin technology in In Vitro Fertilisation.

BACKGROUND: Digital twin technology, originating from aerospace and manufacturing industries, has emerged as a transformative tool in healthcare. In vitro fertilisation (IVF) faces persistent challenges including suboptimal embryo selection, unpredictable treatment outcomes, and limited personalisation of protocols. Despite advances in assisted reproductive technology, existing literature exhibits fragmentation: artificial intelligence applications in embryo selection, ovarian stimulation, and endometrial assessment have been developed independently without systematic integration into comprehensive treatment frameworks. Digital twin technology offers unprecedented opportunities to create virtual replicas of biological systems, enabling real-time monitoring, predictive modelling, and personalised treatment strategies. AIM: This narrative review aims to critically examine the current applications of digital twin technology in IVF, evaluate its potential benefits and limitations, synthesize existing evidence into an integrative conceptual model, and identify future directions for implementation in reproductive medicine. METHOD: A comprehensive narrative review was conducted using PubMed, Scopus, Web of Science, and IEEE Xplore databases. A narrative review approach was selected over systematic review to accommodate the heterogeneity of evidence types in this emerging field, including theoretical frameworks, simulation studies, and proof-of-concept implementations that would be excluded from systematic reviews. Search terms included "digital twin," "IVF," "in vitro fertilisation," "assisted reproductive technology," "embryo selection," and "predictive modelling." Studies published between 2015 and 2025 were included, focusing on original research articles, systematic reviews, and proof-of-concept studies describing digital twin applications in reproductive medicine. RESULTS: Digital twin technology in IVF demonstrates significant potential across multiple domains including embryo development simulation, ovarian response prediction, endometrial receptivity modelling, and personalised stimulation protocols. Current applications integrate artificial intelligence, machine learning algorithms, time-lapse imaging, and omics data to create comprehensive virtual models. Early evidence suggests improvements in embryo selection accuracy, ovarian response prediction, and treatment protocol optimization, though large-scale randomized controlled trials remain limited. Implementation challenges include data integration complexity, computational requirements, regulatory considerations, and validation requirements. CONCLUSION: Digital twin technology represents a paradigm shift in IVF practice, offering personalised, predictive, and precision medicine approaches. This review synthesizes existing evidence to propose an integrative conceptual model for digital twin implementation across the IVF treatment spectrum, identifies critical knowledge gaps, and establishes research priorities to advance clinical translation. Despite current limitations, continued advancement promises improved success rates and patient outcomes.

Humans↗
PubMed1987

In vitro fertilization and embryo transfer in domestic animals: applications in animals and implications for humans.

Extensive research has been conducted in domestic animals, particularly in cattle, in the reproductive technologies of sperm handling, capacitation, and acrosome reaction, superovulation, and embryo handling, sexing, bisection, cryopreservation, and transfer. Because of the economic importance of cattle these technologies have been tested and improved under clinical conditions. The results of employing these procedures are available on tens of thousands of pregnancies and offspring. This information has implications in applying some of the same technologies in human reproduction. The large number of normal progeny produced in cattle after a long prenatal development period, similar to humans, provides some assurance that these technologies, carefully applied, are safe. The basis for these conclusions is documented in the publications cited in this review.

Animals↗
PubMed2005

Cellular and molecular mechanisms regulating oocyte quality and the relevance for farm animal reproductive efficiency.

The efficiency of breeding schemes is dependent on the high fecundity of the selected individuals. Reproductive technologies are constantly pushing the physiological limits, but while the male reproductive potential is almost fully exploited, female reproductive physiology is the subject of constant research. Since the number of offspring that a female can bring to term each pregnancy cannot be changed, the ideal approach is to remove the potential offspring at the beginning of development and to transfer them to recipients of lesser genetic value. The earlier the collection takes place, the higher the number of descendants that a female can generate, so that now, the number of available oocytes becomes the limiting factor. This article will describe how detailed studies on oocyte physiology are beginning to unravel the complex sequence that transforms a small primordial follicle into a large ovulatory follicle containing a mature oocyte. Progressively, the limits to oocyte manipulation have been recognised and gradually overcome with adequate hormonal treatments in vivo and with specific media supplementation in vitro. This has led to the development of highly efficient reproductive technologies and the promise of even greater advances in the future. Surprising new findings, such as ovarian stem cells that can replenish the follicle population or long term embryonic stem cell lines that can differentiate into oocytes, are rapidly changing our expectations.

Animals↗
PubMed2000

Infections and infertility.

Infertility affects 10-15% of all couples. Pelvic infections are an important cause of infertility, primarily as a result of tubal damage. Damage to the fallopian tubes from infections may be due to adhesions, tubal mucosal damage, or tubal occlusion that interferes with normal ovum transport. The infections most commonly related to infertility include gonorrhea, chlamydia, and pelvic inflammatory disease. Tuberculosis also is a common cause of infertility in Third World nations. Sequelae resulting from these infections include ectopic pregnancy, infertility, chronic pelvic pain, hydrosalpinx, and tuboovarian abscess. Neisseria gonorrhoeae and Chlamydia trachomatis are the primary causes of pelvic inflammatory disease. Chlamydial infections may be asymptomatic, and the resulting salpingitis is often referred to as silent pelvic inflammatory disease. Polymicrobial infection with other organisms such as anaerobes or facultative aerobes may be initiated by gonorrhea, chlamydia, or both. Early recognition of infection, prompt institution of appropriate antibiotic therapy, and proper follow-up are important to prevent the sequelae of pelvic inflammatory disease. Surgical intervention may be needed to treat immediate or long-term sequelae of infection. Prevention of pelvic infections should be a high priority. Fortunately, treatment options such as tubal microsurgery and assisted reproductive technologies offer couples reproductive options even when infertility occurs as the result of a previous pelvic infection.

Journal Article↗
PubMed2002

Reproductive strategies for human survival.

Reproductive strategies for the human species have basically remained unaltered since Homo sapiens first appeared, probably in the valleys of Africa: males have always attempted to pass their genes to the largest feasible number of females, selecting those females capable of providing the best quality of oocytes; females invariably have sought a male capable of providing the best means of survival for herself and her offspring. This meant that human sexuality has been essentially conceptive, although it is reasonable to suppose that it began to lose this 'exclusive' connotation early in the cultural evolution of the species. Then, during the 20th century, major revolutions occurred: first, with the advent of contraception, sex without reproduction became a reality; then, with assisted reproduction technology, humans devised reproduction without sex; finally, very recently, women have begun to reproduce even in menopause. Additional strategies will, no doubt, soon be available, although we cannot as yet clearly see whether, or when, reproduction without sex and gametes, or in-vitro gestations will become available.

Humans↗
PubMed1991

The female reproductive cycle: new variations on an old theme.

Understanding the female reproductive cycle is the essence of the practice of reproductive medicine. This article reviews important publications that shine new light on the female reproductive cycle. Menstrual dysfunction can begin at adolescence and persist throughout the reproductive years. Adolescent women with menstrual dysfunction should be evaluated and treated. Approximately 30% of pregnancies terminate in abortion during the first trimester. New epidemiologic data on the etiology of spontaneous abortion are reviewed. Advancing age is associated with a decline in fecundity. Delay in childbearing and advances in assisted reproductive technologies have enabled reproductive endocrinologists to better understand the effects of advancing age on reproductive function. The most important paper that we received supports the timing of breast cancer to the luteal phase of the menstrual cycle. There was a statistically significant increase in 10-year survival in women who had surgery during the luteal phase compared with the follicular phase.

Abortion, Spontaneous↗
PubMed2000

Embryonic origins of health: long-term effects of IVF in human and livestock.

Assisted reproduction technologies have been introduced 1) to overcome reproductive failures in the human, 2) to increase the number of offspring from selected females and 3) to reduce generation intervals in livestock in farm animals. The successful introduction of these technologies in clinical practice and in livestock breeding programs is the result of enormous scientific efforts. In general, the offspring generated by IVF (human) and IVP (cattle) is normal, but as numbers increase the restraints and drawbacks of new reproductive technologies become visible with respect to the overall efficiency as well as to the occurrence of abnormalities and/or anomalies in the offspring. The objective of the present symposium on "Embryonic Origins of Health" is to present "the-state-of-the-art" and to discuss the restraints and possible long term effects of the application of assisted reproduction technology in both human and livestock. This introduction to the symposium focuses on the relation between early embryonic development and post-natal health. We hypothesize that IVF in the human and IVP in cattle influence the timing of cell-cell interactions during the early stages of embryogenesis which finally result in a incorrect timing of gene expression during the phylotypic stage and subsequent organogenesis. These deviations in embryonic timing might have consequence for the postnatal homeostasis and health.

Animals↗
PubMed2001

[Infertility treatment before assisted reproductive techniques].

The prevalence of infertility has increased in recent years, but the medical services to treat these problems are not available for most of the affected couples. The prognosis for fertility is important in order to determine the therapeutic capacity of each service, and to select the couples that could be treated at a primary level, or to send them to more advanced levels of reproductive technology. In practice, the infertility is treated in primary medical levels and the assisted reproductive technology is available only to a limited sector of the poblation. In general, the managed-care plans do not compensate directly for infertility treatments, but they are indirectly paying some therapeutic procedures for fertility.

Adolescent↗