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Current Trends and Future Challenges in Assisted Reproduction
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Current Trends and Future Challenges in Assisted Reproduction

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 4905

Special Issue Editor

Dr. Stefano Canosa

E-Mail Website
Guest Editor
IVIRMA Global Research Alliance, Livet, 10126 Turin, Italy
Interests: clinical embryology; fertility preservation; reproductive genetics; artificial intelligence
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Infertility affects around 10–15% of couples worldwide, with a constantly growing trend in Western countries. Over the last decades, reproductive medicine has undergone a dramatic increase in several clinical and technological upgrades based on translational research discoveries.

In the past, the primary aim of assisted reproduction was to achieve pregnancy at any cost with the existing strategies. Contrastingly, at present, and particularly for the future studies, the objective of infertility care is to increase the chance of cumulative live birth rates for each couple, to individualized treatments based on the needs and characteristics of patients. In fact, the exponential contribution provided by multidisciplinary teams to develop new drugs, minimally invasive diagnostic and therapeutic tools, and advanced technologies has opened new opportunities to offer more effective and efficient approaches for infertility treatment.

In view of the presentation of current trends and future challenges in assisted reproduction, the aim of this Special Issue is to gather different and innovative perspectives for the treatment of human infertility, including both clinical and laboratory aspects. This includes the application of new protocols for ovarian stimulation, gamete and embryo culture and cryopreservation, embryo assessment via cutting-edge technologies such as time-lapse microscopy and artificial intelligence, as well as new and non-invasive applications of preimplantation genetic testing.

In this Special Issue, we would like to invite original clinical and basic research articles, meta-analyses and systematic reviews, aiming to update evidence on the future of assisted reproduction that embraces gynecological, andrological and embryological interests.

Dr. Stefano Canosa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infertility
  • fertility preservation
  • reproductive medicine
  • reproductive genetics
  • assisted reproduction
  • gynecology
  • andrology
  • embryology

Published Papers (5 papers)

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Research

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12 pages, 793 KiB  
Article
Autologous Platelet-Rich Plasma (PRP) in Infertility—Infusion versus Injectable PRP
by Ioana Alexandra Zaha, Anca Huniadi, Florin Bodog, Luana Seles, Mihaela Cristina Toma, Laura Maghiar, Erika Szulay-Bimbo, Alin Bodog, Liliana Sachelarie, Mihai Florea and Liana Stefan
J. Pers. Med. 2023, 13(12), 1676; https://doi.org/10.3390/jpm13121676 - 30 Nov 2023
Cited by 1 | Viewed by 1043
Abstract
(1) Background: During IVF (in vitro fertilization) procedures, endometrial thickness has a significant role in the success of pregnancy outcomes for embryo transfers. Endometrial thickness, a crucial component of endometrial receptivity, is a contentious issue. The regenerative properties of PRP have been shown [...] Read more.
(1) Background: During IVF (in vitro fertilization) procedures, endometrial thickness has a significant role in the success of pregnancy outcomes for embryo transfers. Endometrial thickness, a crucial component of endometrial receptivity, is a contentious issue. The regenerative properties of PRP have been shown in recent research to have positive effects on the endometrium. PRP increases the pregnancy rate in IVF patients with thin endometrium and recurrent implantation failure. In order to demonstrate the efficacy of PRP therapies, this work compares the administration of injectable and infusible PRP during endometrial preparation. (2) Methods: This prospective single-arm control study was conducted at an IVF center in Oradea, Romania. This study included 50 patients; 27 were included in the group with Injectable PRP and 23 in the group with Infusible PRP. The outcome was compared between the two groups, with the primary outcome being the endometrial thickness after the PRP infusion or injection and the secondary outcome being the pregnancy rate in both groups. (3) Results: Patients who were treated with Injectable PRP had a higher pregnancy rate. An improvement in the quality of the endometrium, in terms of thickness, was also observed in the patients who were injected with PRP. (4) Conclusions: Compared to PRP infusions inside the uterus, sub-endometrial PRP injections in frozen embryo transfer methods have a greater pregnancy rate. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Assisted Reproduction)
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12 pages, 1779 KiB  
Article
Sperm DNA Fragmentation after Cryopreservation and Sperm Selection Has No Implications for Clinical Pregnancies and Live Births after Intrauterine Insemination with Donor Sperm
by Alessa Sugihara, Usha Punjabi, Tiziana Chimienti, Ilse Goovaerts, Kris Peeters, Jason Bouziotis and Diane De Neubourg
J. Pers. Med. 2023, 13(12), 1668; https://doi.org/10.3390/jpm13121668 - 28 Nov 2023
Viewed by 941
Abstract
Intrauterine insemination with donor sperm (IUI-D) requires multiple in vitro manipulations such as sperm selection and cryopreservation during which spermatozoa may be exposed to oxidative stress (OS) and other insults that may produce potential damage including sperm DNA fragmentation (SDF). High levels of [...] Read more.
Intrauterine insemination with donor sperm (IUI-D) requires multiple in vitro manipulations such as sperm selection and cryopreservation during which spermatozoa may be exposed to oxidative stress (OS) and other insults that may produce potential damage including sperm DNA fragmentation (SDF). High levels of SDF, referring to damage or breaks in the genetic material of sperm cells, are linked to an increased risk of reproductive failure. This retrospective, observational study set out to evaluate whether SDF assessment could predict clinical outcome in an IUI-D program, where sperm donors are selected on strict conventional semen parameters. A total of 18 donors and 106 recipients were matched for IUI-D. Out of 429 cycles, 100 (23.3%) resulted in clinical pregnancy. We counted 78 live births (18.2% of cycles), while 20 pregnancies ended in miscarriage (4.7% of cycles), 1 in extra-uterine pregnancy and 1 in stillbirth. Female age significantly influenced clinical pregnancy and miscarriage rates. SDF increased after cryopreservation (26.3 ± 14.5%; p < 0.001) and more so after post-thaw density gradient (34.9 ± 22.1%; p = 0.04) without affecting clinical pregnancy (OR [95% CI] 1.01 [0.99; 1.02]; p = 0.27), live birth (1.00 [0.99; 1.02]; p = 0.72) and miscarriage rates (1.02 [1.00; 1.05]; p = 0.08). The implications of our findings extend to a better selection of sperm donors and a better sperm preparation technique tailored to the donor semen’s properties in order to maximize the chances of a favorable treatment outcome. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Assisted Reproduction)
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13 pages, 1231 KiB  
Article
Semen Cryopreservation to Expand Male Fertility in Cancer Patients: Intracase Evaluation of Semen Quality
by Giuseppina Peluso, Veronica Tisato, Ajay Vikram Singh, Donato Gemmati and Fabio Scarpellini
J. Pers. Med. 2023, 13(12), 1654; https://doi.org/10.3390/jpm13121654 - 27 Nov 2023
Cited by 2 | Viewed by 955
Abstract
To preserve male fertility after diagnosis of any kind of cancer, a prompt assessment of the semen quality and an appropriate semen cryopreservation must be performed before radio-chemotherapy starts. The present work aims to evaluate the semen parameters at diagnosis of different cancer [...] Read more.
To preserve male fertility after diagnosis of any kind of cancer, a prompt assessment of the semen quality and an appropriate semen cryopreservation must be performed before radio-chemotherapy starts. The present work aims to evaluate the semen parameters at diagnosis of different cancer patients before cryopreservation and after thawing. Testicular tumors and lymphomas are among the most common cancers in younger patients, and while chemotherapy significantly increases patients’ survival, it can epigenetically alter the semen fluid, resulting in temporary or permanent infertility. We analyzed data from the database of the Gamete Cryopreservation Center (Annunziata Hospital, CS; Italy) in the period of 2011–2020 from a cohort of 254 cancer patients aged 18–56 years. The evaluation was performed in a blind manner and anonymously recovered; the main parameters referring to semen quality were assessed in accordance with the WHO guidelines and decision limits (6th edition; 2021). The cancer types were as follows: testis cancers (TC; n = 135; 53.1%), hematological cancers (HC; n = 76; 29.9%), and other types of cancer (OC; n = 43; 17%). Comparing TC vs. HC (P1) and vs. OC (P2), TC had the worst semen quality: sperm number/mL (P1 = 0.0014; P2 = 0.004), total motility (P1 = 0.02; P2 = 0.07), progressive motility (P1 = 0.04; P2 = 0.05), viability (P1 = 0.01; P2 = 0.02), and percentage of atypical morphology (P1 = 0.05; P2 = 0.03). After semen thawing, viability and progressive motility recovery lowered, accounting for 46.82% and 16.75%, respectively, in the whole cohort; similarly, in the subgroups ascribed to TC, they showed the lowest recovery. Strong correlation existed between pre- and post-cryopreservation viability and progressive motility in the whole cohort (p < 0.001) and in the TC subgroup (p < 0.05). All cancer subgroups, to significantly different extents, had semen findings below the WHO reference values, suggesting diverse sperm susceptibilities to different cancers and cryodamage. Cancer and associated treatments epigenetically affect patients’ semen quality, meaning cryopreservation should be considered a useful personalized prerogative for any kind of cancer in a timely manner. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Assisted Reproduction)
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12 pages, 516 KiB  
Article
Factors Affecting the Potential Efficacy of Intrauterine Platelet-Rich Plasma Infusion on Thin Endometrium in Women with Recurrent Implantation Failure
by Pin-Yao Lin, Chun-I Lee, Yi-Chun Chen, En-Hui Cheng, Chun-Chia Huang, Chung-I Chen, Tsung-Hsien Lee, Yu-Jen Lee and Maw-Sheng Lee
J. Pers. Med. 2023, 13(9), 1419; https://doi.org/10.3390/jpm13091419 - 21 Sep 2023
Cited by 2 | Viewed by 1097
Abstract
Optimizing endometrial thickness (EMT) is crucial for successful embryo implantation, but enhancing thin endometrium remains a significant challenge. Platelet-rich plasma (PRP)-derived therapies have emerged as a promising approach in reproductive medicine due to their capacity to facilitate tissue repair and regeneration. This study [...] Read more.
Optimizing endometrial thickness (EMT) is crucial for successful embryo implantation, but enhancing thin endometrium remains a significant challenge. Platelet-rich plasma (PRP)-derived therapies have emerged as a promising approach in reproductive medicine due to their capacity to facilitate tissue repair and regeneration. This study aims to identify the risk factors associated with the failure of intrauterine PRP infusion for thin endometrium in women with recurrent implantation failure (RIF). We retrospectively reviewed data from 77 women with RIF, all exhibiting an EMT of <7 mm. These women underwent programmed hormone therapy for frozen embryo transfer (FET) and received two autologous intrauterine PRP infusions. Following intrauterine PRP-lysate (PL) infusions, the mean increase in EMT was 1.9 ± 1.2 mm, with EMT reaching 7 mm in 86% of the cases (66/77; average EMT, 8.3 mm). We identified an exceedingly thin EMT as a risk factor impacting the therapeutic efficacy in increasing EMT (p = 0.04, OR: 3.16; 95% CI: 1.03–9.67). Additionally, the number of previous uterine surgeries emerged as a prognostic factor for pregnancy failure following PL infusion (p = 0.02, OR: 2.02; 95% CI: 1.12–3.64). Our findings suggest that an extremely thin EMT and a history of numerous uterine surgeries can impede successful pregnancy, even when an optimal EMT is achieved following PRP infusion. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Assisted Reproduction)
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Review

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14 pages, 989 KiB  
Review
Fertility Preservation in the Era of Immuno-Oncology: Lights and Shadows
by Erica Silvestris, Stella D’Oronzo, Easter Anna Petracca, Claudia D’Addario, Gennaro Cormio, Vera Loizzi, Stefano Canosa and Giacomo Corrado
J. Pers. Med. 2024, 14(4), 431; https://doi.org/10.3390/jpm14040431 - 19 Apr 2024
Viewed by 488
Abstract
In recent years, immuno-oncology has revolutionized the cancer treatment field by harnessing the immune system’s power to counteract cancer cells. While this innovative approach holds great promise for improving cancer outcomes, it also raises important considerations related to fertility and reproductive toxicity. In [...] Read more.
In recent years, immuno-oncology has revolutionized the cancer treatment field by harnessing the immune system’s power to counteract cancer cells. While this innovative approach holds great promise for improving cancer outcomes, it also raises important considerations related to fertility and reproductive toxicity. In fact, most young females receiving gonadotoxic anti-cancer treatments undergo iatrogenic ovarian exhaustion, resulting in a permanent illness that precludes the vocation of motherhood as a natural female sexual identity. Although commonly used, oocyte cryopreservation for future in vitro fertilization and even ovarian cortex transplantation are considered unsafe procedures in cancer patients due to their oncogenic risks; whereas, ovarian stem cells might support neo-oogenesis, providing a novel stemness model of regenerative medicine for future fertility preservation programs in oncology. Recent scientific evidence has postulated that immune checkpoint inhibitors (ICIs) might in some way reduce fertility by inducing either primary or secondary hypogonadism, whose incidence and mechanisms are not yet known. Therefore, considering the lack of data, it is currently not possible to define the most suitable FP procedure for young patients who are candidates for ICIs. In this report, we will investigate the few available data concerning the molecular regulation of ICI therapy and their resulting gonadal toxicity, to hypothesize the most suitable fertility preservation strategy for patients receiving these drugs. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Assisted Reproduction)
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