Fertility and Sterility

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Miscarriage is a relatively common occurrence with many knowns and unknowns and a profound psychological impact on individuals and couples. The editors felt it was time to publish a series of overviews for Views and Reviews on both sporadic miscarriage and recurrent miscarriage. The series starts with prevalence of miscarriage and recurrent miscarriage and subsequently describes the psychological impact, what we know of the genetics, whether uterine natural killer cells may play a role, the association with infections, and potential interventions...

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The endometrial receptivity assay performed poorly in predicting failure of sustained implantation of euploid blastocysts, calling into question its utility in clinical management of frozen embryo transfer timing.

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CONTEXT AND BACKGROUND: The prevalence of uterine fibroids is estimated to be approximately 80%. Fibroids can be associated with abnormal uterine bleeding, pressure symptoms, and infertility. Given this high prevalence, approximately 30,000 myomectomies are performed in the United States per year. Minimally invasive approaches are preferred if feasible. The minimally invasive techniques include, laparoscopic, robot assisted, hysteroscopic, and mini laparotomy. 1-4 OBJECTIVE: To discuss the multiple techniques for optimizing the use of mini-laparotomy in minimally invasive myomectomy...

This revised document incorporates a growing number of published studies about mosaic embryo transfer (MET) and provides current evidence-based considerations for the clinical management of embryos with mosaic results on preimplantation genetic testing for aneuploidy (PGT-A). This document replaces the document titled "Clinical management of mosaic results from preimplantation genetic testing for aneuploidy (PGT-A) of blastocysts: a committee opinion," published in 2020 (Fertil Steril 2020;114:246-54.).

OBJECTIVE: (s): The objectives of our study were to investigate the live birth rate (LBR) per oocyte retrieved during IVF, in patients who had used all their embryos and to extrapolate the LBR in patients with remaining frozen embryos by calculating the expected LBR from these embryos. DESIGN: A retrospective cohort study SETTING: A single academically affiliated fertility clinic PATIENT(S): Autologous IVF cycles from January 2014-December 2020. Data on number of oocytes retrieved, number of embryos obtained and transferred (at cleavage or blastocyst-stage), use of PGT-A, and number of live births (LB) were obtained...

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The field of reproductive endocrinology and infertility (REI) is at a crossroads; there is a mismatch between demand for reproductive endocrinology, infertility and assisted reproductive technology (ART) services, and availability of care. This document's focus is to provide data justifying the critical need for increased provision of fertility services in the United States now and into the future, offer approaches to rectify the developing physician shortage problem, and suggest a framework for the discussion on how to meet that increase in demand...

OBJECTIVE: To describe the feasibility of Hypothermic Machine Perfusion (HPM) in Uterus Transplantation (UT) to potentially improve the preservation of the uterus to enhance graft preservation in the DBD context. UT is a new surgical approach to treat absolute uterus infertility, it can be performed after living donation (LD) or after Donation after Brainstem Death (DBD). In DBD context, uterus is typically the last organ removed after other vital organs with the exception of the Baylor team, which removes the uterus first...

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Physicians involved in third-party assisted reproductive technology arrangements who discover material misconduct or other undisclosed information by a party to the arrangement (such as a gamete or embryo donor, gestational carrier, or intended parent) or by a nonmedical professional participant or entity (such as a recruiting program, gamete or embryo bank, or lawyer) should encourage that party or professional participant to disclose such misconduct or information. In some instances, it is ethically permissible for the physician to either disclose material information to the affected party or to decline to provide or continue to provide care...

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OBJECTIVE: To study the comparison between hysteroscopic morcellation of retained products of conception with ultrasound guided electric vacuum aspiration in terms of intrauterine adhesion formation, as well as efficacy and complications. DESIGN: Randomized controlled, non-blinded trial conducted in three teaching hospitals and one university hospital from April 2015 to June 2022. SUBJECTS: One-hundred seventy-three women with retained products of conception on ultrasound, ranging from 1 to 4 cm, were randomized to receive either hysteroscopic morcellation or electric vacuum aspiration...

Sexually transmitted infections are of major concern to reproductive specialists. Heading the list are human immunodeficiency virus types 1 and 2 and hepatitis B and C viruses. These pathogens, which may cause incurable chronic infections, can be transmitted through assisted reproductive technologies and from infected mothers to the fetus or newborn. This document replaces the document of the same name, last published in 2020.

This manuscript reports on the prevalence of early pregnancy loss. The impact of improved pregnancy diagnosis, as well as influence of increased age and BMI at first birth are discussed.

Miscarriage and recurrent miscarriage affect a significant proportion of every population with research consistently showing it results in profound and often prolonged psychological impacts. Despite the serious psychological impacts, support for miscarriage remains grossly inadequate. There are many ways to ameliorate the impact of these losses, which are not difficult, expensive or time-consuming. At a basic level, people want and need acknowledgement and validation of their grief and their loss and greater information provision at the time of loss...

Approximately 80% of miscarriages happen within the first 12 weeks of gestation. More than half of early losses result from genetic defects, usually presenting as abnormal chromosome numbers or gene rearrangements in the embryo. However, the impact of genetics upon pregnancy loss goes well beyond embryonic aneuploidy. For example, the use of big data has recently led to the discovery of specific gene mutations which may be implicated in sporadic and recurrent miscarriage. Further, emerging data suggest that genetic factors play a role in conditions for which there is a causative association with recurrent pregnancy loss...