The inclusion of blastomeres into the inner cell mass in early-stage human embryos depends on the sequence of cell cleavages during the fourth division

The fate of the ICM in humans is still unknown, due to the ethical difficulties surrounding experimentation in this field. In this study we have explored the existing time-lapse recording data of embryos in the early stages of development, taking advantage of the large refractile bodies (RBs) within blastomeres as cellular markers. Our study found that the cellular composition of the ICM in humans is largely determined at the time of the fourth division and blastomeres which cleave first to fourth, during the fourth division from 8 cells to 16 cells, have the potential to be incorporated in the ICM

Candesartan Mediated Amelioration of Cisplatin-Induced Testicular Damage Is Associated with Alterations in Expression Patterns of Nephrin and Podocin

Nephrin and podocin are known to be closely related to the pharmacological effects of angiotensin-II receptor blocker (ARB). The objectives of this study were to investigate the role of nephrin and podocin using cisplatin-induced testicular damage and to evaluate the effect of ARB. At first, we evaluated the effects of cisplatin either alone or in combination with ARB candesartan on changes in expression patterns of nephrin and podocin in the rat testes. We then conducted in vitro studies to investigate the effects of angiotensin using cultured Sertoli cells, line TM4. As a result, the expression of nephrin and podocin was shown to localize around the basal membrane of seminiferous tubules. Treatment with cisplatin resulted in a marked decrease in the expression of nephrin and podocin and induced a shift of both proteins from linear to granular expression patterns, accompanying the increased apoptotic index in the testes; these changes were partially restored by the additional administration of candesartan. In vitro studies with TM4 revealed the angiotensin-II mediated expression changes of nephrin and podocin. These findings suggest that candesartan can prevent cisplatin-induced testicular damage by regulating expression patterns of the nephrin-podocin complex in the testes

Effectiveness of high‐dose transvaginal progesterone supplementation for women who are undergoing a frozen‐thawed embryo transfer

Abstract Purpose To evaluate the effectiveness of high‐dose progesterone supplementation for women who are undergoing a frozen‐thawed embryo transfer (FET). Methods Among the 2010 FET cycles that were included in the present study, 1188 were 1200 mg/d of vaginal progesterone, while 822 were 900 mg/d. The dose of progesterone that was used was decided by the treatment period and additional progesterone supplementation was used when the serum progesterone levels were <9 ng/mL on luteal day 5. Results The clinical pregnancy rate was higher in the 1200 mg group than in the 900 mg group. The mean serum progesterone level on luteal day 5 in the 1200 mg and 900 mg groups was 12.6 ng/mL and 13.4 ng/mL, respectively. The rate of additional progesterone supplementation was higher in the 1200 mg group. A logistic regression analysis identified a younger age (≤37 years) and the use of 1200 mg progesterone as independent predictive factors for the clinical pregnancy outcome. The analysis of the infant outcomes revealed no significant difference in the distribution of birth ages and weights. Conclusion High‐dose transvaginal progesterone of 1200 mg/d as luteal support contributed to good pregnancy outcomes

Clinical outcome of intrauterine infusion of platelet‐rich plasma in patients with recurrent implantation failure

Abstract Purpose This study aimed to evaluate the effectiveness of intrauterine infusion of platelet‐rich plasma (PRP) before embryo transfer (ET) in recurrent implantation failure (RIF) cases. Methods The authors retrospectively analyzed 54 ET cycles involving frozen and thawed high‐quality blastocysts after intrauterine PRP infusion between September 2019 and November 2020. All patients had a history of at least two times of implantation failure on ET. A total of 54 patients were categorized into two groups: thin endometrium (39 patients) and unexplained implantation failure (15 patients). In the thin‐endometrium group, the endometrial thickness (EMT) was <8.0 mm at cycle days 12–14 in the prior ET cycle. Results Among the 54 ET cycles after PRP infusion, 31 (57.4%) were positive for human chorionic gonadotropin (hCG) and 27 (50%) achieved clinical pregnancy, which was significantly better than that in prior ET cycles without PRP infusion (27.2% and 9.6%, respectively). The EMT was not increased at ET date on the PRP cycle compared with that in the prior ET cycle in both patient groups. Moreover, EMT was not different between the hCG‐positive and hCG‐negative groups. Conclusion Although intrauterine PRP infusion had no superior effect on increasing the EMT than conventional therapeutic agents, it resulted in high pregnancy rates in patients experiencing RIF with or without thin endometrium

Erectile function and its impact on quality of life in Japanese men on hemodialysis

The objective of this study was to characterize the erectile function and its impact on health-related quality of life (HRQOL) in Japanese men on hemodialysis. This study included 65 consecutive Japanese men <80 years on hemodialysis. Erectile function and HRQOL were evaluated using the Sexual Health Inventory for Men (SHIM) and the Short-Form 8 (SF-8) survey, respectively. These 65 men were classified into 54 with SHIM ≤11; relatively severe erectile dysfunction (ED) (group A) and 11 with SHIM ≥12; relatively mild ED (group B). There were significant differences in age, marital status, ankle-brachial index (ABI), and serum levels of free testosterone and prolactin between groups A and B. Of several factors examined, age, marital status and ABI were significantly associated with the severity of ED on univariate analysis, and of these 3 factors, only age was significantly associated with severity of ED on multivariate analysis. SF-8 survey revealed that all scale scores in group A were inferior to those in group B. Comparatively severe ED appeared to be frequently observed in Japanese men on hemodialysis, and this trend was marked in elderly men. Furthermore, the severity of ED had a negative impact on the wide range of HRQOL in these men

#262 : Clinical Outcomes of Embryo Transfer After micro-RNA Based Endometrial Receptivity Analysis (MIRA)

Background and Aims: To date, more than 2,500 micro-RNAs (miRNAs) have been discovered and some of which are considered to play important roles in window of implantation (WOI). In this study, we aimed to evaluate the efficacy of a miRNA-based endometrial receptivity analysis (MIRA) in IVF patients. Method: Patients who were planning for frozen-thawed embryo transfer (ET) cycles with a good quality single-blastocyst after at least 1 previous implantation failure history were recruited for the study. Endometrial tissue samples were collected at the mock ET cycle of hormone replacement therapy on day 5 (120 hours) of progesterone administration. Embryo transfer was conducted at the consecutive or the next cycle by reference to the MIRA result. Results: 38 patient samples were collected along with their clinical information such as age, BMI, and implantation failure history. Out of the 38 samples analyzed, MIRA found 84.2% (32/38) to be receptive, 13.2% (5/38) to be pre-receptive, and 2.6% (1/38) to be post-receptive. A total of 33 patients underwent personalized-ET at the time of statistical analysis. The overall clinical pregnancy rate was 81.8% (27/33), and for each endometrial stages were 81.5% (22/27) for receptive, 80.0% (4/5) for pre-receptive, and 100% (1/1) for post-receptive. Higher rates of non-receptivity were seen in patients with higher BMI and patients who were 36 years old or older. Conclusion: Patients who utilized MIRA, have shown good pregnancy rates of 81.8%. Patients with an abnormal BMI have a higher likelihood of experiencing a displaced window of implantation. BMI could also be an additional factor to consider when recommending patients to undergo endometrial receptivity testing in the future, aside from implantation failure history