The day of embryo transfer affects delivery rate, birth weights, female-to-male ratio, and monozygotic twin rate

Objective To compare the reproductive outcomes between the transfer of cleavage-stage embryos and blastocysts in two different age groups of patients. The reproductive capacity of women decreases by age. This decrease in capacity is directly related to a lower ovarian reserve and errors in the meiotic spindle of the oocyte, which increase chromosomal abnormalities and the formation of aneuploidy embryos with lower chances of implantation. Materials and Methods A total of 1400 intracytoplasmic sperm injection cycles were analyzed. The study patients were divided into two age groups [aged < 36 years (Group I) and aged ≧ 36 years (Group II)]. The groups were subdivided according to the day of embryo transfer (ET)—Day 3 (ET3) and Day 5 (ET5). Results In both age groups, transfer of blastocysts resulted in a higher clinical pregnancy rate and deliveries. An increased twin birth rate was observed in patients who were younger than 36 years on both transfer days compared with those who were older than 36 years of age. There was an elevated percentage of newborn males on ET5 in both age groups. Monozygotic twinning (MZT) rate was observed only among younger patients (<36 years of age), specifically on ET5 compared with ET3. There was no significant difference in the mean birth weight of singleton and twins between the ET3 and ET5 subgroups in the younger group of patients except for the triplets who were significantly heavier in the ET5 group compared with the older group (≧36 years of age) where significant difference was found only on the mean birth weight of singleton. Conclusion The study suggests that if a blastocyst can be obtained in patients of advanced age (≧36 years), it improves their baby take-home rates. Younger patients (aged < 36 years) should undergo elective single blastocyst transfers to reduce multiple pregnancy rates

Novel method of treating ovarian infertility: is Platelet-Rich Plasma a new promising therapy in the future?

Introduction. In today's modern society, the treatment of patients with poor ovarian reserve presents a medical challenge of increased clinical importance. The use of platelet-rich plasma (PRP) is a new hope that improves pregnancy chances. Increased use of the PRP in a number of in vitro centers around the world as well as publication of the first experience in in vitro fertilization entailed the need for this systematic review. Methods. PubMed, Cochrane and Ovid Medline were searched between 2000 and 2019 under the following strategy: [ and and ]. Fourteen original articles published in medical scientific journals were analyzed in this study. The evidence level and quality assessment were made based on the most up-to-date, reliable, scientific evidence as well as from the number of additional relevant citations. Results. Taking the current available proof and evidence into consideration, we can conclude that the PRP method improves the ovarian function and increases the chances of clinical pregnancy. In addition, we assume that, over time, the PRP method objectively improves the ovarian reserves. Recent studies support the theory of increasing the number of preantral follicles, followed by appropriate growth and reduction of follicular atresia. Conclusion. The improvement of the quantity and quality of oocytes with the intra-ovarian application of PRP potentially suggests a new concept of ovarian aging, where the ovarian microenvironment plays a crucial role