Journal of Reproduction & Infertility

Measuring IVF Success: Why the Field Still Lacks Unified Metrics?

Mohammad Reza Sadeghi — Sat, 21 Feb 2026 04:12:11 +0000

The Article Abstract is not available.

A Comparative Analysis of Culture Systems with Human Amniotic Mesenchymal Stem Cells

Sat, 21 Feb 2026 04:16:35 +0000

Background: A "indirect co-culture using mesh" system is commonly employed to maintain spermatogenesis in cancer patients undergoing chemotherapy and radiation. This study aimed to investigate the co-culturing of mouse spermatogonial stem cells (SSCs) with human amniotic mesenchymal stem/stromal cells (hAMSCs) in an op timized environment.

Methods: SSCs from 3-6-day-old mice (n=10) were indirectly co-cultured with hAMSCs via mesh for two weeks. Three groups evaluated: control, SSCs with con ditioned media, and SSCs indirectly co-cultured with hAMSCs. Gene expression an alyzed for Plzf, c-kit, Sycp3, and Prm1. Immunohistochemistry assessed Plzf, and flow cytometry evaluated c-kit and Plzf.

Results: Showed a twofold increase in Plzf-positive cells after 14 days of culture (76.47%, p≤0.05), with a significant elevation in Plzf gene expression observed in the conditioned media group (188.1±65%, p≤0.05). Conversely, the expression of the c-kit gene decreased significantly in both the conditioned media and "indirect co culture using mesh" groups. Notably, Sycp3 and Prm1 expression levels significantly increased in the conditioned media group compared to the control. These findings suggest the potential of conditioned media as a novel feeder for promoting in vitro mouse spermatogenesis.

Conclusion: Our results demonstrate that the inclusion of growth factors, such as GDNF and BMP-4, along with conditioned media and an "indirect co-culture using mesh" system utilizing meshes with SSCs, significantly enhances SSC proliferation and differentiation. The optimized conditions media provided by hAMSCs offer a superior feeder compared to traditional "indirect co-culture using mesh" systems for promoting both the proliferation and differentiation of SSCs.

Association of Circular RNAs with Sperm Fertility Potential: Implications for Male Infertility Diagnosis

Sat, 21 Feb 2026 04:19:26 +0000

Background: Circular RNAs (circRNAs) are biomarkers that may play a role in the pathological processes underlying abnormal spermatogenesis. Four circRNAs present in human semen, namely STK31-hsa-circ-0133980, LRWD1-hsa-circ-0003327, circRNF17-chr13:25341410-25356082, and circBRDT-chr1:92428275-92433817, were investigated in this study and their relationship with sperm parameters was evaluated.

Methods: In this analytical observational study, 45 semen samples were analyzed according to World Health Organization criteria, and were classified into the following groups: normozoospermia (control, n=9), asthenozoospermia (n=10), oligozoospermia (n=9), teratozoospermia (n=9), and oligoasthenoteratozoospermia (n=8). The expression levels of four circRNAs, along with genes related to apoptosis (BCL2, BAX, and Caspase3) and protamination (PRM1 and PRM2), were assessed using real-time polymerase chain reaction (RT-PCR). Sperm quality was additionally assessed on another portion of each semen sample using triple staining, aniline blue, toluidine blue, and eosin–nigrosin. Data were analyzed using Prism software, and the significance of the observed differences was evaluated by one-way ANOVA.

Results: The results showed that changes in circRNA expression levels were significantly related to sperm morphology (all circRNAs, p<0.05), motility (circ-RNF17 and-STK31) (p<0.01), and concentration (circBRDT, p<0.05) compared to the normozoospermia group. Apoptosis and abnormal protamination were increased in all infertile groups, except the asthenozoospermia, as evidenced by upregulation of BAX and Caspase 3 and downregulation of BCL2 and PRM1&2 genes, compared to the normozoospermic group (p<0.001).

Conclusion: The circRNA levels were different in the semen samples with different sperm quality. Our results provide new insights into evaluating sperm functions, supporting the potential role of circRNAs as biomarkers of male fertility.

Dysregulated Kinase Expression in Teratozoospermia and Implications for Male Infertility: An Integrated Gene Expression Study

Sat, 21 Feb 2026 04:21:50 +0000

Background: Teratozoospermia, characterized by abnormal sperm morphology, is a major contributor to male infertility. Kinases, enzymes that catalyze the transfer of phosphate groups to proteins, are crucial regulators of cellular signaling pathways and play significant roles in sperm development and maturation. The purpose of the current study was to identify differentially expressed genes (DEGs) between teratozoospermia and normozoospermia samples and to investigate the role of kinases in these expression changes.

Methods: An integrated analysis of transcriptome data was conducted from teratozoospermia and normozoospermia samples using publicly available gene expression omnibus (GEO) datasets. Three gene expression series (GSE) profiles of teratozoospermia from one superseries were selected and combined. Differential expression analysis was performed using the limma package in R, applying linear modeling and empirical Bayes statistics to identify DEGs with a threshold of adjusted p<0.05. A comprehensive list of human kinase genes was obtained from the KinHub database, and differentially expressed kinases between the two conditions were identified. Functional enrichment analyses including gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) pathways were conducted. Additionally, receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic potential of identified kinases.

Results: Our analysis identified 1,292 DEGs. Among these, 34 kinases were identified (10 upregulated and 24 downregulated). ROR1 and STK39 showed the most significant changes. ROC analysis demonstrated strong diagnostic values for these kinases.

Conclusion: This study is the first comprehensive analysis integrating transcrip-tomic data and kinase-focused gene expression profiling specifically in teratozo-ospermia, suggesting that kinase dysregulation may contribute to teratozoospermia and male infertility.

The Potential Role of Chromosomal Polymorphic Variations Attributed to Male Infertility: A Retrospective Cohort Study

Sat, 21 Feb 2026 04:24:33 +0000

Background: Infertility is a complex condition that can originate from either male or female factors, or both. Genetic factors, such as damage to the Y chromosome, gene defects, and chromosomal anomalies significantly contribute to infertility. Consequently, cytogenetic analysis is a critical component of the systematic clinical evaluation for diagnosing, managing, and monitoring infertility. The purpose of the present study was to assess the prevalence, types, and significance of chromosomal polymorphisms in the East Indian population with a clinical history of male infertility.

Methods: An investigation was conducted on 650 infertile men and 150 fertile men from general population, following the Helsinki Declaration guidelines. A cytogenetic investigation was conducted using G-banding, Ag-NOR banding, and centromeric heterochromatin staining. A Chi-square test was performed to compare the prevalence of chromosomal polymorphic variants.

Results: The results of this study revealed significant chromosomal anomalies among the study population. Specifically, 2.61% of these individuals exhibited numerical chromosomal anomalies, while 1.53% showed structural chromosomal anomalies. Notably, there was a statistically significant (p<0.05) increase in the occurrence of total chromosomal polymorphic variations, with 24% of the infertile males found to have total chromosomal polymorphisms. Furthermore, the prevalence of the Yqh+ variant was statistically significant among infertile males (p=0.010), while the 9qh+ variant also showed a significant prevalence (p=0.0.35).

Conclusion: The increased prevalence of chromosomal polymorphic variants underscores the need to evaluate their potential role in the etiology of male infertility.

The Association Between Mature Oocyte Proportion and IVF Success: A Retrospective Analysis of 2,565 ICSI Cycles

Oya Korkmaz , Seda Karabulut , Elif Yılmaz , Nuri Delikara — Sat, 21 Feb 2026 04:27:35 +0000

Background: IVF/ICSI success depends on the proportion of fertilizable metaphase II (MII) oocytes, yet direct evidence linking mature-oocyte rate to clinical outcomes remains limited. This study aimed to assess the impact of mature oocyte rate on clinical pregnancy outcomes in a large retrospective cohort of women undergoing ICSI.

Methods: A total of 2,565 women who underwent ICSI cycles at a single IVF center in Türkiye were retrospectively analyzed. Patients were stratified into three groups according to mature oocyte proportion: Group 1 (0-50%), Group 2 (51-75%), and Group 3 (76-100%). Data were analyzed per initiated ICSI cycle. Embryo transfer was performed on day 3 or day 5 post-fertilization, depending on embryo quality and patient characteristics. Logistic regression analysis was performed to assess the independent effect of mature oocyte rate on pregnancy outcomes. Statistical signi-ficance was set at p<0.05.

Results: Clinical pregnancy rates were significantly lower in Group 1 (10.23%) compared to Group 2 (28.96%) and Group 3 (29.99%) (p<0.001). Live birth and im-plantation rates increased in the higher maturity groups (7.5% vs. 21.5% vs. 22.9% and 12.1% vs. 24.3% vs. 26.0%, respectively), whereas miscarriage rates decreased (18.9% vs. 13.4% vs. 12.8%). Logistic regression analysis confirmed that a higher mature oocyte proportion was an independent predictor of clinical preg-nancy (Group 2: OR=3.4, 95%CI: 2.5-4.6; Group 3: OR=3.5, 95%CI: 2.6-4.7; p<0.001).

Conclusion: This large-scale retrospective cohort analysis demonstrates that mature oocyte proportion is an important prognostic factor of IVF success. Mature oocyte proportion should be considered an essential parameter in clinical practice and patient counseling.

The Effect of Fetal Intrauterine Blood Transfusion on Ductal Arterial Blood Flow Velocity and Cardiac Output Changes in Fetuses with Rhesus Alloimmunization-Related Anemia

Sat, 21 Feb 2026 04:43:22 +0000

Background: Echocardiographic indicators may be useful as an alternative method to determine the appropriate time for intervention, especially when Doppler assessment of the middle cerebral artery peak systolic velocity (MCA-PSV) is inconclusive. In this study, arterial duct blood flow and cardiac output of fetuses with Rh alloimmunization-related anemia were compared before and after intrauterine transfusion (IUT).

Methods: Fifty intrauterine blood transfusions were performed on anemic fetuses in this study. All cases were attributed to Rh alloimmunization, detected with MCA-PSV Doppler ultrasound imaging assessments. They all underwent intrauterine blood transfusion and echocardiographic assessments a day before and 24 hr after the procedure. The measured cardiac indices included the velocity time integral (VTI) of the aortic and pulmonary valves, the ductus arteriosus acceleration-to-ejection time (AT/ET) ratio, and the MCA-PSV. Analyses were performed in SPSS v24 (p<0.05) using paired t-tests for mean differences and Pearson’s correlation for associations between continuous variables.

Results: Aortic and pulmonary valve VTI, MCA-PSV, and ductus arteriosus AT/ET ratio significantly decreased after intrauterine blood transfusion (p<0.001). The aortic valve VTI and ductus arteriosus accurately detected anemia, with areas under the receiver operating characteristic (ROC) curve of 99.9% and 98.9%, respectively.

Conclusion: All the measured parameters showed significant changes after intrauterine blood transfusion. Aortic valve VTI and ductus arteriosus AT/ET ratio seem to have the highest accuracy in detecting anemia. Echocardiographic assessment can be beneficial in defining the appropriate time for intrauterine blood transfusion in cases where MCA-PSV is inefficient.

Isolated Fallopian Tube Torsion in Chronic Pelvic Pain: A Rare Case

Seyedeh Azam Pourhoseini , Nona Sabeti, Ezat Hajmollarezaei — Sat, 21 Feb 2026 04:45:50 +0000

Background: Abdominal pain is a frequent complaint among women presenting to gynecological and surgical emergency departments. The management approach depends on the severity, nature, and possible underlying causes of the pain, ranging from observation to urgent surgical intervention. One important cause of abdominal pain in women is adnexal torsion, which may occasionally involve only the fallopian tube. This condition can present with non-specific symptoms, making diagnosis challenging. Although ultrasound can reveal features suggestive of ovarian torsion, the findings are not always definitive, and other surgical emergencies such as ectopic pregnancy or appendicitis should also be considered. Early recognition and timely surgical management are essential to preserve fertility and minimize ischemic damage.

Case Presentation: The case is a 28-year-old woman, who presented with chronic pelvic pain and was diagnosed with hydrosalpinx, subsequently confirmed via laparoscopic intervention. Imaging revealed a cystic lesion near the left adnexa, initially interpreted as hydrosalpinx. During laparoscopy, the left fallopian tube was found to be twisted twice, and a salpingectomy was performed.

Conclusion: Isolated fallopian tube torsion (IFTT) is an uncommon clinical condition characterized by torsion of the fallopian tube without ovarian involvement. It may result from predisposing factors such as hydrosalpinx, pelvic inflammatory disease, or congenital anomalies. Symptoms are usually not specific, and imaging results can be uncertain. Laparoscopy remains the gold standard for both diagnosis and treatment, although laparotomy may be required in certain cases. This case highlights the importance of considering IFTT in women with unexplained chronic pelvic pain. Prompt diagnosis and surgical intervention are crucial to prevent complications and preserve reproductive potential.

The Role of Laparoscopy in the Diagnosis and Management of Fallopian Tube Teratomas: A Case Report

Sat, 21 Feb 2026 04:49:38 +0000

Background: The introduction of assisted reproductive technologies (ARTs) has diminished the role of surgery in female factor tubal infertility. The assessment of tubal patency is part of the routine tests taken for the evaluation of infertile couples. Laparoscopy with chromopertubation is still the gold standard test for the evaluation of tubal patency.

Case Presentation: In this article, a rare case of a mature cystic tubal teratoma was diagnosed laparoscopically as part of an infertility workup. An attempt was made to emphasize the importance of laparoscopy in the diagnosis and management of rare fallopian tube entities that may have an impact on female reproductive health. A literature search to find any prior similar cases was conducted using PubMed database. The search terms employed were tubal factor infertility, tubal teratoma, diagnosis, laparoscopy, in vitro fertilization (IVF), and hysterosalpingography (HSG). A total of 4 cases of mature cystic teratomas of the fallopian tube diagnosed laparoscopically as part of infertility workup were reviewed showing that laparoscopic surgery still has a major role in diagnosis and treatment of female infertility.

Conclusion: Tubal teratoma is a rare finding in patients undergoing infertility workup. It is important to highlight the benefits of laparoscopy in confirming the tubal patency test results in patients showing no intraperitoneal spillage of contrast media on hysterosalpingography test. Laparoscopy helps visualize the tubes better aiming to diagnose entities that are difficult to diagnose with hysterosalpingography or ultrasound, while simultaneously providing an opportunity for treatment.

Neuroendocrine Tumors Identified During Laparoscopic Endometriosis Surgery: A Report of 6 Cases

Sat, 21 Feb 2026 04:52:46 +0000

Background: Neuroendocrine tumors (NETs) or carcinoid tumors are rare neoplasms originating from neuroendocrine cells, most commonly found in the appendix. While NETs are often asymptomatic, they may present with abdominal pain, flushing, and diarrhea and are frequently discovered incidentally during surgery for other conditions. Endometriosis has been associated with an increased risk of certain malignancies; however, its relationship with NETs remains unclear. Given the high frequency of laparoscopic surgeries for endometriosis, incidental NET findings pose unique clinical challenges.

Methods: This retrospective case report was conducted at Avicenna Fertility Center, Affiliated to Avicenna Research Institute, Tehran, Iran, from 2016 to 2024. Medical records of six patients (33-55 years old) who underwent laparoscopic surgery for endometriosis, with incidental NETs found in the appendix, were analyzed. Clinical presentation, intraoperative findings, histopathology, and postoperative outcomes were reviewed.

Results: Six women (mean age: 43.7 years) with endometriosis-related symptoms (dysmenorrhea, dyspareunia, and pelvic pain) underwent laparoscopic surgery with appendectomy. The NETs (2–9 mm, all G1, Ki-67 <3%) exhibited invasion into the muscularis propria in three cases and into the subserosal fat in one case; lymph nodes were not evaluated, and no metastases were detected. Immunohistochemistry confirmed neuroendocrine differentiation, with positive chromogranin and synaptophysin staining. Follow-up over 1–5 years showed no evidence of recurrence.
Conclusion: Incidental NET detection during endometriosis surgery highlights the need for routine pathological examination of appendectomy specimens. While no direct link exists between NETs and endometriosis, recognizing these tumors may influence surgical decisions and postoperative management, emphasizing the importance of multidisciplinary care.