Podcasts about oocytes

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: how attacks on abortion access can threaten IVF (1:58), the prevalence of adenoymosis in young people (12:58), and the impact of short-term Western-style diet and hyperandrogenism on ovarian function (26:02). Consider This: https://www.fertstert.org/news-do/writing-wall-ivf-access-could-follow-abortion-s-path F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00040-9/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(25)00021-7/abstract View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: a review of segmental aneuploidies and mosaicism (2:00), early removal of zona pellucida to improve embryo fragmentation (18:12), inflammatory markers in female infertility (31:53), and debating the role of adult content in collection rooms (44:51). F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00039-2/abstract F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00092-8/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00078-8/abstract Consider This: https://www.fertstert.org/news-do/providing-adult-material-fertility-clinics-antiquated-and-nonessential View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Broadcast from KSQD, Santa Cruz on 11-07-2024: Dr. Dawn opens with a guided deep breathing exercise to help listeners manage stress and maintain emotional balance in challenging times. She helps an emailer understand a stress test result for a 72-year-old patient, explaining ST changes, ischemia, and the importance of follow-up angiography tests for heart health evaluation. The show addresses another email from a listener asking for advice about managing alcohol use in an 85-year-old dementia patient. Dr. Dawn discusses medical detox options and medications like Naltrexone for treatment. Dr. Dawn explores the use of low-dose Naltrexone for chronic pain management, particularly in diabetic neuropathy and fibromyalgia. She discusses cataract formation risks associated with St. John's Wort and also mentions the adverse interaction between prostate medications and cataract surgery which increases the risk of complications. Make sure your ophthalmologist knows you are on prostate medications The show features an in-depth explanation of A1 versus A2 milk proteins, their digestive impacts, and potential inflammatory effects in the body. Dr. Dawn concludes with groundbreaking research on creating viable oocytes from stem cells in mice, discussing implications for future fertility treatments.

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: mechanical contractions and fibroid progression (2:22), endometriosis classification and risk of infertility (15:15), the roles of endometrial and mesothelial cells in endometriosis formation (29:36), and fertility coverage for military personnel (43:30). F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00036-7/fulltext F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00090-4/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00053-3/fulltext Consider This: https://www.fertstert.org/news-do/building-family-while-serving-our-nation   View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: radiofrequency ablation of fibroids (3:00), an opinion piece on testing embryos to reduce type 1 diabetes risk (17:42), preeclampsia risk with abnormal semen analysis (29:34), and a review of PCOS and miscarriage (44:33). F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00078-3/fulltext Consider This: https://www.fertstert.org/news-do/preimplantation-genetic-testing-type-1-diabetes F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00055-7/abstract F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00035-5/abstract#:~:text=Some%20studies%20have%20suggested%20an,receptivity%2C%20and%20the%20uterine%20environment View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Presented in partnership with Fertility and Sterility onsite at the 2024 ANZSREI meeting in Sydney, Australia.  The ANZSREI 2024 debate discussed whether patients with unexplained infertility should go straight to IVF. Experts on both sides weighed the effectiveness, cost, and psychological impact of IVF versus alternatives like IUI. The pro side emphasized IVF's high success rates and diagnostic value, while the con side argued for less invasive, cost-effective options. The debate highlighted the need for individualized care, with no clear consensus reached among the audience. View Fertility and Sterility at https://www.fertstert.org/ TRANSCRIPT: Welcome to Fertility and Sterility On Air, the podcast where you can stay current on the latest global research in the field of reproductive medicine. This podcast brings you an overview of this month's journal, in-depth discussion with authors, and other special features. F&S On Air is brought to you by Fertility and Sterility family of journals in conjunction with the American Society for Reproductive Medicine, and is hosted by Dr. Kurt Barnhart, Editor-in-Chief, Dr. Eve Feinberg, Editorial Editor, Dr. Micah Hill, Media Editor, and Dr. Pietro Bordoletto, Interactive Associate-in-Chief. I'd just like to say welcome to our third and final day of the ANZSREI conference. We've got our now traditional F&S podcast where we've got an expert panel, we've got our international speaker, Pietro, and we've got a wonderful debate ahead of us. This is all being recorded. You're welcome, and please think of questions to ask the panel at the end, because it's quite an interactive session, and we're going to get some of the best advice on some of the really controversial areas, like unexplained infertility. Hi, everyone. Welcome to the second annual Fertility and Sterility Journal Club Global, coming to you live from the Australia and New Zealand Society for Reproductive Endocrinology and Infertility meeting. I think I speak on behalf of everyone at F&S that we are so delighted to be here. Over the last two years, we've really made a concerted effort to take the podcast on the road, and this, I think, is a nice continuation of that. For the folks who are tuning in from home and listening to this podcast after the fact, the Australia and New Zealand Society for Reproductive Endocrinology is a group of over 100 certified reproductive endocrinologists across Australia and New Zealand, and this is their annual meeting live in Sydney, Australia. Today's debate is a topic that I think has vexed a lot of individuals, a lot of patients, a lot of professional groups. There's a fair amount of disagreement, and today we're going to try to unpack a little bit of unexplained infertility, and the question really is, should we be going straight to IVF? As always, we try to anchor to literature, and there are two wonderful documents in fertility and sterility that we'll be using as our guide for discussion today. The first one is a wonderful series that was published just a few months ago in the May issue, 2024, that is a views and reviews section, which means there's a series of three to five articles that kind of dig into this topic in depth. And the second article is our professional society guideline, the ASRM Committee Opinion, entitled Evidence-Based Treatments for Couples with Unexplained Infertility, a guideline. The format for today's discussion is debate style. We have a group of six experts, and I've asked them to randomly assign themselves to a pro and a con side. So I'll make the caveat here that the things that they may be saying, positions they may be trying to influence us on, are not necessarily things that they believe in their academic or clinical life, but for the purposes of a rich debate, they're going to have to be pretty deliberate in convincing us otherwise. I want to introduce my panel for today. We have on my immediate right, Dr. Raewyn Tierney. She's my co-moderator for tonight, and she's a practicing board-certified fertility specialist at IVF Australia. And on my immediate left, we have the con side. Going from left to right, Dr. Michelle Quick, practicing board-certified fertility specialist at IVF Australia. Dr. Robert LaHood, board-certified reproductive endocrinologist and clinical director of IVF Australia here in Sydney. And Dr. Clara Bothroyd, medical director at Care Fertility and the current president of the Asia Pacific Initiative in Reproduction. Welcome. On the pro side, going from right to left, I have Dr. Aurelia Liu. She is a practicing board-certified fertility specialist, medical director of Women's Health Melbourne, and clinical director at Life Fertility in Melbourne. Dr. Marcin Stankiewicz, a practicing board-certified fertility specialist and medical director at Family Fertility Centre in Adelaide. And finally, but certainly not least, the one who came with a tie this morning, Dr. Roger Hart, who is a professor of reproductive medicine at the University of Western Australia and the national medical director of City Fertility. Welcome, pro side. Thank you.  I feel naked without it. APPLAUSE I've asked both sides to prepare opening arguments. Think of this like a legal case. We want to hear from the defence, we want to hear from the plaintiffs, and I'm going to start with our pro side. I'd like to give them a few minutes to each kind of introduce their salient points for why we should be starting with IVF for patients with unexplained infertility. Thanks, Pietro. To provide a diagnosis of unexplained infertility, it's really a reflection of the degree investigation we've undertaken. I believe we all understand that unexplained infertility is diagnosed in the presence of adequate intercourse, normal semen parameters, an absence ovulatory disorder, patent fallopian tubes, and a normal detailed pelvic ultrasound examination. Now, the opposing team will try to convince you that I have not investigated the couple adequately. Personally, I'm affronted by that suggestion. But what possible causes of infertility have I not investigated? We cannot assess easily sperm fertilising capability, we cannot assess oocyte quality, oocyte fertilisation potential, embryonic development, euploidy rate, and implantation potential. Surely these causes of unexplained fertility will only become evident during an IVF cycle. As IVF is often diagnostic, it's also a therapeutic intervention. Now, I hear you cry, what about endometriosis? And I agree, what about endometriosis? Remember, we're discussing unexplained infertility here. Yes, there is very good evidence that laparoscopic treatment for symptomatic patients with endometriosis improves pelvic pain, but there is scant evidence that a diagnostic laparoscopy and treating any minor disease in the absence of pain symptoms will improve the chance of natural conception, or to that matter, improve the ultimate success of IVF. Indeed, in the absence of endometriomas, there is no negative impact on the serum AMH level in women with endometriosis who have not undergone surgery. Furthermore, there is no influence on the number of oocytes collected in an IVF cycle, the rate of embryonic aneuploidy, and the live birth rate after embryo transfer. So why put the woman through a painful, possibly expensive operation with its attendant risks as you're actually delaying her going straight to IVF? What do esteemed societies say about a diagnostic laparoscopy in the setting of unexplained infertility? The ESHRE guidelines state routine diagnostic laparoscopy is not recommended for the diagnosis of unexplained infertility. Indeed, our own ANZSREI consensus statement says that for a woman with a minimal and mild endometriosis, that the number of women needed to treat for one additional ongoing pregnancy is between 3 and 100 women with endometriosis. Is that reasonable to put an asymptomatic woman through a laparoscopy for that limited potential benefit? Now, regarding the guidelines for unexplained infertility, I agree the ASRM guidelines do not support IVF as a first-line therapy for unexplained infertility for women under 37 years of age. What they should say, and they don't, is that it is assumed that she is trying for her last child. There's no doubt if this is her last child, if it isn't her last child, sorry, she will be returning, seeking treatment, now over 37 years of age, where the guidelines do state there is good evidence that going straight to IVF may be associated with higher pregnancy rates, a shorter time to pregnancy, as opposed to other strategies. They then state it's important to note that many of these included studies were conducted in an area of low IVF success rates than those currently observed, which may alter this approach, suggesting they do not even endorse their own recommendations. The UK NICE guidelines, what do they say for unexplained infertility? Go straight to IVF. So while you're listening to my esteemed colleagues on my left speaking against the motion, I'd like to be thinking about other important factors that my colleagues on my right will discuss in more detail. Consider the superior efficacy of IVF versus IUI, the excellent safety profile of IVF and its cost-effectiveness. Further, other factors favouring a direct approach to IVF in the setting of unexplained infertility are what is the woman's desired family? We should not be focusing on her first child, we should be focusing on giving her the family that she desires and how we can minimise her inconvenience during treatment, as this has social, career and financial consequences for those impediments for her while we attempt to help her achieve her desired family. Thank you. APPLAUSE I think the young crowd would say that that was shots fired. LAUGHTER Con side? We're going to save the rebuttal for the time you've allocated to that, but first I want to put the case about unexplained infertility. Unexplained infertility in 2024 is very different to what it was 10 and 20 years ago when many of the randomised controlled trials that investigated unexplained infertility were performed. The armamentarium of investigative procedures and options that we have has changed, as indeed has our understanding of the mechanisms of infertility. So much so that that old definition of normal semen analysis, normal pelvis and ovulatory, which I think was in Roy Homburg's day, is now no longer fit for purpose as a definition of unexplained infertility. And I commend to you ICMART's very long definition of unexplained infertility, which really relies on a whole lot of things, which I'm going to now take you through what we need to do. It is said, or was said, that 30% of infertility was unexplained. I think it's way, way less than that if we actually look at our patients, both of them, carefully with history and examination and directed tests, and you will probably reduce that to about 3%. Let me take you through female age first. Now, in the old trials, some of the women recruited were as old as 42. That is not unexplained infertility. We know about oocyte aneuploidy and female ageing. 41, it's not unexplained. 40, it's not unexplained. 39, it's not unexplained. And I would put it to you that the cut-off where you start to see oocyte aneuploidy significantly constraining fertility is probably 35. So unexplained infertility has to, by definition, be a woman who is less than 35. I put that to you. Now, let's look at the male. Now, what do we know about the male, the effect of male age on fertility? We know that if the woman is over 35, and this is beautiful work that's really done many years ago in Europe, that if the woman is over 35 and the male is five years older than her, her chance of natural conception is reduced by a further 30%. So I put it to you that, therefore, the male age is relevant. And if she's 35 and has a partner who's 35 years older than her or more, it's not unexplained infertility. It's related to couple age. Now, we're going to... So that's age. Now, my colleagues are going to take you through a number of treatment interventions other than IVF, which we can do with good effect if we actually make the diagnosis and don't put them into the category of unexplained infertility. You will remember from the old trials that mild or moderate or mild or minimal endometriosis was often included, as was mild male factor or seminal fluid abnormalities. These were really multifactorial infertility, and I think that's the take-home message, that much of what we call unexplained is multifactorial. You have two minor components that act to reduce natural fecundability. So I now just want to take you through some of the diagnoses that contribute to infertility that we may not, in our routine laparoscopy and workup, we may not pick up and have previously been called unexplained infertility. For instance, we know that adenomyosis is probably one of the mechanisms by which endometriosis contributes to infertility. Chronic endometritis is now emerging as an operative factor in infertility, and that will not be diagnosed easily. Mild or minimal endometriosis, my colleagues will cover. The mid-cycle scan will lead you to the thin endometrium, which may be due to unexpected adhesive disease, but also a thin endometrium, which we know has a very adverse prognostic factor, may be due to long-term progestin contraception. We are starting to see this emerge. Secondary infertility after a caesarean section may be due to an isthma seal, and we won't recognise that unless we do mid-cycle scans. That's the female. Let's look at the male. We know now that seminal fluid analysis is not a good predictor of male fertility, and there is now evidence from Ranjith Ramasamy's work that we are missing clinical varicoceles because we failed to examine the male partner. My colleagues will talk more about that. We may miss DNA fragmentation, which again may contribute via the basic seminal fluid analysis. Now, most of these diagnoses can be made or sorted out or excluded within one or two months of your detailed assessment of both partners by history and examination. So it's not straight to IVF, ladies and gentlemen. It's just a little digression, a little lay-by, where you actually assess the patient thoroughly. She did not need a tie for that rebuttal. LAUGHTER Prasad. Thank you. Well, following from what Professor Hart has said, I'm going to show that IVF should be a go-to option because of its effectiveness, cost-effectiveness and safety. Now, let me first talk about the effectiveness, and as this is an interaction session, I would like to ask the audience, please, by show of hands, to show me how many of you would accept a medical treatment or buy a new incubator if it had a 94% chance of failure? Well, let the moderator please note that no hands have been raised. Thank you very much. Yet, the chance of live birth in Australian population following IUI is 6%, where, after IVF, the live birth is 40%. Almost seven times more. Now, why would we subject our patients to something we ourselves would not choose? Similarly, findings were reported from international studies that the hazard ratio of 1.25 favouring immediate IVF, and I will talk later about why it is important from a safety perspective. Cost-effectiveness. And I quote ESHRE guidelines. The costs, treatment options have not been subject to robust evaluations. Now, again, I would like to ask the audience, this time it's an easy question, how many of you would accept as standard an ongoing pregnancy rate of at least 38% for an average IVF cycle? Yeah, hands up. All right, I've got three-quarters of the room. OK. Well, I could really rest my case now, as we have good evidence that if a clinic has got an ongoing pregnancy rate of 38% or higher with IVF with single embryo transfer, then it is more effective, more cost-effective, and should be a treatment of choice. And that evidence comes from the authors that are sitting in this room. Again, what would the patients do? If the patients are paying for the treatment, would they do IUI? Most of them would actually go straight to IVF. And we also have very nice guidelines which advise against IUI based on cost-effectiveness. Another factor to mention briefly is the multiple births, which cost five to 20 times more than singleton. The neonatal cost of a twin birth costs about five times more than singletons, and pregnancy with delivery of triplets or more costs nearly 20 times. Now, the costs that I'm going to quote are in American dollars and from some time ago, from Fertility and Sterility. However, the total adjusted all healthcare costs for a single-dom delivery is about US$21,000, US$105,000 for twins, and US$400,000 for triplets and more. Then the very, very important is the psychological cost of the high risk of failure with IUI. Now, it is well established that infertility has a psychological impact on our patients. Studies have shown that prolonged time to conception extends stress, anxiety, and depression, and sexual functioning is significantly negatively impacted. Literature shows that 56% of women and 32% of men undergoing fertility treatment report significant symptoms of depression, and 76% of women and 61% of men report significant symptoms of anxiety. Shockingly, it is reported that 9.4% of women reported having suicidal thoughts or attempts. The longer the treatment takes, the more our patients display symptoms of distress, depression, and anxiety. Safety. Again, ESHRE guideline says the safety of treatment options have not been subjected to robust evaluation. But let me talk you through it. In our Australian expert hands, IVF is safe, with the risk of complications of ectopic being about 1 in 1,500 and other risks 1 in 3,000. However, let's think for a moment on impact of multiple births. A multiple pregnancy has significant psychological, physical, social, and financial consequences, which I can go further into details if required. I just want to mention that the stillbirth rate increases from under 1% for singleton pregnancies to 4.5% for twins and 8.3% for higher-order multiples, and that multiple pregnancies have potential long-term adverse health outcomes for the offspring, such as the increased risk of health issues through their life, increased learning difficulties, language delay, and attention and behavior problems. The lifelong disability is over 25% for babies weighing less than 1 kilogram at delivery. And please note that the quoted multiple pregnancy rates with IUI can reach up to 33%, although in expert hands it's usually around 15%, which is significantly higher than single embryo transfer. In conclusion, from the mother and child safety perspective, for the reason of medical efficacy and cost effectiveness, we have reasons to believe you should go straight to IVF. We're going to be doing these debates more often from Australia. This is a great panel. One side, please. Unexplained infertility. My colleagues were comparing IUI ovulation induction with IVF, but there are other ways of achieving pregnancies with unexplained fertility. I'm going to take the patient's perspective a little bit here. It's all about shared decision-making, so the patient needs to be involved in the decision-making. And it's quite clear from all the data that many patients with unexplained infertility will fall pregnant naturally by themselves even if you do nothing. So sometimes there's definitely a place in doing nothing, and the patient needs to be aware of that. So it's all about informed consent. How do we inform the patient? So we've got to make a proper diagnosis, as my colleague Dr. Boothright has already mentioned, and just to jump into IVF because it's cost-effective is not doing our patients a justice. The prognosis is really, really important, and even after 20 years of doing this, it's all about the duration of infertility, the age of the patient, and discussing that prognosis with the patient. We all know that patients who have been trying for longer and who are older do have a worse prognosis, and maybe they do need to look at treatment quicker, but there are many patients that we see that have a good prognosis, and just explaining that to them is all they need to achieve a pregnancy naturally. And then we're going to talk about other options. It's wrong not to offer those to patients, and my colleague Dr. Quick will talk about that in a moment. Look, we've all had patients that have been scarred by IVF who've spent a lot of money on IVF, did not fall pregnant, and I think the fact that they weren't informed properly, that the diagnosis wasn't made properly, is very frustrating to them. So to just jump into IVF again is not doing the patients a justice. And look, there are negatives to IVF. There's not just the cost to the patient, the cost to society. As taxpayers, we all pay for IVF. It's funded here, or sponsored to some degree, and it's also the family and everyone else that's involved in paying for this. So this is not a treatment that is without cost. There are some harms. We know that ovarian hyperstimulation syndrome still exists, even though it's much less than it used to be. There's a risk of infection and bleeding from the procedures. And we can look at the baby. The data still suggests that babies born from IVF are smaller and they're born earlier, and monozygotic twinning is more common with IVF, so these are high-risk pregnancies, and all this may have an impact on the long-term health of the babies somewhere down the track at the moment. That is important to still look out for. But I come back to the emotional toll. Our colleagues were saying that finishing infertility quicker helps to kind of reduce the emotional toll, but the procedure itself does have its own toll if it doesn't work, and so we've got to prepare patients, have them informed. But at the end of the day, it's all about patient choice. How can a patient make a choice if we don't make a proper diagnosis, give them a prognosis and offer them some other choices that exist? And running the anchor leg of the race for the pro side. IVF in couples with unexplained infertility is the best tool we have in our reproductive medicine toolkit for multiple reasons. Professor Hart has clarified the definition of unexplained infertility. As a reflection of the degree of investigation we've undertaken. He's explained that IVF is often importantly diagnostic as well as therapeutic, both demonstrating and overcoming barriers to natural conception. Dr Stankiewicz has convinced us that IVF is efficient, safe and cost-effective. My goal is to show you that IVF is the correct therapy to meet the immediate and big picture family planning goals for our patients with unexplained infertility. More than 80% of couples with defined unexplained infertility who attempt IVF treatment will have a baby. In Australia, ANZSREI data shows us that the average age of the female patients who present with primary unexplained infertility is over 35 years. And in fact the average is 38 years. We're all aware that the average age of first maternity in Australia has progressively become later over the past two decades. Currently it stands in the mothers and babies report at 32 years. If the average age of first maternity is 32 years, this means that at least 50% of women attempting their first pregnancy are over 32 years. Research I conducted in Melbourne University with my student Eugenie Pryor asking university students of their family planning intentions and aspirations demonstrated that most people, male and female, want to be parents and most want to have more than one child. However, in Australia, our most recent survey shows that births are at an all-time low, below replacement rate and falling, with an ever greater proportion of our population being unable to have the number of children they aspire to and an ever growing proportion seeking assisted reproductive care. Fertility declines with age. Factors include egg quality concerns, sperm quality concerns and the accumulation of pathologies over time. Adenomyosis, fibroids, endometriosis are concerns that no person is born with. They exist on a spectrum and progress over time and may be contributing factors for unexplained infertility. Our patients, when we meet them, are the best IVF candidates that they will ever be. They are the youngest they will ever be and they have the best ovarian reserve they will ever have. They will generate more euploid embryos now than they will in years to come. The sooner we get our patients pregnant, the sooner they will give birth. It takes nine months to have a baby, 12 months potentially to breastfeed and wean and of course most patients will need time to care for a young infant and recover prior to attempting another pregnancy. IVF and embryo banking may represent not only their best chance of conception with reduced time to pregnancy but also an opportunity for embryo banking to improve their cumulative live birth rate potential over time. By the time our 38-year-old patient returns to try to conceive for a second child, she will undoubtedly be aged over 40. Her chance of live birth per cycle initiated at IVF at this stage has reduced phenomenally. The ANZSREI dataset from our most recent report quotes that statistic to be 5%. Her chance of conception with an embryo frozen at 38 years, conversely, is one in three to one in four. There is no room for doubt that IVF gives couples with unexplained infertility not only the most effective treatment we have to help them have a baby, but their best opportunity to have a family. Last but certainly not least, Dr. Quick, to round out the con sides arguments before we open up for rebuttal. And I'll make a small plea that if you have questions that you'd like to pose directly to the panel, prepare them and we'll make sure we get to them from the audience shortly. Thank you. So, whilst we have heard that we may be bad doctors because we're delaying our patients' time to pregnancy, I would perhaps put it to you that unexplained infertility is a diagnosis which is made based on exclusion. So perhaps you are the bad doctors because you haven't looked hard enough for the cause of the unexplained infertility. So, in terms of the tests that we all would do, I think, we would all ensure that the woman has an ovarian reserve. We would all ensure that she has no structural anomaly inside the uterus. We would all ensure that her tubes are patent. We would all ensure that she has regular cycles. We would ensure that he has a normal semen analysis. I think these are tests that we would all do when trying to evaluate a couple for fertility who are struggling to conceive. And therefore, the chance of them getting pregnant naturally, it's never going to be zero. And one option therefore, instead of running straight to IVF, would be to say, OK, continue timed intercourse because the chance of you conceiving naturally is not actually zero and this would be the most natural way to conceive, the cheapest way to conceive, the least interventional way to conceive. And whether that be with cycle tracking to ensure appropriate timed intercourse, whether that be with cycle tracking to ensure adequate luteal phase support. When you clear the fallopian tubes, we know that there are studies showing an improvement in natural conception. Lipidol or oil-based tubal flushing techniques may also help couples to conceive naturally. And then you don't have this multiple pregnancy rate that IVF has. You don't have the cost that you incur with IVF, not just for the couple but to Australian society because IVF is subsidised in this country. You don't have the risks that the woman goes through to undergo IVF treatment. You don't have the risks that the baby takes on being conceived via IVF. And so conceiving naturally, because it's not going to be zero, is definitely an option for these couples. In terms of further tests or further investigations that you could do, some people would argue, yes, we haven't looked hard enough for the reason for infertility, therefore we know that ultrasound is notoriously bad at picking up superficial endometriosis. We know that ultrasound cannot pick up subtle changes in the endometrium, as Dr Boothroyd referred to chronic endometritis, for example. So these patients perhaps should undergo a hysteroscopy to see if there is an endometrial issue. Perhaps these patients should undergo a laparoscopy to see if there is superficial endometriosis. And there are meta-analyses showing that resecting or treating superficial endometriosis may actually help these couples conceive naturally down the track and then therefore they avoid having more interventional treatment in order to conceive. There is also intrauterine insemination with or without ovarian stimulation, which may improve their chances of conceiving naturally. And that again would be less invasive, less intervention and cheaper for the patient. And we know that therefore there are a lot of other treatment options available to help these couples to conceive. And if it's less invasive, it's more natural, it's cheaper, that ends up being better for the patient. Psychologically as well, which the other side have brought up, even with Dr Stankiewicz's 38% ongoing pregnancy rate, that also means that 62% of his patients are not going to be pregnant. The psychological impact of that cannot be underestimated because for a lot of patients, IVF is your last resort. And when you don't get pregnant with IVF, that creates an issue too for them. Embryo banking, which was also brought up, what happens when you create surplus embryos and what's the psychological impact of having to deal with embryos that you are then not going to use in the future? So therefore for those reasons we feel that IVF is not your first line treatment for couples who are diagnosed with unexplained infertility. There are many other ways to help these couples to conceive. We just have a multitude of things to unpack. And I want to start off by opening up an opportunity for rebuttal. I saw both sides of the panel here taking diligent notes. I think all of us have a full page worth of things that kind of stood out to us. Since the pro side had an opportunity to begin, I'm actually going to start with the con side and allow the con side to answer specific points made by the pro side and provide just a little bit more detail and clarity for why they think IVF is not the way forward. My learned first speaker, wearing his tie of course, indicated that it was all about laparoscopy and IUI, and it's way more than that. I just want to highlight to you the paper by Dressler in 2017 in the New England Journal of Medicine, a randomised controlled trial of what would be unexplained infertility according to the definition I put out, the less than 35 ovulatory normal semen analysis. And the intervention was an HSG with either oil-based contrast or water-based contrast. And over the six months, there was clear separation, and this is an effective treatment for unexplained infertility or mild or minimal endometriosis, however it might work. And there's probably separation out to three years. So as a single intervention, as an alternative to IVF, the use of oil-based contrast is an option. So it's not just about laparoscopy and IUI. I guess the other thing the second speaker did allude to, fairly abysmal success rates with IUI being 6%. That is a problem, and I would like to allude to a very good pragmatic trial conducted by Cindy Farquhar and Emily Lu and their co-workers in New Zealand that really swung the meta-analysis for the use of clomiphene and IUI to clinical efficacy. And they reported a 33% chance of live birth in their IUI and clomiphene arm. I'm going across to Auckland to see what the magic is in that city. What are they doing? The third speaker did allude to the problem of declining fertility, a global problem, and Australia is not alone. We have solved the problem to date, which we've had for 40 years, with immigration. But Georgina Chambers' work shows beautifully that IVF is not the answer to the falling fertility rates. It is a way more complex social problem and is probably outside the scope of today's discussion. So those are my three rebuttals to our wonderful team. Thank you very much. So... You can't bury them. We'll give them an opportunity. Thank you for the opportunity. So I'd like to address some of the points that my learned debaters on the opposition raised. The first speaker really suggested quite a few things that we probably omitted, like endometritis, failing to examine the male. I think things like that... I think, at a good history, that is essential what we do as part of our investigation. We're looking for a history of cesarean section, complications subsequent to that. We're doing a detailed scan, and that will exclude the fact that she's got a poor endometrium development, she's got a cesarean scar niche. A good history of a male will allude to the fact that he has some metabolic disorder, degree of hypogonadism. So we're not delaying anything by these appropriate investigations. Adenomyosis will be raised. I talked about a detailed gynaecological examination. So I honestly think that a very... As my opening line was, a detailed gynaecological scan, obviously with a very good history taken, is essential. We're not delaying her opportunity to go straight to IVF if we've addressed all these factors. The second speaker talked about shared decision-making, and we'd all completely agree with that. But we have to be honest and open about the success, which my second speaker talked about, the success of the treatment we're offering. And one thing we should sort of dwell on is it's all... It's a fundamental description of the success of treatment is probably all about prognostic models, and that who not model, that's the original model about the success of conception, is really... Everything flows on from that, which basically talks about a good prognosis patient. 30% chance of live birth after a year. That's what they talk about, a good prognosis patient. Perhaps the rest of the world is different to your average Australian patient, but if we talked about that being a good prognosis, you've got a one in three chance of being pregnant by a year. I think most of our patients would throttle us. So that is what all the models are sort of based on, that being a good prognosis patient. So I completely agree with the second speaker that we do have a shared decision. We have to be honest with our patients about the success. We have to be honest about giving them the prognosis of any treatment that we offer. But really, as my third speaker was talking about, it's about giving the patient the opportunity to have a family, minimal career disruption, minimal life disruption. We have to be honest and talk about the whole picture. They're focused on the first child because really they can't think beyond that. We're talking about giving them the family that they need. The third speaker spoke very eloquently about the risks associated with the treatment we offer. I believe we offer a very safe service with our IVF, particularly in Australia, with our 2% twin pregnancy rate. We talk about the higher risk of these pregnancies, but they perhaps don't relate to the treatment we're offering. Perhaps, unfortunately, is the patient, if she's got polycystic ovary syndrome, if she's more likely to have diabetes, premature delivery, preeclampsia. So I think often the risks associated with IVF and potentially the risks associated to the child born from IVF perhaps don't relate to the treatment of IVF per se. It may well be the woman and perhaps her partner, their underlying medical condition, which lead those risks. So I strongly would encourage you to believe that you take a very good history from your patient, you do a thorough investigation, as I've alluded to, looking for any signs of ovulatory disorder, any gynaecological disorder by a detailed scan, checking tubal patency and a detailed history and the similarities from the man, and then you'll find you're probably going straight to IVF. APPLAUSE I'd like to talk a bit about the embryo banking and having been in this field for a long time, as a word of caution, we're setting a lot of expectations. I remember going to an ASRM meeting probably 10 years ago where they had this headline, all your embryos in the freezer, your whole family in the freezer, basically expecting that if you get four or five embryos frozen that you'll end up with a family at the end. We all know that for the patient, they're not a percentage, it's either zero or 100%. And if all the embryos don't work, they don't have a family at the end, you know, it didn't work for them and their expectations haven't been met. And the way we talk about the percentages and that we can solve the patient's problems, that we can make families, it doesn't always happen. So the expectations our position is setting here, we're not always able to meet and so we're going to end up with very unhappy patients. So this is just a warning to everyone that we need to tell people that this doesn't always work and sometimes they'll end up with no success at all. And from that point of view, I think the way it's presented is way too simplistic and we've got to go back to looking at the other options and not promising things we can't always deliver. So just taking into account all our esteemed interlocutors have said, we don't necessarily disagree with the amount of investigations that they described because nowhere in our argument we said that as soon as the patient registers with the receptionist, they will direct it to an IVF lab. I think to imply so, we'd be very rich indeed. Maybe there are some clinics that are so efficient. I don't know how it works overseas, but certainly not in Australia. The other point that was made about the cost of IVF and our, again, esteemed interlocutors are very well aware from the studies done here in Australia that actually every baby that we have to conceive through IVF and create and lives is actually more than 10 to 100 times return on investment because we are creating future taxpayers. We are creating people that will repay the IVF treatment costs over and over and over again. So I'll put to you, Rob, that if you are saying that we can't do IVF because it costs money, you are robbing future treasurers of a huge amount of dollars. I hope the American audience is listening. In America, we call embryos unborn children in freezers in certain parts and here they're unborn taxpayers. Con side, final opportunity for rebuttal before some audience questions and one more word from the pro side. Well, actually, Dr Stankiewicz was very happy to hear that you're not going to send your patients straight to the IVF lab because we've managed to convince you that that's not the right thing to do. I clearly have forgotten how to debate because I did all my rebuttals at the end of my presentation but essentially I'll recap because when we're talking about IVF, as we're saying, the chance of pregnancy is not going to be 100% and so there is a psychological impact to IVF not working. There is a psychological impact to banking embryos and creating surplus embryos that eventually may not be used and they were my main rebuttal points in terms of why IVF was not the first-line treatment. Thank you. So we've heard from the opposition some very valid points of how our patients can be psychologically impacted when fertility treatment is unsuccessful. I will again remind you that IVF is the most successful fertility treatment we have in our treatment armoury. We are most likely to help our patients have a baby with IVF. The cumulative pregnancy rates for IVF have started back in the late 70s and early 80s in single-digit percentages. We now, with a best prognosis candidate, have at least a one-in-two chance of that patient having a baby per embryo transfer and in our patients with unexplained infertility, the vast majority of our patients will have success. We also heard from the negative team about the significant chance of pregnancy in patients with expectant management. You're right, there's not a 0% chance of natural conception in patients who have unexplained infertility, but there is a not very good chance. We know from data that we've had for a really long time, going back as far as the Hutterite data, to today's non-contradictory models, which tell us that a couple's chance of conception per month in best prognosis candidates is one in five. If they've been trying for six months, it's one in ten. If they've been trying for 12 months, it's only 5%, and if they've been trying for 24 months, it's less than 1%. So it may not be zero, but it isn't very good. In terms of our team reminding us of the extended ICMART definition of unexplained infertility, we don't argue. When we say someone has unexplained infertility, we make the assumption that they have been comprehensively diagnosed by a robust reproductive endocrinologist, as everyone in this room is. And I would say one closing rebuttal. IUI success rates have been the same for the last 50 years, whereas IVF success rates continue to improve. Why would you offer your patient a treatment from 50 years ago when you can offer them one from today? Thank you. APPLAUSE I'm going to take a personal privilege and ask the first question, in hoping that the microphone makes its way to the second question in the audience. My colleagues on the pro side have said IVF, IVF, IVF. Can you be a little bit more specific about what kind of IVF? Do you mean IVF with ICSI? Do you mean IVF, ICSI, and PGT? Be a little bit more deliberate for us and tell us exactly how the patient with unexplained infertility should receive IVF. As I said in my statement, I think it's a diagnostic evaluation. I think there is an argument to consider ICSI, but I think ICSI does have some negative consequences for children born. I think perhaps going straight to ICSI is too much. I think going straight to PGTA perhaps is too much, unless there is something in their history which should indicate that. But we're talking about unexplained infertility. So I believe a standard IVF cycle, looking at the opportunity to assess embryonic development, is the way to go. I do not think you should be going straight to ICSI. I think the principle of first do no harm is probably a safe approach. I don't know whether my colleagues have some other comments, but I think that would be the first approach rather than going all guns blazing. I can understand, though, in different settings in the world, there may have... We're very fortunate in Australia, we're very well supported from the government support for IVF, but I think the imperatives in different countries may be different. But I think that approach would be the right one first. We'll start with a question from the audience. And if you could introduce yourself and have the question allowed for our members in the audience who are not here. It's Louise Hull here from Adelaide. The question I would like to put to both the pro and con team is that Geeta Mishra from the University of Queensland showed that if you had diagnosed endometriosis before IVF, you were more likely to have a pregnancy and much less likely to have high-order IVF cycles. Given that we now have really good non-invasive diagnostics, we're actually... A lot of the time we can pick up superficial or stage 2 endometriosis if you get the right scan. We're going to do IVF better if we know about it. Can you comment on that impacting even the diagnosis of unexplained infertility? Thanks. I'd love to take that. Can I go first, Roger? LAUGHTER Please do. Look, I'd love to take that question. It's a really good question. And, of course, this is not unexplained infertility, so this is outside the scope here. And I think, really, what we're seeing now, in contrast to where we were at the time of the Markku study, which was all... And the Tulandy study on endometrioma excision, we now see that that is actually damaging to fertility, particularly where there is ovarian endometriosis, and that we compromise their ovarian reserve by doing this surgery before we preserve their fertility, be it oocyte cryopreservation or embryo cryopreservation. So I think it's a bit outside the scope of this talk, but I think the swing of the data now is that we should be doing fertility preservation before we do surgery for deeply infiltrated ovarian endometriosis. And that would fit with Gita's findings. A brief response. Thanks very much, Louise. Yeah, we're talking about unexplained infertility here, and my opening line was we need a history, but a detailed gynaecological ultrasound. I think it's important it's a really good ultrasound to exclude that, because the evidence around very minor endometriosis is not there. I agree with significant endometriosis, but that's not the subject of this discussion. But I do believe with very minimal endometriosis there is really no evidence for that. Janelle MacDonald from Sydney. I'm going to play devil's advocate here. So everyone is probably aware of the recent government inquiry about obstetric violence. I'm a little concerned that if we are perceived to be encouraging women to IVF first, are we guilty as a profession of performing fertility violence? That's just digressing a little bit, just thinking about how the consumers may perceive this. I think our patients want to have a baby, and that's why they come to see us, and that's what we help them to do through IVF. I'm not sure the microphone's working. And just introduce yourself. I'm from Sydney, Australia. Can I disagree with you, Roger, about that question about minimal and mild endometriosis? I'm 68, so I'm old enough to have read a whole lot of papers in the past that are probably seen as relics. But Mark Khoo published an unusual study, because it was actually an RCT. Well, sorry, not an RCT. It was a study whereby... Well, it was an RCT, and it was randomised really well. It was done in Canada, and there were about 350 subjects, and they were identified to have stage 1 or stage 2 endometriosis at laparoscopy. And the interesting thing is it was seen as an intervention which didn't greatly increase the chance of conception, but it doubled the monthly chance of conception. So there was clearly a difference between those patients who didn't have endometriosis and those that had stage 1 and stage 2 endometriosis. So the intervention did actually result in an improvement. One of the quotes was, well, I heard since then, well, it didn't make much difference. But when you realise that infertility is multifactorial, there were probably other factors involved as well. So any increase like that in stage 1 and stage 2 endometriosis sufferers was clearly beneficial for them. So I wouldn't disagree with you completely, but I do think you've got to take it on board that there is some evidence that surgical intervention can help. And certainly in those patients whereby the financial costs of IVF are still quite, even in Australia, astronomical. Many patients can get this through the public sector or the private sector treatment of their endometriosis laparoscopically very cheaply or at no cost. Thanks, Dr Persson. So you're right that there was also a counter-randomised controlled trial by the Grupo Italiano which was a counter to that. And actually did not show any benefit. But I believe the Marcu study demonstrated an excess of conception and with treatment of minima and endometriosis of about 4% per month for a few months. So absolutely, that shared decision-making. Personally, I wouldn't like a laparoscopy to give me an extra 4% chance of a natural conception for four months, which I think the data was. So basically, the basis to my statement that I said without going into great detail was a review article published by Samy Glarner recently in Reproductive Biology and Endocrinology. And their conclusions were what I basically said, that from looking at all the data, there is no real evidence of intervention for minor endometriosis. We're not talking about pain or significant diagnosed endometriosis on the outcomes of IVF, ovarian reserve, egg quality, embryo development, and euploidy rate. So that was the basis of my... I hate to disagree... I hate to agree with my opponents in a debate, but I'm going to... But there is actually a new network analysis by Rui Wang and some serious heavyweights in evidence-based medicine that pulls together the surgical studies. And the thing that made the most difference to this of mild and minimal endometriosis from a fertility point of view, not pain, is the use of oil-based uterine contrast. And I commend that paper to you, which fits with exactly what Roger is saying. Hi, my name's Lucy Prentice.  I work in Auckland. And I just wanted to point out the New Zealand perspective a little bit. Where we come from a country with very limited public funding for IVF. I'm currently running an RCT with Cindy Farquad directly looking at IVF versus IUI for unexplained infertility. And I'd just like to point out that both the ASRM and ESHRE guidelines, which are the most recent ones, both suggest that IUI should be a first-line treatment with oral ovarian stimulation. We have no evidence that IVF is superior based on an IPD meta-analysis published very recently and also a Cochrane review. And although we would love to be able to complete the family that our patients want from IVF and embryo banking, that option is really not available to a lot of people in New Zealand because of prohibitive costs. We know that IUI with ovarian stimulation is a very effective treatment for people with poor prognosis and unexplained infertility. And I also would just like to add that there's not a cost-effectiveness analysis that shows an improvement in cost-effectiveness for IVF. There's also never been a study looking at treatment tolerability between the two, so I don't think that you can say that IVF is a treatment that people prefer over IUI. So I may turn around and shoot myself in the foot based on our results that will be coming out next year, but I think at the moment I don't think you can say that IVF is better than IUI with ovarian stimulation for unexplained. We have time for two more questions from the audience, and we have two hands in the back. Now we can. It's the light green. OK. Hossam Zini from Melbourne. Thank you very much for the debate. It's very interesting. The problem is that all of the studies that have been done about comparing IUI to IVF, they are not head-to-head studies. The designs are different. They are having, like, algorithmic approach. For example, they compare three or four or five cycles of IUI to one cycle of IVF. But about 10 years ago, our group at the Royal Women's Hospital, we have done a study, a randomized control study, to compare IUI to IVF head-to-head, and we randomized the patients at the time of the trigger who only developed, so we did a low stimulation to get two to three follicles only, and that's why it was so hard to recruit lots of patients. So the criticism that was given to the study that it's a small sample size, but we end up with having IVF as a cost-effective treatment. Our IVF group had a live birth rate about 38%, and on the IUI, 12%. And with our cost calculations, we find out that the IVF is much more cost-effective than the IUI. But I believe that we all now believe in individualized kind of treatment, so patients probably who are younger than 34 years old probably wouldn't go straight to IVF. Maybe I'll do a laparoscopy and a histroscopy first, okay, and we may give them a chance to achieve a natural conception in the next three months or so. Patients who are older than 35, 37 years old probably will benefit straight from IVF. But again, in day-to-day life cases, we will not force the patient to go straight to IVF. I will talk to her and I'll tell her, these are your options, expectant treatment. This is the percentage that you would expect. IUI, this is what you expect. IUI with ovulation induction, this is what you expect. IVF, this is what you expect. And then she will discuss that with her partner and come back to me and tell me what she wants to do. Thanks. I saw a hand show up right next to you, so I'll add one more question given our time limitation. Thanks so much, Kate Stone-Mellon. I'd like to ask our panel to take themselves out of their role playing and put themselves in another role where they were the head of a very, very well-funded public service, and I'd like to ask the two sides what they really think about what they would do with a patient at the age of 35 with 12 months of unexplained infertility. Well, can I say that? Because that's my role in a different hat. LAUGHTER So, yeah, I run the state facility service in Western Australia. We looked at the data, because obviously that's what we're doing, IUI, IVF, and unfortunately we stopped doing IUI treatment. The success rate was so low. So we do go straight to IVF with unexplained infertility. Disappointing, as I'm sure you hear that, Kate, that we do. We looked at the data. Yeah, I think that I would still offer the patients the options, because some people don't want to do IVF. Even though it's completely free, they may not still want to do the injections and the procedure and take on the risks of the actual egg collection procedure. I don't know, religious issues with creating embryos. Yeah, I would still give patients the option. We have time for one more question in the back. We'll take the other ones offline afterwards. We'll get you a microphone just to make sure our listeners afterwards can listen. Following on from the New Zealand experience, which I've experienced... Hello? Yeah. From the New Zealand experience, and having worked here extensively and in New Zealand, you're not comparing apples with apples, Claire. That unexplained couple in New Zealand will wait five years to get funding and currently perhaps another two years to get any treatment. That's then an apples group compared to the pilot group who may, in fact, walk past the hospital and get treatment. The other thing about this, I think, that we need to forget, or don't forget, is the ethics of things here, two of which is that the whole understanding of unexplained infertility needs research and thinking. And if it wasn't for that understanding of what is the natural history of normal and then the understanding of pathology, we wouldn't do a lot of things in medicine. So if we have got a subgroup here that's unexplained, it's not just to the patient, we have a responsibility to future patients and ourselves to be honest and do research and learn about these factors. Now, it doesn't answer the debate, but it is something that's what drives the investigation and management of unexplained delay. And, for example, at the moment, there's quite a discussion about two issues of ethics, one about the involuntary childlessness of people that don't get to see us but don't have those children that they wanted to have because they didn't want to undergo treatment, or it was the involuntary childlessness of a second or subsequent child. And that's quite a big research issue in Europe, I realise, at the moment. And the final thing is about the information giving. The British case Montgomery 2015 has changed consent substantially, for those of you from England, that all information given to patients must include and document the discussion about expectant management versus all the different types of treatment, for and against and risks. And we're not currently doing that in IVF in this area, but if you read about what's happened in England, it's transformed consent in surgery. And I think a lot of our decision-making isn't in that way. So there are a couple of ethical principles to think about. Wonderful questions from the audience. Since we're coming up at the end of our time, we typically end the debate with closing remarks, but we'll forego that for this debate. And I'd actually like to just poll the audience. After hearing both the pro and the con side's arguments, by a show of hands, who in the audience believes that for the patient with unexplained infertility, as defined and detailed here broadly, should we be beginning with IVF? Should we be going straight to IVF? So by a show of hands. And I would say probably 50% of the room raised their hand. And those who think we should not be going straight to IVF? It feels like a little bit more. 40-60, now that I saw the other hands. Well, I'm going to call this a hung jury. I don't know that we have a definitive answer. Please join me in a round of applause for our panelists. In America, we would call that election interference. I wanted to thank our panelists, our live audience, and the listeners of the podcast. On behalf of Fertility and Sterility, thank you for the invitation to be here at your meeting and hosting this debate live from the Australian New Zealand Society for Reproductive Endocrinology meeting in Sydney, Australia. Thank you. This concludes our episode of Fertility and Sterility On Air, brought to you by the Fertility and Sterility family of journals in conjunction with the American Society for Reproductive Medicine. This podcast was developed by Fertility and Sterility and the American Society for Reproductive Medicine as an educational resource and service to its members and other practicing clinicians. While the podcast reflects the views of the authors and the hosts, it is not intended to be the only approved standard of living or to direct an exclusive course of treatment. The opinions expressed are those of the discussants and do not reflect Fertility and Sterility or the American Society for Reproductive Medicine.    

We find out if IVF, In Vitro Fertilization, is right for your operation.  We have the latest news and markets, plus your chance to get your hands on more Ranch It Up gear.  Tune in to this all new episode of the Ranch It Up Radio Show.  Be sure to subscribe on your favorite podcasting app or on the Ranch It Up Radio Show YouTube Channel.   EPISODE 199 DETAILS Is IVF, In Vitro Fertilization, Right For Your Herd Understanding In Vitro Fertilization   What Is In Vitro Fertilization In Vitro Fertilization (IVF) is the process of creating embryos from oocytes (unfertilized egg cells) by fertilizing them with semen in a Petri dish. Oocytes are first collected from the ovaries of donors by ultrasound-guided follicular aspiration. They are then matured in a Petri dish and fertilized 20-24 hours later. Conventional, sexed frozen, or reverse-sorted semen may be used for fertilization. Oocytes then develop in an incubator for seven days, at which point the resulting viable embryos are transferred into recipients.  How Does In Vitro Fertilization Work In-Vitro Fertilization resembles conventional ET by allowing cows to produce multiple calves per year. This is accomplished by generating embryos from elite cows called donors and transferring them into cows with less genetic merit called recipients. After this, there are many differences in the way the procedure works.  In IVF, oocytes (unfertilized eggs) are collected using a specially designed probe, fitted with an ultrasound transducer which allows the ovary to be visualized during the aspiration procedure. The technician locates and stabilizes the ovary via rectal palpation of the reproductive tract. The aspiration probe is inserted vaginally where the transducer and ovary meet with only the vaginal wall separating the two. The probe has an attached needle guide that houses a 55cm long needle. This needle will transverse the vaginal membrane and is inserted into fluid filled follicles, containing oocytes, located on the ovary. The contents of the follicles are aspirated out and captured in a searchable filter. The filter is then taken into the lab where it is rinsed and searched using a microscope; the oocytes are then retrieved, counted, and graded.    Once the oocytes have been processed they are moved into dishes with special media designed to mature them. The dishes are placed in an incubator for 18 to 24 hours where the maturation process takes place. The following day, semen is added to the dishes containing the matured oocytes and fertilization takes place. The media and incubator are designed to mimic the cow's uterine environment as pertains to temperature, pH, etc. Following fertilization, the oocytes are left in the incubators for the next 7 days as a percentage of them develop into embryos. They can then be evaluated under a microscope and quality graded just as you would conventional ET embryos. The grade one and two embryos are now ready to be loaded into transfer straws and implanted into recipient cows that were in standing heat 7-8 days prior to the transfer date or frozen for transfer at a later date.   Potential Applications of IVF, In Vitro Fertilization Embryo production from pregnant donors — Because the cervix and uterus are not penetrated during the process of aspiration, oocytes can still be collected without disturbing the fetus. Donors can be safely aspirated from about 45-100 days of gestation. On rare occasions donors can be aspirated up to 6 months of gestation, as long as the ovaries are accessible to the technician. This application is a good alternative for operations wanting to get a jump on the next generation. In years past, breeders were forced to decide whether to risk future productivity of young donors by flushing them as virgins or just postponing embryo production until after their first calf. By getting the heifers pregnant first, they are already on their way to calving in a normal window with their counterparts. It also works well for those operations that want to keep donors on a 365-day calving interval, and can help reduce reproductive failures such as cysts in donors that remain open for long periods of time.  Production from donors that do not make embryos in ET — Various reasons can cause donors to be nonproductive in ET. Blockages, scaring, uterine infections, and un-passable cervixes are some of the more common reproductive tract abnormalities that can be overcome through IVF. Also, donors prone to overstimulation or those that produce a high percentage of unfertilized eggs, generally perform well in IVF Donors that typically fail to stimulate and ovulate little to no ova will not necessarily benefit from IVF.  Adding value to semen —With IVF, less semen is needed than in a typical AI or ET procedure because oocytes are contained in small dishes during the fertilization period. This allows for tremendous opportunities. Depending on quality, one straw of conventional semen can fertilize oocytes from as many as 15 donors. This allows breeders to maximize the effectiveness of rare or expensive semen. If sex selected pregnancies are desired the IVF system offers distinct advantages over conventional ET. Quality sexed frozen semen tends to be more effective in IVF because less sperm cells are necessary. Generally 1-2 straws are sufficient per donor, depending on how many oocytes she has produced. Semen does not have to be sexed prior to freezing in order to get sexed pregnancies. Conventionally frozen semen can be sorted for the desired sex prior to fertilization in the IVF process – this is termed reverse sorting. It should be noted that not all bulls will work after reverse sorting. Also, oocytes from high producing donors can be placed in separate dishes making it possible to use more than one sire and still be able to identify the matings of the resulting embryos.  Short interval between procedures —The IVF procedure can be repeated more often than conventional ET. Donors are routinely placed on bi-weekly schedules. During a 90 day period a donor could be aspirated up to 6 times. Within a given time frame, more total pregnancies can be created through an IVF program when compared to ET.  Other applications — Because donors do not have to be cycling in order to perform the IVF procedure, embryos can be created from cows that have not yet returned to estrus postpartum and heifers that have not reached puberty. Oocytes can also be recovered from the ovaries of slaughtered females or donors prior to a death event. For Additional Information Click HERE RanchChannel.Com Now Has The Futures Markets Futures Markets RanchChannel.com now has futures markets at your fingertips!  Feeder Cattle, Live Cattle, Corn, Wheat, Soybeans, Soybean Oil, Milk Class IV, and Ethanol.  Information is provided by DTN and market information may be delayed by as much as 10 minutes.  Click Here for more information! The Ranch It Up Radio Show Beef Trivia Contest What is the name of the record $1.51 million bull raised by Schaff Angus Valley? The first correct answer will get a Ranch It Up T-Shirt!  The correct answer is America! UPCOMING SALES & EVENTS ISA Beefmasters: October 5, 2024, San Angelo, Texas World Famous Miles City Bucking Horse Sale: May 15 - 18, 2025   BULL SALE REPORT & RESULTS Churchill Cattle Company Van Newkirk Herefords Gardiner Angus Ranch Cow Camp Ranch Jungels Shorthorn Farms Ellingson Angus Edgar Brothers Angus Schaff Angus Valley Prairie Hills Gelbvieh Clear Springs Cattle Company CK Cattle Mrnak Hereford Ranch Frey Angus Ranch Hoffmann Angus Farms Topp Herefords River Creek Farms Upstream Ranch Gustin's Diamond D Gelbvieh Schiefelbein Farms Wasem Red Angus Raven Angus Krebs Ranch Yon Family Farms Chestnut Angus Eichacker Simmentals & JK Angus Windy Creek Cattle Company Pedersen Broken Heart Ranch Mar Mac Farms Warner Beef Genetics Arda Farms & Freeway Angus Leland Red Angus & Koester Red Angus Fast - Dohrmann - Strommen RBM Livestock Weber Land & Cattle Sundsbak Farms Hidden Angus Wheatland Cattle Company Miller Angus Farms L 83 Ranch U2 Ranch Vollmer Angus Ranch A & B Cattle Carter Angus Farms Roller Ranch Montgomery Ranch Jorgensen Farms DLCC Ranch Four Hill Farm North Country Angus Alliance Spruce Hill Ranch Wilson Angus   FEATURING Brad Brundage Trans Ova Genetics https://transova.com @TransOvaGenetics Kirk Donsbach: Stone X Financial https://www.stonex.com/   @StoneXGroupInc    Mark Vanzee Livestock Market, Equine Market, Auction Time https://www.auctiontime.com/ https://www.livestockmarket.com/ https://www.equinemarket.com/ @LivestockMkt @EquineMkt @AuctionTime Shaye Koester Casual Cattle Conversation https://www.casualcattleconversations.com/ @cattleconvos   Questions & Concerns From The Field? Call or Text your questions, or comments to 707-RANCH20 or 707-726-2420 Or email RanchItUpShow@gmail.com FOLLOW Facebook/Instagram: @RanchItUpShow SUBSCRIBE to the Ranch It Up YouTube Channel: @ranchitup Website: RanchItUpShow.com https://ranchitupshow.com/ The Ranch It Up Podcast is available on ALL podcasting apps. https://ranchitup.podbean.com/ References https://www.stonex.com/ https://www.livestockmarket.com/ https://www.equinemarket.com/ https://www.auctiontime.com/ https://gelbvieh.org/ https://www.imogeneingredients.com/ https://alliedgeneticresources.com/ https://westwayfeed.com/ https://medoraboot.com/ http://www.gostockmens.com/ https://www.imiglobal.com/beef https://www.tsln.com/ https://transova.com/ https://axiota.com/ https://axiota.com/multimin-90-product-label/ https://ranchchannel.com/ https://www.wrangler.com/ https://www.ruralradio147.com/ https://www.rfdtv.com/ https://www.facebook.com/annualfcaqualityreplacementheifersale https://transova.com/ https://transova.com/wp-content/uploads/2020/05/IVF_Powerful_Tool.pdf

In this month's Fertility and Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include a review of studies of menstrual fluid (2:18), changing our language regarding progestin protocols (18:35), and nanoscale motion tracing of spermatozoa (26:46). F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00032-X/fulltext Consider This: https://www.fertstert.org/news-do/language-matters-rename-progestin-priming-progestin-protocols-vitro-fertilization-ivf F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00037-5/fulltext View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

We start to dive into the topic of In Vitro Fertilization.  Plus we have the latest news and markets, and share how you can get your hands on more Ranch It Up Gear by playing What's Your Beef trivia on this all new episode of the Ranch It Up Radio Show.  Be sure to subscribe on your favorite podcasting app or on the Ranch It Up Radio Show YouTube Channel. EPISODE 196 DETAILS Why In Vitro Fertilization From Trans Ova Genetics What Is In Vitro Fertilization In Vitro Fertilization (IVF) is the process of creating embryos from oocytes (unfertilized egg cells) by fertilizing them with semen in a Petri dish. Oocytes are first collected from the ovaries of donors by ultrasound-guided follicular aspiration. They are then matured in a Petri dish and fertilized 20-24 hours later. Conventional, sexed frozen, or reverse-sorted semen may be used for fertilization. Oocytes then develop in an incubator for seven days, at which point the resulting viable embryos are transferred into recipients. Latest Cattle Industry News Colorado has largest H5N1 outbreak in US history Colorado health officials have confirmed 10 human cases of avian flu, marking the largest outbreak of human bird flu infections in U.S. history. The Centers for Disease Control and Prevention (CDC) reported 11 cases of highly pathogenic avian influenza (H5N1) in humans since 2022, with 10 occurring this year. The Colorado Department of Public Health and Environment  announced that two poultry farms in Weld County have birds infected with H5N1, with three confirmed cases at one farm and six at another. Another human case was detected in a dairy farm worker in the state. The state's health agency said the count is up to 47 infected herds in the state. State and federal officials said the concern for the virus is still low due to the lack of person-to-person transmission.  However, the latest scientific article on H5N1 avian influenza finds that the virus, which has forced the culling of tens of millions of birds on poultry farms since January 2022, can spread with relative ease among dairy cows, domestic cats and even a raccoon. So far, no mutations have been found in the strain's genome that would allow the virus to spread more easily in humans, despite the clear transmissions between mammals. Since April 2022, public health authorities have confirmed 11 human cases from cattle and poultry farms, seven of which occurred among workers involved in a cull this summer in response to a poultry outbreak in Colorado. Those human cases showed the same virus circulating in dairy herds, which suggests that the poultry outbreak in that area was transmitted back to birds via local cows. Ag land market could be showing signs of settling According to Farmers National Company, the agricultural land market has been “nothing short of exceptional during the past five years.” Gains in value are common across all classes of land in every region of the country. Strong commodity markets, moderate interest rates, buyer demand and an overall healthy agricultural economy have also supported the growth of land values during this time. Paul Schadegg, senior vice president of real estate operations at Farmers National Company says a lot has changed in the past 12 months and even more has changed within the past five years.  He said moving into the second half of 2023 and the first half of 2024, we've experienced significant increases in interest rates, declining grain markets, and inflation. Despite these negative pressures, the land market has remained relatively resilient but shows signs of settling in general, including single-digit decreases in specific areas.” One aspect of the agricultural land market is the long-term appreciation of land value. Over the past 25 years, land values have experienced a stair-stepping trend following the ups and downs of the agricultural economy. As grain markets and farm profitability rose, the land markets followed while leveling off as markets and profitability did the same. Schadegg said each plateau has set a new value standard sustained through production, demand and profitability. Schadegg went on to say that with farm operators being the largest segment of land buyers, the biggest impact on land values moving forward will be profitability in agriculture. If profit opportunities are limited, motivation to buy will decrease and, subsequently, pressure land values into a downward trend. For more detailed analysis of each region of the country, click HERE. Stockmanship & Stewardship Clinic In Utah For the first time ever, the Stockmanship and Stewardship tour will be hosted in Utah! Hosted at the Sevier County Fairgrounds (Richfield, UT) attendees will experience two days of nothing but cattle talk, trade show, and great food!  World-renowned animal-handling experts will provide cattle-handling demonstrations both horseback and on foot.  Events will also include a live steak cooking demonstration preceding one of the meals provided, several raffles, a panel segment with ag leaders of Utah, and a Q&A session with Congresswoman Celeste Maloy.  For more information, click HERE.  Yearlings and Calves Fetch Top Prices at Northern Livestock Video Auction Summertime Classic Sale The Northern Livestock Video Auction's (NLVA) Summertime Classic sale offered 189,000 head of feeder cattle July 22, 23, 24 & 25. For complete market reports click HERE and HERE. RanchChannel.Com Now Has The Futures Markets Futures Markets RanchChannel.com now has futures markets at your fingertips!  Feeder Cattle, Live Cattle, Corn, Wheat, Soybeans, Soybean Oil, Milk Class IV, and Ethanol.  Information is provided by DTN and market information may be delayed by as much as 10 minutes.  Click Here for more information! The Ranch It Up Radio Show Beef Trivia Contest What Was The First State To Have Cattle In The U.S. The first correct answer will get a Ranch It Up T-Shirt!  The correct answer is Florida! UPCOMING SALES & EVENTS ISA Beefmasters: October 5, 2024, San Angelo, Texas World Famous Miles City Bucking Horse Sale: May 15 - 18, 2025 BULL SALE REPORT & RESULTS Churchill Cattle Company Van Newkirk Herefords Gardiner Angus Ranch Cow Camp Ranch Jungels Shorthorn Farms Ellingson Angus Edgar Brothers Angus Schaff Angus Valley Prairie Hills Gelbvieh Clear Springs Cattle Company CK Cattle Mrnak Hereford Ranch Frey Angus Ranch Hoffmann Angus Farms Topp Herefords River Creek Farms Upstream Ranch Gustin's Diamond D Gelbvieh Schiefelbein Farms Wasem Red Angus Raven Angus Krebs Ranch Yon Family Farms Chestnut Angus Eichacker Simmentals & JK Angus Windy Creek Cattle Company Pedersen Broken Heart Ranch Mar Mac Farms Warner Beef Genetics Arda Farms & Freeway Angus Leland Red Angus & Koester Red Angus Fast - Dohrmann - Strommen RBM Livestock Weber Land & Cattle Sundsbak Farms Hidden Angus Wheatland Cattle Company Miller Angus Farms L 83 Ranch U2 Ranch Vollmer Angus Ranch A & B Cattle Carter Angus Farms Roller Ranch Montgomery Ranch Jorgensen Farms DLCC Ranch Four Hill Farm North Country Angus Alliance Spruce Hill Ranch Wilson Angus FEATURING Emily Warnimont Trans Ova Genetics https://transova.com/ @TransOvaGenetics Kirk Donsbach: Stone X Financial https://www.stonex.com/   @StoneXGroupInc    Mark Van Zee Livestock Market, Equine Market, Auction Time https://www.auctiontime.com/ https://www.livestockmarket.com/ https://www.equinemarket.com/ @LivestockMkt @EquineMkt @AuctionTime Shaye Koester Casual Cattle Conversation https://www.casualcattleconversations.com/ @cattleconvos Questions & Concerns From The Field? Call or Text your questions, or comments to 707-RANCH20 or 707-726-2420 Or email RanchItUpShow@gmail.com FOLLOW Facebook/Instagram: @RanchItUpShow SUBSCRIBE to the Ranch It Up YouTube Channel: @ranchitup Website: RanchItUpShow.com https://ranchitupshow.com/ The Ranch It Up Podcast available on ALL podcasting apps. Rural America is center-stage on this outfit. AND how is that? Tigger & BEC Live This Western American Lifestyle. Tigger & BEC represent the Working Ranch world and cattle industry by providing the cowboys, cowgirls, beef cattle producers & successful farmers the knowledge and education needed to bring high-quality beef & meat to your table for dinner. Learn more about Jeff 'Tigger' Erhardt & Rebecca Wanner aka BEC here: TiggerandBEC.com https://tiggerandbec.com/ #RanchItUp #StayRanchy #TiggerApproved #tiggerandbec #rodeo #ranching #farming References https://www.stonex.com/ https://www.livestockmarket.com/ https://www.equinemarket.com/ https://www.auctiontime.com/ https://gelbvieh.org/ https://www.imogeneingredients.com/ https://alliedgeneticresources.com/ https://westwayfeed.com/ https://medoraboot.com/ http://www.gostockmens.com/ https://www.imiglobal.com/beef https://www.tsln.com/ https://transova.com/ https://axiota.com/ https://axiota.com/multimin-90-product-label/ https://ranchchannel.com/ https://www.wrangler.com/ https://www.ruralradio147.com/ https://www.rfdtv.com/ https://www.facebook.com/annualfcaqualityreplacementheifersale https://transova.com/ https://www.meatingplace.com/Industry/News/Details/115394 https://www.meatingplace.com/Industry/News/Details/115411 https://www.cattlebusinessweekly.com/articles/ag-land-market-could-be-showing-signs-of-settling/ https://www.stockmanshipandstewardship.org/ https://www.northernlivestockvideo.com/catalog-list/?saleid=1517 https://westernagnetwork.com/yearlings-and-calves-fetch-top-prices-at-nlva-summertime-classic-sale?fbclid=IwY2xjawEU3mtleHRuA2FlbQIxMQABHXK4mXlpi2ZP7eUhcxifUlFxPGbTWXFd0J7erN8Vvj-W9uzfQF1LwyRX1Q_aem_WKFFI8lQz0qZ5ce93ATfeg https://usda.library.cornell.edu/concern/publications/vq27zn41g

In this month's Fertility & Sterility: Unplugged, we examine articles from F&S's sister journals! Topics this month include biomarkers for improving sperm parameters with varicocele repair (1:42), side effects with minimal controlled stimulation with in vitro maturation (14:48), and the use of a GnRH antagonist for heavy menstrual bleeding with fibroids (33:53). F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00007-0/abstract F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00029-6/fulltext F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00073-4/fulltext View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include counseling on pregnancy complications in PCOS patients (2:05), sorting early spermatocytes from testicular biopsies (14:04), and diversity statements on REI fellowship websites (27:01). F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00055-2/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00015-6/abstract Consider This: https://www.fertstert.org/news-do/diversifying-future-analyzing-rei-fellowship-websites-and-their-diversity-statements View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: IVF in film (3:03), a rat model of fallopian tube torsion (12:25), comparing letrozole regimens for PCOS (24:13), and a review of chronic endometritis (36:46). Consider This: https://www.fertstert.org/news-do/evaluation-accuracy-and-portrayal-vitro-fertilization-film F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00018-1/abstract F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00045-X/fulltext F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00006-9/abstract   View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: melatonin and implantation (4:38), whole-genome screening of embryos (12:21), and bioengineering assisted reproductive technology (24:45).  Consider This: https://www.fertstert.org/news-do/can-oral-melatonin-supplementation-increase-blastocyst-implantation-success-women F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00001-1/fulltext  F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00002-1/pdf   View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility and Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: fluoroscopic-guided hysteroscopic tubal cannulation (1:59), follicular-fluid phthalates and ovarian reserve (15:26), epigenetics of endometriosis (28:23), and decisions around embryo disposition (40:48). F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00014-X/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(23)00068-X/abstract F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00003-3/abstract  Consider This: https://www.fertstert.org/news-do/fate-supernumerary-cryopreserved-embryos-out-site-but-not-out-mind   View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Amander Clark, Ph.D., delves into crafting artificial ovaries for fertility and aging research. She stresses the importance of diversity in stem cell studies to ensure comprehensive findings. By assembling ovarian models from various genetic backgrounds, her team aims for inclusive representation in biomedical research, potentially offering insights into reproductive health and disease. Series: "Stem Cell Channel" [Health and Medicine] [Show ID: 38334]

Amander Clark, Ph.D., delves into crafting artificial ovaries for fertility and aging research. She stresses the importance of diversity in stem cell studies to ensure comprehensive findings. By assembling ovarian models from various genetic backgrounds, her team aims for inclusive representation in biomedical research, potentially offering insights into reproductive health and disease. Series: "Stem Cell Channel" [Health and Medicine] [Show ID: 38334]

Amander Clark, Ph.D., delves into crafting artificial ovaries for fertility and aging research. She stresses the importance of diversity in stem cell studies to ensure comprehensive findings. By assembling ovarian models from various genetic backgrounds, her team aims for inclusive representation in biomedical research, potentially offering insights into reproductive health and disease. Series: "Stem Cell Channel" [Health and Medicine] [Show ID: 38334]

Amander Clark, Ph.D., delves into crafting artificial ovaries for fertility and aging research. She stresses the importance of diversity in stem cell studies to ensure comprehensive findings. By assembling ovarian models from various genetic backgrounds, her team aims for inclusive representation in biomedical research, potentially offering insights into reproductive health and disease. Series: "Stem Cell Channel" [Health and Medicine] [Show ID: 38334]

Amander Clark, Ph.D., delves into crafting artificial ovaries for fertility and aging research. She stresses the importance of diversity in stem cell studies to ensure comprehensive findings. By assembling ovarian models from various genetic backgrounds, her team aims for inclusive representation in biomedical research, potentially offering insights into reproductive health and disease. Series: "Stem Cell Channel" [Health and Medicine] [Show ID: 38334]

BUFFALO, NY- February 21, 2024 – A new #researchpaper was #published in Aging (listed by MEDLINE/PubMed as "Aging (Albany NY)" and "Aging-US" by Web of Science) Volume 16, Issue 3, entitled, “Disruption of mitochondrial unfolded protein response results in telomere shortening in mouse oocytes and somatic cells.” Caseinolytic peptidase P (CLPP) plays a central role in mitochondrial unfolded protein response (mtUPR) by promoting the breakdown of misfolded proteins and setting in motion a cascade of reactions to re-establish protein homeostasis. Global germline deletion of Clpp in mice results in female infertility and accelerated follicular depletion. Telomeres are tandem repeats of 5'-TTAGGG-3' sequences found at the ends of the chromosomes. Telomeres are essential for maintaining chromosome stability during somatic cell division and their shortening is associated with cellular senescence and aging. In this new study, researchers Mauro Cozzolino, Yagmur Ergun, Emma Ristori, Akanksha Garg, Gizem Imamoglu, and Emre Seli from Yale School of Medicine, IVIRMA Global Research Alliance and Imperial College London asked whether the infertility and ovarian aging phenotype caused by global germline deletion of Clpp is associated with somatic aging, and tested telomere length in tissues of young and aging mice. “In this study, we asked whether the infertility and ovarian aging phenotype caused by global germline deletion of Clpp is associated with somatic aging, and tested telomere length in young and aging mice gametes, gonads and somatic tissues.” The team found that impaired mtUPR caused by the lack of CLPP is associated with accelerated telomere shortening in both oocytes and somatic cells of aging mice. In addition, expression of several genes that maintain telomere integrity was decreased, and double-strand DNA breaks were increased in telomeric regions. Their results highlight how impaired mtUPR can affect telomere integrity and demonstrate a link between loss of mitochondrial protein hemostasis, infertility, and somatic aging. “Our findings demonstrate how loss of mitochondrial protein homeostasis may accelerate telomere shortening in oocytes and somatic cells, and provide a link between reproductive and somatic aging.” DOI - https://doi.org/10.18632/aging.205543 Corresponding author - Emre Seli - emre.seli@yale.edu Sign up for free Altmetric alerts about this article - https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.205543 Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts Keywords - aging, telomere length, Clpp, mitochondrial dysfunction, unfolded protein response About Aging-US Launched in 2009, Aging-US publishes papers of general interest and biological significance in all fields of aging research and age-related diseases, including cancer—and now, with a special focus on COVID-19 vulnerability as an age-dependent syndrome. Topics in Aging-US go beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR, among others), and approaches to modulating these signaling pathways. Please visit our website at https://www.Aging-US.com​​ and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc Media Contact 18009220957 MEDIA@IMPACTJOURNALS.COM

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: HCG as a predictor of pregnancy outcome after IVF (1:38), progestin ovulation suppression and embryo development (13:30), expanded carrier screening in sperm donors (29:30), and the future of fertility in the metaverse (42:30). F&S Reviews: https://www.fertstertscience.org/article/S2666-335X(23)00072-1/pdf   F&S Science: https://www.fertstertreviews.org/article/S2666-5719(24)00001-X/fulltext  F&S Reports: https://www.fertstertreports.org/article/S2666-3341(23)00107-1/fulltext  Consider This: https://www.fertstert.org/news-do/exploring-metaverse-fertility-clinics-future-treatment View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: the growing role of private equity in fertility care with special guests Jane Zhu and Paula Amato (1:26), ART outcomes after fertility-sparing treatment for endometrial neoplasia (21:00), testicular compensation after unilateral orchiectomy in a mouse model (35:00), and comparing ART outcomes between conventional IVF and non-indicated ICSI (44:21). Consider This: https://www.fertstert.org/news-do/growing-role-private-equity-fertility-measured-view F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(23)00010-5/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(23)00053-8/fulltext F&S Reports: https://www.fertstertreports.org/article/S2666-3341(23)00106-X/fulltext View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Fertility & Sterility on Air brings you some great interviews from ASRM 2023 in New Orleans, LA! In Part 2, we bring you some more science, including the first prize paper and discussion with two of our plenary speakers, followed by a focus on the ASRM mission. Topics include: clinical outcomes of mosaic embryo transfers (Manuel Viotti, Svetlana Madjunkova) (1:17), the potential for anti-mullerian hormone as a novel contraceptive (David Pépin) (14:59), a bioengineering approach to the study of endometriosis and adenomyosis (Linda Griffith) (24:10), plans for a year of equity, access, and innovation with new ASRM president Paula Amato (31:34), and Michael Simoni introducing the medical students in the ASRM Career Pathways Program (42:08). View Fertility and Sterility at https://www.fertstert.org/  

Fertility & Sterility on Air brings you some great interviews from ASRM 2023 in New Orleans, LA! In Part 1, we discuss science with leaders in the field and presenters from the conference. Topics include rates of vasectomy after the overturn of Roe v. Wade (Jessica Schardein) (1:11), ultrasound-guided ovarian ablation for PCOS (Karl Hansen) (6:32), intramyometrial carboprost for hysteroscopic myomectomy (Sarah Capelouto Cromack) (16:47), platelet-rich plasma and endometrial quality (Wael Elbanna) (25:09), oral GnRH antagonist for ovarian suppression in IVF (Marco Mouanness) (36:56), use of a microfluidic sperm selection device and blastocyst formation (Robert Rydze) (47:05), and risk of adverse maternal outcomes with fertility treatment across racial and ethnic populations (Sara Phillips) (55:59). View Fertility and Sterility at https://www.fertstert.org/  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: a discussion of the limitations of peer review (1:47), a case of an accessory cavitated uterine mass (12:31), fertility outcomes after uterine niche repair (20:07), and comparing artificial intelligence to embryologist embryo selection (37:50). Consider This: https://www.fertstert.org/news-do/peer-review-today-necessary-yet-inadequate-call-unlocking-potential  F&S Reports: https://www.fertstertreports.org/article/S2666-3341(23)00102-2/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(23)00057-5/pdf F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(22)00006-8/pdf View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: IVF outcomes for patients with HIV (1:33), using sperm methylation patterns to determine IUI and IVF success (13:40), a survey of the public's views on embryo disposition (24:35), and a special visit from F&S Reviews Editor-in-Chief Anne Steiner (34:20)!  Consider This: https://www.fertstert.org/news-do/viewpoints-embryo-cryopreservation-and-disposition-after-overturn-roe-v-wade-amazon  F&S Reports: https://www.fertstertreports.org/article/S2666-3341(21)00041-6/fulltext  F&S Science: https://www.fertstertscience.org/article/S2666-335X(23)00049-6/fulltext F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(23)00008-7/fulltext View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: medications that impair male fertility (1:53), IVF after gender-affirming hormonal therapy in a mouse model (16:26), a randomized trial of follicular vs. luteal IVF starts (22:46), and whether artificial intelligence can improve access to care (32:15). F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(23)00007-5/pdf F&S Science: https://www.fertstertscience.org/article/S2666-335X(23)00048-4/pdf F&S Reports: https://www.fertstertreports.org/article/S2666-3341(23)00078-8/pdf Consider This: https://www.fertstert.org/news-do/can-artificial-intelligence-mitigate-disparities-access-fertility-care   View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

A new editorial paper was published in Aging (listed by MEDLINE/PubMed as "Aging (Albany NY)" and "Aging-US" by Web of Science) Volume 15, Issue 15, entitled, “Epigenetic aging in oocytes.” Aging-related phenotypes span many different tissues and cell types, and start to occur at different ages - a different typical age for every cell type. In their new editorial, researchers Peera Wasserzug-Pash and Michael Klutstein from The Hebrew University of Jerusalem discuss one of the earliest occurring aging events in the human body, which is the beginning of female reproductive aging and deterioration. The clinical cut-off for advanced maternal age (AMA), a condition associated with poor reproductive outcomes, is 35 years old. “The early onset of reproductive aging poses a significant challenge to clinicians since a global consistent increase in maternal age at first birth has occurred in recent decades, effectively shortening the available time window for reproduction [1].” As the rate of patients with advanced maternal age rises, and with it, the number of patients in fertility clinics, so does the necessity for a fundamental understanding of the reproductive aging process. In recent years, it has been established that there is a substantial dominating influence of oocyte quality loss on age-related fertility decline. This is best demonstrated by the rise in IVF success rates in reproductively aged women when they receive an egg donation from a younger woman. Oocyte quality loss is characterized by diminished cellular function and an increased occurrence of chromosomal nondisjunctions. “Our recent publication [4] addresses the question of additional, epigenetic mechanisms that lead to the occurrence of age-related oocyte quality loss.” DOI - https://doi.org/10.18632/aging.204976 Corresponding author - Michael Klutstein - michaelk@ekmd.huji.ac.il Video short - https://www.youtube.com/watch?v=KHOVKKaJykY&t=45s Sign up for free Altmetric alerts about this article - https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.204976 Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts Keywords - aging, oocytes, heterochromatin, epigenetics, maturation About Aging-US Launched in 2009, Aging-US publishes papers of general interest and biological significance in all fields of aging research and age-related diseases, including cancer—and now, with a special focus on COVID-19 vulnerability as an age-dependent syndrome. Topics in Aging-US go beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR, among others), and approaches to modulating these signaling pathways. Please visit our website at https://www.Aging-US.com​​ and connect with us: SoundCloud - https://soundcloud.com/Aging-Us Facebook - https://www.facebook.com/AgingUS/ Twitter - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Media Contact 18009220957 MEDIA@IMPACTJOURNALS.COM

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: age-related mosaic embryo occurrences (1:09), artificial intelligence and time-lapse imaging for euploid embryo selection (10:28), splitting egg freezing between fertility preservation and donation (19:54), and the impact of bariatric surgery on male fertility (25:20).   F&S Reports: https://www.fertstertreports.org/article/S2666-3341(23)00039-9/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(23)00035-6/fulltext Consider This: https://www.fertstert.org/news-do/subsidies-and-reimbursement-medical-fees-revisiting-old-concept-egg-sharing-donation F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(22)00017-2/fulltext   View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: transposons and recurrent pregnancy loss (1:16), male fertility after spinal cord injury (8:52), rise in vasectomy consults after the Dobbs decision (18:25), and a survey of supplement use (24:02). F&S Science:  https://www.fertstertscience.org/article/S2666-335X(23)00033-2/pdf F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(23)00002-6/fulltext Consider This:  https://www.fertstert.org/news-do/increased-focus-vasectomy-overturn-roe-v-wade-catalyzes-rise-u-s-vasectomy-requests F&S Reports:  https://www.fertstertreports.org/article/S2666-3341(22)00138-6/fulltext   View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: DHEA use for IVF patients (2:07), the ideal number of oocytes to reach live birth (10:47), in vitro maturation with cumulus cells (20:57), and sperm DNA fragmentation (29:12). Consider This:  https://www.fertstert.org/news-do/some-caution-dhea-supplementation  F&S Reports:  https://www.fertstertreports.org/article/S2666-3341(23)00046-6/fulltext  F&S Science:  https://www.fertstertscience.org/article/S2666-335X(23)00032-0/fulltext  F&S Reviews:  https://www.fertstert.org/article/S0015-0282(20)31541-7/fulltext  View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.04.20.537668v1?rss=1 Authors: Tatickova, M., Trebichalska, Z., Kyjovska, D., Otevrel, P., Kloudova, S., Holubcova, Z. Abstract: Egg quality is a limiting factor of female fertility and assisted reproductive technology (ART) success. Oocytes recovered from hyperstimulated ovaries often display morphological anomalies suspected to compromise their fertilization and developmental potential. Knowledge of (ab)normal oocytes intracellular organization is vital to establish reliable criteria for morphological evaluation of oocytes intended for in vitro fertilization (IVF). Here, we investigated the fine morphology of 22 dysmorphic IVF oocytes exhibiting different types of cytoplasmic irregularities, namely (1) refractile bodies, (2) centrally-located cytoplasmic granularity (CLCG), (3) smooth endoplasmic reticulum (SER) disc, and (4) vacuoles. Transmission electron microscopy (TEM) revealed the structural basis of these aberrations and indicated that the underlying cause of two of the studied morphotypes was inordinate organelle clustering. To address the mechanism required for accurate organelle positioning, we used cytoskeleton-targeting chemical compounds and performed a series of inhibition experiments involving a total of 133 human oocytes maturing in vitro. Fluorescence and electron microscopy showed that disruption of actin, not microtubules, led to the aggregation of subcellular structures resembling the morphological pattern seen in abnormal oocytes. These results imply that actin serves as a regulator of organelle distribution during human oocyte maturation. The ultrastructural analogy between dysmorphic eggs retrieved in IVF cycles and oocytes, in which actin network integrity was perturbed, suggests that dysfunction of the actin cytoskeleton might be implicated in generating common cytoplasmic aberrations. Knowledge of human oocytes inner workings and the origin of morphological abnormalities is a step forward to more objective egg quality assessment in clinical practice. SUMMARY SENTENCEUltrastructural analysis of eggs exhibiting cytoplasmic abnormalities combined with inhibition experiments indicates that dysfunction of the actin network might be involved in the development of oocyte dysmorphisms. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.03.07.531472v1?rss=1 Authors: Frolikova, M., Blazikova, M., Capek, M., Chmelova, H., Valecka, J., Kolackova, V., Valaskova, E., Gregor, M., Komrskova, K., Horvath, O., Novotny, I. Abstract: Super-resolution (SR) microscopy is a cutting-edge method that can provide detailed structural information with high resolution. However, the thickness of the specimen has been a major limitation for SR methods, and larger structures have posed a challenge. To overcome this, the key step is to optimize sample preparation to ensure optical homogeneity and clarity, which can enhance the capabilities of SR methods for the acquisition of thicker structures. Oocytes are the largest cells in the mammalian body and are crucial objects in reproductive biology. They are especially useful for studying membrane proteins. However, oocytes are extremely fragile and sensitive to mechanical manipulation and osmotic shocks, making sample preparation a critical and challenging step. We present an innovative, simple, and sensitive approach to oocyte sample preparation for 3D STED acquisition. This involves alcohol dehydration and mounting into a high refractive index medium. This extended preparation procedure allowed us to successfully obtain a unique 2-channel 3D STED super-resolution image of an entire mouse oocyte. By optimizing sample preparation, we can overcome the limitations of SR methods and obtain high-resolution images of larger structures, such as oocytes, Knowledge of which are important for understanding fundamental biological processes. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.01.31.525662v1?rss=1 Authors: Smits, M. A. J., Schomakers, B. V., van Weeghel, M., Wever, E. J. M., Wust, R. C. I., Dijk, F., Janssens, G. E., Goddijn, M., Mastenbroek, S., Houtkooper, R., Hamer, G. Abstract: Human ovarian ageing encompasses the age-related decline in female fertility. Oxidative stress and mitochondrial dysfunction in oocytes are suggested as causal, but corroborating evidence is limited. Using immunofluorescence imaging on human ovarian tissue, we found oxidative damage by protein and lipid (per)oxidation at the primordial follicle stage. Additionally, using comprehensive metabolomics and lipidomics, a cohort of 150 human germinal vesicles and metaphase I oocytes and 15 corresponding cumulus cell samples displayed a shift in glutathione to oxiglutathione ratio and depletion of phospholipids. Age-related changes in polar metabolites suggested a decrease in mitochondrial function, as demonstrated by NAD+, purine and pyrimidine depletion, while glycolysis substrates and glutamine accumulated with age. Oocytes of advanced maternal age likely used alternative energy sources like glycolysis and the adenosine salvage pathway, and possibly increased ATP production in cumulus cells. These findings indicate that oocytes of advanced maternal age suffer from oxidative damage and mitochondrial dysfunction. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.01.13.523952v1?rss=1 Authors: Mihalas, B. P., Pieper, G. H., Currie, C. E., Kelly, D. A., Hartshorne, G. M., McAinsh, A. D., Anderson, R. A., Marston, A. L. Abstract: Aneuploid human eggs (oocytes) are a major cause of infertility, miscarriage and chromosomal disorders. Such aneuploidies increase greatly as women age, originating from defective linkages between sister-chromatids (cohesion) in meiosis. We found evidence that loss of a specific pool of the cohesin protector protein, shugoshin 2 (Sgo2) contributes to this phenomenon. Our data indicate that Sgo2 preserves sister chromatid cohesion in meiosis by protecting a cohesin bridge between sister chromatids. In human oocytes, Sgo2 localizes to both sub-centromere cups and the pericentromeric bridge which spans the sister chromatid junction. Sgo2 normally colocalizes with cohesin, however, in oocytes from older women, Sgo2 is frequently lost specifically from the pericentromeric bridge and sister chromatid cohesion is weakened. Mps1 and Bub1 kinase activities maintain Sgo2 at sub-centromeres and the pericentromeric bridge. Removal of Sgo2 throughout meiosis I by Mps1 inhibition reduces cohesion protection, increasing the incidence of single chromatids at meiosis II. Therefore, Sgo2 deficiency in human oocytes can exacerbate the effects of maternal age by rendering residual cohesin at pericentromeres vulnerable to loss in anaphase I. Our data show that maternal age-dependent loss of Sgo2 at the pericentromere bridge in human oocytes impairs cohesion integrity and contributes to the increased incidence of aneuploidy observed in human oocytes with advanced maternal age. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.11.17.516899v1?rss=1 Authors: Jung, G. I., Londono-Vasquez, D., Park, S., Skop, A., Balboula, A., Schindler, K. Abstract: Successful embryo development is dependent upon maternally deposited components. During egg formation, developmental competence is acquired through regulated translation of maternal mRNA stores. In addition, egg precursors undergo two rounds of chromosome segregation, each coupled to an asymmetric cytokinesis that produces two non-functional polar bodies. In somatic cells, cytokinesis produces two daughter cells and one midbody remnant (MBR), a signaling organelle assembled from the midbody (MB), which first appears in Telophase. MBs contain transcription and translation factors, and epigenetic modifiers. Once MBs mature to MBRs by abscission, they can be subsequently phagocytosed by another cell and influence cellular function or fate. Although the significance of MBs is elucidated in several cell types like neurons, cancer cells and stem cells, the presence and function of MBs in gametes and their roles in reproductive fitness are unknown. Here, we examined the formation and regulation of meiotic midbodies (mMB) in mouse oocytes. We find that although mouse oocyte mMBs contain analogous structures to somatic MBs, they also have a unique cap-like structure composed of the centralspindlin complex, and that cap formation depends upon an asymmetric microtubule abundance in the egg compared to the polar body. Furthermore, our results show that mMBs are translationally active ribonucleoprotein granules, supported by detection of ribosomes, polyadenylated mRNAs and nascent translation. Finally, by pharmacological and laser ablation-based approaches, we demonstrate that the mMB cap is a barrier to prevent translated products from leaving the egg and escaping into the polar body. Crucially, this barrier is critical for successful early embryonic development. Here, we document an evolutionary adaptation to the highly conserved process of cytokinesis in mouse oocytes and describe a new structure and new mechanism by which egg quality and embryonic developmental competence are regulated. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.11.04.514992v1?rss=1 Authors: Leem, J., Kim, J.-S., Oh, J. S. Abstract: Because DNA double-strand breaks (DSBs) greatly threaten genomic integrity, effective DNA damage sensing and repair are essential for cellular survival in all organisms. However, DSB repair mainly occurs during the interphase and is repressed during mitosis. Here, we show that, unlike mitotic cells, oocytes can repair DSBs during meiosis through microtubule-dependent chromosomal recruitment of the CIP2A-MDC1-TOPBP1 complex from spindle poles. After DSB induction, we observed spindle shrinkage and stabilization, as well as BRCA1 and 53BP1 recruitment to chromosomes and subsequent DSB repair during meiosis I. Moreover, p-MDC1 and p-TOPBP1 were recruited from spindle poles to chromosomes in a CIP2A-dependent manner. This pole-to-chromosome relocation of the CIP2A-MDC1-TOPBP1 complex was impaired not only by depolymerizing microtubules but also by depleting CENP-A or HEC1, indicating that the kinetochore/centromere serves as a structural hub for microtubule-dependent transport of the CIP2A-MDC1-TOPBP1 complex. Mechanistically, DSB-induced CIP2A-MDC1-TOPBP1 relocation is regulated by PLK1 but not by ATM activity. Our data provide new insights into the critical crosstalk between chromosomes and spindle microtubules in response to DNA damage to maintain genomic stability during oocyte meiosis. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.10.28.514302v1?rss=1 Authors: Radousky, Y. A., Hague, M. T. J., Fowler, S., Paneru, E., Codina, A., Rugamas, C., Hartzog, G., Cooper, B. S., Sullivan, W. Abstract: A broad array of endosymbionts radiate through host populations via vertical transmission, yet much remains unknown concerning the cellular basis, diversity and routes underlying this transmission strategy. Here we address these issues, by examining the cellular distributions of Wolbachia strains that diverged up to 50 million years ago in the oocytes of 18 divergent Drosophila species. This analysis revealed three Wolbachia distribution patterns: 1) a tight clustering at the posterior pole plasm (the site of germline formation); 2) a concentration at the posterior pole plasm, but with a significant bacteria population distributed throughout the oocyte; 3) and a distribution throughout the oocyte, with none or very few located at the posterior pole plasm. Examination of this latter class reveals Wolbachia accesses the posterior pole plasm during the interval between late oogenesis and the blastoderm formation. We also find that one Wolbachia strain in this class concentrates in the posterior somatic follicle cells that encompass the pole plasm of the developing oocyte, suggesting these are the source of Wolbachia that ultimately occupy the germline. In contrast, strains in which Wolbachia concentrate at the posterior pole plasm generally exhibit no or few Wolbachia in the follicle cells associated with the pole plasm. Phylogenomic analysis indicates that closely related Wolbachia strains tend to exhibit similar patterns of posterior localization, suggesting that specific localization strategies are a function of Wolbachia-associated factors. Previous studies revealed that endosymbionts rely on one of two distinct routes of vertical transmission: continuous maintenance in the germline (germline-to-germline) or a more circuitous route via the soma (germline-to-soma-to-germline). Here we demonstrate that Wolbachia strains infecting Drosophila species maintain the diverse arrays of cellular mechanisms necessary for both of these distinct transmission routes. This characteristic may account for its ability to infect and spread globally through a vast range of host insect species. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

On this episode we discuss the document on vitrification released earlier this year. Our guest today is Dr. Sangita Jindal, the IVF Lab Director and associate professor at the Albert Einstein College of Medicine and Montefiore's Institute for Reproductive Medicine. Link to document: A review of best practices of rapid-cooling vitrification for oocytes and embryos: a committee opinion More information on these topics is at www.asrm.org Tell us your thoughts on the show by e-mailing asrm@asrm.org Please subscribe and rate the show on Apple podcasts ,Google Play, or wherever you get your podcasts. ASRM Today Series Podcasts are supported in part by the ASRM Corporate Member Council

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.08.01.232512v1?rss=1 Authors: Jang, J. K., Gladstein, A., Das, A., Cisco, Z., McKim, K. Abstract: Meiosis in female oocytes lack centrosomes, the major microtubule-organizing center, which may make them especially vulnerable to aneuploidy. In the acentrosomal oocytes of Drosophila, meiotic spindle assembly depends on the chromosomal passenger complex (CPC). Aurora B is the catalytic component of the CPC while the remaining subunits regulate its localization. Using an inhibitor of Aurora B activity, Binucleine 2, we found that continuous Aurora B activity is required to maintain the oocyte spindle during meiosis I. Furthermore, the necessity of a kinase for spindle regulation suggests that spindle dynamics is regulated by phosphatases. Our result have shown that the protein complex Protein Phosphatase 2A (PP2A) opposes CPC activity, probably by dephosphorylating spindle associated proteins such as the Kinesins. PP2A exists in two varieties, B55 and B56. While both antagonize Aurora B, they typically exhibit different localization and function. B55 has only minor roles in meiosis I spindle function. The B56 subunit is encoded by two partially redundant paralogs in the Drosophila genome, wdb and wrd. Knocking down both B56 subunits showed they are critical for multiple functions during meiosis I, including maintaining sister centromere and arm cohesion, end-on microtubule attachments, and the metaphase I arrest in oocytes. We found that WDB recruitment to the centromeres depends on BubR1, MEI-S332, and kinetochore protein SPC105R. However, only SPC105R is required for cohesion maintenance during meiosis I. We propose that SPC105R promotes cohesion maintenance by recruiting two proteins that further recruit PP2A, MEI-S332, and the Soronin homolog Dalmatian. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.07.30.228270v1?rss=1 Authors: Imakubo, M., Takayama, J., Okada, H., Onami, S. Abstract: Background: Oocyte quality decreases with aging, thereby increasing errors in fertilization, chromosome segregation, and embryonic cleavage. Oocyte appearance also changes with aging, suggesting a functional relationship between oocyte quality and appearance. However, no methods are available to objectively quantify age-associated changes in oocyte appearance. Results: We show that statistical image processing of Nomarski differential interference contrast microscopy images can be used to quantify age-associated changes in Caenorhabditis elegans oocyte appearance. Max-min Value (mean difference between the maximum and minimum intensities within each moving window) quantitatively characterized the difference in oocyte cytoplasmic texture between 1- and 3-day-old adults (Day 1 and Day 3 oocytes, respectively). With an appropriate parameter set, the gray level co-occurrence matrix (GLCM)-based texture feature Correlation (COR) more sensitively characterized this difference than the Max-min Value. Manipulating the smoothness of and/or adding irregular structures to the cytoplasmic texture of Day 1 oocyte images reproduced the difference in Max-min Value but not in COR between Day 1 and Day 3 oocytes. Increasing the size of granules in synthetic images recapitulated the age-associated changes in COR. Manual measurements validated that the cytoplasmic granules in oocytes become larger with aging. Conclusions: The Max-min Value and COR objectively quantify age-related changes in C. elegans oocyte in Nomarski DIC microscopy images. Our methods provide new opportunities for understanding the mechanism underlying oocyte aging. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.06.27.174136v1?rss=1 Authors: Greenblatt, E. J., Spradling, A. C. Abstract: Mutations in Fmr1 are the leading heritable cause of intellectual disability and autism spectrum disorder. We previously found that Fmr1 acts as a ~2-fold activator of translation of large proteins in Drosophila oocytes, in contrast to its proposed role as a repressor of translation elongation. Here, we show that genes associated with autism spectrum disorders tend to be dosage-sensitive and encode proteins that are larger than average. Reanalysis of Fmr1 KO mouse cortex ribosome profiling data demonstrates that autism-associated mRNAs encoding large proteins exhibit a concordant reduction in ribosome footprints, consistent with a general role for Fmr1 as a translational activator. We find no evidence that differential ribosomal pausing affects translational output in Fmr1-deficient Drosophila oocytes or mouse cortex. Furthermore, long Fmr1 target transcripts are preferentially enriched in stress granules upon acute stress. Our data thus identify a critical role for Fmr1 in promoting the translation of long, stress-sensitive, autism-associated mRNAs. Copy rights belong to original authors. Visit the link for more info

In Australia the wait for donor oocytes in some fertility clinics is up to 3 years. The options for most people ttc is to ask friends or relatives, advertise themselves or use overseas companies to source oocytes for their long awaited child. Genevieve Uys was an oocyte donor herself and has 9 donor children around the world. After her experiences donating oocytes, she found herself in a unique position to create her own company to assist more families complete their dream of having a baby. Traveling donors has a database of oocyte donors and will work with fertility clinics to co-ordinate cycles and prepare all the necessary documentation. IG : @traveling_donors  IG : @just.vieve   www.travelingdonors.com    https://web.facebook.com/Traveling.Donors/

This week I wanted to discuss a common pattern that we all use from time to time, projection. I don’t mean the obvious ones, such as getting stuck in traffic and coming home grumpy. Or having a tough meeting and taking your frustration out of your work colleagues … I am talking about the sneakier projections, the ones that build up over time. Once you get to know the clues, you will be able to spot these projections much sooner and take evasive action! So, let’s jump right into the podcast …. Perception is Projection is a common term used today to describe how we interact with others and project onto them, what we are refusing to acknowledge in ourselves. ‘Our outer world is indeed a reflection of our inner world’

The topic is meiosis in mammalian oocytes, or how we make the eggs that make our babies. Molecular biology research happens at the Medical Research Council lab of Molecular Biology in Cambridge. The LMB... The post scientist 65: the cytologist – Melina Schuh oocytes and reproduction (2014) appeared first on Roger Frost: science, sensors and automation.

We take a trip back to the womb and before, to find out about early development. Plus, the importance of placentas, why the age of your womb rather than your eggs matters, and a video game-inspired gene of the month. Like this podcast? Please help us by supporting the Naked Scientists

In my thesis 25 feline ovaries (Felis catus) were studied using histological, glycohistochemical, immunhistochemical and ultrastructural methods. Additionally to the different follicle stages, the ovarian stroma and the thecal glands were also evaluated. For the glycohistochemical investigations, an appropriate panel of lectins was used, including Concanavalin Agglutinin (Con A), Wheat germ Agglutinin (WGA), Wheat germ Agglutinin succinylated (WGAs), Sambucus nigra Agglutinin (SNA) , Pisum sativum Agglutinin (PSA), Ricinus communis Agglutinin (RCA), Viscum album Agglutinin (VAA), Phaseolus vulgatis Erythroagglutinin (PHA E), Maackia amurensis Agglutinin I (MAA I), Phaseolus vulgaris Leukoagglutinin (PHA L), Sophora japonica Agglutinin (SJA) and Griffonia simplicifolia Agglutinin I (GSA I). The most interesting glycohistochemical staining was the strong reaction of WGA in the zona pellucida and the surrounding corona radiata cells. The staining with WGA-FITC demonstrates N-acetylglucosamine and sialic acids in the zona pellucida and the surrounding corona radiata. The immunhistochemical examination using antibodies against cytokeratins, vimentin, laminin, desmin, synemin, tubulin, SMA, S100, connexin 43, ERα and progesterone receptors showed the localization of cytoskeletal components within the different compartments of the feline ovary and the distribution of steroid hormone receptors. The ovarian surface epithelium contains not only cytokeratins but also synemin and nuclear estrogen receptors. The interstitial gland cells show a strong immunohistochemical staining with antibodies against vimentin, S100 and connexin 43. A similar immunohistochemical staining pattern was also observed in cells of the theca interna of tertiary follicles. The immunohistochemical staining pattern differs between the luteal cells derived from granulosa cells (granulosa lutein cells) or from thecal cells (theca lutein cells). The small theca cells only showed a distinct reaction with tubulin and S100 antibodies, in contrast to the large luteal cells which reacted much more strongly. In the rete ovarii the expression of cytokeratins, tubulin, progesterone receptors and ERα could be immunohistochemically demonstrated. Oocytes of the follicles of different developmental stages only showed a positive reaction with the synemin antibody. At all developmental stages, the follicle cells showed a strong immunohistochemical staining with the tubulin antibody. The intensity of connexin immunostaining increased during follicular development within the follicular epithelium from primordial to tertiary follicles. This proves the increase in the number of gap junctions in the follicular epithelium during follicle growth. In contrast the staining intensity with the vimentin antibody decreased in granulosa cells from primordial to tertiary follicles. This may indicate the remodelling of the cytoskeleton of the granulosa cells in growing follicles to obtain steroidogenic potential. The formation of nuclear ERα and progesterone receptors varies under the influence of different hormones, depending on the ovarian cycle. The rete ovarii is the only structure in which both receptor types are expressed. ERα can be detected in granulosa cells of some primary follicles, as well as in the ovarian surface epithelium. Progesterone receptors are localized in the theca interna of tertiary follicles and in small luteal cells and fibrocytes of the corpus luteum. In conclusion the feline ovary shows, in comparison to other mammals, an early differentiation of cytoskeletal and glykan containing elements. The zona pellucida is already formed in primary follicles and the granulosa cells contain vimentin filaments and gap junctions, which can already be observed in the stage of primordial follicle. The distribution of the S100 protein in the ovary of the cat differs fundamentally from all other species investigated so far. S100 was predominantly found in steroidogenic cells and may indicate its involvement in steroidogenesis, in conjunction with the expression of vimentin and connexin.

Frog oocytes evade the checkpoint Most dividing cells possess a spindle assembly checkpoint that prevents them from entering anaphase until all their chromosomes are correctly attached to the metaphase spindle. Shao et al. reveal that Xenopus eggs lack this checkpoint, allowing them to undergo meiosis in the absence of microtubules or in the presence of monopolar spindles. This biosights episode presents the paper by Shao et al. from the April 15, 2013 issue of The Journal of Cell Biology and includes an interview with senior author Johné Liu (Ottawa Hospital Research Institute, Canada). Produced by Caitlin Sedwick and Ben Short. See the associated paper in JCB for details on the funding provided to support this original research. Subscribe to biosights via iTunes or RSS View biosights archive The Rockefeller University Press biosights@rockefeller.edu

Although many aspects of ovarian differentiation have been established,comparatively little is known about prenatal follicle formation anddifferentiation of bovine ovaries. The objective of this investigationwas to study the role of the surface epithelium during the developmentof germ cell nests, germ cell cords and follicle formation in the fetalbovine ovary. Associated important proliferation and apoptotic featureswere further investigated. Additionally, the expression pattern of theS100 protein was detected. A strong increase of mitotic figures wasdetected in the surface epithelium, germ cell nests and germ cell cordsof ovaries with a crown-rump length (CRL) of 13.0-58.0 cm. Oocytes werepositively stained with S100 in bovine ovaries from fetuses with a CRLof 21.0 cm. The staining intensity enhanced parallel to increasingoocyte and follicle sizes during the ovary development. In later stages,a strong staining for S100 was observed in healthy oocytes incontradistinction to atretic oocytes where no expression of the S100protein could be found. In conclusion, increasing mitosis index ofsurface epithelium cells, as well as oogonia directly beneath thesurface epithelium, in combination with open surface connection duringstages from a CRL of 11.0-94.0 cm of bovine fetal ovaries could play animportant role in the period of time of ongoing folliculogenesis andderivation of granulosa cells. Additionally, S100-positive oocytes inprimordial and later follicle stages joined by a high rate ofKi67-positive index in surrounding granulosa cells indicate that in theoocytes the S100 protein can perhaps be a useful marker for intactoocytes in bovine ovaries.

Sat, 11 Feb 2012 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/14244/ https://edoc.ub.uni-muenchen.de/14244/1/Demant_Myriam.pdf Demant, Myriam ddc:590, ddc:500, Tierärztl

Professor Kindregan discusses issues surrounding oocyte retrieval for the purpose of posthumous reproduction following anoxic brain injury. The NE Journal of Medicine published an article on this topic featuring Professor Kindregan July 15, 2010.

Guest: Brian Kaplan, MD Host: Lauren Streicher, MD While freezing embryos has long been an option, many single women who hope to have a future partner, are requesting oocyte preservation rather than utilizing donor sperm. Dr. Kaplan discusses new methods of cryopreservation , current clinical recommendations and outcomes.

Guest: Brian Kaplan, MD Host: Lauren Streicher, MD While freezing embryos has long been an option, many single women who hope to have a future partner, are requesting oocyte preservation rather than utilizing donor sperm. Dr. Kaplan discusses new methods of cryopreservation , current clinical recommendations and outcomes.

The objective of this work was to examine follicular and oocyte growth in canine ovaries with light and electron microscopic techniques and to characterize canine oocytes during in vitro maturation. Ovaries of healthy bitches of different ages (4 months to 12.5 years)and breeds were used, which had undergone elective ovariohysterectomy at local veterinary clinics. The ovaries of 15 bitches were fixed in Bouin`s solution or paraformaldehyde (4%) for immunohistochemical studies and of three bitches in Karnovsky`s solution for electron microscopic evaluation. COCs and oocytes were recovered from 61 other bitches by slicing the ovaries. They were then examined before and after in vitro maturation (24 to 72 hours) in modified TCM-199 either by native evaluation or after fixation in paraformaldehyde (4%) and nuclear staining (propidium iodide/Hoechst 33342), immunofluorescence or glycohistochemistry. The evaluation of the fluorescence microscopic staining was performed by confocal laser scanning microscopy. Oocytes and COCs after 0, 24, 72 and 90 hours of in vitro maturation were also subjected to electron microscopic examination. The morphology of the canine ovary in light and electron microscopic aspects is comparable to that of other domestic animals. Primordial, primary, secondary and tertiary follicles were regularly seen. The diameter of the oocytes and of the germinal vesicle, as well as the thickness of the zona pellucida, clearly increases during oocyte development. Growing canine oocytes are characterized ultrastructurally by rapid growth in the number of cellular organelles, particularly mitochondria, smooth endoplasmatic reticulum and lipid droplets. Mitotic division starting at the primary follicle stage can be regularly observed by immunostaining with the proliferation marker Ki-67. Further immunohistochemical studies on ovaries indicate that estrogen receptors alpha and beta, as well as MMP-1, -2, -14 and TIMP-2 show a specific distribution in bitches. Canine oocytes could easily be isolated by slicing the ovaries. The number of recovered oocytes was clearly influenced by the age of the donor bitch but not by the breed, the reproductive status or the transportation time between time of surgery in the veterinary clinic and the recovery of the oocytes in the laboratory. 48% of all isolated oocytes had a dark homogenous ooplasm and multiple dense layers of cumulus cells. After in vitro maturation, morphological changes like the formation of vesicles and the loss of cumulus cells could be observed in most of the COCs. Immediately after recovery, the nuclei of all oocytes were at the germinal vesicle stage, although the chromatin showed different degrees of condensation. While first signs of the resumption of meiosis were seen after 24 hours of culture, only one oocyte in metaphase II could be seen after 72 hours. Nuclear and cytoplasmatic maturation could be detected by electron microscopy for up to 24 hours of in vitro culture, as well as signs of degeneration, which were even more prominent after longer culture periods. The immunoreaction of ZP3beta, alpha-Tubulin and Connexin 43 and the binding sites of the lectins WGA and SBA showed characteristic changes in canine oocytes and COCs before and after in vitro maturation.

Sat, 1 Jan 1994 12:00:00 +0100 http://epub.ub.uni-muenchen.de/3652/ http://epub.ub.uni-muenchen.de/3652/1/3652.pdf Singer-Lahat, Dafna; Lotan, Ilana; Biel, Martin; Flockerzi, Veit; Hofmann, Franz; Dascal, Nathan Singer-Lahat, Dafna; Lotan, Ilana; Biel, Martin; Flockerzi, Veit; Hofmann, Franz und Dascal, Nathan (1994): Cardiac calcium channels expressed in Xenopus oocytes are modulated by dephosphorylation but not by cAMP-dependent phosphorylation. In: Receptors and Channels, Vol. 2: pp. 215-226.

L-Type calcium channel was expressed in Xenopus laevis oocytes injected with RNAs coding for different cardiac Cu2+ channel subunits, or with total heart RNA. The effects of activation of protein kinase C (PKC) by the phorbol ester PMA (4β-phorbol 12-myristate 13-acetate) were studied. Currents through channels composed of the main (1) subunit alone were initially increased and then decreased by PMA. A similar biphasic modulation was observed when the 1 subunit was expressed in combination with 2/δ, β and/or γ subunits, and when the channels were expressed following injection of total rat heart RNA. No effects on the voltage dependence of activation were observed. The effects of PMA were blocked by staurosporine, a protein kinase inhibitor. β subunit moderated the enhancement caused by PMA. We conclude that both enhancement and inhibition of cardiac L-type Ca2+ currents by PKC are mediated via an effect on the 1 subunit, while the β subunit may play a mild modulatory role.