[ΙΤ]Exposure to chemicals may reduce the size of ovarian reserve and linked to lower egg counts in humans

Fertility in women is dependent on ovarian follicles that contain immature oocytes. All follicles are formed during fetal development and should last for the reproductive lifespan of the woman. At most, there are a few million non-growing follicles in the ovaries of the female fetus during mid-gestation, and thereafter, the numbers decrease.

At the onset of puberty, a few hundred thousand follicles remain. Menopause commences when the number of follicles has decreased to a level that cannot sustain the hormonal secretion required for menstrual cycle. On average, the age at the onset of natural menopause is around 50 years. Cessation of menstrual cycles before the age of 40 years is classified as premature ovarian insufficiency.

There are no direct ways of counting the numbers of non-growing follicles present in ovaries in vivo, and therefore, several surrogate markers are used instead. For example, antral follicle count (AFC), serum levels of follicle stimulating hormone (FSH), estradiol and anti-Müllerian hormone (AMH) are commonly used to estimate ovarian reserve although all these markers relate more directly to growing follicles.

AMH is a growth factor secreted by primary, secondary and small antral follicles up to about 4 mm in diameter. It has become an established biomarker of ovarian reserve due to several advantages over other methods: serum AMH can be easily measured from a single blood sample and the levels do not significantly fluctuate during ovarian cycle. However, AMH also has its limitations. It may fluctuate during the course of pregnancy. While it is mostly used in fertility investigations, AMH does not predict fecundability or other outcomes in the general population. The value of AMH as a biomarker of ovarian reserve in healthy women, and factors affecting its level, still needs more research.

Several reviews have raised concerns about the effects of pervasive exposure to industrial chemicals on reproductive health in women. Major international organizations highlight the need to study chemical disruption of female reproductive system in more detail, including the Endocrine Society, World Health Organization and International Pollutants Elimination Network and the International Federation of Gynecology and Obstetrics.

The study cohort consisted of women who underwent elective caesarean section at the Karolinska University Hospital Huddinge. During the period 2015 –2018, there were 145 women who participated in the study. The scientists wanted to focus specifically on fertility in women and investigated associations between chemical exposures and ovarian reserve. Using a cohort of pregnant women undergoing caesarean section, they had a unique opportunity to measure the size of ovarian reserve in two ways: directly by counting the numbers of follicles in biopsied ovarian tissue samples, and indirectly by measuring the level of AMH in serum by retrieving biobanked samples collected during routine first visit for antenatal care.

Concentrations of 31 persistent organic pollutants (POPs) were measured in the same serum samples. Collectively, their results confirm the often-reported association of POPs with higher odds for infertility time-to-pregnancy (TTP >12 months) and further suggest that exposure to lipophilic POPs associates with lower ovarian reserve. Although the cohort was relatively small, this encourages to pursue studies on chemicals and germ cell quantity in women in more detail, a topic that has been studied for decades in men.

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

New evidence identified on safety of IVF embryo screening method

Researchers at the University of Kent have identified crucial new evidence on the safety and efficacy of a controversial area of IVF treatment – preimplantation genetic testing for aneuploidy (PGT-A).

PGT-A is the screening for gross genetic (chromosomal) abnormalities in human IVF embryos with a view to improving IVF success rates and guarding against miscarriage. The UK Human Fertilisation and Embryology Authority’s (HFEA) however recently assigned it a “red light” in terms of its safety and efficacy. The current study provides strong evidence for the benefits of PGT-A.
The, researchers used the HFEA’s own 2016-2018 data to examine live birth and other outcomes reported, with and without PGT-A. Statistical analysis of differences between PGT-A and “regular” IVF cycles was performed, grouping by maternal age, the leading known risk factor for chromosome abnormalities.

Data was gathered for nearly 2,500 PGT-A, out of a total of over 190,000 cycles in total. Live Birth Rate per embryo transferred and per treatment cycle was significantly higher for all PGT-A vs regular IVF age groups. In patients aged over 40, the reported live birth rates were 3-11 times greater when using PGT-A compared to regular IVF alone.
There was also a reduced number of transfers per live birth, particularly for women aged over 40, implying patients became pregnant faster if PGT-A was used.
Though the study identified strong evidence-based benefits of PGT-A, it is limited in matching with complete clinical indication information, PGT-A and non PGT-A cohorts.

PGT-A is a controversial process in IVF. Proponents argue that evidence suggests this treatment is effective and safe. Opponents argue that, until randomised clinical trials establish this unequivocally, patients should not be subjected to it; especially as this is a paid-for treatment.
On the basis of a traffic light system designed to assess the suitability of adjunct treatments for IVF, the HFEA previously assigned the process two Red Lights as a treatment whose efficacy and safety had not been established. This was recently changed to one red light.

Darren Griffin, Professor of Genetics at Kent and Lead Author on the paper said: ‘This data will hopefully aid the HFEA in their continual surveillance of the “Red traffic light” guidance that currently states there is no evidence that PGT-A is effective or safe. The guidance could be revised in the light of this new data for patient benefit. I appreciate the collegial way in which the HFEA have assisted in providing this data and their open-mindedness to the prospect of revisiting their guidance and traffic light system.’

Source: Obs Gynae &Midwifery News

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

Intake of red meat, either as processed or unprocessed, is a major culprit in promoting endometriosis risk

Endometriosis is an estrogen-dependent chronic gynecologic disorder that significantly reduces the quality of life of affected women. Characterized by adhesions of endometrial fragments in extra-uterine sites (predominantly in the peritoneal cavity and ovary but occasionally on the diaphragm, liver, and abdominal wall), the condition occurs in ~10% of the general population and is associated with infertility, pelvic pain, and increased risks for ovarian and other cancers.

Our understanding of its etiology and complex, multi-factorial origins remains inadequate. Moreover, its asymptomatic nature at the early stages can significantly delay clinical diagnosis. Treatment options are currently limited to hormonal therapy or surgical management; however, these methods are non-curative, may not align with women’s reproductive goals, and frequently lead to recurrence after cessation of treatment. Delineating the factors that contribute to lesion development and progression is key to providing opportunities for prevention and more efficacious therapeutic interventions.

Diet is a leading risk factor for many chronic diseases. The linkage between diet and endometriosis, summarized in a recent review, underscores the ability of anti-inflammatory components present in foods to mitigate endometriosis. Nevertheless, there are certain caveats to consider. Read more:

What do you think about “stop eating red meat”?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

Doing more with less: Sperm without a fully active tail move faster and more efficiently

Sperm cells moving their long tail to swim through the body in search of an egg is a familiar image, but a fully ‘powered’ tail may not be the key to success, according to a new UK study which could be crucial for improving the outcomes of assisted fertility treatments.


Propulsion of sperm and how the cell uses its tail to move through the thick fluids of the reproductive tract to reach and fertilise an egg has been well studied. However, the role of the specific parts of the tail, including the inactive area at the very tip, which it is thought, lacks the structure needed to generate motor activity, remains unclear.

A multi-disciplinary team of mathematicians and scientists from the University of Birmingham used mathematical simulations to analyse the effect that this inactive region has on the overall movement of the sperm and how this contributes to the speed and efficiency of the cell’s motility. The study is the first modelling simulation study to investigate the detailed effects of this area, which measures just 3 microns – or 25 times smaller than the width of a human hair.

Results showed that instead of hindering the cell, the inactive region at the end of the tail actually enables faster and more efficient swimming. Simulations showed as much as a 430% increase in efficiency and a 70% increase in velocity in sperm cells with an inactive end region of the tail compared with cells where the tail was fully active. It is thought that the research could offer key insights into what enables a sperm cell to function.

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

Is there any seasonal pattern to fecundability? When is most likely for babies to be conceived?

In human populations, there are strong seasonal patterns of births that vary across geographic regions and time periods. However, previous studies of seasonality and fecundity are limited because they examine season of birth rather than season of conception and therefore neglect to account for seasonal variation in initiating attempts to conceive or pregnancy loss or differences in gestational length.

The scientists conducted a preconception cohort study of 14.331 women residing in North America. Participants were attempting to conceive without fertility treatment and had been attempting pregnancy for ≤6 menstrual cycles at enrolment. They collected information on season of each pregnancy attempt using last menstrual period dates over the study period. Pregnancy was reported on female bi-monthly follow-up questionnaires. They fit log-binomial models with trigonometric regression to examine periodic variation in fecundability. They accounted for seasonal variation in initiation of pregnancy attempts by including indicator variables for menstrual cycle of attempt in the regression models.

According to the results the initiation of pregnancy attempts peaked in September, with stronger seasonality in North America than in Denmark (48 vs. 16% higher probability initiating attempts in September compared with March). After accounting for seasonal variation in initiation of pregnancy attempts, they observed modest seasonal variation in fecundability, with a peak in the late fall and early winter in both cohorts, but stronger peak/low ratios in North America (1.16; 95% confidence interval [CI]: 1.05, 1.28) than in Denmark (1.08; 95% CI: 1.00, 1.16). When they stratified the North American data by latitude, they observed the strongest seasonal variation in the southern USA (peak/low ratio of 1.45 [95% CI: 1.14, 1.84]), with peak fecundability in late November.

An understanding of how fecundability varies across seasons could help identify factors that can impair reproductive function. Neglecting to account for seasonal variation in initiation of pregnancy attempts could bias estimates of seasonal patterns in fecundability. This is the first preconception cohort study to examine seasonal variation in fecundability after accounting for seasonality in initiation of pregnancy attempts. Fecundability was highest in the fall and lowest in the spring, with stronger effects in southern latitudes of North America, suggesting that seasonal exposures may affect fecundity.

What do you think about “Trying a different season to conceive”?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

WiFi may Cause Infertility

Dangerous levels of microwave radiation from Wi-Fi and other devices were discovered in school classrooms in Ontario as measured by students from Peel District School Board. The radiation levels found were strong enough to cause infertility problems.

The students organized an open meeting in order to inform all school students about the dangers they are exposed to due to the radiation levels and that they can actually be harmed by this. They were determined to find ways to protect themselves in case the school Board was not willing to, since students are more exposed to wireless devices than any other group. The Peel Board announced that classroom microwave levels are lower than federal safety limits.  But recently these limits were questioned by the Parliamentary Standing Committee on Health indicating that these amounts of radiation could possibly cause a series of health issues including cancer and infertility.

Frank Clegg CEO of Canadians for Safe Technology, one of the speakers in the students’ meeting, claimed that” the Board is misleading its students because the high levels of radiation were measured with only four Wi-Fi devices operating while there are normally 50 devices in use. The students have also invited an international expert on cancer, Dr. Anthony Miller who would give them a lecture on the risks of cancer from common wireless devices like cell phones and Wi-Fi.

In 2011 the W.H.O. declared microwave radiation from Wi-Fi and cell phones to be a “possible carcinogen“, along with formaldehyde and car exhaust. Infertility is also a serious effect that cannot be ignored. Therefore, a thorough investigation on the matter and the development of a policy to substantially reduce wireless exposures to students and staff are of high importance.

A simple way to reduce the radiation dose and exposure time for children and staff is by turning off the Wi-Fi devices when not in use since they are constantly emitting radiation even when no one is using the internet.

What is now advisable is to post in every classroom the Instructions for “Best Practices”  which include:

  1. The safest solution is to provide wired connections
  2. Avoid prolonged, close contact with wireless routers
  3. If students are not using the internet, make sure they de-activate the WiFi
  4. Find out if the router has an easily accessible power switch that can be
    turned off when you don’t need access to the Internet

As a parent, would you be against Wi-Fi use in school?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

Male age interferes with embryo growth in IVF treatment

Does male age affect embryo growth or quality in couples undergoing IVF treatment?

Literature shows that Advanced paternal age (APA) is associated with decreased sperm quality and fecundity. However, the effect of male age on embryo growth in an IVF setting remains inconclusive. Literature concerning male influences on IVF success is scarce and approaches used to analyse embryo outcomes differ by study.


This study was part of the longitudinal Epigenetic Legacy of Paternal Obesity (ELPO) study for which fathers and mothers were followed from pre-pregnancy until the birth of their child. Couples were recruited from April 2015 to September 2017. A total of 1057 embryos from 87 couples were studied.

Dutch-speaking couples planning to undergo an IVF treatment were recruited at the Leuven University Fertility Center in Flanders, Belgium. Anthropometrics were documented and compared to the general Flemish population. Semen characteristics, pregnancy rates and the following embryo characteristics were recorded: number of blastomeres, symmetry and percentage fragmentation.

The scientists observed a significant inverse association between APA and a key determinant for scoring of embryo quality: older men were less likely to produce an embryo of eight blastomeres at Day 3, compared to younger fathers.

Because of the study’s small sample size and its monocentric nature, a larger study is warranted to confirm the results. The scientists suggest a heightened need for future research into male age and its potential effects on embryo growth, embryo quality and ART outcomes. Clinical decision-making and preventative public health programmes would benefit from a better understanding of the role of men, carried forward by the Paternal Origins of Health and Disease (POHaD) paradigm.

What would you comment on the age of men in relation to the above article?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

Sperm count affects cumulative birth rate of assisted reproduction cycles in relation to ovarian response

To explore the possible influence of sperm quality, as assessed by prewash total sperm count (TSC), on cumulative success rates in assisted reproduction cycles.

Methods: Retrospective study carried out in private IVF centre. Seven hundred sixty-five couples undergoing complete ICSI cycles, i.e. whose all embryos were transferred or disposed of. Couples were characterised by male infertility and female age younger than 36 years. Couples with a combination of female and male infertility factors were excluded. The primary outcome measure was cumulative live birth rate. Secondary outcomes were cumulative pregnancy and miscarriage rates. No specific interventions were made.

Results: Higher TSC values have a positive impact on cumulative success rates in cycles characterised by few retrieved oocytes (1 to 5), while does not influence the outcome of cycles with a normal (6 to 10) or high (> 10) number of retrieved oocytes.

Conclusions: The study highlights the importance of sperm quality for the efficacy of assisted reproduction treatments. This influence may remain relatively cryptic in association with normal or high ovarian response, but emerge decisively in cases of reduced ovarian response, suggesting a relationship between ovarian response and oocyte ability to compensate for paternal-derived deficiencies.

What do you think about “Improve sperm quality before assisted reproductive cycles ”?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

Female obesity increases the risk of miscarriage of euploid embryos

In this study, 3,480 cycles of in vitro fertilization with preimplantation genetic testing for aneuploidy (PGT-A) in the blastocyst stage and euploid embryo transfer were divided into four groups according to patient body mass index (BMI).

The primary outcome was the miscarriage rate, which included both biochemical and clinical miscarriages. Secondary outcomes were implantation, pregnancy, clinical pregnancy, and live birth rates.
Cycles were divided into four groups according to BMI (kg/m 2): underweight (<18.5; n = 155), normal weight (18.5–24.9; n = 2,549), overweight (25–29.9; n = 591), and obese (≥30; n = 185). The number of PGT-A cycles per patient was similar in the four groups. Fertilization rate, day of embryo biopsy, technique of chromosomal analysis, number of euploid embryos, number of transferred embryos, and method of endometrial preparation for embryo transfer were similar in the four BMI groups. Miscarriage rates were significantly higher in women with obesity compared to women with normal weight, mainly due to a significant increase in the clinical miscarriage rates. Live birth rates also were lower in women with obesity. Obesity in women and day 6 trophectoderm biopsy were found to influence the reduced live birth rate.
Women with obesity experience a higher rate of miscarriage after euploid embryo transfer than women with a normal weight, suggesting that other mechanisms than aneuploidy are responsible for this outcome.

What do you think about “Check your BMI before starting a fertility treatment”?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

A surprising link with unexplained infertility: a possible Covid-19 paradox?

Unexplained infertility represents about 22–28 percent of infertility causes.
The diagnosis is based on the exclusion of common causes using standard fertility investigation.


Over the years, the causes of unexplained infertility or subfertility have been identified in pre-existing associated pathologies, such as alterations of the immune system, thyroid dysfunctions, and coagulopathies.

Studies regarding the influence of psychological factors on the development of infertility highlighted that spontaneous pregnancies following adoption or the decision to remain childless are absolute exceptions. The link between stress and infertility in humans is still unclear. For many women, the effect of infertility and the subsequent medical therapy represents a considerable emotional stress.

Accordingly, the relationship between the environment and the reproductive capacity has been proved to have a direct correlation.
Previous work demonstrated that stress is associated with changes in eating habits and exercise, resulting in a complicated spectrum of reproductive disorders.

However, the potential impact of the interrelationship between stress and frequency of sexual intercourse on reproductive efficacy was not sufficiently described.

The low frequency of sexual intercourse in the couple is often not mentioned during the anamnestic investigation, mostly because this issue is a source of frustration and shame.

Psychological stress, physical fatigue, lack of adequate time, and geographical distance represent the main determinants of low frequency of sexual intercourse. Therefore, there is a considerable proportion of couples with unexplained infertility that is treated with assisted reproduction techniques, who would have been able to naturally conceive a baby by simply increasing their sexual activity.

On March 10-2020, Italy became the first democratic country since World War II to impose a national lockdown. In few days, the outbreak spread from a northern crisis to a national one. Restriction measures are imposed to stay home and seek permission for essential travel.

Many companies have started smart working for their employees. At the same time, both the most accredited national and European scientific societies for reproductive medicine and the National Transplant Center, the institute that is responsible for the control of the Centres for ART (PMA) in Italy, have arranged to postpone the cycles of ARTs, waiting for the end of the coronavirus pandemic.

In order to assess the potential impact of insufficient sexual activity on infertility, the group studied whether recent COVID-19-releated lockdown in Italy had any effect on conception ability of couples with unexplained infertility. The scientists included in the study 50 couples with unexplained infertility. In these couples, medically assisted procreation techniques were temporarily suspended because of the lockdown, as imposed by the Italian Institute of Health. Interestingly, they found that 14% of the couples conceived naturally after years (average 2 ± 0.7 years) of infertility.

All the seven couples were contacted by phone, and all confirmed a significant increase in sexual activity, from an average of 2/month to two to three times/week (p < 0.001). They all stated that the longer time spent together at home contributed to the increase of their sexual activity.

It has to be noted that the spontaneous pregnancy rate is so significantly close to that in the literature of unexplained infertility (14% vs 15%, p = 0.9).
Therefore, lockdown and smart working during the pandemic have increased the frequency of sexual intercourse and could have unmasked the real cause of infertility or unexplained subfertility in these couples. It seems unlikely that a reduction of psychological stress would have contributed to the success to the natural conception of a baby in these seven couples, because of the extremely high stress levels felt in Italy during these months, in which more than 25,000 deaths due to COVID-19 were reported.

The team observation seems to suggest that insufficient sexual activity should always be ruled out in couples referring to reproductive centers for fertility issues. It is interesting to note that couples confined to home, naturally increase the amount of sexual intercourse.

Clinicians probably should resist to the temptation to begin an active treatment and not immediately propose medical treatments in these couples. The real impact of insufficient sexual activity on unexplained infertility warrants further clarification in larger studies.

What do you think about “Increase the frequency of sexual intercourse”?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

Does coenzyme Q10 supplementation improve fertility outcomes?


Increased oxidative stress has been identified as a pathogenetic mechanism in female infertility. However, the effect of specific antioxidants, such as coenzyme Q10 (CoQ10), on the outcomes after Assisted Reproductive Technologies (ART) has not been clarified.

The aim of this study was to systematically review and meta-analyze the best available evidence regarding the effect of CoQ10 supplementation on clinical pregnancy (CPR), live birth (LBR), and miscarriage rates (MR) compared with placebo or no-treatment in women with infertility undergoing ART.

Five randomized-controlled trials fulfilled eligibility criteria (449 infertile women; 215 in CoQ10 group and 234 in placebo/no treatment group). Oral supplementation of CoQ10 resulted in an increase of CPR when compared with placebo or no-treatment (28.8% vs. 14.1%, respectively).This effect remained significant when women with poor ovarian response and polycystic ovarian syndrome were analyzed separately. No difference between groups was observed regarding LBR and MR.

The conclusion of the study in the journal was that the oral supplementation of CoQ10 may increase CPR when compared with placebo or no-treatment, in women with infertility undergoing ART procedures, without an effect on LBR or MR.

These types of supplements should only be taken on the recommendation of your doctor.

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

Is intracytoplasmic sperm injection (ICSI) better as a technique than traditional IVF?

A question that couples very often ask when starting an assisted reproduction program is related to the two most common techniques used to achieve egg fertilization and the coveted pregnancy.

Confirmation of the best technique given through this study based on the highest rates of blastocysts per egg used for the procedure.

In this retrospective study, 62 ICSI/IVF cycles were analyzed with the eggs divided for each technique. Eggs from these cycles were used randomly in ICSI or the classical IVF procedure. Two hundred and thirty-four ICSI cycles and 152 cycles of classical IVF were further analyzed for comparison.

This method of analysis using sibling oocyte split (half oocytes for IVF and other half for ICSI from the same stimulation cycle) showed quite interesting results. In particular, when comparing and calculating the two pronucleus (2PN) in the oocytes between the classical IVF group and the group of ICSI, the quality of blastocysts was clearly higher in the first case (IVF) with a statistically significant degree (p < 0.05).

This study confirms that the ICSI technique is not a panacea nor does it have higher success rates for all couples. It should only be used in cases where it is required and if certain specific criteria are met in order to maximize the chances of pregnancy.

Do you believe that this study will help couples and clinics in choosing the most appropriate technique?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

A new discovery that could reverse the fertility clock, poor egg quality and increase IVF success rates

Increasing maternal age and subsequent infertility have rapidly become a significant challenge to family planning, as a result of the irreversible decline in female fertility in mammals. The rate-limiting factor for successful pregnancy is oocyte quality, which significantly declines from late in the third decade of life in humans.

Despite the enormous demand, there are no clinically viable strategies to either preserve or rejuvenate oocyte quality during aging, which is defined by the capacity of the oocyte to support meiotic maturation, fertilization, and subsequent embryonic development. A non-invasive, pharmacological treatment to maintain or restore oocyte quality during aging would alleviate a rate-limiting barrier to pregnancy with increasing age that has driven demand for assisted reproduction technologies (ARTs) such as in vitro fertilization (IVF).

Although somatic tissues undergo continual regeneration through turnover by a self-renewing population of resident precursor stem cells, oocytes in the ovary are laid down during in utero development in humans, where they form a finite pool that does not undergo self-renewal. Oocytes are therefore highly susceptible to age-related dysfunction.

The molecular basis for the decline in oocyte quality with advancing age implicates genome instability, reduced mitochondrial bioenergetics, increased reactive oxygen species (ROS), and disturbances during meiotic chromosome segregation due to compromised function of the spindle assembly checkpoint (SAC) surveillance system. The molecular cause of chromosome mis-segregation in oocytes with advancing age is still unknown, and as a result, there are no pharmacological strategies to correct this problem. Understanding the molecular or metabolic basis of this defect could lead to therapies that could maintain or even rescue female fertility with advancing age.

The metabolite nicotinamide adenine dinucleotide (NAD+/NADH) is a prominent redox cofactor and enzyme substrate that is essential to energy metabolism, DNA repair, and epigenetic homeostasis. Levels of this essential cofactor decline with age in somatic tissues, and reversing this decline through treatment with metabolic precursors for NAD+ has gained attention as a treatment for maintaining late-life health.

A team of scientists at the University of Queensland reports sought to determine whether NAD+ declined in oocytes with age, contributing to infertility and declining oocyte quality, and whether this could be reversed through treatment with the NAD+ precursor nicotinamide mononucleotide (NMN).

To address these questions, they used mice, whose fertility starts to decline around 8 months of age due to oocyte defects that are similar to those in humans. Twelve-month-old females were treated with NMN in drinking water (2 g/L) for 4 weeks, following which mature metaphase-II (MII) oocytes were recovered and subjected to multispectral microscopy imaging of autofluorescence to determine the relative abundances of native fluorophores. Consistent with their hypothesis, they found that NAD(P)H levels declined in oocytes from aged animals, compared with young (4- to 5-week-old) animals, and NMN treatment increased NAD(P)H levels in oocytes from aged animals, restores oocyte quality and enhances ovulation rate and fertility. Furthermore, supplementation of NMN in embryo culture media reversed the adverse effects of age on development.

The present study supports the premise that age-related reductions in NAD+ availability are a determinant of declining oocyte quality and female infertility and that pharmacological restoration of NAD+ opens a therapeutic window for the treatment of age-related infertility.

Several questions remain, including how NMN treatment would restore oocyte quality in aged animals. One well-known consequence of poor oocyte quality with advancing age is chromosome segregation defects, which overwhelmingly affect the first meiotic division (MI). Indeed, 80%–90% of age-related embryonic aneuploidy is the consequence of female MI errors. Out of caution, we suggest that these supplements should not be taken by women wishing to become pregnant until further studies have been completed.

Having demonstrated that in vivo NMN treatment in aged animals improved oocyte quality and increased ovulation rate and birth rates, they next showed that supplementing embryo culture media with NMN improved embryo development in embryos derived from oocytes from aged animals, but not young animals, supporting the idea that this intervention addresses an age-related deficit in oocyte NAD+ levels.

This finding is highly relevant to the clinical practice of IVF. In addition to age-related issues of decreased oocyte numbers and oocyte quality, mitotic aneuploidy and poor preimplantation embryo development limit the number of euploid blastocysts available for transfer with increasing maternal age. The increasing preference for blastocyst-stage transfers in clinical IVF underscores the importance of reaching more advanced developmental milestones and clinical demand for interventions that can improve embryo development.


This work represents a clinically tractable pharmacological intervention to non-invasively treat female infertility caused by a loss of oocyte viability in reproductively aged females, with important clinical implications. They envisage this work could lead to the development of orally delivered therapeutics that enhance oocyte quality for natural conception or IVF. Moreover, this work could enhance the success rates of existing IVF protocols by improving embryo culture conditions and developmental outcomes.

Any intervention that improves fertility would lead to cost savings and lower the emotional stress of failed IVF rounds or infertility that can lead to long term psychological and social issues, including depression and relationship breakdown.

This could represent an intervention that enables women with poor oocyte quality to have children with their own genetic makeup, because currently, these women have no alternative but to use donated oocytes. While promising, they caution against the use of NAD+-raising supplements until these clinical studies have been completed.

Do you think this new discovery could be a revolution for IVF industry and woman fertility?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

The first birth of a child, by a woman with breast cancer after thawing of immature cryopreserved oocytes

The issue of fertility preservation (FP) in young cancer patients has become an important issue. Although many techniques have been developed, vitrification of fertilized or unfertilized eggs recovered after controlled ovarian stimulation, prior to cancer treatment, is now the most established and effective method of maintaining female fertility.

When ovarian stimulation is not possible or contraindicated, cryopreservation of the ovaries or vitrification of eggs / embryos after in vitro maturation (IVM) of eggs recovered from small follicles may be alternatives. The place of IVF in the strategy of women FPs has recently been discussed.

We herein report the case of a 29-year-old nulligravida woman diagnosed with left grade III invasive ductal carcinoma. The tumor was positive for both estrogen receptors and progesterone and negative for Her2 overexpression. After left tumorectomy with sentinel node biopsy (1N+/4), adjuvant chemotherapy was scheduled 3 weeks later.

17 small follicles were detected by vaginal ultrasound on the 16th day of the cycle before counseling to maintain fertility. Due to the contraindication of ovarian stimulation for oncological purposes, the patient was offered oocyte vitrification after maturation of eggs (IVM) in the laboratory in combination with ovarian cryopreservation.

Seven immature oocytes were retrieved and were matured and vitrified in the laboratory. Five years later, the patient experienced infertility. The pregnancy was approved by the oncology team, but the patient was advised to avoid ovarian stimulation.

Therefore, the multidisciplinary decision was the re-utilization of cryopreserved oocytes as a first choice. The six oocytes were thawed and all survived the procedure, allowing fertilization with Intracytoplasmic Sperm Injection (ICSI) technique. Five embryos were created and one of them was transferred to the uterus. The patient became pregnant and gave birth to a healthy baby boy.

This is the first live birth achieved using vitrification and in vitro egg maturation (IVM) to maintain fertility (FP) in a woman with cancer. This approach was based on the inability to perform ovarian stimulation based on the patient’s oncological history. Therefore, IVM should be considered as a viable and effective choice in the strategy for women to maintain fertility.

The article was published in Analls of Oncology.

Do you think that this technique could be used by any woman who does not want to use hormones for in vitro fertilization?

Hey! If you found this post interesting or useful, you can help us get even better by subscribing to our newsletter. Just write your email and you’ll have the latest news regarding fertility issues. Thank you once more for your help.

Hair sample tests may give women more accurate fertility predictions

Women wanting to know how many eggs they have left may in future be able to have their hair tested to reveal their hormone levels.

A signalling chemical related to women’s fertility called anti-Müllerian hormone (AMH) is incorporated into hair shafts while they are still underneath the skin. Testing the hair may give a better indication of fertility than current blood tests.

AMH is released by eggs in the ovaries, the number of which decline with age. Blood AMH levels broadly correlate with how many eggs a woman has left, and therefore how long it will be before she stops being fertile.

Some firms offer AMH blood testing for any woman trying to get pregnant – although doctors’ bodies have warned that for the general population, it isn’t a good indicator of how likely someone is to conceive. But for people having IVF, it does predict which women are likely to respond well or poorly to stimulation of their ovaries, according to the European Society of Human Reproduction and Embryology.


In future, women may be able to send off a hair sample for testing, instead of having a blood sample taken. In a group of 152 women aged between 18 and 65, hair AMH levels correlated with levels in their blood, and with the number of eggs present in their ovaries as seen by an ultrasound scan – but hair levels of the hormone tracked age better than blood levels, suggesting the hair test may be more accurate.

Hormone levels in hair may be a better indicator of longer-term average blood levels than a one-off blood sample, says Sarthak Sawarkar at US fertility company MedAnswers, who did the study. “Hair is a medium that can accumulate biomarkers over several weeks, while hormone levels in blood can fluctuate rapidly in response to stimuli,” he said in a statement.

The work was presented at this year’s online meeting of the European Society of Human Reproduction and Embryology.

Salve! Se hai trovato questo post interessante o utile, puoi aiutarci a migliorare ancora di più iscrivendoti alla nostra newsletter. Basta scrivere la tua e-mail e avrete le ultime notizie per quanto riguarda i problemi di fertilità. Grazie ancora una volta per il vostro aiuto.

Human eggs prefer some men’s sperm over others

Human eggs use chemical signals to attract sperm. New research from Stockholm University and Manchester University NHS Foundation Trust shows that eggs use these chemical signals to choose sperm. Different women’s eggs attract different men’s sperm—and not necessarily their partner’s.


Humans spend a lot of time and energy choosing their partner. A new study by researchers from Stockholm University and Manchester University NHS Foundation Trust (MFT) shows that choosing your partner continues even after sex—human eggs can “choose” sperm.
“Human eggs release chemicals called chemoattractants that attract sperm to unfertilized eggs. We wanted to know if eggs use these chemical signals to pick which sperm they attract,” said John Fitzpatrick, an Associate Professor at Stockholm University.

The researchers examined how sperm respond to follicular fluid, which surrounds eggs and contains sperm chemoattractants. The researchers wanted to find out if follicular fluids from different females attracted sperm from some males more than others.

“Follicular fluid from one female was better at attracting sperm from one male, while follicular fluid from another female was better at attracting sperm from a different male,” said Professor Fitzpatrick.
“This shows that interactions between human eggs and sperm depend on the specific identity of the women and men involved.”

The egg does not always agree with the women’s choice of partner.

The researchers found that eggs did not always attract more sperm from their partner compared to sperm from another male.
Ιs this egg or sperm choice? Professor Fitzpatrick explained that sperm have only one job—to fertilize eggs—so it doesn’t make sense for them to be choosy. Eggs on the other hand can benefit by picking high quality or genetically compatible sperm.

“The idea that eggs are choosing sperm is really novel in human fertility,” said Professor Daniel Brison, the scientific director of the Department of Reproductive Medicine at Saint Marys’ Hospital, which is part of MFT, and the senior author of this study.
The University of Manchester Honorary Professor added: “Research on the way eggs and sperm interact will advance fertility treatments and may eventually help us understand some of the currently ‘unexplained’ causes of infertility in couples.”

“I’d like to thank every person who took part in this study and contributed to these findings, which may benefit couples struggling with infertility in future.”
The article “Chemical signals from eggs facilitate cryptic female choice in humans” is published in the scientific journal Proceedings of the Royal Society B.

Huge trial underway for ‘very promising’ AI tool to boost IVF success

Australian fertility experts are now testing the technique, which uses artificial intelligence to improve the odds of a successful pregnancy, in the largest trial of its kind in the world.
As part of the international study, led by national fertility provider Virtus Health, 1000 patients will be recruited at five IVF clinics across Australia, alongside sites in Ireland and Denmark.

artificial intelligence

During each IVF cycle, embryos will be grown in an incubator fitted with time-lapse cameras to assess the embryo during the five-day incubation period.
The embryo ranking system was built by training the artificial intelligence using thousands of images where it was known whether the pregnancy was successful or not.
What the AI tool can do is analyze .all the embryos. The embryo with the highest score can then be selected for transfer by the embryologist with the aim of accelerating the chance to a successful pregnancy

Dr Illingworth said the purpose of the study was to determine whether the technology can shorten the time it takes a woman to fall pregnant, ultimately saving aspiring parents thousands of dollars in fertility treatment.

Coronavirus Covid-19 detected in semen

The novel coronavirus can persist in the semen of men who are recovering following infection, according to a new study.

Covid-19 detected in semen

The preliminary findings of a Chinese study raise the small possibility that the virus could be sexually transmitted.

According to the Authors from The Eighth Medical Center of Chinese People’s Liberation Army General Hospital, “to avoid contact with the patient’s saliva and blood may not be enough, since the survival of SARS-CoV-2 in a recovering patient’s semen maintains the likelihood to infect others”.

They also added “If it could be proved that SARS-CoV-2 can be transmitted sexually in future studies, sexual transmission might be a critical part of the prevention of transmission, especially considering the fact that SARS-CoV-2 was detected in the semen of recovering patients”.

Should you always immediately intervene when your baby cries?


Leaving an infant to ‘cry it out’ from birth up to 18 months does not adversely affect their behaviour development or attachment, researchers from the University of Warwick have found, they also discovered that those left to cry cried less and for a shorter duration at 18 months of age.

Researchers from the University of Warwick have today, the 11th of March had the paper ‘Parental use of ‘cry it out’ in infants: No adverse effects on attachment and behavioural development at 18 months’ published in the Journal of Child Psychology and Psychiatry.

In the paper they deal with an issue that is discussed for decades by parent websites and parents without much scientific evidence: Should you always immediately intervene when your baby cries?

The sample with complete longitudinal data comprised 178 infants and their caretakers. Parental use of ‘leaving infant to cry out’ and cry duration were assessed with maternal report at term, 3, 6 and 18 months, and frequency of crying was assessed at term, 3 and 18 months of age. Attachment was measured at 18 months using the strange situation procedure. Behavioural development of the infant was assessed with two observational measures and a parent-report questionnaire at 18 months.

Contemporary practice of some parents in the United Kingdom to occasionally or often ‘leaving infant to cry it out’ during the first 6 months was not associated with adverse behavioural development and attachment at 18 months. Increased use of ‘leaving to cry it out’ with age may indicate differential responding by parents related to infant self-regulation.

What do you think about “leaving infant to cry it out”?

Processed meat kills sperm. Bacon Harms Male Fertility?

Emerging literature suggests that men’s diets may affect semen quality, but there is little knowledge about the relation between meat intake and male fertility. A new study, currently published in Fertility and Sterility, showed that processed meat intake was negatively associated to fertilization rate in conventional IVF cycles. Even though it was found no link between overall meat consumption and successful fertilization, men who avoided processed meat such as sausage, bacon, and canned meat had a 28 percent higher success rate than those who consumed these foods daily.

Processed meat was associated with lower sperm concentration and morphology, reflecting sperm normality.

These data are in an agreement with findings of another recent study which examined the association between intake of meat and fish in relation to semen quality indicators among men attending a fertility clinic. It appears that just one piece of bacon a day can damage a man’s fertility, while eating a portion of whitefish such as cod or halibut every day can improve it. More specifically processed meat was associated with lower sperm concentration and morphology, reflecting sperm normality. Men who consumed less than a slice of bacon a day had 30% more normal sperm than those who ate higher quantities of processed meats.

On the other hand, foods like poultry and fish have been positively associated with fertilization rates. It is already known that high intake of processed meat is linked to other health issues and so advising men to consume more fish and white meat instead of processed red meats may improve their health generally as well as possibly be good for their fertility.

Would you keep your man away from bacon?