Unlocking Infertility: Enhancing Pregnancy Rates With Personalized Embryo Transfers Using Optimal Time for Endometrial Receptivity Analysis in Recurrent Implantation Failure Patients Undergoing In Vitro Fertilization.

Background Infertility remains a significant global challenge, and recurrent implantation failure (RIF) poses a considerable concern in assisted reproductive technology. Understanding the factors contributing to implantation failure is essential for developing accurate diagnostic tools and treatment strategies. Endometrial receptivity (ER) during the window of implantation is crucial for successful embryo implantation in in vitro fertilization (IVF) procedures. Molecular-based endometrial receptivity analysis and next-generation sequencing provide insights into ER, but there is a lack of research on these in the Indian population, particularly in patients with RIF. This retrospective cohort study evaluates the effectiveness of Optimal Timing for Endometrial Receptivity Analysis (OpERA)-guided personalized embryo transfer (pET) in Indian patients with a history of RIF. Methodology The study includes 158 female patients with a history of failed embryo transfers who underwent OpERA testing before frozen embryo transfer. Patients were categorized based on the number of previous failed transfers. OpERA outcomes were assessed, and clinical outcomes were compared between groups undergoing preimplantation genetic testing for aneuploidy (PGT-A) with and without OpERA. Endometrial preparation involved hormone replacement therapy, and OpERA testing was performed at the Neuberg Centre for Genomic Medicine using RNA extraction, cDNA conversion, and sequencing. Results OpERA outcomes showed no significant differences in receptive rates among patient groups. Group 3, with three or more failed transfers, exhibited significantly higher biochemical pregnancy rates (BPRs), clinical pregnancy rates (CPRs), and abortion rates (ARs) compared to Groups 1 and 2. OpERA with PGT-A showed significantly higher BPR, implantation rate, CPR, and lower AR compared to OpERA without PGT-A. Conclusions OpERA-guided pET, especially with PGT-A, demonstrated improved pregnancy outcomes, particularly in patients with a history of RIF. The study emphasizes the importance of OpERA in determining optimal transfer timing, moving beyond the traditional reliance on embryo quality alone. OpERA presents promise in predicting pregnancy outcomes for Indian patients with previous IVF failures. The integration of OpERA and PGT-A represents a significant advancement in personalized reproductive medicine, offering new hope for individuals grappling with infertility complexities.

Single-day HER2neu amplification assessment using chip-based digital PCR in formalin-fixed paraffin-embedded breast carcinoma tissue.

INTRODUCTION: Human epidermal growth factor receptor 2 (HER2) amplification is present in almost 15%-20% of breast cancer tumors, making it an important parameter for testing. The present study was designed to evaluate a chip-based digital PCR (dPCR) system for assessing HER2 amplification from formalin-fixed paraffin-embedded breast carcinoma tissue and to compare this system with immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). MATERIALS AND METHODS: A total of 84 breast carcinoma tissue samples were analyzed by IHC, FISH, and chip-based dPCR in a blinded manner. RESULTS: All nine IHC-positive and 35 IHC-negative samples had equivalent results with dPCR, taking an amplification ratio threshold of 1.8 as a positive result. Of the 40 IHC equivocal samples, 10 were assessed as positive, 27 as negative, and three as equivocal by dPCR. CONCLUSION: These results demonstrate that chip-based dPCR is suitable for HER2 amplification detection in formalin-fixed paraffin-embedded samples in a clinical setting, providing the advantages of superior turnaround time, cost-effectiveness, and increased precision with absolute quantification compared with conventional tests such as FISH and IHC. This methodology was especially beneficial in tissue samples with low DNA concentration.

Environmental & lifestyle factors in deterioration of male reproductive health.

BACKGROUND & OBJECTIVES: Male reproductive function in the general population has been receiving attention in recent years due to reports of various reproductive and developmental defects, which might be associated with various lifestyle and environmental factors. This study was carried out to determine the role of various lifestyle and environmental factors in male reproduction and their possible association with declining semen quality, increased oxidative stress as well as sperm DNA damage. METHODS: Semen samples were obtained from 240 male partners of the couples consulting for infertility problem. Semen analysis was carried out using WHO criteria and subjects were categorized on the basis of self reported history of lifestyle as well as environmental exposure. The oxidative and antioxidant markers; lipid peroxidation (LPO), superoxide dismutase (SOD) and catalase (CAT) as well as DNA damage by acridine orange test (AO) were determined. RESULTS: The presence of abnormal semen parameters was significantly higher among the lifestyle and/or environmental exposed subjects as compared to the non-exposed population. Further, the levels of antioxidants were reduced and sperm DNA damage was more among the lifestyle and/or environmental exposed subjects, though the changes were not significant. INTERPRETATION & CONCLUSIONS: These findings indicated that various lifestyle factors such as tobacco smoking, chewing and alcohol use as well as exposure to toxic agents might be attributed to the risk of declining semen quality and increase in oxidative stress and sperm DNA damage.

Knowledge and attitude regarding mercury handling and disposal in students.

The present cross-sectional study was carried out in higher secondary schools of the science specialty in Ahmedabad. A total of 653 students (196 taught in English, 395 taught in Gujarati and 62 taught in Hindi) from seven schools were included. The interview technique was used for data collection using a predesigned questionnaire. A total of 457 (70%) were boys and 196 (30%) were girls. About two-thirds of the study participants had handled mercury at sometime in their life and home was the common place where it was handled. More than half of the Hindi-taught students did not know about its physical appearance. The majority of the Gujarati-taught students knew that mercury is harmful to health whereas one-third of the English- and Hindi-taught students considered mercury to be harmless. A total of 46% of the Gujarati-taught and 44% of the English-taught students had encountered spilled mercury at sometime in their life and 21.6% of English-taught and 25% of Hindi-taught students had either smelled or played with spilled mercury. More than two-thirds of the English- and Hindi-taught students recommended the usual cleaning method whereas 81.8% of Gujarati-taught students suggested a special method should be used for the disposal of spilled mercury. The majority of the students did not know whether mercury could be substituted by a harmless substance.

Lifestyle factors in deteriorating male reproductive health.

Many health problems are related to lifestyle and dietary factors. Increasing trend in reproductive disorders observed in recent years may be associated at least in part with these factors, which are compounded by some of the new emergent life styles. The data available suggests that lifestyle factors such as obesity, tobacco smoking or chewing, alcohol and some of the illicit drugs like cocaine, cannabis etc and exposure to extreme heat, have adverse effects on male reproduction. The data on other factors such as use of mobile phone and stress on reproductive health are inadequate and need detailed study. Lifestyle related diseases could be lowered with modification in diet, living and working environment etc. Sub-fertile and/or normal subjects have some control over their reproductive function by adopting healthy lifestyles to avoid additional complications.