Stovezky YR, Romanski PA, Bortoletto P, Spandorfer SD. Antimüllerian hormone is not associated with embryo ploidy in patients with and without infertility undergoing in vitro fertilization with preimplantation genetic testing. Fertil Steril. 2023 Mar;119(3):444-453. doi: 10.1016/j.fertnstert.2022.11.018. Epub 2022 Nov 21. PMID: 36423663.

Asami M, Lam BYH, Hoffmann M, Suzuki T, Lu X, Yoshida N, Ma MK, Rainbow K, Gužvić M, VerMilyea MD, Yeo GSH, Klein CA, Perry ACF. A program of successive gene expression in mouse one-cell embryos. Cell Rep. 2023 Feb 28;42(2):112023. doi: 10.1016/j.celrep.2023.112023. Epub 2023 Jan 31. PMID: 36729835.

Poretsky L, Yeshua A, Cantor T, Avtanski D, Stojchevski R, Ziskovich K, Singer T. The effects of irisin and leptin on steroidogenic enzyme gene expression in human granulosa cells: In vitro studies. Metabol Open. 2023 Jan 13;17:100230. doi: 10.1016/j.metop.2023.100230. PMID: 36686605; PMCID: PMC9853360.

Adeleye AJ, Kawwass JF, Brauer A, Storment J, Patrizio P, Feinberg E. The mismatch in supply and demand: reproductive endocrinology and infertility workforce challenges and controversies. Fertil Steril. 2023 Jan 13:S0015-0282(23)00045-6. doi: 10.1016/j.fertnstert.2023.01.007. Epub ahead of print. PMID: 36642303.

New EP, Kodama S, Devine K, Jahandideh S, Imudia AN, Plosker SM. Live birth associated with peak serum estradiol levels in letrozole intrauterine insemination cycles. Fertil Steril. 2023 Jan 10:S0015-0282(23)00006-7. doi: 10.1016/j.fertnstert.2023.01.003. Epub ahead of print. PMID: 36634734.

Chung EH, Mebane S, Harris BS, White E, Acharya KS. Oncofertility research pitfall? Recall bias in young adult cancer survivors. F S Rep. 2022 Dec 30;4(1):98-103. doi: 10.1016/j.xfre.2022.12.007. PMID: 36959952; PMCID: PMC10028472.

Friedman J, Sheeder J, Lazorwitz A, Polotsky AJ. Herbal supplement use among reproductive-aged women in an academic infertility practice. F S Rep. 2022 Dec 17;4(1):104-111. doi: 10.1016/j.xfre.2022.12.001. PMID: 36959959; PMCID: PMC10028423.

Santoro N. Reproductive endocrinology and infertility: the specialty with an ever changing alphabet soup. Fertil Steril. 2022 Dec;118(6):1035. doi: 10.1016/j.fertnstert.2022.10.012. Epub 2022 Nov 6. PMID: 36351855.

Dr. Nanette Santoro introduces Drs. Legro and DeCherney, and their Fertile Battle discussion topic: the application of genetics in the current and future Reproductive Endocrinology and Infertility practice.

Morris JM, Romanski PA, Harris BS. Mind the Gap – Isthmoceles and Infertility. Fertil Steril. 2022 Dec 7:S0015-0282(22)02093-3. doi: 10.1016/j.fertnstert.2022.12.006. Epub ahead of print. PMID: 36496081.

Prior studies have determined that a large isthmocele, an indentation of the myometrium at the site of incision from poor healing of the uterine tissue following Cesarean delivery, produces multiple unfavorable outcomes related to embryo implantation and development. This study enrolled women with unexplained infertility and prior Cesarean delivery resulting in a large isthmocele (residual overlying myometrial thickness of < 3 mm or residual myometrial thickness of <50% of adjacent myometrial tissue) and the primary outcome was endometrial thickness in the presence or absence of intrauterine fluid. Results from this study suggest that presence of an intrauterine fibroid had no significant effect on endometrial thickness (p=0.25), and that there exists a relationship between intrauterine fluid and a slightly longer duration of infertility (24 vs. 27 months; p=0.02).

Marsh P, Radif D, Rajpurkar P, Wang Z, Hariton E, Ribeiro S, Simbulan R, Kaing A, Lin W, Rajah A, Rabara F, Lungren M, Demirci U, Ng A, Rosen M. A proof of concept for a deep learning system that can aid embryologists in predicting blastocyst survival after thaw. Sci Rep. 2022 Dec 7;12(1):21119. doi: 10.1038/s41598-022-25062-z. PMID: 36477633; PMCID: PMC9729222.

Doyle N, Jahandideh S, Hill MJ, Widra EA, Levy M, Devine K. Effect of Timing by Endometrial Receptivity Testing vs Standard Timing of Frozen Embryo Transfer on Live Birth in Patients Undergoing In Vitro Fertilization: A Randomized Clinical Trial. JAMA. 2022 Dec 6;328(21):2117-2125. doi: 10.1001/jama.2022.20438. PMID: 36472596; PMCID: PMC9856480.

Frozen embryo transfers have gained popularity in recent years, and in 2020, 75% of fertility treatment cycles involved embryo cryopreservation. This randomized clinical trial was initiated to determine if the use of endometrial receptivity assay (ERA) to time frozen euploid blastocyst transfer increases the probability of live birth. Study participants were planning to undergo IVF, PGT-A testing, and frozen embryo transfer. Participants were aged 30 to 40 years old at the time of egg retrieval and likely to produce at least 1 euploid blastocyst. 767 patients were randomized to one of two study arms: use of ERA to time frozen embryo transfer, or standard timing for embryo transfer. Results from the study indicate that live birth rate is not improved with the use of ERA testing, compared to standard timing of frozen embryo transfer (58.5% vs. 61.9%, respectively; difference, -3.4% [95% CI, -10.3% to 3.5%]; rate ratio [RR], 0.95 [95% CI, 0.79 to 1.13]; P = 0.38). Similarly, clinical pregnancy rate was not improved with the use of ERA testing, compared to the control group (68.8% vs. 72.8%, respectively; difference, −4.0% [95% CI, −10.4% to 2.4%]; RR, 0.94 [95% CI, 0.80 to 1.12]; P = .25).

Santoro N. FSH: The Goldilocks Hormone, Too Little, Too Much, Just Right. Fertil Steril. 2022 Dec 5:S0015-0282(22)02058-1. doi: 10.1016/j.fertnstert.2022.12.003. Epub ahead of print. PMID: 36481419.

In this Views and Reviews, Dr. Nanette Santoro discusses the complexities related to FSH dosing during IVF. Recent research has supported the use of higher dosages of FSH during ovarian stimulation, but these high doses of FSH may affect tissues outside the desired gonadal targets. The current literature surrounding the topic suggests that there is still much to learn regarding FSH and ovarian stimulation.

Go KJ, Romanski PA, Bortoletto P, Patel JC, Srouji SS, Ginsburg ES. Meeting the challenge of unclaimed cryopreserved embryos. Fertil Steril. 2022 Dec 4:S0015-0282(22)01744-7. doi: 10.1016/j.fertnstert.2022.09.323. Epub ahead of print. PMID: 36476953.

As the number of IVF treatment cycles with supernumerary embryos and freeze-all cycles continues to increase across the United States, many practices are faced with the storage and responsibility of a growing number of unclaimed embryos. Authors examine the importance of thorough and inclusive informed consent for embryo cryopreservation, discuss patients’ attitudes and decisions while they have embryos in storage, practice obligations, and alternative dispositions options for patients rather than embryo discard in the laboratory.

Christmas M, Janssen I, Joffe H, Upchurch D, Santoro N, Kravitz HM. Menopause hormone therapy and complementary alternative medicine, quality of life, and racial/ethnic differences: the Study of Women’s Health Across the Nation (SWAN). Menopause. 2022 Dec 1;29(12):1357-1364. doi: 10.1097/GME.0000000000002087. Epub 2022 Oct 16. PMID: 36256923.

A SWAN survey was completed by 2,514 midlife women with vasomotor and/or genitourinary symptoms of menopause from seven sites across the United States to investigate a relationship between hormone therapy or complementary alternative medicine and self-reported quality of life, and if race/ethnicity influences hormone therapy and complementary alternative medicine’s relationship with quality of life. The major findings from the study include: across all ethnicities/races, neither contemporary alternative medicine nor hormone therapy were associated with self-reported quality of life; white women using hormone therapy reported higher quality of life; Black and Hispanic women reported the lowest use of hormone therapy but more frequent menopausal symptoms, compared to other ethnicities and races.

DeCherney AH, Brolinson M, Whiteley G, Legro RS, Santoro N. Is the “E” being removed from Reproductive Endocrinology to be replaced by a “G” for Genetics? Fertil Steril. 2022 Dec;118(6):1036-1043. doi: 10.1016/j.fertnstert.2022.10.011. Epub 2022 Nov 7. PMID: 36357198.

This is a divided discussion from physician researchers either supporting or challenging the mastery of genetics within the Reproductive Endocrinology and Infertility practice. Pro-genetics contributors summarize the historical and recent contributions from genetic screening to the field of reproductive medicine and implicate reproductive medicine’s reliance on genetic screening tools to diagnose and treat many causes of infertility. Those supporting the integration of genetics in the reproductive practice suggest that the reproductive endocrinologist should also exhibit expertise in genetics due to the integration and application of genetic tools within the practice. The opposing side indicates that while genetics are integral to the field, and the contributions from genetic testing have greatly enhanced the knowledge of reproductive endocrinologists, the field of genetics is far too in-depth to be added to the already expansive expertise of endocrinologists, and vice versa, a reproductive geneticist would be too specialized to be detrimental to the development of genetic technologies.

Jonah Bardos, MD, Jacyln Kwal, MD, Wayne Caswell, MS, Samad Jahandideh, PhD, Melissa Stratton, BS, Michael Tucker, PhD, Alan Decherney, MD, Kate Devine, MD, Micah Hill, DO, Jeanne E. O’Brien, MD, MSc. Accepted, Fertil Steril. 2022.

This retrospective study gathered data from embryos of donor oocytes that underwent trophectoderm biopsy and PGT-A from four different laboratories to investigate variation in euploid blastocyst rate and live birth rate across different laboratories when controlling for blastocyst quality. Results from the study suggest that there are differences in euploid blastocyst rate and live birth rates for a young and healthy population between laboratories, suggesting that not all PGT-A laboratories are comparable.

Cayton Vaught KC, Hazimeh D, Carter AS, Devine K, Maher JY, Maguire M, McGee EA, Driggers PH, Segars JH. AKAP13 Enhances CREB1 Activation by FSH in Granulosa Cells. Reprod Sci. 2022 Nov 18. doi: 10.1007/s43032-022-01097-5. Epub ahead of print. PMID: 36401072.

Johnson J, Kim SY, Sam PK, Asokan R, Cari EL, Bales ES, Luu TH, Perez L, Kallen AN, Nel-Themaat L, Polotsky AJ, Post MD, Orlicky DJ, Jordan KR, Bitler BG. Expression and T cell Regulatory Action of the PD-1 Immune Checkpoint in the Ovary and Fallopian Tube. Am J Reprod Immunol. 2022 Nov 17. doi: 10.1111/aji.13649. Epub ahead of print. PMID: 36394352.

This study was initiated to better understand how native ovary and fallopian tube cells interact with resident immune cells. Ovarian and fallopian tube samples were obtained, and PD-1 and ligan protein expression were assesed. Human follicular fluid was also obtained, of which protein expression was assessed, and treated with human T-cells to measure interferon gamma. Findings from this study suggest that soluble and membrane bound PD-1 pathway proteins are expressed in non-lymphoid/non-myeloid cells of the human ovary and were found in the fluid collected from peri-ovulatory follicles in egg retrieval procedures during IVF. Specifically, PD-1, PD-L2, and PD-L1, were present in the human ovarian cortex pre- and post-menopausally in various amounts. After menopause, PD-L1 was found distributed in the cortex more extensively compared to pre-menopause. Results also suggest that these ligands are present in human follicular fluid at levels capable of activating T-cells. The findings indicate that the PD-1 pathway dually helps to protect the ovary, oocytes, and embryos in the fallopian tubes from autoimmune reactions while also functioning as a protective immune system against infection.

Bakkensen JB, Flannagan KSJ, Mumford SL, Hutchinson AP, Cheung EO, Moreno PI, Jordan N, Feinberg EC, Goldman KN. A SART data cost-effectiveness analysis of planned oocyte cryopreservation versus in vitro fertilization with preimplantation genetic testing for aneuploidy considering ideal family size. Fertil Steril. 2022 Nov;118(5):875-884. doi: 10.1016/j.fertnstert.2022.07.022. Epub 2022 Sep 26. PMID: 36175208; PMCID: PMC9613595.

Using the SART-CORS database, this study evaluated the cost-effectiveness of oocyte cryopreservation as a mean of deferred reproductive as opposed to no oocyte cryopreservation with IVF and PGT-A testing at advanced reproductive age in women desiring one or two live births. Notable findings from the study include for women desiring one child, a higher chance of live birth occurs if oocyte cryopreservation occurs before age 39, with the highest chance of live birth occurring when oocyte cryopreservation occurs before age 32. Women desiring two children saw the most success when one cycle of oocyte cryopreservation occurred before age 37 and two cycles before age 39 rather than IVF with PGT-A at an advanced age. In this group, women had highest success of live birth when two cycles of oocyte cryopreservation occurred before age 31. Analysis of the data suggests that oocyte cryopreservation is a cost-effective strategy for delayed childbearing. This study is important as more patients are choosing to delay childbearing and incorporate ART into their family building.

Combs A, Kimes MJ, Jaslow CR, Hayes H, O’Leary LB, Levy MJ, Kutteh WH. Perception of pain and the oocyte donor experience: a retrospective analysis of commercial US donors. Reprod Biomed Online. 2022 Nov;45(5):906-912. doi: 10.1016/j.rbmo.2022.06.013. Epub 2022 Jun 22. PMID: 36058796.

Pain is a commonly reported side effect among oocyte donors, but literature addressing donor pain perception is lacking. To better understand pain perception among donors and bring attention to the short-term effects of donation to donors, authors of the presented study emailed a 40-question quantitative and qualitative survey to a group of Donor Egg Bank USA donors who donated between 2016 and 2019. The survey covered subjects such as demographics, donor’s motivation for donating, reproductive history, and the consent and donor experience. Of the 503 oocyte donors who opened the survey link, 48.9% (246 participants) completed at least 90% of the survey. A large portion of women reported more pain than expected (42.7%). Particularly, the largest pain disparity between expectations and experience occurred in the week after retrieval (25.8%). Donors also reported high levels of satisfaction and felt that the consent process prepared them for retrieval, with 94% recalling being counselled on the potential for pain. This study provides information that may be helpful to women who are considering oocyte donation, but further studies should address the short-term, as well as long-term, effects of pain to oocyte donors.