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Since the introduction of pre-implantation genetic testing PGT in assisted reproductive technology, it has become a routine to examine for missing or extra chromosomes known as aneuploidy, genetic disorders, and chromosome structural rearrangements in embryos. These tests are mainly used by couples with advanced maternal age, recurrent pregnancy loss, repeated implantation failure, or a family history of genetic diseases.
In the journey of assisted reproductive technology (ART), in-vitro fertilization (IVF) has emerged as a transformative solution for individuals and couples striving to achieve parenthood. Among the various techniques in IVF, Frozen Embryo Transfer (FET) has gained remarkable prominence. Frozen Embryo Transfer, FET involves the cryopreservation of embryos and their subsequent thawing and transfer during a later menstrual cycle. Over the years, FET has demonstrated significant advantages, particularly in yielding higher implantation and pregnancy rates as compared to fresh embryo transfers. This article explores how FET has evolved, the scientific rationale behind its success, and its implications for reproductive medicine.
Infertility is defined by the American College of Obstetricians and Gynecologists as the inability to become pregnant after 12 months or more of unprotected intercourse for women under 35 and after six months for women over 35.
Ovarian cancer is one of the leading causes of cancer deaths among women. A woman's risk of getting ovarian cancer during her lifetime is about 1 in 91. Her lifetime chance of dying from ovarian cancer is about 1 in 143. This cancer mainly develops in older women. About half of the women who are diagnosed with ovarian cancer are 63 years or older.
Summary
Bacterial cells in the human body account for 1-3% of total body weight and are at least equal in number to human cells. Recent research has focused on understanding how the different bacterial communities in the body (eg, gut, respiratory, skin, and vaginal microbiomes) predispose to health and disease. The microbiome of the reproductive tract has historically been assumed to be identical to the vaginal bacterial flora, and the uterus classically was considered to be a sterile cavity but recently has been shown to have its own unique microbiome.
A genital Lactobacillus-dominated flora plays a pivotal role in determining fertility. Lactobacilli dominate the microbial community and are commonly associated with a healthy genital status. Any pathological modification of this Lactobacillus-dominated flora is associated with poor reproductive outcomes. This finding adds a novel microbiological dimension to the reproductive process.
Summary
At mid-cycle, uterine contractions are predominantly cervical-fundal (from the bottom of the uterus to the top), specifically toward the fallopian tubes. The amplitude and frequency of the contractions increase significantly as ovulation approaches. There is evidence that this facilitates sperm ascension towards the distal (far) end of the fallopian tubes, where fertilization occurs. Women with endometriosis display marked uterine hyperperistalsis that differs significantly from the contractions of women without endometriosis. At mid-cycle, uterine contractions in women with endometriosis became dysperistaltic (abnormal), arrhythmic, and convulsive, while in controls, peristalsis continues to show long and regular cervical-fundal (normal) contractions. This may explain the high incidence of infertility even in women with only mild endometriosis.