Objective This study aims to explore the impacts of short-term insemination and early rescue intracytoplasmic sperm injection (E-RICSI) on clinical and neonatal outcomes for IVF patients. Methods A retrospective analysis was conducted on the clinical data from the patients who underwent fresh embryo transfer at the Reproductive Center from January 2019 to December 2023. Patients were divided into four groups based on fertilization method:short-term IVF group (n=204),conventional IVF group (n=208),E-RICSI group (n=13) and conventional ICSI group (n=92). The fertilization rates,embryo development,pregnancy outcomes,and neonatal outcomes were compared between the short-term IVF and conventional IVF groups,and between the E-RICSI and conventional ICSI groups. Results There were no statistically significant differences in embryo development,clinical pregnancy,miscarriage,ectopic pregnancy,live birth rates,neonatal sex,and birth weight between the short-term IVF group and conventional IVF group. Similarly,no significant differences were observed in the E-RICSI group compared to the conventional ICSI group (P>0.05). However,the fertilization rate (79.11％ vs. 84.39％,P<0.001) and the rate of 2PN zygotes (63.98％ vs. 70.83％,P<0.001) were significantly lower in the short-term IVF group compared to the conventional IVF group;The fertilization rate (65.49％ vs. 91.68％,P<0.001) and the rate of 2PN zygotes (57.75％ vs. 88.35％,P<0.001) were significantly lower in the E-RICSI group compared to the conventional ICSI group. Conclusions Although the fertilization rate of short-term insemination and E-RICSI is lower than that of conventional IVF and ICSI,it has no effect on embryonic development,preg-nancy outcome and neonatal outcome. Short-term insemination combined with early rescue ICSI is an effective and safe technology to prevent complete fertilization failure.

Objective This study aims to explore the impacts of short-term insemination and early rescue intracytoplasmic sperm injection (E-RICSI) on clinical and neonatal outcomes for IVF patients. Methods A retrospective analysis was conducted on the clinical data from the patients who underwent fresh embryo transfer at the Reproductive Center from January 2019 to December 2023. Patients were divided into four groups based on fertilization method:short-term IVF group (n=204),conventional IVF group (n=208),E-RICSI group (n=13) and conventional ICSI group (n=92). The fertilization rates,embryo development,pregnancy outcomes,and neonatal outcomes were compared between the short-term IVF and conventional IVF groups,and between the E-RICSI and conventional ICSI groups. Results There were no statistically significant differences in embryo development,clinical pregnancy,miscarriage,ectopic pregnancy,live birth rates,neonatal sex,and birth weight between the short-term IVF group and conventional IVF group. Similarly,no significant differences were observed in the E-RICSI group compared to the conventional ICSI group (P>0.05). However,the fertilization rate (79.11％ vs. 84.39％,P<0.001) and the rate of 2PN zygotes (63.98％ vs. 70.83％,P<0.001) were significantly lower in the short-term IVF group compared to the conventional IVF group;The fertilization rate (65.49％ vs. 91.68％,P<0.001) and the rate of 2PN zygotes (57.75％ vs. 88.35％,P<0.001) were significantly lower in the E-RICSI group compared to the conventional ICSI group. Conclusions Although the fertilization rate of short-term insemination and E-RICSI is lower than that of conventional IVF and ICSI,it has no effect on embryonic development,preg-nancy outcome and neonatal outcome. Short-term insemination combined with early rescue ICSI is an effective and safe technology to prevent complete fertilization failure.

Background::In vitro fertilization (IVF) has emerged as a transformative solution for infertility. However, achieving favorable live-birth outcomes remains challenging. Current clinical IVF practices in IVF involve the collection of heterogeneous embryo data through diverse methods, including static images and temporal videos. However, traditional embryo selection methods, primarily reliant on visual inspection of morphology, exhibit variability and are contingent on the experience of practitioners. Therefore, an automated system that can evaluate heterogeneous embryo data to predict the final outcomes of live births is highly desirable. Methods::We employed artificial intelligence (AI) for embryo morphological grading, blastocyst embryo selection, aneuploidy prediction, and final live-birth outcome prediction. We developed and validated the AI models using multitask learning for embryo morphological assessment, including pronucleus type on day 1 and the number of blastomeres, asymmetry, and fragmentation of blastomeres on day 3, using 19,201 embryo photographs from 8271 patients. A neural network was trained on embryo and clinical metadata to identify good-quality embryos for implantation on day 3 or day 5, and predict live-birth outcomes. Additionally, a 3D convolutional neural network was trained on 418 time-lapse videos of preimplantation genetic testing (PGT)-based ploidy outcomes for the prediction of aneuploidy and consequent live-birth outcomes.Results::These two approaches enabled us to automatically assess the implantation potential. By combining embryo and maternal metrics in an ensemble AI model, we evaluated live-birth outcomes in a prospective cohort that achieved higher accuracy than experienced embryologists (46.1% vs. 30.7% on day 3, 55.0% vs. 40.7% on day 5). Our results demonstrate the potential for AI-based selection of embryos based on characteristics beyond the observational abilities of human clinicians (area under the curve: 0.769, 95% confidence interval: 0.709–0.820). These findings could potentially provide a noninvasive, high-throughput, and low-cost screening tool to facilitate embryo selection and achieve better outcomes. Conclusions::Our study underscores the AI model’s ability to provide interpretable evidence for clinicians in assisted reproduction, highlighting its potential as a noninvasive, efficient, and cost-effective tool for improved embryo selection and enhanced IVF outcomes. The convergence of cutting-edge technology and reproductive medicine has opened new avenues for addressing infertility challenges and optimizing IVF success rates.

Objective:To investigate the effect of different assisted reproductive technologies (ART) and transplanted embryos at different developmental stages on live birth sex ratio in frozen-thawed embryo transfer (FET) cycles.Methods:From April 2010 to October 2018, the clinical data of patients and neonatal underwent in vitro fertilization-frozen-thawed embryo transfer (IVF-FET), intracytoplasmic sperm injection-frozen-thawed embryo transfer (ICSI-FET) and preimplantation genetic testing-frozen-thawed embryo transfer (PGT-FET) cycles that led to birth in the Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center were retrospectively analyzed. The relationship of the sex ratio of the live births to different ART and transplanted embryos at different developmental stages was studied. Results:1) IVF-FET cycles included 898 couples (920 FET cycles) and 1166 babies, with a general sex ratio of 106.7. The live birth sex ratio increased gradually at pre-morula stage, morula stage and blastocyst stage embryo transfer (99.0, 135.4, 142.6), but no statistical difference was observed between the groups ( P>0.05). 2) ICSI-FET cycles included 415 couples (433 FET cycles) and 555 babies, with a general live birth sex ratio of 111.0. After the transfer of embyos at different stages the proportion of male babies displayed no significant difference ( P>0.05). 3) PGT-FET cycles included 33 couples (33 FET cycles) and 33 babies, with a general live birth sex ratio of 153.8. Transplantation of blastocysts in IVF, ICSI or PGT had no significant effect on the proportion of male babies ( P>0.05). Conclusion:In FET cycles, compared with embryo transfer at early stage, late stage embryo transfer may be associated with a higher live birth sex ratio. The transfer of ICSI-FET embryos at different developmental stages and the transfer of blastocysts by IVF, ICSI or PGT technique did not affect the sex ratio of live birth.

Objective:To investigate the effect of different assisted reproductive technologies (ART) and transplanted embryos at different developmental stages on live birth sex ratio in frozen-thawed embryo transfer (FET) cycles.Methods:From April 2010 to October 2018, the clinical data of patients and neonatal underwent in vitro fertilization-frozen-thawed embryo transfer (IVF-FET), intracytoplasmic sperm injection-frozen-thawed embryo transfer (ICSI-FET) and preimplantation genetic testing-frozen-thawed embryo transfer (PGT-FET) cycles that led to birth in the Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center were retrospectively analyzed. The relationship of the sex ratio of the live births to different ART and transplanted embryos at different developmental stages was studied. Results:1) IVF-FET cycles included 898 couples (920 FET cycles) and 1166 babies, with a general sex ratio of 106.7. The live birth sex ratio increased gradually at pre-morula stage, morula stage and blastocyst stage embryo transfer (99.0, 135.4, 142.6), but no statistical difference was observed between the groups ( P>0.05). 2) ICSI-FET cycles included 415 couples (433 FET cycles) and 555 babies, with a general live birth sex ratio of 111.0. After the transfer of embyos at different stages the proportion of male babies displayed no significant difference ( P>0.05). 3) PGT-FET cycles included 33 couples (33 FET cycles) and 33 babies, with a general live birth sex ratio of 153.8. Transplantation of blastocysts in IVF, ICSI or PGT had no significant effect on the proportion of male babies ( P>0.05). Conclusion:In FET cycles, compared with embryo transfer at early stage, late stage embryo transfer may be associated with a higher live birth sex ratio. The transfer of ICSI-FET embryos at different developmental stages and the transfer of blastocysts by IVF, ICSI or PGT technique did not affect the sex ratio of live birth.

One of the great challenges in assisted reproduction today is the management of cases with poor-quality oocytes. Ooplasmic transfer (OT) has been used with the aim of augmenting embryo viability in patients with multiple implantation failures, usually associated with developmentally compromised oocytes. The justification for the technique was that the ooplasm from the donor contained beneficial components lacking in the recipient's oocytes, and that the transfer of these components to the recipient's oocytes would result in normal growth and viability. This review focuses on concerns regarding its use in assisted reproduction, like mitochondrial functioning, mitochondrial DNA heteroplasmy, regulation of apoptosis, cleavage division, epigenetic modifications, oocyte contents and mRNA which are the factors affecting oocytes due to mixing of two entities. The applications, efficacy and adverse effects of OT techniques in human are summarized.

One of the great challenges in assisted reproduction today is the management of cases with poor-quality oocytes. Ooplasmic transfer (OT) has been used with the aim of augmenting embryo viability in patients with multiple implantation failures, usually associated with developmentally compromised oocytes. The justification for the technique was that the ooplasm from the donor contained beneficial components lacking in the recipient's oocytes, and that the transfer of these components to the recipient's oocytes would result in normal growth and viability. This review focuses on concerns regarding its use in assisted reproduction, like mitochondrial functioning, mitochondrial DNA heteroplasmy, regulation of apoptosis, cleavage division, epigenetic modifications, oocyte contents and mRNA which are the factors affecting oocytes due to mixing of two entities. The applications, efficacy and adverse effects of OT techniques in human are summarized.