Objective: This study aimed to develop a configurable clean room paradigm with low air pressure for assisted reproductive technology (ART) clinics and demonstrate the concept’s efficacy using in vitro fertilization (IVF) treatment. Methods: A high-standard clean room system with positive pressure (13 Pa) was built using accessible materials and equipment for ART laboratories. Methods for controlling and evaluating the clean room’s characteristics were developed and implemented for quality assessment and calibration to maximize efficiency. The feasibility of the flexible clean room concept was assessed by analyzing the key performance indicators of embryo culture and IVF treatment. Results: After 3 weeks of testing, the concentration of particles ≥0.5 μm was 6.04 times lower than the International Organization for Standardization (ISO) class 5 standard (3,520 particles/m3) in the IVF laboratory. Air pressure, noise, temperature, and humidity were controlled stably and appropriately. Five days after installation and handover, the volatile organic compound concentration dropped to 0.00 ppm. With blastocysts and a respectable blastocyst rate, embryonic culture with female patients younger than 40 matched the criteria (63.5% and 38.9%, respectively). After vitrified blastocysts were transferred, the pregnancy and implantation rates were 58.5% and 36.2%, respectively, demonstrating a high degree of treatment success. Conclusion Our customizable, high-quality, low-air-pressure clean room model can be implemented to achieve positive outcomes for infertility treatment.

Objective: This study aimed to develop a configurable clean room paradigm with low air pressure for assisted reproductive technology (ART) clinics and demonstrate the concept’s efficacy using in vitro fertilization (IVF) treatment. Methods: A high-standard clean room system with positive pressure (13 Pa) was built using accessible materials and equipment for ART laboratories. Methods for controlling and evaluating the clean room’s characteristics were developed and implemented for quality assessment and calibration to maximize efficiency. The feasibility of the flexible clean room concept was assessed by analyzing the key performance indicators of embryo culture and IVF treatment. Results: After 3 weeks of testing, the concentration of particles ≥0.5 μm was 6.04 times lower than the International Organization for Standardization (ISO) class 5 standard (3,520 particles/m3) in the IVF laboratory. Air pressure, noise, temperature, and humidity were controlled stably and appropriately. Five days after installation and handover, the volatile organic compound concentration dropped to 0.00 ppm. With blastocysts and a respectable blastocyst rate, embryonic culture with female patients younger than 40 matched the criteria (63.5% and 38.9%, respectively). After vitrified blastocysts were transferred, the pregnancy and implantation rates were 58.5% and 36.2%, respectively, demonstrating a high degree of treatment success. Conclusion Our customizable, high-quality, low-air-pressure clean room model can be implemented to achieve positive outcomes for infertility treatment.

Objective: This study aimed to develop a configurable clean room paradigm with low air pressure for assisted reproductive technology (ART) clinics and demonstrate the concept’s efficacy using in vitro fertilization (IVF) treatment. Methods: A high-standard clean room system with positive pressure (13 Pa) was built using accessible materials and equipment for ART laboratories. Methods for controlling and evaluating the clean room’s characteristics were developed and implemented for quality assessment and calibration to maximize efficiency. The feasibility of the flexible clean room concept was assessed by analyzing the key performance indicators of embryo culture and IVF treatment. Results: After 3 weeks of testing, the concentration of particles ≥0.5 μm was 6.04 times lower than the International Organization for Standardization (ISO) class 5 standard (3,520 particles/m3) in the IVF laboratory. Air pressure, noise, temperature, and humidity were controlled stably and appropriately. Five days after installation and handover, the volatile organic compound concentration dropped to 0.00 ppm. With blastocysts and a respectable blastocyst rate, embryonic culture with female patients younger than 40 matched the criteria (63.5% and 38.9%, respectively). After vitrified blastocysts were transferred, the pregnancy and implantation rates were 58.5% and 36.2%, respectively, demonstrating a high degree of treatment success. Conclusion Our customizable, high-quality, low-air-pressure clean room model can be implemented to achieve positive outcomes for infertility treatment.

Background: Suicide continues to be a leading cause of death worldwide. Recently, more than 45,000 children in the age group of 10 to 19 years died by suicide, making it the second leading cause of death in the age group of 15 to 19, surpassed only by traffic accidents, tuberculosis, and fighting. Objective: To determine the prevalence of suicidal ideation among adolescents whose parents are separated/divorced; and to explore the factors associated with suicidal ideation and describe adverse experiences among adolescents. Methods: A cross-sectional descriptive study was conducted in 309 adolescents with separated/separated parents in Hue City. Data was collected through direct interviews using a structured questionnaire. Suicidal ideation was defined as the presence of thoughts or plans related to suicide within the last 12 months. Multivariate logistic regression was applied to identify factors associated with suicidal ideation in adolescents with separated/ separated parents. Results: The study found that 15.5% (95% CI:11.7 - 20.1) of adolescents with separated /separated parents reported experiencing suicidal thoughts, in which men accounted 8.4% (95% CI:5.6 – 11.2) and women accounted 7.1% (95% CI:4.5 - 10.6). Several factors were identified as increasing the risk of suicidal ideation, including alcohol use (OR = 3.24; 95% CI:1.42 - 7.42), hyperactivity/inattention (OR = 4.96; 95% CI:1.58 - 15.605), and a poor quality of family relationships (OR = 4.82; 95% CI:1.26 - 18.50). On the contrary, certain factors were found to reduce the risk, including being in the 14-15 age group of 14-15 (OR = 0.26; 95% CI:0.10 - 0.69) and participating in physical activity (OR = 0.44; 95% CI:0.21 – 0.94). Conclusions: The research highlights a significant percentage of adolescents with separated / divided parents who experience suicidal ideation. Therefore, it is imperative for families, schools, and society to develop comprehensive strategies to monitor and address various risky behaviours among students simultaneously.

Objectives: We assessed the prevalence of stress, anxiety, and depression among adolescents living in families with separated or divorced parents in Hue City, Vietnam and identified factors associated with these conditions. Methods: This cross-sectional study enrolled 309 adolescents, aged 12 to 17 years, living in families with separated or divorced parents in Hue City, Vietnam. The depression anxiety stress scale-21 (DASS-21) was used to measure stress, anxiety, and depression. Predictors of overall and individual mental health problems were identified using ordered and binary logistic regression, respectively. Results: The DASS-21 scale revealed a 49.2% prevalence of stress, while anxiety and depression had s prevalence rates of 61.5%. Among participants, 42.4% experienced all 3 mental health issues. Several factors were identified as significant predictors of mental health problems, including poor to average economic status (adjusted odds ratio [aOR], 2.00; 95% confidence interval [CI], 1.21–3.31; p=0.007); being in high school (aOR, 5.02; 95% CI, 2.93–8.60; p<0.001); maternal occupation of teacher, healthcare professional, or official (aOR, 2.39; 95% CI, 1.13–5.03; p=0.022); longer duration of family separation or divorce (aOR, 1.24; 95% CI, 1.05–1.45; p=0.009); living with one’s mother (aOR, 1.69; 95% CI, 1.03–2.76; p=0.04); alcohol consumption (aOR, 1.70; 95% CI, 0.99–2.92; p=0.050); and being bullied (aOR, 5.33; 95% CI, 1.10–25.69; p=0.037). Most of these factors were associated with stress, anxiety, and depression. Additionally, smoking was associated with stress. Conclusion Adolescents with separated or divorced parents were at increased risk of stress, anxiety, and depression. The findings of this study provide important implications for prevention programs.

Objective: This study aimed to compare the efficacy of physiological intracytoplasmic sperm injection (PICSI) and intracytoplasmic sperm injection (ICSI) in terms of the fertilization rate and embryo quality using sibling oocyte cycles. Methods: This prospective, cross-sectional study collected data from 76 couples who underwent their first cycle at the Hue Center for Reproductive Endocrinology and Infertility, Vietnam, between May 2019 and November 2021. The inclusion criteria were cycles with at least eight oocytes and a sperm concentration of 5×106/mL. Sperm parameters, sperm DNA fragmentation (SDF), fertilization, and the quality of cleavage-stage embryos on day 2 and blastocysts on day 5 were examined. Results: From 76 ICSI cycles, 1,196 metaphase II (MII) oocytes were retrieved, half of which were randomly allocated to either the PICSI (n=592) or ICSI (n=604) treatment group. The results showed no significant difference between the two groups in terms of fertilization (72.80% vs. 75.33%, p=0.32), day 2 cleavage rate (95.13% vs. 96.04%, p=0.51), blastulation rate (52.68% vs. 57.89%), and high-quality blastocyst rate (26.10% vs. 31.13%, p=0.13). However, in cases where SDF was low, 59 cycles consisting of 913 MII oocytes produced a considerably higher blastulation rate with PICSI than with ICSI (50.49% vs. 35.65%, p=0.00). There were no significant differences between the pregnancy outcomes of the PICSI and ICSI embryo groups following embryo transfer. Conclusion Using variable sperm quality provided no benefit for PICSI versus ICSI in terms of embryo outcomes. When SDF is low, PICSI appears to be able to produce more blastocysts.

As the associations of sperm DNA fragmentation with morphology have not been examined in detail, this study aimed to investigate the relationship between abnormalities of morphological details and DNA integrity in human sperm. Methods: In this cross-sectional study, men from infertile couples were enrolled at Hue Center for Reproductive Endocrinology and Infertility, Vietnam. Conventional semen parameters, including morphological details, were analyzed following the World Health Organization 2010 criteria. Sperm DNA fragmentation was evaluated using a sperm chromatin dispersion assay. The relationships and correlations between semen parameters, sperm morphology, and the type of halosperm and the DNA fragmentation index (DFI) were analyzed. Results: Among 130 men in infertile couples, statistically significant differences were not found in the sperm halo type between the normal and abnormal sperm morphology groups. The percentage of round-head spermatozoa was higher in the DFI >15% group (16.98%±12.50%) than in the DFI ≤15% group (13.13% ±8.82%), higher values for amorphous heads were found in the DFI >15% group, and lower values for tapered heads were observed in the DFI ≤15% group; however, these differences were not statistically significant. Small-halo sperm and the DFI were positively correlated with round-head sperm (r=0.243, p=0.005 and r=0.197, p=0.025, respectively). Conclusion: The rate of general sperm morphological abnormalities in semen analysis was not related to sperm DNA integrity. However, round sperm heads were closely associated with sperm DNA fragmentation.

BACKGROUND/OBJECTIVES: Although children of ethnic minority groups are experiencing a transition from a predominance of undernutrition to overnutrition, there is little evidence of a dual-malnutrition burden. Therefore, this study examined the double burden of malnutrition among school-aged ethnic minority children living in mountainous areas and its association with their diets. SUBJECTS/METHODS: A cross-sectional study was conducted from September 2019 to March 2020 in 3 mountainous areas of Northern Vietnam among 1,556 ethnic minority schoolaged children. The prevalence of under-nutrition (stunting and thinness) and over-nutrition (overweight and obesity) were measured using the WHO 2006 child growth standards (height-for-age and BMI-for-age Z-score). Nutritional practices were evaluated by the frequency of food consumption based on a 4-level scale. RESULTS: The percentage of children with stunting and thinness were 14.0% and 5.4%, respectively, while the figure for overweight/obesity was 9.4%. The factors positively associated with stunting were living in a family with more than 2 children or being Muong/ other ethnicities compared to the Tay ethnicity. Children who consumed fish/shrimps/crabs or milk weekly/daily were less likely to be undernourished compared to those who never consumed these foods. By contrast, children who never consumed foods rich in vitamin A precursors and vitamin A and fruit or consumed daily snacks/junk food were more likely to be overweight/obese. CONCLUSIONS Undernutrition remains a common issue among school-aged children and adolescents of ethnic minority groups, while over-nutrition exists simultaneously. Public health nutrition programs promoting adequate diets and positive lifestyle changes related to nutrition are essential to tackle the double burden of malnutrition among ethnic minority children.

OBJECTIVE: Sperm cryopreservation has been widely used in assisted reproductive technology, as it offers great potential for the treatment of some types of male infertility. However, cryopreservation may result in changes in membrane lipid composition and acrosome status, as well as reductions in sperm motility and viability. This study aimed to evaluate sperm DNA fragmentation damage caused by conventional freezing using the sperm chromatin dispersion test. METHODS: In total, 120 fresh human semen samples were frozen by conventional methods, using SpermFreeze Solution as a cryoprotectant. Routine semen analysis and a Halosperm test (using the Halosperm kit) were performed on each sample before freezing and after thawing. Semen parameters and sperm DNA fragmentation were compared between these groups. RESULTS: There was a significant decrease in sperm progressive motility, viability, and normal morphology after conventional freezing (32.78%, 79.58%, and 3.87% vs. 16%, 55.99%, and 2.55%, respectively). The sperm head, midpiece, and tail defect rate increased slightly after freezing. Furthermore, the DNA fragmentation index (DFI) was significantly higher after thawing than before freezing (19.21% prior to freezing vs. 22.23% after thawing). Significant increases in the DFI after cryopreservation were observed in samples with both normal and abnormal motility and morphology, as well as in those with normal viability. CONCLUSION: Conventional freezing seems to damage some sperm parameters, in particular causing a reduction in sperm DNA integrity.
Acrosome ; Chromatin ; Cryopreservation ; DNA Fragmentation ; DNA ; Freezing ; Humans ; Infertility, Male ; Male ; Membranes ; Reproductive Techniques, Assisted ; Semen ; Semen Analysis ; Sperm Head ; Sperm Motility ; Spermatozoa ; Tail

OBJECTIVE: In frozen and thawed embryos, the zona pellucida (ZP) can be damaged due to hardening. Laser-assisted hatching (LAH) of embryos can increase the pregnancy rate. This study compared thinning and drilling of the ZP before frozen embryo transfer (FET). METHODS: Patients were randomly allocated into two groups for LAH using thinning or drilling on day 2 after thawing. Twenty-five percent of the ZP circumference and 50% of the ZP thickness was removed in the thinning group, and a hole 40 µm in diameter was made in the drilling group. RESULTS: A total of 171 in vitro fertilization/intracytoplasmic sperm injection FET cycles, including 85 cycles with drilling LAH and 86 cycles with thinning LAH, were carried out. The thinning group had a similar β-human chorionic gonadotropin-positive rate (38.4% vs. 29.4%), implantation rate (16.5% vs. 14.4%), clinical pregnancy rate (36.0% vs. 25.9%), miscarriage rate (5.8% vs. 2.4%), ongoing pregnancy rate (30.2% vs. 23.5%), and multiple pregnancy rate (7.0% vs. 10.6%) to the drilling LAH group. There were no significant differences in pregnancy outcomes between subgroups defined based on age (older or younger than 35 years) or ZP thickness (greater or less than 17 µm) according to the LAH method. CONCLUSION: The present study demonstrated that partial ZP thinning or drilling resulted in similar outcomes in implantation and pregnancy rates using thawed embryos, irrespective of women's age or ZP thickness.
Abortion, Spontaneous ; Chorion ; Embryo Transfer* ; Embryonic Structures* ; Female ; Humans ; In Vitro Techniques ; Methods ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Pregnancy, Multiple ; Reproductive Techniques, Assisted ; Spermatozoa ; Zona Pellucida