In this article, we focused on the impact of precisely chemically modified FLI maturation medium enriched with fibroblast growth factor 2 (FGF2), leukemia inhibitory factor (LIF), insulin-like growth factor 1 (IGF1), and polyvinyl alcohol (PVA) and its potential to improve the efficiency of in vitro production of porcine embryos. We hypothesized that enhancing the composition of the maturation medium could result in an elevated production of embryos in vitro and can affect EGA. FLI medium resulted in a significantly higher rate of oocyte blastocyst maturation and formation compared to the control DMEM medium. In addition, immunocytochemical labelling confirmed the detection of UBF in 4-cell FLI parthenogenic embryos, suggesting similarities with natural embryo development. Through RNAseq analysis, upregulated genes present in 4-cell FLI embryos were found to play key roles in important biological processes such as cell proliferation, cell differentiation, and transcriptional regulation. Based on our findings, we demonstrated the positive influence of FLI medium in the evaluation of in vitro embryo production, EGA detection, transcriptomic and proteomic profile, which was confirmed by the positive activation of the embryonal genome in the 4-cell stage of parthenogenetically activated embryos.

• MeSH
• blastocysta účinky léků   metabolismus   MeSH
• fertilizace in vitro MeSH
• fibroblastový růstový faktor 2 * farmakologie   MeSH
• insulinu podobný růstový faktor I * farmakologie   MeSH
• kultivační média * chemie   farmakologie   MeSH
• leukemický inhibiční faktor * farmakologie   MeSH
• oocyty MeSH
• prasata embryologie   genetika   MeSH
• proteomika MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

The quandary known as the Intracytoplasmic Sperm Injection (ICSI) paradox is found at the juncture of Assisted Reproductive Technology (ART) and 'andrological ignorance' - a term coined to denote the undervalued treatment and comprehension of male infertility. The prevalent use of ICSI as a solution for severe male infertility, despite its potential to propagate genetically defective sperm, consequently posing a threat to progeny health, illuminates this paradox. We posit that the meteoric rise in Industrial Revolution 4.0 (IR 4.0) and Artificial Intelligence (AI) technologies holds the potential for a transformative shift in addressing male infertility, specifically by mitigating the limitations engendered by 'andrological ignorance.' We advocate for the urgent need to transcend andrological ignorance, envisaging AI as a cornerstone in the precise diagnosis and treatment of the root causes of male infertility. This approach also incorporates the identification of potential genetic defects in descendants, the establishment of knowledge platforms dedicated to male reproductive health, and the optimization of therapeutic outcomes. Our hypothesis suggests that the assimilation of AI could streamline ICSI implementation, leading to an overall enhancement in the realm of male fertility treatments. However, it is essential to conduct further investigations to substantiate the efficacy of AI applications in a clinical setting. This article emphasizes the significance of harnessing AI technologies to optimize patient outcomes in the fast-paced domain of reproductive medicine, thereby fostering the well-being of upcoming generations.

• MeSH
• asistovaná reprodukce MeSH
• intracytoplazmatické injekce spermie * MeSH
• lidé MeSH
• mužská infertilita * diagnóza   genetika   terapie   MeSH
• sperma MeSH
• umělá inteligence MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• dopisy MeSH

Asistovaná reprodukcia je pomerne rýchlo sa rozvíjajúci odbor medicíny, ktorý poskytuje liečbu neplodným párom. Od narodenia prvého dieťaťa zo „skúmavky“ uplynulo viac než 45 rokov, za ktoré obdobie boli vyvinuté rôzne metodiky za účelom zvýšenia úspešnosti liečby. Samotná spontánna koncepcia je podmienená mnohými faktormi, o ktorých máme aj v súčasnosti pomerne málo informácií. Vývoj asistovanej reprodukcie postupne odhaľuje jednotlivé významné procesy a stavy ktoré ovplyvňujú vznik a vývoj úspešnej tehotnosti. Diabetes mellitus a s ním spojené metabolické poruchy majú negatívny vplyv na kvalitu pohlavných buniek, fertilizáciu, nidáciu a vývoj tehotnosti. Identifikácia a úspešná liečba diabetu má preto dôležitý význam pred zahájením liečby neplodnosti.

Assisted reproduction is a relatively rapidly developing field of medicine focused on the treatment of infertile couples. More than 45 years have passed since the birth of the first “test- tube baby”. Since that time various methods were developed to increase the success rate of the treatment. Spontaneous conception itself is conditioned by many factors, about which we still have relatively little information. The development of assisted reproduction techniques gradually reveals important processes and conditions that influence the development of a successful pregnancy. Diabetes mellitus and associated metabolic disorders have a negative impact on the quality of gametes, fertilization as well as the development of pregnancy. Identification and successful treatment of diabetes plays a key role before starting infertility treatment.

• MeSH
• asistovaná reprodukce MeSH
• diabetes mellitus MeSH
• erektilní dysfunkce etiologie   terapie   MeSH
• fertilizace in vitro metody   MeSH
• komplikace diabetu * prevence a kontrola   MeSH
• lidé MeSH
• menstruační cyklus MeSH
• mužská infertilita diagnóza   etiologie   terapie   MeSH
• oocyty MeSH
• spermatogeneze MeSH
• syndrom polycystických ovarií diagnóza   komplikace   terapie   MeSH
• ženská infertilita diagnóza   etiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH

• MeSH
• fertilizace in vitro MeSH
• genetická predispozice k nemoci MeSH
• genetické testování MeSH
• geny BRCA1 MeSH
• geny BRCA2 MeSH
• lidé MeSH
• mutace MeSH
• nádory prsu * diagnóza   prevence a kontrola   MeSH
• webová vysílání jako téma MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• novinové články MeSH

• MeSH
• asistovaná reprodukce klasifikace   MeSH
• fertilizace in vitro klasifikace   MeSH
• infertilita * terapie   MeSH
• lidé MeSH
• preimplantační diagnóza klasifikace   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

• Klíčová slova
• zygotic splitting,
• MeSH
• dvojčata monozygotní MeSH
• fertilizace in vitro metody   MeSH
• gravidita MeSH
• incidence MeSH
• lidé MeSH
• přenos embrya metody   přístrojové vybavení   MeSH
• rozdělení zygoty MeSH
• těhotenství mnohočetné * statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

Světová zdravotnická organizace definuje obezitu jako abnormální nebo nadměrné hromadění tuku, které poškozuje zdraví. Obezita a nadváha mají negativní vliv nejen na celkové zdraví, ale do značné míry také na reprodukční zdraví. Obezita je spojena se sníženou plodností, častějšími těhotenskými ztrátami a dalšími těhotenskými komplikacemi. Vzhledem k pandemii obezity bude stále větší podíl žen vyhledávajících lékařskou pomoc pro neplodnost trpět nadváhou nebo obezitou. Obezita se podílí na patogenezi syndromu polycystických vaječníků (PCOS – polycystic ovary syndrome) a přibližně 40–70 % pacientek s PCOS má nadváhu nebo obezitu. Riziko potratu je zvýšené u žen s obezitou, které otěhotní po in vitro fertilizaci, a to bez ohledu na to, zda jsou použity vlastní oocyty, či oocyty darované. U mužů je souvislost mezi obezitou a sníženou plodností prozkoumána méně než u žen. Mezi mechanizmy, kterými může obezita ovlivnit spermatogenezi, patří tepelné účinky, hyperestrogenizmus, hypogonadotropní hypogonadizmus, diabetes mellitus, sexuální dysfunkce a epigenetické poruchy spermií. Obezita žen i mužů ovlivňuje negativně výsledky asistované reprodukce. Ženy s nadváhou či obezitou by měly být informovány o celkových zdravotních i porodnických rizicích a o nižší úspěšnosti léčby neplodnosti metodami asistované reprodukce.

The World Health Organization defines obesity as an abnormal or excessive accumulation of fat that is harmful to health. Obesity and overweight have a negative effect not only on general health, but also on reproductive health. Obesity is associated with reduced fertility, more frequent pregnancy losses and other pregnancy complications. Due to an obesity pandemic, an increasing proportion of women seeking medical help for infertility will be overweight or obese. Obesity is involved in the pathogenesis of polycystic ovary syndrome (PCOS), approximately 40–70% of PCOS patients are overweight or obese. The risk of miscarriage is increased in obese women who become pregnant after in vitro fertilisation, regardless of whether their own oocytes or donated oocytes are used. In men, the link between obesity and reduced fertility is less well-studied than in women. Mechanisms by which obesity may affect spermatogenesis include thermal effects, hyperestrogenism, hypogonadotropic hypogonadism, diabetes mellitus, sexual dysfunction, and sperm epigenetic disorders. Obesity in both women and men negatively affects the results of assisted reproduction. Overweight or obese women should be informed about the overall health and obstetric risks and about the lower success rate of infertility treatment with assisted reproduction methods.

• MeSH
• asistovaná reprodukce MeSH
• fertilizace in vitro MeSH
• lidé MeSH
• nadváha * komplikace   MeSH
• obezita * komplikace   MeSH
• těhotenství MeSH
• ženská infertilita * etiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

Role of male factor in recurrent abortion and in vitro fertilization failure has not been fully defined yet and there is much controversy about evaluating male patients with normal semen analysis. One of the factors that might help establish the male role is DNA fragmentation index. However, strong correlation between this factor and quality of semen, has caused many clinicians to believe that it does not help in abortion and implantation failure. We aim to assess this factor in our patients. In a prospective observational study, we assessed age, duration of infertility, undesired fertility related events (assisted reproductive techniques attempts and abortions), semen parameters and DNA fragmentation index in patients with multiple abortions or in vitro fertilization failures and analysed the results by statistical software SPSS version 24. DNA fragmentation index was remarkably correlated with age, duration of infertility and semen parameters. Among all groups in our study, patients with abnormal semen analysis had statistically significant higher level of DNA fragmentation. Ten percent of patients with normal or slightly abnormal semen analysis had abnormally high SDFI (sperm DNA fragmentation index). Checking DNA fragmentation index is recommended in all couples with fertilization problems even in the presence of normal semen analysis. It might be more reasonable to assess it in aged men, long duration of infertility or candidates with remarkable semen abnormality.

• MeSH
• analýza spermatu MeSH
• fertilizace in vitro metody   MeSH
• fragmentace DNA MeSH
• habituální potrat * MeSH
• lidé MeSH
• mužská infertilita * diagnóza   genetika   MeSH
• senioři MeSH
• sperma MeSH
• spermie MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

Cíl: Shrnout aktuální možnosti kryokonzervace ovariální tkáně jako jednu z dalších možných metod pro zachování plodnosti u žen. Metodika: Literární přehled získaný ze studií a prací týkajících se kryokonzervace ovariální tkáně. Závěr: Kryokonzervace ovariální tkáně a její následná transplantace má významný potenciál pro zachování plodnosti nejen pro prepubertální a onkologické pacientky, ale také pro pacientky s různými zdravotními indikacemi vedoucími k předčasné ovariální insuficienci. Pro zachování co nejlepší kvality oocytů v kryokonzervované ovariální tkáni je nezbytné neustále optimalizovat, standardizovat a porovnávat jak kryokonzervační protokoly, postupy a strategie, tak i proces rozmražení ovariální tkáně s její následnou transplantací.

Objective: To summarize the current possibilities of ovarian tissue cryopreservation as one of the other possible methods for fertility preservation in women. Methods: Literature review obtained from studies and literature related to ovarian tissue cryopreservation. Conclusion: Cryopreservation of ovarian tissue and its subsequent transplantation has a significant potential for preserving fertility not only for prepubertal and oncological patients, but also for patients with various medical indications leading to premature ovarian insufficiency. In order to maintain the best possible quality of oocytes in cryopreserved ovarian tissue, it is necessary to constantly optimize, standardize and compare both cryopreservation protocols, procedures and strategies, as well as the process of thawing ovarian tissue with its subsequent transplantation.

• Klíčová slova
• onkofertilita, kryokonzervace ovariální tkáně, pomalé mražení, in vitro maturace,
• MeSH
• asistovaná reprodukce MeSH
• fertilizace in vitro MeSH
• kryoprezervace metody   MeSH
• lidé MeSH
• odběr oocytu metody   MeSH
• odběr tkání a orgánů MeSH
• zachování plodnosti * metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

STUDY QUESTION: What are the data and trends on ART and IUI cycle numbers and their outcomes, and on fertility preservation (FP) interventions, reported in 2019 as compared to previous years? SUMMARY ANSWER: The 23rd ESHRE report highlights the rising ART treatment cycles and children born, alongside a decline in twin deliveries owing to decreasing multiple embryo transfers; fresh IVF or ICSI cycles exhibited higher delivery rates, whereas frozen embryo transfers (FET) showed higher pregnancy rates (PRs), and reported IUI cycles decreased while maintaining stable outcomes. WHAT IS KNOWN ALREADY: ART aggregated data generated by national registries, clinics, or professional societies have been gathered and analyzed by the European IVF-Monitoring (EIM) Consortium since 1997 and reported in a total of 22 manuscripts published in Human Reproduction and Human Reproduction Open. STUDY DESIGN, SIZE, DURATION: Data on medically assisted reproduction (MAR) from European countries are collected by EIM for ESHRE each year. The data on treatment cycles performed between 1 January and 31 December 2019 were provided by either national registries or registries based on initiatives of medical associations and scientific organizations or committed persons in one of the 44 countries that are members of the EIM Consortium. PARTICIPANTS/MATERIALS, SETTING, METHODS: Overall, 1487 clinics offering ART services in 40 countries reported, for the second time, a total of more than 1 million (1 077 813) treatment cycles, including 160 782 with IVF, 427 980 with ICSI, 335 744 with FET, 64 089 with preimplantation genetic testing (PGT), 82 373 with egg donation (ED), 546 with IVM of oocytes, and 6299 cycles with frozen oocyte replacement (FOR). A total of 1169 institutions reported data on IUI cycles using either husband/partner's semen (IUI-H; n = 147 711) or donor semen (IUI-D; n = 51 651) in 33 and 24 countries, respectively. Eighteen countries reported 24 139 interventions in pre- and post-pubertal patients for FP, including oocyte, ovarian tissue, semen, and testicular tissue banking. MAIN RESULTS AND THE ROLE OF CHANCE: In 21 countries (21 in 2018) in which all ART clinics reported to the registry 476 760 treatment cycles were registered for a total population of approximately 300 million inhabitants, allowing the best estimate of a mean of 1581 cycles performed per million inhabitants (range: 437-3621). Among the reporting countries, for IVF the clinical PRs per aspiration slightly decreased while they remained similar per transfer compared to 2018 (21.8% and 34.6% versus 25.5% and 34.1%, respectively). In ICSI, the corresponding PRs showed similar trends compared to 2018 (20.2% and 33.5%, versus 22.5% and 32.1%) When freeze-all cycles were not considered for the calculations, the clinical PRs per aspiration were 28.5% (28.8% in 2018) and 26.2% (27.3% in 2018) for IVF and ICSI, respectively. After FET with embryos originating from own eggs, the PR per thawing was at 35.1% (versus 33.4% in 2018), and with embryos originating from donated eggs at 43.0% (41.8% in 2018). After ED, the PR per fresh embryo transfer was 50.5% (49.6% in 2018) and per FOR 44.8% (44.9% in 2018). In IVF and ICSI together, the trend toward the transfer of fewer embryos continues with the transfer of 1, 2, 3, and ≥4 embryos in 55.4%, 39.9%, 2.6%, and 0.2% of all treatments, respectively (corresponding to 50.7%, 45.1%, 3.9%, and 0.3% in 2018). This resulted in a reduced proportion of twin delivery rates (DRs) of 11.9% (12.4% in 2018) and a similar triplet DR of 0.3%. Treatments with FET in 2019 resulted in twin and triplet DR of 8.9% and 0.1%, respectively (versus 9.4% and 0.1% in 2018). After IUI, the DRs remained similar at 8.7% after IUI-H (8.8% in 2018) and at 12.1% after IUI-D (12.6% in 2018). Twin and triplet DRs after IUI-H were 8.7% and 0.4% (in 2018: 8.4% and 0.3%) and 6.2% and 0.2% after IUI-D (in 2018: 6.4% and 0.2%), respectively. Eighteen countries (16 in 2018) provided data on FP in a total number of 24 139 interventions (20 994 in 2018). Cryopreservation of ejaculated sperm (n = 11 592 versus n = 10 503 in 2018) and cryopreservation of oocytes (n = 10 784 versus n = 9123 in 2018) were most frequently reported. LIMITATIONS, REASONS FOR CAUTION: Caution with the interpretation of results should remain as data collection systems and completeness of reporting vary among European countries. Some countries were unable to deliver data about the number of initiated cycles and/or deliveries. WIDER IMPLICATIONS OF THE FINDINGS: The 23rd ESHRE data collection on ART, IUI, and FP interventions shows a continuous increase of reported treatment numbers and MAR-derived livebirths in Europe. Although it is the largest data collection on MAR in Europe, further efforts toward optimization of both the collection and the reporting, from the perspective of improving surveillance and vigilance in the field of reproductive medicine, are awaited. STUDY FUNDING/COMPETING INTEREST(S): The study has received no external funding and all costs are covered by ESHRE. There are no competing interests.

• MeSH
• asistovaná reprodukce * MeSH
• dítě MeSH
• fertilizace in vitro * MeSH
• lidé MeSH
• registrace MeSH
• retrospektivní studie MeSH
• sperma MeSH
• těhotenství s dvojčaty MeSH
• těhotenství MeSH
• úhrn těhotenství na počet žen v reprodukčním věku MeSH
• výsledek těhotenství epidemiologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH