Embryo morphology and morphokinetics have been studied for their association with euploid embryos. However, the results are controversial, especially in the advanced-aged women group, when the risk of aneuploidy increases significantly. This prospective cohort study evaluated the association between embryo development between day-3 cleavage and day-5 blastocyst stages and euploidy rates, determined using preimplantation genetic testing for aneuploidy (PGT-A). Embryos from women aged 35 years and above who underwent intracytoplasmic sperm injections and PGT-A were studied. Day-3 cleavage-stage embryos were evaluated for their cell number, and day-5 blastocyst-stage embryos were evaluated for their morphological grade. Embryo development from day 3 to day 5 was categorized as either good or poor development and evaluated for its association with the PGT-A results. We evaluated 325 embryos from 101 infertile couples. It was found that 55.17% of blastocysts with good development and 29.83% with poor development were euploid. A significant association was found between embryo development and euploidy rates in advanced-aged women (p < 0.001). Also, there were significantly higher rates of euploid embryos with good blastocyst morphological grades, especially blastocyst expansion grades and trophectoderm grades. In conclusion, embryo morphokinetics shows promising results in predicting euploidy in advanced female age.

Context: In controlled ovarian hyperstimulation cycles, 15% of oocytes have been proven to be immature. Key factors include failure in signal transmission from the cumulus cell to the oocyte, insufficient level of luteinizing hormone, and internal conditions of the oocyte itself. Aims: The aim of the present study was to investigate the effect of human chorionic gonadotropin (hCG) on the in vitro maturity of partially cumulus-denuded immature oocytes collected after controlled ovarian stimulation for in vitro fertilization (IVF). Settings and Design: This was a prospective, randomized controlled design at the department of obstetrics and gynaecology, university hospital. Subjects and Methods: Infertile women underwent gonadotropin-releasing hormone antagonist stimulated protocol for IVF with final maturation triggered by hCG, partially cumulus-denuded immature human oocytes were allocated to two groups: the first was treated with fertilization medium and the second was treated with fertilization medium and hCG. They were cultured for 24 h. Outcomes measured were the oocyte maturation rates to metaphase II (MII) and glucose-6-phosphate dehydrogenase (G6PD) activity of in vitro maturation (IVM) mature oocytes which represent the oocyte quality. Statistical Analysis Used: The Mann–Whitney U-test and One-way ANOVA were used to compare continuous variables, and Chi-square was used for categorical data. Results: In all, 250 immature stimulated oocytes were allocated (125 per group). The maturation rate was higher in the hCG supplement group (48% vs. 39.2%) without significance. The positive brilliant cresyl blue results among the MII oocytes developed from the metaphase I (MI) were significantly higher in the hCG group (P = 0.001). Conclusions: Rescue IVM in fertilization culture medium plus hCG was slightly better than that in the only fertilization culture. MII oocytes developed from MI in hCG supplemented medium had a higher quality based on the measured G6PD activity.

Polycystic ovarian syndrome (PCOS) is a common endocrine disorder characterized by ovulatory dysfunction. Fertility outcomes in PCOS patients are often suboptimal, potentially owing to alterations in the follicular fluid (FF) microenvironment. However, the differences in FF hormone levels between PCOS and non-PCOS patients, as well as their correlation with assisted reproductive technology (ART) outcomes, remain unclear. This prospective study included 18 PCOS patients and 18 infertile women without PCOS (control group) undergoing intracytoplasmic sperm injection at the Division of Reproductive Medicine, Ramathibodi Hospital. The primary objective was to compare ART outcomes between the groups. Furthermore, FF testosterone, dehydroepiandrosterone sulfate, and luteinizing hormone levels were evaluated to assess their correlation with these outcomes. The number of retrieved oocytes was significantly higher in the PCOS group; however, the rates of metaphase II oocyte formation, fertilization, blastocyst formation, and high-quality blastocyst formation were comparable between the groups. Although FF testosterone and FF luteinizing hormone levels were higher in the PCOS group than in the control group, the differences were not statistically significant. Spearman correlation analysis showed that FF testosterone levels were negatively correlated with fertilization rate (r = −0.3496, p = 0.0366). These findings suggest that increased FF testosterone levels may negatively correlation with fertilization rates, which may reflect one of the contributing factors to the suboptimal ART outcomes observed in PCOS patients.

In this cross-sectional prospective study, advanced next-generation sequencing technology was used to compare the molecular karyotyping of individual human sperm cells in infertile couples with severe oligoteratozoospermia (i.e., low sperm count and motility) to those of infertile couples with normal semen. Fourteen infertile couples who were patients at Ramathibodi Hospital in Bangkok, Thailand, were recruited from January to November 2023, and they were categorized into two groups based on semen analysis results. The study group comprised couples with severe oligoteratozoospermia, whereas the control group exhibited normal semen. Individual sperm cells from the semen samples were isolated by the micromanipulation technique for subsequent whole-genome amplification and next-generation sequencing, where the primary outcome was the aneuploidy rate. Seventy individual sperm cells were isolated with a 90% success rate for amplification. The next-generation sequencing results showed that the aneuploidy rate was 25%–75%, with a mean of 48.28% in the study group. In contrast, the control group exhibited aneuploidy rates of 0–75%, with a mean of 15.15%. The difference between the two groups was statistically significant (odds ratio: 5.8, 95% confidence interval: 1.30–26.03). Sperm cells of the study group showed a threefold higher aneuploidy rate than those in the control group, even though the sperm cells were selected by micromanipulation for their normal morphology. Comprehensive counseling is recommended to address elevated aneuploidy rates that potentially surpass those of the general infertile population. Guidance on preimplantation genetic testing is also recommended to ensure the transfer of embryos with normal chromosomes.