Isthmocele is a gynecological condition characterized by a disruption in the uterine scar, often associated with prior cesarean sections. This anatomical anomaly can be attributed to inadequate or insufficient healing of the uterine wall following a cesarean incision. It appears that isthmocele may impact a woman’s quality of life as well as her reproductive capacity. The incidence of isthmocele can range from 20% to 70% in women who have undergone a cesarean section. This review aims to sum up the current knowledge about the effect of isthmocele on fertility and the possible therapeutic strategies to achieve pregnancy. However, currently, there is not sufficiently robust evidence to indicate the need for surgical correction in all asymptomatic patients seeking fertility. In cases where surgical correction of isthmocele is deemed necessary, it is advisable to evaluate residual myometrial thickness (RMT). For patients with RMT >2.5–3 mm, hysteroscopy appears to be the technique of choice. In cases where the residual tissue is lower, recourse to laparotomic, laparoscopic, or vaginal approaches is warranted.

The final trigger of oocyte maturation is a pivotal step in assisted reproductive technology (ART). Different molecules and protocols—including human chorionic gonadotropin (hCG), gonadotropin-releasing hormone agonists (GnRHa), the dual trigger, the double trigger, and emerging agents such as kisspeptin—have been investigated to optimize oocyte competence, embryo development, and pregnancy outcomes while minimizing the risk of ovarian hyperstimulation syndrome (OHSS). HCG remains the most widely used trigger, but its pharmacological profile is associated with a significant risk of OHSS. GnRHa has emerged as an alternative in antagonist cycles, abolishing the risk of severe OHSS but often requiring tailored luteal phase support. Several strategies, including hCG, GnRHa, and combined approaches, have shown improvements in specific outcomes such as the oocyte maturity (MII) rate, fertilization rate, embryo development parameters, and, in selected contexts, a reduction in OHSS risk. Kisspeptin represents a promising option; however, its use remains predominantly within the research setting, with clinical application still limited to early-phase or highly selected studies. Beyond the choice of molecule, the timing of trigger administration—adjusted to follicle size, estradiol concentrations, and progesterone levels—also influences oocyte competence and subsequent clinical outcomes. Triggering final oocyte maturation remains a multifaceted decision that should be individualized according to patient characteristics, ovarian response, and risk of OHSS. Although hCG remains the historical reference standard, accumulating but heterogeneous evidence suggests that GnRHa-based strategies, including dual-trigger protocols, may improve specific outcomes in selected patient subgroups. However, results across trials are inconsistent, particularly in poor responders, and any exposure to hCG maintains a residual risk of OHSS. Kisspeptin represents a promising but still experimental option, with current data largely limited to early-phase clinical studies in highly selected high-risk populations. Well-designed randomized trials are required to clarify the true impact of these strategies on live birth, to refine timing and dosing, and to better define which patients are most likely to benefit.

In recent decades, exposure to electromagnetic fields (EMFs) generated by standard devices has raised concerns about possible effects on reproductive health. This cross-sectional observational study examined the impact of EMFs on sperm motility in a sample of 102 healthy males aged 20–35 years in the IVF laboratory. Semen samples were exposed to different sources of EMF for one hour, and motility was assessed immediately thereafter. The results showed a significant reduction in progressive sperm motility after exposure to EMFs generated by mobile phones and Wi-Fi repeaters in the laboratory. In contrast, other equipment showed no significant effects. The study demonstrated a statistically significant reduction in progressive sperm motility following in vitro exposure to electromagnetic fields (EMFs) emitted by mobile communication devices and wireless local area network access points. Conversely, other electromagnetic emitting devices evaluated did not elicit significant alterations in this parameter. These findings suggest a potential negative impact of specific EMF sources on semen quality, underscoring the necessity for further comprehensive research to elucidate the clinical implications and to develop potential mitigation strategies aimed at reducing risks to male reproductive health. This study discourages the introduction of mobile phones in IVF laboratories and recommends positioning Wi-Fi repeaters on the ceiling.

Objective: To evaluate patient perceptions regarding ultrasound-guided embryo transfer, visualisation of embryos prior to transfer, and continuity of care with the same physician during in vitro fertilisation (IVF) treatments. Setting: Between January and September 2023, this study was conducted at the IVF MOMO’ FertiLIFE centre in Bisceglie, Italy. Design: Descriptive and observational study based on an anonymous survey administered to IVF patients at the time of embryo transfer. The goal was to assess the subjective emotional and psychological response to selected procedural elements of the embryo transfer process. Participants: Out of 284 distributed questionnaires, 200 were included in the final analysis. Inclusion required fully completed responses. Questionnaires with incomplete, unclear answers or patient refusal were excluded. The study group was compared with the general IVF patient population treated at the centre over the past 5 years to ensure representativeness. Methods: Patients completed a structured questionnaire using a five-point Likert scale. Statistical analysis included descriptive statistics, Spearman’s rank correlation, Friedman test, and exploratory factor analysis. Ethical approval was obtained (CELFer no. 07/2021), and all participants provided written informed consent. Results: The majority of patients reported a heightened sense of calm and reassurance during ultrasound-guided embryo transfer. Viewing embryos on a monitor before transfer was also positively perceived. A strong preference emerged for continuity of care with the same physician throughout the IVF process. While this study did not assess objective stress levels or clinical outcomes, the findings highlight the psychological comfort associated with these patient-centred practices. Limitations: This single-centre study is based on self-reported data and lacks objective assessments of psychological well-being. Therefore, results reflect personal perceptions rather than measurable clinical outcomes. Broader, multicentre research using validated psychological tools is needed to confirm and expand these findings. Furthermore, the questionnaire used in this study was developed internally and not validated externally with standardised psychometric instruments. Conclusions: This study provides insight into IVF patients’ subjective experiences, emphasising the perceived emotional benefits of specific procedural and relational aspects of care. These findings support the integration of patient-centred strategies—such as visual engagement and physician continuity—into routine IVF practice to enhance overall patient well-being.