To determine and compare the prevalence of insulin resistance and carbohydrate metabolism parameters in women with endometrial pathology 100 perimenopausal women with abnormal uterine bleeding and/or abnormal endometrium were included into the study. Hysteroscopy with biopsy was performed. The study population was divided into four groups according to histopathological results of the endometrium: non-atypical endometrial hyperplasia, endometrial polyp, endometrial cancer and controls. Fasting glucose and insulin levels and OGTT, IR indexes, occurrence of diabetes, pre-diabetic state, overweight, obesity and hypertension were assessed. Insulin resistance was diagnosed in 41.0% of the patients. The prevalence of markers of insulin resistance increased to 57.1% in cases with confirmed endometrial pathology compared to 31.8% in histologically normal endometrium (p57 microU/ml in case of hyperplasia and >61 microU/ml in endometrial polyps). Insulin resistance and carbohydrate metabolism disturbances are common in women with endometrial pathologies. In these patients there is clinical basis for recommending lifestyle modification (change of diet, more physical activity), or for introduction of pharmaceutical insulin-sensitizing agents.

The study of Anti-Müllerian Hormone (AMH) has garnered considerable attention due to its critical implications in assessing and understanding both female and male fertility potential. Traditionally, AMH is recognized for its pivotal role in evaluating ovarian reserve and is a cornerstone in reproductive health assessments for women. The aim of this study was to challenge the traditional interpretation of AMH as a standalone predictor of IVF success. Through a retrospective analysis of 600 patients undergoing ICSI, we reveal that women with low AMH levels, traditionally classified as poor responders, can achieve unexpectedly high oocyte numbers, blastocyst formation, and pregnancy rates. This highlights the limitations of using AMH alone to predict IVF outcomes. Our findings advocate the importance of integrating additional factors, such as follicle-stimulating hormone (FSH), and the need for a more individualized approach to fertility treatment planning.

Recent progress in assisted reproductive medicine has introduced novel therapeutic possibilities for couples experiencing various reproductive challenges or subfertility. A critical concern in this field is the diminished ovarian response to hormonal treatments preceding ovum pickup, necessitating personalised and optimised protocols to enhance ovarian response across different age groups. Furthermore, a common male factor in IVF couples, oligozoospermia, characterised by a low sperm count, significantly impacts the success rates of assisted reproductive technologies, posing an increasing challenge for in vitro fertilisation clinics. Lifestyle choices, dietary habits, and overall health behaviours have also demonstrably affected fertility outcomes in the 21st century. This original article aims to highlight the synergistic importance of both partners’ health, specifically addressing poor ovarian response and oligozoospermia, in achieving successful conception. Our study analysed intracytoplasmic sperm injection outcomes in couples affected by both aforementioned conditions and proposed an optimal management strategy. This study shows that oligozoospermia significantly reduced ICSI fertilisation and cleavage rates. Poor ovarian responders experienced more cancelled cycles due to fewer embryos. While blastocyst rates relative to zygotes were comparable, overall success was lower in groups with male factor infertility and poor ovarian response, necessitating personalised treatment approaches.

There is no doubt that maternal aging, also known as reproductive aging, can contribute to the increased rates of aneuploidy observed in blastocysts generated from women of advanced age who undergo in vitro fertilization (IVF). Additionally, the hatching process of the blastocyst, which is crucial for successful implantation, may be impaired in aneuploid embryos. Aneuploid embryos often exhibit abnormal cell division and chromosomal distribution, which can lead to disruptions in the hatching process. Due to ethical restrictions, preimplantation genetic testing for aneuploidy (PGT-A) is unavailable in all countries. Therefore, our retrospective study of 502 couples who underwent intracytoplasmic sperm injection (ICSI) aimed to elucidate if embryonic features, such as the ability to hatch and embryonic diameter, could be a reliable estimator for the success rate after embryo transfer, especially for women aged 26-45 years, and for IVF clinics which do not have access to PGT-A. The small hatching blastocysts (Bl. 5) group had a significant (p < 0.001) higher percentage of euploid embryos (≤35 Y- 73%, >35Y- 51%) compared to large (Bl. 4) counterparts (≤35 Y-58%, >35 Y- 38%). In patients aged 34-38 years, we detected 10% more euploid blastocysts in the hatching group than the expanding ones, which was a significant difference (p < 0.05). In conclusion, when selecting non-PGT-A tested embryos for embryo transfer (ET) or frozen embryo transfer (FET), a small hatching blastocyst seems to be a better choice than a large expanded one, especially for advanced-age patients for whom the risk of aneuploidy is higher.