Unexplained female infertility and ART: clinic, embryology, genetic items
This study compared ART outcomes in women with unexplained infertility versus those with known causes, finding reduced oocyte maturation and fertilization rates, and identifying specific mutations in unexplained infertility patients.
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The study investigated causes of poor effectiveness of assisted reproductive technologies (ART) in 58 couples with primary “unexplained” female infertility, using retrospective clinic and embryology data from 1003 couples undergoing 1879 ART programs and additional molecular genetic testing. Women were assessed with standard infertility workups including laparoscopy, and ART included individualized ovarian stimulation, mainly ICSI, and transfer of ≤2 blastocyst-stage embryos, while pregnancy was evaluated by β-hCG and ultrasound; the authors state key limitations that their data provide only a rationale for deeper gene-function study and that much analysis was constrained to stages up to biochemical pregnancy, with “clinical” pregnancy defined only by later ultrasound confirmation. Sequencing of 93 female-infertility–associated genes (NGS with Proton Ion Torrent and confirmation by Sanger) found significant targeted variants in 19/34 (55.9%) unexplained cases, including point mutations (transitions) and microdeletions affecting gene groups related to oocyte maturation (OOMD), preimplantation blastocyst lethality (PREMBL), and potentially vascular/implantation factors. Relevance to endometriosis: endometriosis is listed as an established cause included in the control group and referenced among prior causes contributing to infertility evaluations, though the paper’s main focus is genetic contributors to unexplained infertility.
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