Intrauterine administration of platelet-rich plasma (PRP) is a technique currently under intensive investigation. PRP therapy has the potential to play a complementary role in treatment protocols for women with a thin endometrium or a history of recurrent implantation failure (RIF). The principle of PRP is based on the release of multiple biologically active factors (e. g., cytokines, growth factors) following administration, which initiate reparative processes such as the synthesis of new connective tissue or revascularization. A major advantage of PRP therapy is its favorable safety profile, as no serious adverse effects have been reported to date. In the following study, we summarize our clinical experience with intrauterine PRP administration at our IVF center. The aim of this study was to evaluate the effect of PRP on the clinical pregnancy rate in women with recurrent implantation failure.

Introduction Empty follicle syndrome (EFS) may occur in in vitro fertilization (IVF) cycles that use a gonadotropin-releasing hormone (GnRH) antagonist protocol with a single GnRH agonist trigger. We evaluated whether a rescue human chorionic gonadotropin (hCG) trigger can salvage oocyte retrieval in these cases, and identified factors associated with obtaining a transferable embryo. Methods Among 4,778 cycles triggered with a GnRH agonist alone between June 2014 and February 2019, we retrospectively identified 43 cycles, in 43 patients, in which no mature oocyte was obtained at the initial retrieval, and a rescue hCG protocol with repeat ovum pick-up was performed. Cycles were divided into an embryo-transfer (ET)-positive group, in which a transferable embryo was obtained (n = 30), and an ET-negative group (n = 13). Baseline and peri-trigger hormone levels were compared, and thresholds for baseline luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were derived by receiver operating characteristic analysis and evaluated in contingency tables. Results The incidence of GnRH agonist trigger failure was 0.9% (43/4,778 cycles). Oocytes were collected in 37 of 43 cycles, and a transferable embryo was obtained in 30 (69.8%); frozen-thawed transfer resulted in 18 live births, a live birth rate of 41.9% per rescue cycle. A baseline LH threshold of 1.9 mIU/mL (area under the curve (AUC) 0.83) and a baseline FSH threshold of 5.4 mIU/mL (AUC 0.85) distinguished the two groups (P < 0.001 for both); the corresponding odds of failing to obtain a transferable embryo were 33.0 (95% CI 3.7-296) and 60.0 (95% CI 6.3-572), with confidence intervals reflecting the small number of events. All 43 patients developed ovarian hyperstimulation syndrome (OHSS): 28 mild and 15 moderate. No severe OHSS requiring hospitalization occurred. Conclusions A rescue hCG trigger is a workable management strategy for EFS following a GnRH agonist trigger, yielding live births in cycles that would otherwise have been cancelled. All patients in this series developed mild or moderate OHSS, and none developed severe OHSS, although with 43 cycles the series is too small to establish the risk of severe OHSS. Baseline LH and FSH, together with the change in estradiol and progesterone between the first and second triggers, may help estimate the probability of obtaining a transferable embryo, but these thresholds are exploratory and require prospective validation.

Artificial oocyte activation (AOA) with Calcium ionophore (Ca-I) application has been shown to improve fertilization rates in patients with poor reproductive outcomes and fertilization failure; however, the effect of Ca-I on embryomorphokinetic parameters remains unclear. The aim of this study was to evaluate the effect of AOA with Ca-I application on embryomorphokinetic parameters and clinical pregnancy outcomes. In this retrospective cohort study, a total of 412 cycles were involved and participants were classified into two groups as intracytoplasmic sperm injection ICSI + AOA (n = 225) and ICSI (n = 187). There were no significant differences between groups in terms of baseline parameters. When the duration from 2PN to tB (time to blastulation) was examined, t2, t3, t4, or t5 times were not significantly different between the groups; however, Ca ionophore application was found to extend time to start of blastulation (tsB) time and tB (p < 0.05). Optimal time-lapse parameters (t5, cc2, S2, and t5-t2) also did not differ between the two groups, and there were no significant differences in embryo grades determined by optimal time-lapse parameters. According to the fertilization and pregnancy results, no significant differences were found between the groups. In conclusion, Ca ionophore application does not seem to affect most embryomorphokinetic parameters except blastulation time, and the clinical importance of this finding needs further research.

This study employed an exploratory qualitative methodology to examine how IVF clinics in the United States develop and implement policies regarding the transfer of embryos that test positive for genetic conditions through preimplantation genetic testing for monogenic disorders (PGT-M). The study explored who is involved in creating these policies, and the key factors influencing these decisions. Semi-structured interviews were conducted with genetic counselors working in IVF clinics across the United States. Participants were asked about clinic policies regarding PGT-M positive embryos, their role in policy creation, and how patient requests are handled. Transcripts were analyzed thematically to identify patterns in clinic practices, policy rationales, and decision-making processes. Findings showed considerable variation in how clinics approach PGT-M affected embryo transfers. While one clinic follows strict guidelines that prohibit the transfer of embryos with pathogenic variants (including likely pathogenic variants or variants of uncertain significance [VUS]), others allow case-by-case consideration, particularly when patients face barriers to further IVF cycles. Common policy frameworks prioritize transfer of unaffected embryos, with affected embryos considered only after other options are exhausted. Key factors influencing policy decisions included ethical considerations, clinic values, provider discretion, legal and insurance frameworks, and concerns about the child's future quality of life. Despite formal protocols, many clinics still assess individual cases, underscoring the complexity of balancing standardization with patient-centered care. Genetic counselors often serve as intermediaries, advocating for patients while navigating institutional limitations. This study highlights the need for clearer, yet flexible, guidelines on PGT-M positive embryo transfer to ensure consistency while preserving patient autonomy. Greater integration of genetic counselors into policy development and clinical decision-making can support more ethically grounded and informed reproductive care.

The rapid growth of genomic sequencing demands fast, accurate, and scalable analysis methods. In viral genomic classification, expanding labeled reference collections can make supervised models costly to update and dependent on fixed label sets, motivating retrieval-based genomic classification as a simpler, more flexible alternative. We present a unified benchmark of supervised and retrieval-based methods for viral genomic sequence classification across three viral classification tasks: hepatitis C virus (HCV) genotyping, COVID-19 discrimination, and human papillomavirus (HPV) genotyping. We compare standard sequence encodings (one-hot, k-mers, FCGR) with dense embeddings (dna2vec, DNABERT). For each representation, we evaluate supervised classifiers (Random Forest, Decision Tree, XGBoost) and retrieval-based classification, where sequence vectors are indexed with FAISS and labels are assigned via similarity-weighted k-NN. Furthermore, we benchmark multiple FAISS index types (Flat, IVF, HNSW, IVFPQ, OPQ) to characterize accuracy-speed-memory trade-offs at scale. The results show that XGBoost and retrieval using Flat or IVF indexes achieve strong classification performance under different computational profiles. Compressed indexes such as IVFPQ and OPQ substantially reduce memory usage, although their accuracy loss depends on the dataset and representation. Overall, supervised XGBoost provides a favorable accuracy-size trade-off, while retrieval-based classification remains competitive and allows labeled reference sequences to be incorporated without retraining a global classifier. This benchmark provides practical guidance for selecting sequence representations, classifiers, and vector-search indexes under different accuracy, memory, and update requirements.