Episode Description:

Endometrial Scratching has been used worldwide by many IVF specialists to increase the chances of pregnancies.

Usually done in the cycle just before IVF and an endometrial pipette or a hysteroscopy guided procedure is performed.

In this podcast, our guest, Dr Mohan Kamath will be joined by our ASPIRE moderator, Dr Maruf Siddiqui to explore the controversies and recent study findings of Endometrial scratching.

Episode Description:

PGT-A has been utilized in the field of ART for more than 30 years starting from testing a few chromosome with FISH technique to comprehensive chromosome screening with NGS nowadays. The use of PGT-A still have much debates on its benefit as well as cost-effectiveness. Embryo biopsy to obtain cells for PGT-A also has changed from cleavage stage biopsy to blastocyst biopsy and researches are still actively going on for the non-invasive PGT-A.
With the advancing experience and technologies, there are much to discuss on PGT-A in ART on its value when incorporating into fertility treatment.

Episode Description:

This episode explores key topics related to embryo implantation, including the process of decidualization and the biological mechanisms behind it, as well as its critical role in successful implantation. It also delves into the factors that can disrupt decidualization, leading to recurrent implantation failure or miscarriage. The discussion covers various diagnostic tests used to assess endometrial health and evaluates their effectiveness in predicting outcomes. Additionally, the episode highlights ongoing research aimed at improving our understanding of endometrial receptivity and looks ahead to potential advancements in the field over the next decade.

This episode covers:

Numerous studies have demonstrated that mitochondria can be transferred from stem cells to pathologically injured cells, leading to mitochondrial functional restoration. Mitochondrial transplantation has lower immunogenicity, making exogenous transplantation of healthy mitochondria a promising therapeutic approach for treating diseases, such as genetic disorders, metabolic disorders and many more. Mitochondrial Replacement Techniques (MRTs) have been used in clinical practice to prevent the genetic transmission of maternally inherited mitochondrial diseases. However these techniques can also be applied to treat infertility especially for advanced reproductive aged women with impaired oocyte quality in those who do not accept the choice of egg donation. This ED Talk will be moderated by Prof Duru Shah in conversation with Dr Meenakshi Choudhary to discuss the various clinical, legal and ethical issues associated with MRTs.

This episode covers:

The practice of cryopreserving the testicular tissues of prepubertal boys for future fertility is a fairly new procedure that not everyone knows about or has accepted. Although still experimental, it carries with it a lot of potential and promise that many should understand to be able to grasp the viability of such a demanding undertaking.

This episode covers:

Perimenopause is the transition before menopause, marked by symptoms like hot flashes, irregular periods, and mood changes, lasting 4 to 10 years. Menopause occurs when a person hasn’t had a period for 12 months. Treatment for symptoms includes lifestyle changes, over-the-counter remedies, and hormone replacement therapy (HRT), which can relieve hot flashes and prevent bone loss. While HRT is effective, it carries risks like breast cancer and heart disease, though recent research suggests these risks depend on factors like age and therapy type. Treatment should be personalized, with some individuals benefiting from non-hormonal options like antidepressants.

This episode covers:

• Freeze All Approach: Preference for using “Freeze All” either universally or solely for rescue situations, and considerations on timing for initiating a FET cycle afterward.

• FET Protocols: Inquiry into preferred protocols for FET, including True Natural vs. Modified Natural cycles and Mild Ovarian Stimulation Cycle.

• Artificial Cycle Analysis: Discussion of the advantages and disadvantages of the Artificial Cycle or Hormone Replacement cycle, including when to start Progesterone administration.
• Reproductive Outcomes: Examination of various protocols in relation to pregnancy rates, live birth rates, miscarriage rates, pregnancy complications, and neonatal morbidity.

Progestin-primed ovarian stimulation (PPOS) is increasingly utilized in assisted reproductive technology (ART) for ovarian stimulation. Various progestins have been employed with comparable success. Studies indicate that the ovarian response to stimulation with PPOS is similar to that with gonadotrophin-releasing hormone (GnRH) analogues. Differences in the duration of stimulation or gonadotrophin consumption are minor and clinically insignificant. PPOS offers the advantages of oral administration and lower medication costs compared to GnRH analogues, making it a more cost-effective option for fertility preservation and planned freeze-all cycles. However, for fresh embryo transfer, PPOS may be less cost- effective depending on the local costs associated with the additional initial frozen embryo transfer cycle. Oocytes retrieved from PPOS cycles exhibit similar developmental potential, including comparable blastocyst euploidy rates. Frozen embryo transfer outcomes from PPOS and GnRH analogue cycles appear similar in terms of ongoing pregnancy/live birth rates and obstetric and perinatal outcomes. While some studies have reported lower cumulative live birth rates with PPOS, these studies have methodological limitations, such as arbitrary definitions of cumulative live birth rate. PPOS has been used successfully in all patient types, except for those with progesterone receptor-positive breast cancer, and appears to be a patient-friendly and cost-effective option if fresh embryo transfer is not planned.

The episode focuses on the nuanced interplay between euploid, aneuploid, mosaic, and segmental aneuploidy in embryos analyzed by Preimplantation Genetic Testing for Aneuploidy (PGT-A). We will explore the success rates of euploid pregnancies following the transfer of euploid embryos, highlighting the predictive value of PGT-A. The discussion extends to “mosaic” and “segmental aneuploid” embryos, examining the implications of these diagnoses and their management in clinical practice. We will delve into the origins of mosaic embryos and the challenges they present in decision-making processes. Additionally, the lecture will address the accuracy and inconsistencies of PGT-A testing platforms, shedding light on the impact of technological advancements on the interpretation of results. By providing an overview of the current landscape and emerging trends in PGT-A, this talk aims to equip participants with a deeper understanding of its role in enhancing reproductive outcomes.

In this episode of ASPIRE Ed Talk, host Professor Arthur Chang is joined by the guest Dr Krishna Chaitanya Mantravadi, to discuss the significant health challenges currently facing embryologists. Dr Krishna, an advocate for the wellness in the IVF laboratory, addresses the intense stress, high incidence of burnout, and the overall impact of these factors on physical and mental health within the field. Key topics include the demanding nature of the work despite its planned and elective character, the physical and mental health risks associated with the profession, and strategies for managing these challenges. Data from a survey reveal alarming rates of stress and burnout among professionals. The session emphasizes the importance of work-life balance, regular health check-ups, and institutional support to mitigate these issues. The discussion also covers necessary reforms in workplace practices and government policies to support the health and productivity of embryologists.

Every ART cycle whether Fresh or Frozen needs Luteal Support for it to be successful.

The discussion focused on the relationship between gut dysbiosis and infertility, particularly in the context of polycystic ovary syndrome (PCOS). Gut dysbiosis, an imbalance in gut microbiota composition and function, is increasingly recognized as a contributing factor to infertility. Factors such as diet, medication, lifestyle, and disease conditions can disrupt the gut microbiota balance, leading to dysbiosis. Dysbiosis affects various aspects of reproductive health, including sperm quality in males and hormonal regulation in females, potentially leading to infertility and other reproductive disorders.

Anaesthesia during ovum pick-up is a very unique scenario for anaesthesiologist as it involves very brief procedures in special circumstances. Much to discuss on the effect of anaesthesia on the gametes and also much to discuss on the supra-physiologic level of hormone on anaesthesia. This podcast is very special to have a guest speaker, Prof. Atsushi Tanaka, who is both a reproductive specialist as well as a certified anaesthesiologist.

On this ASPIRE EdTalk Podcast Professor Louise Hull will interview Endocrinologist Professor Gary Wittert from The University of Adelaide. They will discuss what doctors can look out for with regard to Adrenal Disorders and how to care for patients with Adrenal Disorders.

They will also explore questions like How do you distinguish PSOC and underlying adrenal disorder and what investigations are likely to be used.

Both hyper and hypothyroidism can affect male and female fertility. Awareness of thyroid status in the infertile couple is crucial because of its significant, frequent, and reversible or preventable effect on infertility. The podcast aims to explore the intricate relationship between thyroid health and reproductive challenges. Our distinguished expert will illuminate the complexities, share invaluable insights, and address your inquiries, empowering us with knowledge to navigate this crucial nexus with greater understanding and efficacy. This interactive session is poised to uncover solutions and foster enhanced patient care in the realm of thyroid dysfunction and infertility in the couple.