Many risk factors can potentially influence sperm quality. Telomeres confer stability on the chromosome and their dysfunction has been implicated in conditions such as cancer, aging, and lifestyle. The impact of lifestyle on sperm cell telomeres is unclear. The objectives of this study were to evaluate the impact of lifestyle behaviors on telomere length in sperm and to follow the correlation with pregnancy outcomes in patients undergoing in vitro fertilization (IVF). In this prospective observational study, sperm was analyzed for telomere length (TL). Men were asked to report lifestyle behaviors including occupation (physical or sedentary), smoking duration and amount, physical activity, dietary habits, and where they keep their cellular phone (bag, pants, or shirt pocket). Correlations among semen analysis, TL, men’s habits, and embryo quality and pregnancy outcomes were evaluated. Among 34 patients recruited, 12 had longer TL and 13 shorter TL. Sperm motility was negatively correlated with TL (Pearson correlation = −.588, p = .002). Smoking adversely affected native sperm motility (53% motility in nonsmokers vs. 37% in smokers; p = .006). However, there was no significant impact on TL. The group with longer telomeres demonstrated significant association with healthy diet (10/12 vs. 6/13; p = .05) and a trend toward more sports activity, weekly (16/84 vs. 7/91; p = .04) compared with the shorter telomeres group. This study suggests that lifestyle, healthy diet, and sports activity are associated with long telomeres in sperm. Sperm quality is also influenced by patients’ habits. The study strongly recommends maintaining a healthy lifestyle to preserve general health and fertility.

The effect of the luteinizing hormone (LH) elevation before the human chorionic gonadotropin (hCG) trigger in ovulatory frozen-thawed embryo transfer (Ovu-FET) cycles has not been determined. We aimed to investigate whether triggering ovulation in Ovu-FET cycles affects the live birth rate (LBR), and the contribution of elevated LH at the time of hCG trigger. This retrospective study included Ovu-FET cycles performed in our center from August 2016 to April 2021. Modified Ovu-FET (hCG trigger) and true Ovu-FET (without hCG trigger) were compared. The modified group was divided according to whether hCG was administered, before or after LH increased to > 15 IU/L and was twice the baseline value. The modified (n = 100) and true (n = 246) Ovu-FET groups and both subgroups of the modified Ovu-FET, those who were triggered before (n = 67) or after (n = 33) LH elevation, had comparable characteristics at baseline. Comparison of true vs. modified Ovu-FET outcomes revealed similar LBR (35.4% vs. 32.0%; P = 0.62), respectively. LBR were similar between the modified Ovu-FET subgroups regardless of the hCG trigger timing (31.3% before vs. 33.3% after LH elevation; P = 0.84). In conclusion, LBR of Ovu-FET were not affected by hCG trigger or whether LH was elevated at the time of hCG trigger. These results add reassurance regarding hCG triggering even after LH elevation.

This study investigates the incidence of irregular cleavage (IRC) among human embryos and their influence on IVF treatment outcomes. This study was designed as a prospective observational study in a single-centre IVF clinic including 1,001 women who underwent 1,976 assisted reproduction treatments during 2016–2021. Morphokinetics of embryos was analysed and evaluated for the association between IRC and women’s characteristics, treatment characteristics, and pregnancy outcome. We found IRC incidence to be 17.5% (1,689/9,632 embryos). Of these, 85% embryos had one IRC, and 15% had multiple IRC. 35% of IRC events occurred during the embryo's first cell cycle. IRC embryos were found to correlate with male factor (p = 0.01) and higher ICSI rate (p = 0.01). Age, BMI, parity, basal FSH level, stimulation protocol and number of retrieved oocytes did not differ between groups. Embryos with early IRC or more than one IRC event had lower blastulation rate (p = 0.01 and p = 0.01, respectively). Fresh cycles with IRC embryos had a lower clinical pregnancy rate (p = 0.01), and early IRC embryos had a lower live birth rate (p = 0.04) compared to embryos without IRC. Frozen embryo transfer (FET) cycles of blastocyst embryos, with and without IRC, had comparable results. In conclusion, number of abnormal cleavage events and their timing are of great importance for the prognosis of the developing human embryo.

This study evaluated β-hCG changes during the early period of pregnancy in an attempt to predict successful pregnancy outcomes in ART. It determined the median values of the β-hCG and the 2-day β-hCG increments of clinical vs. biochemical pregnancies. The results of fresh day 3 embryo, frozen day 3 embryo and frozen day 5 embryo transfers were evaluated. The cutoff values of β-hCG and the 2-day increments predicting clinical pregnancy and delivery were determined. All women who underwent embryo transfer and had a singleton pregnancy from January 2017–December 2019 were included. As expected, clinical pregnancies had higher initial median β-hCG values compared to biochemical pregnancies (fresh day 3 (400 vs. 73 mIU/ml), frozen day 3 (600 vs. 268.5 mIU/ml) and frozen day 5 (937 vs. 317 mIU/ml). Nonetheless, the abortion rate was significantly lower in the group with β-hCG above the cutoff values in fresh (141 mIU/ml), and frozen (354.5 mIU/ml) cleavage stage transfers (17.2% vs. 44%, P<0.001 and 18.5% vs. 38%, P=0.003, respectively). Blastocyst transfers resulted in higher median initial β-hCG compared to cleavage embryo transfers (937 vs. 600 mIU/ml), and the initial β-hCG values from frozen cleavage embryos were higher compared to fresh cleavage embryos (600 vs. 400 mIU/ml). Earlier implantation in frozen cycles may be caused by freezing-thawing procedures. Moreover, in fresh cycles, negative effects of the hormonal milieu of fresh cycles may delay implantation. Results indicate that high initial β-hCG and high 2-day β-hCG increments demonstrated better outcomes, including more clinical pregnancies and fewer abortions.