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Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence

Preimplantation genetic testing metrics, euploid blastocyst yield, and meiotic spindle integrity across repeated cycles without intervening washout phases.

69 sources ↓Last researched 2026-10-20
Hierarchy:
Natural & Life SciencesMedicine, Health & LongevityReproductive Medicine & Human FertilityAssisted Reproductive Technology & Gamete DonationOocyte Quality, Embryo Aneuploidy, and Blastocyst CompetenceLeaf node (no child sub-branches yet)
+ Associated nodes:
Cryopreservation of Gametes and Embryos (intersects) Non-Invasive Preimplantation Genetic Testing (niPGT) (intersects) Oocyte Morphology Assessment (intersects) Preimplantation Genetic Testing and Polygenic Selection (intersects)
State of the Field Monograph · AI Research Synthesis4 min read · 69 sources · 19 graded findingsPeak certainty: T1

State of the Field: Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence

Preimplantation genetic testing metrics, euploid blastocyst yield, and meiotic spindle integrity across repeated cycles without intervening washout phases. Grounded synthesis across 69 primary sources and 19 graded findings within Reproductive Medicine & Human Fertility → Assisted Reproductive Technology & Gamete Donation.

Synopsis · Executive Overview

In patients aged 40 and older, reproductive competence is primarily constrained by meiotic spindle assembly defects, which rise with age due to impaired sister chromatid cohesion and kinetochore function. Data consistently demonstrate that maternal age is the strongest independent predictor of blastocyst euploidy rates. While PGT-A utilizing NGS offers high concordance (99.5%) for aneuploidy detection, intervention efficacy remains focused on maximizing the number of embryos available for testing. Double stimulation protocols (DuoStim) have emerged as a viable approach to increase the cumulative yield of euploid embryos in poor-prognosis patients, raising the proportion of patients achieving at least one euploid blastocyst from 42.3% to 65.5%. Conversely, the impact of metabolic adjuncts and androgen supplementation on aneuploidy rates remains largely unproven in human clinical trials.

Section I · Primary Literature & Evidence Synthesis

What the Peer-Reviewed Record Establishes

The primary research record in Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence is stratified by study design so that meta-analyses and replicated randomised controlled trials (T1–T2) carry greater epistemic weight than observational cohorts (T3–T4) or preclinical laboratory work (T5). Leading graded findings establish the core empirical baseline: [T1] Double stimulation within a single menstrual cycle (Shanghai Protocol) significantly increases metaphase II oocyte yield in poor ovarian responders. [12] [T1] Robust ovarian stimulation is associated with a higher proportion of aneuploidy in embryos compared to natural cycles, but results in a higher absolute number of euploid embryos available for transfer. [33]

Further clinical and mechanistic stratification across the literature demonstrates: [T3] Maternal age is an independent factor influencing blastocyst euploidy rates in patients undergoing IVF with PGT-A. [14] [T3] Double stimulation within the same ovarian cycle (DuoStim) achieves comparable fertilization, blastocyst, and euploidy rates between luteal and follicular phase stimulations, raising the proportion of poor-prognosis patients obtaining at least one euploid blastocyst from 42.3% to 65.5% (n=310). [48]

Section II · Mechanisms, Interventions & Subgroup Calibration

Comparative Evaluation of Levers & Theoretical Models

Within Reproductive Medicine & Human Fertility → Assisted Reproductive Technology & Gamete Donation, mechanistic and clinical evaluation in Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence focuses on preimplantation genetic testing metrics, euploid blastocyst yield, and meiotic spindle integrity across repeated cycles without intervening washout phases. Primary publications in the current corpus span Medicina, Research Square, Archives of Gynecology and Obstetrics, Journal of Assisted Reproduction and Genetics.

Section III · Historical Trajectory & Contested Frontiers

Evolution of the Field, Open Debates & Active Trials

Chronologically, the field evolved through key inflection points: in 2018, Blastocyst-stage Biopsy Adoption (Implementation of comprehensive chromosome screening at the trophectoderm stage over day 3 biopsy to improve euploidy detection and clinical success); in 2021, PPOS clinical efficacy trial (Randomized controlled trial confirming PPOS results in comparable euploidy rates to GnRH antagonist protocols); in 2023, The BISTIM RCT (First randomized controlled trial comparing DuoStim directly to consecutive antagonist cycles in poor responders, finding no oocyte yield benefit).

Active scientific debates and unresolved methodological tensions centre on: Conflicting findings on PPOS safety and efficacy in older populations, with some studies indicating significantly lower euploidy rates. (contested) Lack of high-quality randomized clinical trials supporting DHEA or carnitine supplementation to reduce aneuploidy rates in women with diminished ovarian reserve. (weak evidence) Disagreement on whether DuoStim yields higher total oocyte counts compared to conventional consecutive cycles. (contradiction)

Section IV · Evidentiary Gaps & Research Frontiers

Open Questions & Priorities for the Next Research Sweep

Methodological priorities and open empirical questions queued for the next research sweep across Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence focus on resolving subgroup effect sizes, causal mechanisms, and long-term outcomes:

  • Threshold effects of androgen levels on oocyte quality in patients with diminished ovarian reserve.
  • Mechanistic causal link between PPOS protocols and potential variations in euploidy rates in patients over 38.
  • The long-term impact of repeated rapid stimulation cycles (DuoStim) on ovarian follicular recruitment and long-term ovarian health.
  • Optimal clinical management of segmental aneuploidies during blastocyst transfer decisions.

Evidence Hierarchy (Graded Claims)

  • T1Synthesis of trials
    2 (11%)
  • T2Randomised trial
    0 (0%)
  • T3Observational, large
    11 (58%)
  • T4Observational, small or case-based
    2 (11%)
  • T5Preclinical or mechanistic
    2 (11%)
  • T6Opinion, news or unverified
    2 (11%)
12 settled4 debated3 contested / frontier

Study Designs in Indexed Literature

  • Meta-analyses, Systematic Reviews & Guidelines5 (7%)
  • Randomised Controlled Trials (RCTs)6 (9%)
  • Prospective Cohorts & Clinical Registries18 (26%)
  • Preclinical, Cellular & Computational Models12 (17%)
  • Primary Literature & Archive Records28 (41%)

Publication Timeline Velocity

Fig. 1 — Field Evidence Architecture & Publication Trajectory. Distribution of methodological study designs (69 indexed publications) and 19 extracted claims graded from T1 (meta-analyses and guidelines) to T6.
Primary Citations & Landmark Studies

Key Studies Anchoring This Monograph

Synthesis & Conclusions

State of the Field Conclusions

Taken together, the evidence record in Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence (69 primary sources, 19 graded claims, highest certainty T1 — Synthesis of trials) separates replicated high-tier findings from early-stage hypotheses. The 4 open research priorities detailed above guide the next autonomous literature and clinical trial sweep.

Key Quantitative Takeaways

  • [T1] Double stimulation within a single menstrual cycle (Shanghai Protocol) significantly increases metaphase II oocyte yield in poor ovarian responders.
  • [T1] Robust ovarian stimulation is associated with a higher proportion of aneuploidy in embryos compared to natural cycles, but results in a higher absolute number of euploid embryos available for transfer.
  • [T3] Maternal age is an independent factor influencing blastocyst euploidy rates in patients undergoing IVF with PGT-A.
  • [T3] Double stimulation within the same ovarian cycle (DuoStim) achieves comparable fertilization, blastocyst, and euploidy rates between luteal and follicular phase stimulations, raising the proportion of poor-prognosis patients obtaining at least one euploid blastocyst from 42.3% to 65.5% (n=310).
  • Open frontier in Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence: Threshold effects of androgen levels on oocyte quality in patients with diminished ovarian reserve.
Historical timeline (3 milestones, 2018–2023)
  1. 2018

    Blastocyst-stage Biopsy Adoption

    Implementation of comprehensive chromosome screening at the trophectoderm stage over day 3 biopsy to improve euploidy detection and clinical success.

  2. 2021

    PPOS clinical efficacy trial

    Randomized controlled trial confirming PPOS results in comparable euploidy rates to GnRH antagonist protocols.

  3. 2023

    The BISTIM RCT

    First randomized controlled trial comparing DuoStim directly to consecutive antagonist cycles in poor responders, finding no oocyte yield benefit.

Evidence by study design (19 findings across T1–T6)

Strongest support first. The bar beside each finding shows its grade.

Synthesis of trials

  1. #1 Double stimulation within a single menstrual cycle (Shanghai Protocol) significantly increases metaphase II oocyte yield in poor ovarian responders.

    The Shanghai Protocol at Ten: Revolutionizing IVF through Ovarian Cy… (2025)

    The protocol reduces treatment duration for women requiring multiple cycles, though its effect on long-term live birth rates requires further standardization and study.

  2. #2 Robust ovarian stimulation is associated with a higher proportion of aneuploidy in embryos compared to natural cycles, but results in a higher absolute number of euploid embryos available for transfer.

    DebatedAssociation of ovarian stimulation and embryonic aneuploidy in in vi… (2021)

    This highlights the tension between maximizing yield per cycle versus potential qualitative impacts of stimulation.

Observational, large

  1. #3 Maternal age is an independent factor influencing blastocyst euploidy rates in patients undergoing IVF with PGT-A.

    Antinuclear antibodies do not affect euploidy rate in preimplantatio… (2024)

    Maternal age is the primary demographic factor impacting oocyte quality and chromosomal stability.

  2. #4 Double stimulation within the same ovarian cycle (DuoStim) achieves comparable fertilization, blastocyst, and euploidy rates between luteal and follicular phase stimulations, raising the proportion of poor-prognosis patients obtaining at least one euploid blastocyst from 42.3% to 65.5% (n=310).

    Double Stimulation in the Same Ovarian Cycle (DuoStim) to Maximize t… (2018)

    Demonstrates that immediate consecutive ovarian stimulation without an intervening washout interval maintains blastocyst competence while substantially improving cumulative euploid embryo yield in poor-prognosis patients.

  3. #5 Cumulative live birth rates in patients undergoing repeated IVF/ICSI cycles continue to increase significantly through at least 6 to 10 blastocyst transfers, suggesting a high inherent success potential even without PGT-A.

    Cumulative live birth rates of 31 478 untested embryos from 11 463 w… (2025)

    Real-world data from over 11,000 women show cLBR reaching 78% after 10 blastocyst transfers, challenging the clinical definition of recurrent implantation failure.

  4. #6 In poor ovarian responders, dual ovarian stimulation within the same cycle (DuoStim) provides no significant benefit in the total number of oocytes retrieved compared to two consecutive antagonist cycles.

    DebatedThe BISTIM study: a randomized controlled trial comparing dual ovari… (2023)

    An RCT found no superiority of same-cycle dual stimulation over two conventional consecutive cycles in poor responders.

  5. #7 Progestin-primed ovarian stimulation (PPOS) protocols show comparable euploidy rates and pregnancy outcomes to GnRH antagonist protocols for women undergoing PGT-A.

    Comparison of the euploidy rate in preimplantation genetic testing f… (2025); Euploidy rate and pregnancy outcomes in preimplantation genetic test… (2025)

    PPOS provides an alternative stimulation method that does not negatively impact embryo competence or ploidy rates in clinical practice.

  6. #8 Trophectoderm biopsy at the blastocyst stage is associated with higher euploidy rates and increased cumulative live birth rates compared to cleavage-stage (day 3) biopsy.

    Transition from blastomere to trophectoderm biopsy: comparing two pr… (2018)

    Moving to blastocyst-stage biopsy represents a technological standard to improve laboratory diagnostic accuracy.

  7. #9 Segmental aneuploidies (>15 Mb) occur in 10.4% of oocytes, increase to 24.3% in cleavage-stage embryos predominantly via post-fertilization mitotic breakage, and decline to 15.6% at the blastocyst stage (n=635 patients).

    The incidence and origin of segmental aneuploidy in human oocytes an… (2017)

    Distinguishes mitotic-origin structural chromosome fragmentation from meiotic whole-chromosome aneuploidy during preimplantation development.

  8. #10 In women aged 35 or older, blastocyst euploidy rates are associated with morphology but not with developmental rate (day 5 versus day 6).

    Effect of Blastocyst Morphology and Developmental Rate on Euploidy a… (2022)

    Morphological quality remains a predictor of euploidy even in older maternal age groups, whereas the developmental speed advantage observed in younger women is not statistically significant for women ≥35.

  9. #11 There is a positive correlation between blastocyst morphologic grading and euploidy rates, though clinical pregnancy rates may not differ significantly between age groups when PGT-A is utilized.

    DebatedCorrelation between Morphologic Grading and Euploidy Rates of Blasto… (2019)

    Morphological assessment is a standard but imperfect tool for predicting genetic competence.

  10. #12 The impact of progestin-primed ovarian stimulation (PPOS) on euploid blastocyst rates in patients aged 38 and older is contested; while some data show a severe reduction in euploidy (5.4% vs 26.7%), larger studies suggest rates are comparable to conventional antagonist protocols.

    ContestedAnalysis of euploidy rates in preimplantation genetic testing for an… (2023); Progestin Primed Ovarian Stimulation (PPOS) protocol yields lower eu… (2023); Comparison of euploidy rates of blastocysts in women treated with pr… (2020)

    One cohort reported significantly lower euploidy in AMA patients under PPOS, whereas others found no significant difference in blastocyst formation or aneuploidy rates.

  11. #13 Androgen levels in infertile women do not demonstrate a direct association with embryo aneuploidy rates, although threshold effects at extremely low levels remain a subject of investigation.

    ContestedIs there an androgen level threshold for aneuploidy risk in infertil… (2015)

    The role of androgen supplementation in improving egg quality is a common point of contention in reproductive clinical practice.

Observational, small or case-based

  1. #14 Next-generation sequencing reliably detects blastocyst aneuploidy in preimplantation genetic screening, exhibiting 99.5% concordance across 192 blastocysts compared with array comparative genomic hybridization in patients with a median age of 39.3 years (n=55).

    Application of next-generation sequencing technology for comprehensi… (2014)

    Validates high-resolution next-generation sequencing as a clinically accurate methodology for comprehensive chromosome screening in advanced reproductive age cycles.

  2. #15 DHEA supplementation (4-12 weeks) is associated with reduced aneuploidy rates in women with diminished ovarian reserve.

    DebatedDehydroepiandrosterone (DHEA) reduces embryo aneuploidy: direct evid… (2010)

    While one matched case-control study found significant reduction in aneuploidy, the clinical utility is debated given the sample size and need for larger validation.

Preclinical or mechanistic

  1. #16 Mitochondrial membrane potential increases dynamically during oocyte maturation, concentrating elevated metabolic activity locally in the vicinity of the first meiotic spindle.

    The spatio-temporal dynamics of mitochondrial membrane potential dur… (2019)

    Reveals the spatial compartmentalization of mitochondrial energy production required to support meiotic spindle assembly and accurate chromosome segregation.

  2. #17 Metabolic dysfunction, specifically insulin resistance and obesity, induces oxidative stress and meiotic spindle abnormalities in oocytes, leading to impaired mitochondrial function and chromosomal misalignment.

    Differential effects of high fat diet-induced obesity on oocyte mito… (2020); Maternal insulin resistance causes oxidative stress and mitochondria… (2012)

    Animal models consistently demonstrate that hyperinsulinemia and high-fat diets degrade oocyte bioenergetics and structural integrity.

Opinion, news or unverified

  1. #18 Aneuploidy rates in oocytes and embryos are primarily attributed to meiotic spindle assembly defects, which increase with advanced maternal age due to impaired sister chromatid cohesion and kinetochore function.

    The Meiotic Spindle, Mechanisms of Chromosome Segregation and Aneupl… (2026); Impact of Maternal Age on Oocyte and Embryo Competence. (2018); Ovarian ageing: the role of mitochondria in oocytes and follicles (2016)

    Understanding the mechanisms of meiotic failure is critical for managing reproductive expectations in women over 40.

  2. #19 Carnitine supplementation (LC, ALC, PLC) is proposed as a mitochondrial modulator to enhance oocyte bioenergetics and counteract age-related redox imbalances, though clinical evidence in humans remains limited.

    Marketed ahead of evidenceCarnitines as Mitochondrial Modulators of Oocyte and Embryo Bioenerg… (2022)

    While biochemical pathways suggest benefit for reproductive aging, the claim is currently supported by expert reviews and in-vitro evidence rather than large human trials.

Where the record disagrees (3 controversies)

  • Conflicting findings on PPOS safety and efficacy in older populations, with some studies indicating significantly lower euploidy rates.

    Findings #12

  • Lack of high-quality randomized clinical trials supporting DHEA or carnitine supplementation to reduce aneuploidy rates in women with diminished ovarian reserve.

    Findings #15, #19

  • Disagreement on whether DuoStim yields higher total oocyte counts compared to conventional consecutive cycles.

    Findings #4, #6

Node lineage & crossover disciplines

Parent lineage, active node, direct child sub-branches, and associated crossover disciplines across the Tree of Knowledge.

Hierarchy:
Natural & Life SciencesMedicine, Health & LongevityReproductive Medicine & Human FertilityAssisted Reproductive Technology & Gamete DonationOocyte Quality, Embryo Aneuploidy, and Blastocyst CompetenceLeaf node (no child sub-branches yet)
+ Associated nodes:
Cryopreservation of Gametes and Embryos (intersects) Non-Invasive Preimplantation Genetic Testing (niPGT) (intersects) Oocyte Morphology Assessment (intersects) Preimplantation Genetic Testing and Polygenic Selection (intersects)
  • + intersects Cryopreservation of Gametes and Embryos — Shared mechanisms, study designs, or quantitative benchmarks between Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence and Cryopreservation of Gametes and Embryos.
  • + intersects Non-Invasive Preimplantation Genetic Testing (niPGT) — Shared mechanisms, study designs, or quantitative benchmarks between Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence and Non-Invasive Preimplantation Genetic Testing (niPGT).
  • + intersects Oocyte Morphology Assessment — Shared mechanisms, study designs, or quantitative benchmarks between Oocyte Morphology Assessment and Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence.
  • + intersects Preimplantation Genetic Testing and Polygenic Selection — Shared mechanisms, study designs, or quantitative benchmarks between Oocyte Quality, Embryo Aneuploidy, and Blastocyst Competence and Preimplantation Genetic Testing and Polygenic Selection.

Branches

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Primary indexed sources (69)

Primary scientific literature, systematic reviews, and clinical trial registrations indexed for this branch.

  1. The Meiotic Spindle, Mechanisms of Chromosome Segregation and Aneuploidy in Aging Human Oocytes: An Update Review — Romualdo Sciorio, Gyöngyvér Téglás, Luca Tramontano et al. Medicina, 2026, unknown · DOI: 10.3390/medicina62091810
  2. Honest Denominators: Post-ICSI Oocyte Degeneration Masks Conventional Laboratory KPIs, and Degeneration-Penalized and MII-Anchored Indices Reveal the True Outcome — Onder E, Olcay IO, Duzcu T et al. Research Square, 2026, unknown · DOI: 10.21203/rs.3.rs-10133095/v1
  3. Is assisted oocyte activation an effective method in poor responders? — Ayşe Altun Akpınar, Burçin Karamustafaoğlu Balcı, Çiğdem Çelik et al. Archives of Gynecology and Obstetrics, 2026 · DOI: 10.1007/s00404-026-08491-3
  4. The effect of single versus group culture on cumulus-oocyte complexes from early antral follicles — Mohammadreza Ebrahimi, Laura Mara, Sara Succu et al. Journal of Assisted Reproduction and Genetics, 2025, animal, 9 citations · DOI: 10.1007/s10815-025-03404-w
  5. Cumulative live birth rates of 31 478 untested embryos from 11 463 women challenge traditional recurrent implantation failure definitions. — Dhaenens L, Colman R, De Croo I et al. Human reproduction (Oxford, England), 2025, cohort, 8 citations · DOI: 10.1093/humrep/deaf036
  6. Comparison of the euploidy rate in preimplantation genetic testing for aneuploidy cycles following progestin-primed versus gonadotropin-releasing hormone antagonist protocol: a randomized controlled study. — Wang L, Wang JY, Zhang Y et al. Reproductive biology and endocrinology : RB&E, 2025, rct, 4 citations · DOI: 10.1186/s12958-025-01404-0
  7. Pregnancy Rates After Frozen Embryo Transfer: Insights from an Indian Government Hospital — Sholen Acharya, Sheila Balakrishnan, Deepak Rath International Journal of Multidisciplinary Research and Growth Evaluation, 2025, 3 citations · DOI: 10.54660/.ijmrge.2025.6.2.965-972
  8. Euploidy rate and pregnancy outcomes in preimplantation genetic testing for aneuploidy cycles using progestin-primed ovarian stimulation versus GnRH antagonist protocol — Hu Tan, Li Huang, Wenjuan Liu et al. Reproductive Biology and Endocrinology, 2025, cohort, 2 citations · DOI: 10.1186/s12958-025-01398-9
  9. Analysis of Surplus Cryopreserved Blastocysts in Fresh Donor Oocyte Cycles — Shelun Tsai, Xiaoyue Ma, Samantha R. Spring et al. JAMA Network Open, 2025, 1 citations · DOI: 10.1001/jamanetworkopen.2025.6193
  10. Superovulation alters telomere length and telomerase component levels in mouse oocytes — Betul Tire, Günel Talibova, Yesim Bilmez et al. Journal of Ovarian Research, 2025, 1 citations · DOI: 10.1186/s13048-025-01735-x
  11. An early prediction model for high-quality blastocyst development based on ANA titer and baseline demographic characteristics in the first IVF/ICSI cycle — Kai Ding, Yidan Chen, Wei Jiang et al. Journal of Ovarian Research, 2025 · DOI: 10.1186/s13048-025-01830-z
  12. The Shanghai Protocol at Ten: Revolutionizing IVF through Ovarian Cycle Dynamics — Zeev Shoham, Ariel Weissman Journal of IVF-Worldwide, 2025, meta analysis · DOI: 10.46989/001c.138419
  13. 3-Methyl-4-nitrophenol Exposure Deteriorates Oocyte Maturation by Inducing Spindle Instability and Mitochondrial Dysfunction — Fan Chen, Anfeng Luo, Mingguo Li et al. International Journal of Molecular Sciences, 2024, animal, 6 citations · DOI: 10.3390/ijms25073572
  14. Antinuclear antibodies do not affect euploidy rate in preimplantation genetic testing for aneuploidy — Mei Liu, Yueyue Hu, Honglu Diao et al. Reproductive BioMedicine Online, 2024, cohort, 1 citations · DOI: 10.1016/j.rbmo.2024.104734
  15. Evaluating the ratio of mature oocytes to immature oocytes in oocyte cohorts aspirated from HIV seropositive and HIV seronegative females post-controlled ovarian hyperstimulation — Ndlela Nombuso Felicia 2024 · DOI: 10.51415/10321/6446
  16. Comparison of the euploidy rate in preimplantation genetic testing for aneuploidy cycles following progestin-primed versus gonadotropin-releasing hormone antagonist protocol: a randomized controlled study — Wang L, Wang JY, Zhang Y et al. Research Square, 2024, unknown · DOI: 10.21203/rs.3.rs-4877438/v1
  17. Progestin Primed Ovarian Stimulation (PPOS) protocol yields lower euploidy rate in older patients undergoing IVF — Angel Hsin-Yu Pai, Yen-Ju Sung, Chia‐Jung Li et al. Reproductive Biology and Endocrinology, 2023, cohort, 46 citations · DOI: 10.1186/s12958-023-01124-3
  18. The BISTIM study: a randomized controlled trial comparing dual ovarian stimulation (duostim) with two conventional ovarian stimulations in poor ovarian responders undergoing IVF — Nathalie Massin, Inès Abdennebi, Géraldine Porcu‐Buisson et al. Human Reproduction, 2023, rct, 43 citations · DOI: 10.1093/humrep/dead038
  19. Analysis of euploidy rates in preimplantation genetic testing for aneuploidy cycles with progestin-primed versus GnRH agonist/antagonist protocol — Lu Wang, Jingyun Wang, Yuan Zhang et al. European journal of medical research, 2023, cohort, 32 citations · DOI: 10.1186/s40001-023-01000-1
  20. Image Processing Approach for Grading IVF Blastocyst: A State-of-the-Art Review and Future Perspective of Deep Learning-Based Models — Iza Sazanita Isa, Umi Kalsom Yusof, Murizah Mohd Zain Applied Sciences, 2023, systematic review, 25 citations · DOI: 10.3390/app13021195
  21. Treatment modalities for poor ovarian responders — Federica Di Guardo, Nicola Pluchino, Panagiotis Drakopoulos Therapeutic Advances in Reproductive Health, 2023, expert opinion, 5 citations · DOI: 10.1177/26334941221147464
  22. Recent Advances in Male Reproductive System — Wei Wu IntechOpen eBooks, 2023, expert opinion, 2 citations · DOI: 10.5772/intechopen.1000558
  23. The Major Factors Affecting Oocyte Quality in IVF Cycles: A Narrative Review — Myriam G. Boueri, Marita Saliba, Joe Haydamous et al. International Journal of Clinical Research, 2023, systematic review, 1 citations · DOI: 10.38179/ijcr.v3i1.277
  24. Carnitines as Mitochondrial Modulators of Oocyte and Embryo Bioenergetics — Martina Placidi, Giovanna Di Emidio, Ashraf Virmani et al. Antioxidants, 2022, expert opinion, 48 citations · DOI: 10.3390/antiox11040745
  25. Effect of Blastocyst Morphology and Developmental Rate on Euploidy and Live Birth Rates in Preimplantation Genetic Testing for Aneuploidy Cycles With Single-Embryo Transfer — Na Li, Yichun Guan, Bingnan Ren et al. Frontiers in Endocrinology, 2022, cohort, 32 citations · DOI: 10.3389/fendo.2022.858042
  26. Ultrastructural Evaluation of the Human Oocyte at the Germinal Vesicle Stage during the Application of Assisted Reproductive Technologies — Maria Grazia Palmerini, Sevastiani Antonouli, Guido Macchiarelli et al. Cells, 2022, expert opinion, 11 citations · DOI: 10.3390/cells11101636
  27. Patient-tailored reproductive health care — Jan Tesařík, Raquel Mendoza‐Tesarik Frontiers in Reproductive Health, 2022, expert opinion, 4 citations · DOI: 10.3389/frph.2022.917159
  28. Oocyte aneuploidy rates in river and swamp buffalo types (Bubalus bubalis) determined by Multi-color Fluorescence In Situ Hybridization (M-FISH) — Alfredo Pauciullo, Carmine Versace, A. Perucatti et al. Scientific Reports, 2022, cohort, 4 citations · DOI: 10.1038/s41598-022-12603-9
  29. The Role of Decidual Subpopulations in Implantation, Menstruation and Miscarriage — Joanne Muter, Chow‐Seng Kong, Jan Joris Brosens Frontiers in Reproductive Health, 2021, expert opinion, 46 citations · DOI: 10.3389/frph.2021.804921
  30. Glutathione protects against the meiotic defects of ovine oocytes induced by arsenic exposure via the inhibition of mitochondrial dysfunctions — Jingyu Ren, Shubin Li, Chunyu Wang et al. Ecotoxicology and Environmental Safety, 2021, 26 citations · DOI: 10.1016/j.ecoenv.2021.113135
  31. Telomere Dysfunction in Oocytes and Embryos From Obese Mice — Juan Ge, Congyang Li, Hongzheng Sun et al. Frontiers in Cell and Developmental Biology, 2021, animal, 22 citations · DOI: 10.3389/fcell.2021.617225
  32. Comparing sequential vs day 3 vs day 5 embryo transfers in cases with recurrent implantation failure: randomized controlled trial — Haitham Atef Torky, Ali M. Ahmad, Ahmed Hussein et al. JBRA, 2021, rct, 13 citations · DOI: 10.5935/1518-0557.20200083
  33. Association of ovarian stimulation and embryonic aneuploidy in in vitro fertilization cycles with preimplantation genetic testing: A narrative systematic review — J. Rodriguez-Purata, María José Gómez-Cuesta, Enrique Cervantes-Bravo JBRA, 2021, systematic review, 7 citations · DOI: 10.5935/1518-0557.20210069
  34. Letrozole as an adjunct treatment in antagonist cycles that previously failed in poor responders — Melek Turaç Kaçar, Alper Biler, Can Köse et al. Ginekologia Polska, 2021, cohort, 3 citations · DOI: 10.5603/gp.a2021.0116
  35. Comparison of euploidy rates of blastocysts in women treated with progestins or GnRH antagonist to prevent the luteinizing hormone surge during ovarian stimulation — Antonio La Marca, Martina Capuzzo, Sandro Sacchi et al. Human Reproduction, 2020, case control, 65 citations · DOI: 10.1093/humrep/deaa068
  36. Differential effects of high fat diet-induced obesity on oocyte mitochondrial functions in inbred and outbred mice — Waleed F. A. Marei, Anouk Smits, Omnia Mohey‐Elsaeed et al. Scientific Reports, 2020, animal, 55 citations · DOI: 10.1038/s41598-020-66702-6
  37. High rates of aneuploidy, mosaicism and abnormal morphokinetic development in cases with low sperm concentration — Semra Kahraman, Yucel Sahin, Hakan Kadir Yelke et al. Journal of Assisted Reproduction and Genetics, 2020, 47 citations · DOI: 10.1007/s10815-019-01673-w
  38. Luteal phase stimulation versus follicular phase stimulation in poor ovarian responders: results of a randomized controlled trial — J. Llácer, Belén Moliner, Lydia Luque et al. Reproductive Biology and Endocrinology, 2020, rct, 28 citations · DOI: 10.1186/s12958-020-00570-7
  39. Nitric Oxide-induced Protein S-nitrosylation Causes Mitochondrial Dysfunction and Accelerates Post-ovulatory Aging of Oocytes in Cattle — Yingjie Niu, Dongjie Zhou, Wenjun Zhou et al. Journal of Animal Reproduciton and Biotechnology, 2020, animal, 16 citations · DOI: 10.12750/jarb.35.1.102
  40. The spatio-temporal dynamics of mitochondrial membrane potential during oocyte maturation — Usama Al-Zubaidi, Jun Liu, Özgür Çınar et al. Molecular Human Reproduction, 2019, animal, 118 citations · DOI: 10.1093/molehr/gaz055
  41. Ovarian stimulation for freeze-all IVF cycles: a systematic review — Yossi Mizrachi, Eran Horowitz, Jacob Farhi et al. Human Reproduction Update, 2019, systematic review, 106 citations · DOI: 10.1093/humupd/dmz037
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