Objective: To evaluate mobile applications available for patients undergoing assisted reproduction and assess the extent of their clinical validation.

Methods: A systematic search was conducted in the Apple App Store and Google Play between September 1, 2023 and September 30, 2023 to identify mobile applications related to assisted reproduction. Apps were evaluated using the mobile app rating scale (MARS). In parallel, a literature search of PubMed, Scopus, Embase, and Web of Science was performed to identify clinical studies related to mobile applications in assisted reproduction. Clinical validation status and MARS scores were recorded, and findings were synthesized to highlight the gap between commercially available apps and research-based evidence.

Results: From 1 143 apps screened, 11 met the inclusion criteria. Mean MARS score across apps was 3.63, with Leeaf scoring the highest (4.60). However, only one application (Embie) was supported by published research. The literature research identified 13 relevant studies, mostly randomized controlled trials, cohort studies, or usability studies. While research-based apps demonstrated clinical utility (e.g., MediEmo, PreLiFe, Patient Journey App), most were unavailable on app stores. This revealed a disconnect between research-backed applications and those accessible to patients.

Conclusions: Although several mobile apps for assisted reproduction demonstrate high usability and quality, few are clinically validated. The lack of integration between research and practice highlights the need for stronger collaboration between researchers, developers, and policymakers to ensure that patients access safe and effective tools.

Objective: To evaluate the effect of reality therapy counselling on the levels of stress, anxiety and depression of women awaiting the result of amniocentesis.

Methods: This randomized clinical trial was conducted on the pregnant women who had referred to genetic laboratory to provide their amniocentesis samples in Isfahan, Iran from November 2019 to February 2020. Pregnant women were divided into the control and intervention groups. The control group received routine care. The intervention group received reality therapy counselling during eight merged sessions (two sessions in week). Each therapy session lasted for 90 to 120 minutes. Both groups completed the Depression, Anxiety and Stress Scale-21 items (DASS-21) questionnaire level before and after the intervention. These three variables (depression, anxiety and stress) were the primary variables of the study.

Results: 64 pregnant women were included, with 32 in each group. Before the intervention, the mean score of anxiety and depression had no significant difference between the control and intervention groups, but after the reality therapy counselling, the mean scores of stress, anxiety, and depression in the intervention group decreased significantly compared to the control group (P<0.001).

Conclusions: Reality therapy counselling can be offered as a simple, effective and accessible way to reduce stress, anxiety and depression in women awaiting amniocentesis result.

Objective: To assess whether personalized embryo transfer guided by endometrial receptivity array (ERA) improves implantation and pregnancy rates in women with implantation failure.

Methods: This retrospective case-control study was conducted on women with previous implantation failure. The women were divided into two groups, i.e, women who underwent ERA and those who underwent embryo transfer without ERA testing. ERA was performed using Igenomix. ERA results were interpreted as receptive or non-receptive. Women underwent frozen embryo transfer on the 6th day of progesterone (P+5). The primary outcomes were implantation rate, clinical pregnancy rate, abortion rate, and negative pregnancy rate.

Results: This study included 229 women with previous implantation failure, with 154 in the ERA group and 75 in the no ERA group. The mean age of the women of the ERA group was (32.2±4.1) years, and that of the no ERA group was (31.5±4.8) years. Women in the ERA group had a higher implantation rate (60.4%) and clinical pregnancy rate (57.1%) compared to those in the no ERA group (48.0% and 46.7%, respectively). In addition, implantation rate of the nonreceptive ERA group was higher than the no ERA group (65% vs. 48%), and clinical pregnancy rate was also higher in the non-receptive ERA group than the no ERA group (65% vs. 47%). The abortion rate of the no ERA group was 9% and that of the non-receptive ERA group was 10%. 52% no ERA group women and 35% non-receptive ERA group women had negative pregnancy results.

Conclusions: Women who have undergone personalised embryo transfer guided by ERA have a higher clinical pregnancy rate than women who have not after previous implantation failure.

Objective: To assess the effects of azoxystrobin on sperm quality, hormone levels and testicular structure in Swiss albino mice.

Methods: 48 Swiss albino male mice were divided into 7 groups containing 6 mice in each group except Group VII in which 12 mice were taken. Group I served as the control group and treated with vehicle (distil water for 30 and 60 days). Azoxystrobin at three different doses (125, 250, 500 mg/kg body weight) was orally administered to Group II, III and IV for 30 days and Group V, VI and VI for 60 days. After dose completion, sperm parameters, hormonal profile and testis histology were analysed. Half animals of group VII (500 mg/kg body weight) were left untreated for next 30 days to assess the recovery from reproductive toxicity.

Results: At azoxystrobin 125 and 250 mg/kg, sperm viability, count, and motility remained largely unaffected, but a significant decline was observed at azoxystrobin 500 mg/kg after 30 days. After 60 days, all dose levels led to a significant decrease in sperm parameters. Morphological abnormalities in sperm, such as globular heads, bent or coiled tails, and headless or tailless sperm, were noted to be increased in a dose dependent manner. Antioxidant parameters, serum level of reproductive hormones and steroidogenic enzymes followed a similar trend with non-significant changes at low and medium doses but a marked decline at the high dose after both 30 and 60 days of exposure. Histopathology of testis also revealed degenerative changes in seminiferous tubules and Leydig cell.

Conclusions: Azoxystrobin exposure at high dose (500 mg/kg) affects sperm quality and disrupts testicular function via potentially impairing antioxidant defences, deregulating steroidogenesis in Swiss albino male mice.

Rationale: Recurrent pregnancy loss and recurrent implantation failure are frequently linked to immune dysregulation, particularly heightened natural killer (NK) cell activity, cytokine imbalance, and autoantibody presence. Lipid emulsion therapy, originally designed for parenteral nutrition, is increasingly recognized for its immunomodulatory potential in reproductive medicine.

Patient concerns: A 34-year-old woman with five years of infertility, four first-trimester miscarriages, and three failed in vitro fertilization (IVF) cycles despite transfer of morphologically optimal embryos presented for evaluation.

Diagnosis: Routine genetic, endocrine, metabolic, thrombophilia, and anatomical investigations were unremarkable. Immunological testing revealed elevated antiphospholipid and anti-thyroid peroxidase (anti-TPO) antibodies, increased NK cell activity, an imbalanced Th1/ Th2 cytokine ratio, and raised tumor necrosis factor-alpha (TNF-α), suggesting immune-mediated reproductive dysfunction.

Interventions: The patient underwent IVF with transfer of a single euploid blastocyst following intravenous lipid emulsion therapy (20%, 100 mL), administered before transfer, on transfer day, and biweekly until 12 weeks. Associated therapies included aspirin, enoxaparin, progesterone, levothyroxine, and supplementation.

Outcomes: Serum beta-human chorionic gonadotropin (β-hCG) and ultrasound confirmed pregnancy with subsequent NK cell normalization. The pregnancy was uncomplicated, resulting in spontaneous vaginal delivery of a healthy male infant.

Lessons: Lipid emulsion therapy may improve implantation and pregnancy outcomes in immune-mediated recurrent pregnancy loss and recurrent implantation failure, but larger trials are required to validate efficacy and optimize protocols.