To generate an effective embryo prediction model and identify a non-invasive evaluation method by analyzing microRNAs (miRNAs) in embryo culture medium. Analysis of microRNA profiles from spent culture medium of blastocysts with good morphology that did or did not result in pregnancy. Clinical and experimental research. Sixty patients who underwent thawed embryo transfer of blastocysts after intracytoplasmic sperm injection. None. The association of miRNA abundance levels secreted by blastocysts in culture medium and implantation success. Our RNA sequencing analysis found a total of 53 differentially expressed miRNAs in the culture media of pregnancy and non-pregnancy groups. Twenty-one miRNAs were analyzed for their potential to predict implantation success. Eight miRNAs (hsa-miR-191-5p, hsa-miR-320a, hsa-miR-92a-3p, hsa-miR-509-3p, hsa-miR-378a-3p, hsa-miR-28-3p, hsa-miR-512-5p, and hsa-miR-181a-5p) were further extracted from the results of a logistic regression analysis of qPCR Ct values. A prediction model for high-quality blastocysts was generated using the eight miRNAs, with an average accuracy of 0.82 by 5-fold cross validation. We isolated blastocyst miRNAs that may predict implantation success and created a model to predict viable embryos. Increasing the number of investigated cases and further studying the effect of each miRNA on embryonic development is needed to refine the miRNA-based predictive model.

In cases of testicular sperm extraction sperm aspiration and severe oligozoospermia for which intracytoplasmic sperm injection (ICSI) is indicated, there are cases where motile sperm are difficult to obtain even from collected semen. In cases when little or no motile sperm is obtainable from prepared sperm suspension. We stimulated sperm motility using pentoxifylline and then selected live sperm. The clinical outcomes of recovery of live sperm were compared with cases in which motile sperm was obtainable. Fertilization and embryo recovery rates of the pentoxifylline group were significantly lower than those of the control group. However, the pregnancy, implantation, and abortion rates of the pentoxifylline group were not significantly different from those of the control group, suggesting a favorable outcome if a viable embryo is implanted. Moreover, no abnormal findings were found in babies subsequently born. Considering that the important point of ICSI is to inject live sperm, pentoxifylline treatment was effective in cases where sperm sorting was difficult.

In ICSI, sperm is selected based on its motility and shape under 200–400× magnification. However, sperm morphology, especially the existence of vacuoles, may relate to sperm nuclear DNA fragmentation. Bartoov et al. reported the application of sperm selection under high (1,000–6,000×) magnification, which they referred to as IMSI (intracytoplasmic morphologically-selected sperm injection). In our initial trials, the fertilization, blastocyst development, pregnancy and miscarriage rates of 115 single blastocyst transfer cycles with IMSI or ICSI were 84.0% vs. 75.5%, 47.5% vs. 43.7%, 50.0% vs. 47.4% and 10.0% vs. 11.0%, respectively. Further studies are required to establish the systems and clarify the indications for IMSI.