Jan Steffen Kruessel

• Prof. Dr. med.
• Heinrich Heine University Düsseldorf

To date, very little is known about how apoptosis and autophagy affect human endometrial stromal cells (ESCs), particularly how these processes might determine the depth of implantation in humans. Before investigating how apoptosis and autophagy might modulate the implantation process in an infertile population, it is necessary to clarify how these...

Background/Objectives: In this observational prospective cohort study, conducted at the Fertility Centre of the University Hospital, Duesseldorf Germany, the spontaneous reversal capacity and the effect of waiting time on an adverse vaginal microbiome profile in subfertile patients were investigated. Methods: Vaginal swabs of 76 patients were obtai...

Study question Do couples with two blastocysts opting for DET have a better outcome than those with SET, freezing of the second and eventually subsequent second SET? Summary answer More children are born after 2x SET with the overwhelming majority (96.3%) of these children being singletons, whereas after 1x DET 49.5% are multiples What is known a...

Study question What is the effect of 30mg oral dydrogesterone (DYD), given to induce endometrial receptivity in natural-proliferative-phase-FET-cycles (NPP-FET), on ovulation, progesterone and DYD/DHD-levels, respectively, and outcomes? Summary answer Oral DYD 30mg allows scheduling endometrial receptivity in natural cycles while not interfering w...

Background This study aimed to evaluate the offspring sex ratio, born through fresh and cryo-thawed single blastocyst (BL) transfers regarding a single morphological, static parameter, namely, BL diameter. Methodology This retrospective, observational study was conducted at an assisted reproductive technology (ART) center, Kinderwunschzentrum Niede...

Zusammenfassung Hintergrund Die Synchronisierung zwischen der Embryonalentwicklung und dem rezeptiven Zustand des Endometriums beeinflusst den Erfolg von Techniken der assistieren Reproduktion erheblich. Die endometriale Genexpressionsanalyse wurde eingeführt, um den optimalen Zeitpunkt für den Embryotransfer molekularbiologisch zu bestimmen. Fra...

Die in Deutschland seit 1990 verbotene Eizellspende ist für Frauen mit einer verminderten Anzahl oder Qualität von Eizellen die einzige Option für das Erleben einer Schwangerschaft und die Geburt eines Kindes. Nach fast 40 Jahren haben sich anfängliche Befürchtungen zur Gesundheitsgefährdung der Spenderinnen oder zur psychosozialen Entwicklung der...

The success of our current fertility treatment using in vitro fertilization (IVF) is still measured by the pregnancy rates achieved but optimally by the birth of a child. These rates have been documented by the German IVF Registry with respect to the homologous IVF/intracytoplasmic sperm injection (ICSI) treatment since 1991 and showed steadily ris...

Counseling and decisions about possible fertility preservation during pregnancy should be discussed and confirmed on an interdisciplinary basis, taking into account the week of pregnancy at the time of diagnosis. The nearer the due date of the unborn child, the more likely and earlier birth is sought, so that the mother can consider all the options...

Endometrial scratching (ES) has been widely used in assisted reproductive technology to possibly improve pregnancy rates, but its exact mechanism is still not understood or investigated, and its benefits are controversially discussed. Hypothetically, ES may trigger a local immune response, leading to an improved endometrial receptivity. So far, it...

Background: As of today, the effect of coronavirus disease 2019 (COVID-19) on male fertility remains unclear. Studies published so far have partly contradictory results, likely due to very small sample sizes and heterogeneous populations. To gain a deeper understanding of the impact of COVID-19 on male fertility, we performed a prospective case-co...

Purpose Displaced endometrial receptivity has been discussed as a possible cause of recurrent implantation failure in patients undergoing assisted reproductive technology. The aim of this study was to document our experience with the endometrial receptivity analysis in patients with recurrent implantation failure. Methods This retrospective cohort...

This non-interventional study compared the effectiveness of recombinant human follicle-stimulating hormone (r-hFSH) and recombinant human luteinizing hormone (r-hLH) (2:1 ratio) versus r-hFSH alone for ovarian stimulation (OS) during assisted reproductive technology treatment in women aged 35-40 years, using real-world data from the Deutsches IVF-R...

Artificial intelligence is steadily being integrated into all areas of medicine. In reproductive medicine, artificial intelligence methods can be utilized to improve the selection and prediction of sperm cells, oocytes, and embryos and to generate better predictive models for in vitro fertilization. The use of artificial intelligence in this field...

Study question: What are the pregnancy and live birth rates for ovarian tissue transplantation and which factors are associated with the success rate? Summary answer: Pregnancy and live birth rates per transplanted woman are 32.7% and 26.5% and success rate is associated with female age and first versus repeated transplantation. What is known a...

Background: With the introduction of COVID-19 vaccines in 2021, concerns arose regarding their impact on male fertility. Therefore, this study investigated the effect of mRNA- and vector-based COVID-19 vaccination on male fertility by analyzing sperm parameters in subjects with unrestricted and restricted fertility. Methods: In this prospective sel...

Assisted reproductive technologies (ART) may be supplemented with in vitro gametogenesis (IVG). Although IVG is still experimental the question arises whether IVG offers any moral advantages compared to implemented methods. The aim of the paper is to display the landscape of ethical arguments in favour or against IVG. ART-related ethical issues in...

There is growing evidence that changes in the eutopic endometrial immune profile are a cause of endometriosis-associated infertility. Women affected by endometriosis experience a 2-fold increased risk of infertility compared to healthy controls. In our study we aimed to map out endometrial expressions of uterine natural killer cells, plasma cells,...

Cyclophosphamide is still clinically used in rheumatic diseases with severe disease courses. Cyclophosphamide has a pronounced gonadotoxic effect largely depending on the cumulative dose. The risk of amenorrhea is reported to be in the range of 12–54% and is dependent on the age of the patient at initiation of treatment. Every patient of reproducti...

Background To date, there is no reliable non-invasive marker for the early detection and diagnosis of endometriosis available possibly resulting in a delayed diagnosis and consequently an unnecessary long ordeal for the individual woman. Therefore, the primary objective of the current study was to evaluate whether the combination of a thyroid-stimu...

Study question What is the influence of time on the vaginal microbiome-based prediction of IVF/ICSI success? Summary answer Time influences the vaginal microbiome-based prediction of IVF/ICSI success. What is known already The association between the microbiome of the lower female reproductive tract and subfertility is discussed extensively sugge...

492 Fortbildung und Kongress í Aufgrund der Corona-Pandemie wird zunehmend die Befürchtung ge-äußert, dass die adäquate medizini-sche Versorgung eingeschränkt sein könnte. Die Stiftung Endometriose-Forschung (SEF) hat deshalb in Zu-sammenarbeit mit dem Deutschen IVF-Register die Situation von Frau-en mit Endometriose im Jahr 2020 untersucht, einem...

Background: This phase IV routine care study evaluated ovarian responses when using a biosimilar follitropin alfa r-hFSH (Bemfola®) for controlled ovarian stimulation (COS) in women undergoing assisted reproductive technology (ART) treatment who were pituitary-suppressed with a gonadotrophin-releasing hormone (GnRH) antagonist. Methods: This mul...

PurposeThe main objective of Repro-Can-OPEN Study Part 2 is to learn more about oncofertility practices in optimum resource settings to provide a roadmap to establish oncofertility best practice models.Methods As an extrapolation for oncofertility best practice models in optimum resource settings, we surveyed 25 leading and well-resourced oncoferti...

Increasing female age is directly associated with an increase in the abortion rate. The contribution of the male as the cause of an abortion has been less analyzed. A reduction in the quality of the spermatogram is the predominant consideration. Optimizing selection and culture conditions of the gametes is a worldwide effort in the field of reprodu...

The success of in vitro fertilization (IVF) treatment is mainly dependent on the age of the female patient and the genetic characteristics of the oocyte. As only half of the embryos have a euploid chromosome set, preimplantation genetic testing (PGT-A) can be used for the identification of euploid embryos to establish a better pregnancy rate compar...

PurposeInfertility is a debilitating situation that millions of women around the world suffer from, but the causal relationship between infertility and endometriosis is still unclear. We hypothesize that the immune cell populations of uterine natural killer cells (uNK) and plasma cells (PC) which define chronic endometritis could differ in patients...

The value of artificial intelligence (AI) to benefit infertile patients is a subject of debate. This paper presents the experience of one aspect of AI, machine learning (ML), coupled with patient empathy to improve utilisation of assisted reproduction technologies (ART), which is an important aspect of care that is under recognised. Although ART pr...

The interaction of sperm with the oocyte is pivotal during the process of mammalian fertilization. The limited numbers of sperm that reach the fallopian tube as well as anatomic restrictions indicate that human sperm-oocyte encounter is not a matter of chance but a directed process. Chemotaxis is the proposed mechanism for re-orientating sperm towa...

Objective To investigate the presence of viral RNA in human semen of severe-acute-respiratory syndrome coronavirus 2 (SARS-CoV-2) recovered and positive patients and to evaluate its presence and relevance on semen parameters. Design Pilot cohort study Setting University hospital Patients 34 adult males were distributed into a) patients in conval...

Das ovarielle Überstimulationssyndrom bleibt bis heute ein Risiko in der Kinderwunschtherapie, kann aber in seltenen Fällen auch spontan auftreten. Es gilt für die Praxis, Patientinnen mit erhöhtem Risiko vor Beginn einer Stimulationsbehandlung zu identifizieren (z. B. Patientinnen mit PCOS, hohem AMH-Wert, großer Anzahl antraler Follikel). Innerha...

Die Frage nach Zusatzmethoden oder zusätzlichen Maßnahmen wird vonseiten der Patienten meistens nach dem zweiten erfolglosen Embryotransfer gestellt. Beantwortet werden die Fragen selbstverständlich im Arzt-Patientinnen-Gespräch, aber dank moderner Zeiten und Internet und Social Media auch anonym in Chats, Foren und Plattformen offengelegt. In dies...

Die rechtliche Regelung der Fortpflanzungsmedizin ist dringend reformbedürftig. Das Embryonenschutzgesetz von 1990 erfasst die neuesten technischen Entwicklungen nicht, ist in manchen Bereichen unstimmig und lückenhaft, setzt die betroffenen Frauen, Paare und Kinder unnötigen gesundheitlichen Risiken aus, erschwert paradoxerweise die Durchsetzung v...

Introduction Supporting and counselling couples with fertility issues prior to starting ART is a multidisciplinary diagnostic and therapeutic challenge. The first German-language interdisciplinary S2k guideline on “Diagnosis and Therapy Before Assisted Reproductive Treatments (ART)” was published in February 2019. The guideline was developed in the...

Study question: How do anti-Müllerian hormone (AMH) serum concentrations and follicle densities (FDs) change with age and disease and what are the implications for fertility preservation? Summary answer: AMH concentrations and FD do not correlate in young women, and AMH but not FD is reduced in some diseases, limiting the value of AMH as a predi...

Energy balance is essential for all species. Ligand-receptor interactions mediate processes that regulate body activities like reproduction and metabolism based on the energy status. Such receptors are the heparan sulfate proteoglycans and specifically the family of syndecans. Therefore we investigated the differences of metabolic parameters of het...

Fast 3 % aller in Deutschland lebend geborenen Kinder des Jahres 2016 sind aus einer Befruchtung außerhalb des Körpers entstanden. Der Bedarf an Kinderwunschtherapien steigt stetig. Für die Paare bedeutet dies nach endlich erfolgter Indikationsstellung erneut einen langen Weg – beginnend mit dem Erstgespräch, über Diagnostik und Zyklusmonitoring, b...

Research question: Is overnight transportation of ovarian tissue before cryopreservation in a centralized cryobank from the FertiPROTEKT network feasible? Design: Data from 1810 women with cryopreserved ovarian tissue after overnight transportation from December 2000 to December 2017 were analysed with a focus on transportation, tissue activity...

Premature gonadal failure is a common problem in patients with systemic lupus erythematosus (SLE) when gonadotoxic therapies are applied. The preservation of gonadal function and fertility is of great importance to many predominantly young SLE patients. Some fertility preservation methods are well established and well known, whereas others are cons...

Background Syndecan-1 is a heparan sulfate proteoglycan acting as a co-receptor for cytokines and growth factors mediating developmental, immunological and angiogenic processes. In human, the uteroplacental localization of Syndecan-1 and its reduced expression in pregnancy-associated pathologies, such as the intrauterine growth restriction, suggest...

Background: The molecular signature of endometrial receptivity still remains barely understood, especially when focused on the possible benefit of therapeutical interventions and implantation-related pathologies. Therefore, the protein composition of tissue and isolated primary cells (endometrial stromal cells, ESCs) from endometrial scratchings of...

The cryopreservation of ovarian tissue with subsequent transplantation of the tissue represents an established method of fertility protection for female patients who have to undergo gonadotoxic therapy. The procedure can be performed at any point in the cycle and thus generally does not lead to any delay in oncological therapy. With the aid of this...

Onkologische und nichtonkologische Erkrankungen können die gegenwärtige oder zukünftige Fertilität beeinträchtigen, entweder durch die Krankheit selbst oder durch notwendig chirurgische Eingriffe, hormonelle und/oder gonadotoxische Behandlungen. Sie erfordern damit einen adäquaten fertilitätsprotektiven Ansatz – sprich eine unbedingte Beratung und,...

Introduction Numerous couples discontinue fertility treatment before achieving the objective, the birth of a child. The aim of this retrospective data analysis is to identify the reasons for early discontinuation of therapy (drop-out). Materials and Methods Retrospective data analysis. With the aid of the German IVF Registry (D·I·R®), a total of 12...

Der verfrühte Eintritt einer Frau in die Wechseljahre kommt häufig unerwartet und unerwünscht. Üblicherweise ist zu diesem Zeitpunkt der Kinderwunsch noch nicht erfüllt. Hinzu kommen Wechseljahresbeschwerden, die die Patientin körperlich und psychisch belasten. Die Diagnose der prämaturen Ovarialinsuffizienz wird durch die Bestimmung der erhöhten G...

Die rechtliche Regelung der Fortpflanzungsmedizin ist dringend reformbedürftig. Das Embryonenschutzgesetz von 1990 erfasst die neuesten technischen Entwicklungen nicht, ist in manchen Bereichen unstimmig und lückenhaft, setzt die betroffenen Frauen, Paare und Kinder unnötigen gesundheitlichen Risiken aus, erschwert paradoxerweise die Durchsetzung v...

Die rechtliche Regelung der Fortpflanzungsmedizin ist dringend reformbedürftig. Das Embryonenschutzgesetz von 1990 erfasst die neuesten technischen Entwicklungen nicht, ist in manchen Bereichen unstimmig und lückenhaft, setzt die betroffenen Frauen, Paare und Kinder unnötigen gesundheitlichen Risiken aus, erschwert paradoxerweise die Durchsetzung v...

Während für die Behandlung des symptomatischen Uterus myo-matosus sowohl wirksame operative, nicht-invasive (MRgFUS) und invasive Verfahren (UAE) als auch medikamentöse Therapien zugelassen sind, wird bei asymptomatischem Uterus myomatosus derzeit häufig zugewartet. Um spätere Beeinträchtigungen bei der Erfüllung des Kinderwunsches zu verhindern, s...

Patientinnen mit Endometriose sind neben ihren chronischen Schmerzen häufig mit ungewollter Kinderlosigkeit konfrontiert. Allerdings verbessert sich die Chance auf Eintritt einer spontanen Schwangerschaft nach einer Sanierungsoperation in den ersten Monaten deutlich, v. a. im ASRM(American Society for Reproductive Medicine)-Stadium I–II. Eine Opera...

Fertility-preserving measures are becoming important for patients receiving oncological treatment. One method involves cryopreservation of ovarian tissue and transplanting it when treatment is completed. We report complications resulting from surgical and fertility medicine, and the results of procedures for the removal and transplantation of ovari...

Die rechtliche Regelung der Fortpflanzungsmedizin ist dringend reformbedürftig. Das Embryonenschutzgesetz von 1990 erfasst die neuesten technischen Entwicklungen nicht, ist in manchen Bereichen unstimmig und lückenhaft, setzt die betroffenen Frauen, Paare und Kinder unnötigen gesundheitlichen Risiken aus, erschwert paradoxerweise die Durchsetzung v...

During the last decades the incidence of diabetes has dramatically increased as well as the number of pregnant diabetic women. There is still missing data regarding patterns and shifts of immune cell populations due to pregnancy with or without diabetes. The study aimed to investigate the impact of pregnancy, type 1 diabetes (T1D) and gestational d...

Purpose: A modified application technique of intrauterine insemination (IUI) is slow release insemination (SRI), first described by Muharib et al. (Hum Reprod 7(2):227-229, 1992), who postulated higher pregnancy rates with a slow release of spermatozoa for 3 h. Methods: To investigate this approach, two randomized controlled, cross-over pilot st...

Objective: To identify and estimate the importance of risk factors on pregnancy loss until the end of the second trimester after clinical pregnancy was achieved by either in vitro fertilisation (IVF) or intra-cytoplasmic sperm injection (ICSI). Study design: Retrospective cohort study including 588 cycles with fresh embryo transfers and 150 cycl...

Successful implantation of the embryo into the human receptive endometrium is substantial for the establishment of a healthy pregnancy. This study focusses on the role of Syndecan-1 at the embryo-maternal interface, the multitasking coreceptor influencing ligand concentration, release and receptor presentation, and cellular morphology. CXC motif li...

STUDY QUESTION What is the success rate in terms of ovarian activity (menstrual cycles) as well as pregnancy and delivery rates 1 year after orthotopic ovarian transplantations conducted in a three-country network? SUMMARY ANSWER In 49 women with a follow-up >1 year after transplantation, the ovaries were active in 67% of cases and the pregnancy a...

Over the last decade, research to improve success rates in reproductive medicine has focused predominantly on the understanding and optimization of embryo quality. However, the emergence of personalized medicine in ovulation induction and embryology has shifted the focus to assessing the individual status of the endometrium. The endometrium is cons...

Introduction: Patients receiving fertility treatment in Germany appear to be disadvantaged in comparison to those in other countries due to the restrictive Embryo Protection Act ("Embryonenschutzgesetz, ESchG"), which prohibits the selection of a "top" embryo. The so-called German Middleway ("Deutscher Mittelweg, DMW") now provides for a liberal in...

Der Jahreskongress der Europäischen Gesellschaft für Fortpflanzungsmedizin und Embryologie (ESHRE) brillierte im Jahr 2015 mit einem neuen Teilnehmerrekord. Über 10.000 Experten kamen nach Lissabon, um sich in 275 freien Vorträgen und aus etwa 600 Posterbeiträgen über die neuesten Studien zu informieren (. Abb. 1). Ein Rekord wurde auch bei der Zah...

To systematically review the reporting of MII (MII) oocyte development after xenotransplantation of human ovarian tissue. Systematic review in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Not applicable. Not applicable. Formation of MII oocytes after xenotransplantation of human...

Human embryo invasion and implantation into the inner wall of the maternal uterus, the endometrium, is the pivotal process for a successful pregnancy. Whereas disruption of the endometrial epithelial layer was already correlated with the programmed cell death, the role of apoptosis of the subjacent endometrial stromal cells during implantation is i...

Über Social Freezing, dem vorsorglichen Einfrieren von Eizellen, damit eine Frau auch noch in späteren Jahren schwanger werden kann, wird viel diskutiert. Im Mittelpunkt des nachfolgenden Beitrags stehen weniger ethische als vielmehr medizinische und gesellschaftliche Aspekte. Wie funktioniert Sozial Freezing, welche Erfolgsraten sind zu erwarten,...