Editorial: Highlights in Assisted Reproduction 2023/24

Eitan Lunenfeld^1*Johnny S. YOUNIS²

• ¹Ariel University, Ariel, Israel
• ²Tzafon Medical Center, Tiberias, Israel

RIF is not substantial. When endometrial scratching was first introduced to increase implantation rates, especially in cases with RIF it showed encouraging results, although the biological mechanism was not very clear. Furthermore, big RCTs trying to modulate the intrauterine immune response by IV intralipid and increasing live birth rates are lacking. Mrosk et al., in their retrospective study, did not show convincing evidence for the "add on" endometrial scratching on live birth rates. In this study, patients previously identified with increased uNK cells (>300 uNK cells/mm 2 ) were offered an off-label intralipid infusion therapy that did not demonstrate any benefit.When IVF was first introduced by Edward and Steptoe, it first used natural cycles and Laparoscopic oocyte retrieval to treat tubal disease. With the development of ART sophisticated ovarian stimulation protocols were developed as well as trans vaginal ultrasound guided oocyte retrieval. Furthermore, the indications for IVF were extended to male infertility as well as oocyte cryopreservation for the purpose of fertility preservation and surrogacy. The case report by Ingold et al demonstrates the feasibility and safety of combined laparoscopic and transvaginal oocyte retrieval in a woman with vaginal recurrence of cervical adenocarcinoma following radical hysterectomy, using "random start " ovarian stimulation protocol employing Aromatase Inhibitors, Gonadotropins, GnRH antagonist and GnRH agonist for final oocyte maturation to eliminate OHSS. This case report represents a "tailored made" treatment management for a specific, unusual case.As assisted reproduction continues to evolve, future studies should focus on refining personalized treatment strategies, improving safety profiles of stimulation protocols, and identifying evidence-based interventions for challenging cases such as recurrent implantation failure. High-quality, prospective research is essential to validate current practices, clarify immunological contributions, and expand access to individualized care across diverse patient populations.There is no question that we have not yet reached the goal of efficacy, and more challenges are ahead. However, it is crucial that while trying to conquer the challenges, we do not slip into the ethical slippery slope and always remember that we are dealing with germ lines, which have consequences for the next generation.