Is there any possible synergic effect of fertility outcome between spindle view-assisted intracyto-plasmic sperm injection (SV-ICSI) with or without assisted oocyte activation (AOA) for patients with low fertilization rate history? To explore the answer, a retrospective study was held in our fertility center by reviewing patients receiving SV-ICSI during 2019/03 to 2023/06. Total 47 pa-tients were included, the fertility outcomes of intervention group (AOA-SV-ICSI, 14 patients) and control group (SV-ICSI, 33 patients), such as fertilization rate, blastocyst formation rate and clin-ical pregnancy rate, were analyzed. The blastocyst formation rate between groups was signifi-cantly higher in AOA-SV-ICSI group (p=0.020), but the fertilization rate and clinical pregnancy rate did not reach any statistical significance. This discovery of increased blastocyst formation rate in low fertilization rate patients could possibly help them in getting more usable embryos in fertility treatment.

Mechanical ventilation (MV), used in patients with acute lung injury (ALI), induces diaphragmatic myofiber atrophy and contractile inactivity, termed ventilator-induced diaphragm dysfunction. Phosphoinositide 3-kinase- (PI3K-) is crucial in modulating fibrogenesis during the reparative phase of ALI; however, the mechanisms regulating the interactions among MV, myofiber fibrosis, and PI3K- remain unclear. We hypothesized MV with or without bleomycin treatment would increase diaphragm muscle fibrosis through the PI3K- pathway. Five days after receiving a single bolus of 0.075 units bleomycin intratracheally, C57BL/6 mice were exposed to 6 or 10 mL/kg MV for 8 h after receiving 5 mg/kg of AS605240 intraperitoneally. In wild-type mice, bleomycin exposure followed by MV 10 mL/kg prompted significant increases in disruptions of diaphragmatic myofibrillar organization, transforming growth factor-1, oxidative loads, Masson’s trichrome staining, extracellular collagen levels, positive staining of -smooth muscle actin, PI3K- expression, and myonuclear apoptosis (P < 0.05). Decreased diaphragm contractility and peroxisome proliferator activated receptor- coactivator-1 levels were also observed (P < 0.05). MV-augmented bleomycin-induced diaphragm fibrosis and myonuclear apoptosis were attenuated in PI3K-γ-deficient mice and through AS605240-induced inhibition of PI3K- activity (P < 0.05). MV-augmented diaphragm fibrosis after bleomycin-induced ALI is partially mediated through PI3K-γ. Therapy targeting PI3K-γ may ameliorate MV-associated diaphragm fibrosis.