Reproduction & fertility最新文献

{"title":"Perceived effectiveness of endometriosis therapies on fatigue: an international survey.","authors":"Kevin K W Kuan, Florian Heinzl, Andrew W Horne, Lucy H R Whitaker, Jana Heine, Christine Bekos","doi":"10.1530/RAF-25-0010","DOIUrl":"10.1530/RAF-25-0010","url":null,"abstract":"<p><strong>Graphical abstract: </strong></p><p><strong>Abstract: </strong>Current endometriosis treatments primarily focus on pain management, despite many patients also experiencing fatigue, which significantly impacts their quality of life. This study aimed to evaluate the perceived effectiveness of endometriosis treatments in managing fatigue. An international anonymous survey was conducted using the Qualtrics platform, with participants (aged 16 years and over) and a self-reported diagnosis of endometriosis. The survey collected demographic information, the brief fatigue inventory, and perceived impact of treatments on fatigue over the past 5 years. Ethical approval was granted by the Edinburgh Medical School Research Ethics Committee. Data analysis was performed using R, with results presented as medians and interquartile ranges. From 12 April to 25 May 2023, 2,907 responses were collected. Our results showed that fatigue was significantly worsened during menstruation (median: -2, IQR: -3 to -1) and slightly worsened during ovulation (median: -1, IQR: -2 to 0). Analysis revealed limited associations between common medical treatments, such as analgesics or hormonal therapy, and improvements in fatigue symptoms. Use of gonadotrophin-releasing hormone (GnRH) agonists was linked to a worsened fatigue, reported by 54% users. Surgical interventions and changes in rest patterns showed minimal improvement, while other behavioural modifications showed little to no effect. These findings suggest that current endometriosis treatments are largely ineffective in addressing fatigue. Limitations of this study include recall bias and confounding factors, which may influence perceived effectiveness of endometriosis therapies on fatigue. This underscores the need for more comprehensive management strategies to better support patients experiencing endometriosis-associated fatigue.</p><p><strong>Lay summary: </strong>Endometriosis is a common chronic pain condition affecting 180 million women worldwide. Many women with endometriosis also report that fatigue significantly impacts their quality of life. Despite this, fatigue management has been largely neglected, and there are limited studies that have evaluated the benefit of current endometriosis treatments on fatigue. This international survey aimed to evaluate the perceived effectiveness of various therapies for endometriosis on fatigue, including pain medication, hormonal medication, surgery and behavioural changes. Pain medication and most hormonal therapies provided limited relief. However, gonadotrophin-releasing hormone (GnRH) agonists worsened fatigue in more than half of the users. These results suggest that existing endometriosis treatments are largely ineffective in addressing fatigue, highlighting the need for improved strategies to address this symptom to enhance quality of life for women with endometriosis.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":"6 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence model for the assessment of unstained live sperm morphology.","authors":"Jermphiphut Jaruenpunyasak, Prawai Maneelert, Marwan Nawae, Chainarong Choksuchat","doi":"10.1530/RAF-25-0014","DOIUrl":"10.1530/RAF-25-0014","url":null,"abstract":"<p><strong>Abstract: </strong>Traditional sperm morphology assessment requires staining and high magnification (100×), rendering sperm unsuitable for further use. We aimed to determine whether an in-house artificial intelligence (AI) model could reliably assess normal sperm morphology in living sperm and compare its performance with that of computer-aided semen analysis and conventional semen analysis methods. In this experimental study, we enrolled 30 healthy male volunteers aged 18-40 years at the Songklanagarind Assisted Reproductive Centre, Songklanagarind Hospital. We developed a novel dataset of sperm morphological images captured with confocal laser scanning microscopy at low magnification and high resolution to train and validate an AI model. Semen samples were divided into three aliquots and assessed for unstained live sperm morphology using the AI model, whereas computer-aided and conventional semen analysis methods evaluated fixed sperm morphology. The performance of our in-house AI model for evaluating unstained live sperm morphology was compared with that of the other two methods. The in-house AI model showed the strongest correlation with computer-aided semen analysis (r = 0.88), followed by conventional semen analysis (r = 0.76). The correlation between computer-aided semen analysis and conventional semen analysis was weaker (r = 0.57). Both the in-house AI and conventional semen analysis methods detected normal sperm morphology at significantly higher rates than computer-aided semen analysis. The in-house AI model could enhance assisted reproductive technology outcomes by improving the selection of high-quality sperm with normal morphology. This could lead to better outcomes of intracytoplasmic sperm injections and other fertility treatments.</p><p><strong>Lay summary: </strong>We evaluated a new in-house AI model for assessing the shape and size (morphology) of live sperm without staining and performed comparisons with computer-aided semen analysis and conventional semen analysis, which require sperm to be fixed and stained before analysis. This new method of assessing unstained, live sperm is significant because it facilitates viable sperm selection for use in assisted reproductive technology immediately after assessment, ultimately contributing to improved fertility outcomes. The AI model allowed sperm morphology assessments with significantly improved accuracy and reliability. By using high-resolution images and advanced microscopy, the AI model could detect subcellular features. This AI model could be an effective tool in clinical settings, because it minimizes subjectivity and improves sperm selection for assisted reproductive technologies, potentially leading to higher success rates in infertility treatments. Further research can refine the model and validate its effectiveness in diverse clinical environments.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":"6 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative mtDNA copy number in embryo spent culture medium is not a reliable biomarker of human embryo aneuploidy.","authors":"Sasipat Teerawongsuwan, Kodchakorn Wiangwised, Nattapavee Ngampiyakul, Nitid Wanikorn, Panida Boonnithipaisit, Panyada Khiuhok, Phanthitra Aekudompong, Amarin Narkwichean, Sirinun Pongmayteegul, Ruttachuk Rungsiwiwut","doi":"10.1530/RAF-25-0001","DOIUrl":"https://doi.org/10.1530/RAF-25-0001","url":null,"abstract":"<p><strong>Graphical abstract: </strong></p><p><strong>Abstract: </strong>Mitochondrial DNA (mtDNA) from embryonic cells is released into the spent culture medium (SCM) during cellular processes, providing a potential biomarker of embryo health. Analysing mtDNA levels in SCM enables a non-invasive evaluation of embryo quality and potential developmental abnormalities. In this retrospective study, we aimed to investigate the relationship between relative mtDNA copy number in embryo SCM and key factors, including embryo fragmentation, morphological quality and chromosomal abnormalities. Fertilised embryos produced through intracytoplasmic sperm injection were cultured to the blastocyst stage in an incubator. Embryo fragmentation was assessed on day 3 using the Istanbul criteria, while morphological grading was evaluated on day 5 using the Gardner criteria. On day 5, trophectoderm (TE) biopsies were performed for preimplantation genetic testing for aneuploidy, followed by embryo cryopreservation and collection of embryo SCM. The mtDNA was quantified using quantitative PCR. Statistical analyses using the Mann-Whitney U and Kruskal-Wallis tests (significance at P < 0.05) showed that relative mtDNA copy number did not significantly differ among embryos with fragmentation levels <10%, 10-25% and >25% (P > 0.05). For blastocyst grading, which evaluates the inner cell mass (ICM) and TE, no significant difference was observed in relative mtDNA copy number between grades B and C for ICM (P = 0.190) and TE (P = 0.289). Furthermore, a trend towards higher relative mtDNA levels was observed in aneuploid than in euploid embryos, although the difference was not statistically significant. Thus, relative mtDNA copy number in SCM may not accurately reflect embryo characteristics, such as fragmentation, morphological grading or chromosomal abnormalities.</p><p><strong>Lay summary: </strong>This study examined whether the amount of mitochondrial DNA (mtDNA) in the fluid used to culture embryos in the laboratory could indicate embryo quality. We assessed various factors, including the appearance of the embryos, the presence of fragmented cells and the occurrence of chromosomal abnormalities. Fertilized eggs were cultured until they developed into blastocysts, and the amount of mtDNA in the culture fluid was measured using a machine that detects genetic material. The results revealed no clear association between mtDNA levels and embryo appearance or fragmentation. Although embryos with chromosomal abnormalities had slightly more mtDNA, the difference was not statistically significant. These findings suggest that mtDNA in the culture fluid may not be a reliable marker for assessing embryo quality or chromosomal status.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":"6 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormonal balance, anovulatory cycles and luteal phase deficiency: exploring relationships between hematological variables, sex hormones and V̇O2max in athletes.","authors":"Paula Recacha-Ponce, Pilar Suárez-Alcázar, Carlos Hernando, Pablo Salas-Medina, Maria Muriach, Pablo Baliño, Isabel Guisado-Cuadrado, Eladio Collado-Boira","doi":"10.1530/RAF-24-0119","DOIUrl":"https://doi.org/10.1530/RAF-24-0119","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Graphical abstract: &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;The impact of the menstrual cycle on physical fitness in athletes remains controversial in the scientific literature. Notable fluctuations in sex hormones occur at three key phases of the menstrual cycle, during which estrogen and progesterone levels vary significantly. In addition, the presence of regular bleeding does not ensure ovulation; therefore many women may not be aware that they have anovulatory cycles. These sex hormones can influence the physiology of women and can affect their level of cardiorespiratory performance depending on the phase of the menstrual cycle they are in. Method: Twenty-seven women aged 18-40 years with regular cycles were recruited. All participants had to be athletes classified as level II-III of the McKay et al. 2022 proposal based on training volume/physical activity metrics, among other variables. Cardiorespiratory fitness was indirectly assessed using V̇O2max measurements. Blood samples were collected on three occasions to determine the phase of the menstrual cycle by analyzing sex hormone levels. In addition, urine analyses were performed to detect ovulation, which was positive in all participants. To classify a cycle as ovulatory, progesterone levels must reach 16 nmol/L during the mid-luteal phase. However, it was observed that 26% of the sample did not reach this threshold, exhibiting anovulatory cycles or cycles with deficient luteal phases. Thus, two study groups were created: the ovulatory menstrual cycle group (n = 20) and the menstrual cycle group with deficient/anovulatory luteal phases (n = 7). These groups did not show statistically significant differences in age, weight, body mass index or V̇O2max during the bleeding phase (phase I). Female sex hormones did not show significant differences in the anovulatory cycle group, whereas they did show significant differences in the ovulatory cycle group. A high prevalence of female athletes with anovulatory menstrual cycles was observed. Women with ovulatory cycles experienced changes in their V̇O2max (P = 3.78E-4), in contrast to women with anovulatory cycles, who exhibited stable V̇O2max levels throughout their cycle (P = 0.638). Women with anovulatory menstrual cycles exhibit linear patterns of sex hormones throughout the menstrual cycle, which could lead to the maintenance of physical fitness throughout the cycle. In ovulatory cycles, it would be possible to polarize the training load according to the phase of the menstrual cycle. Monitoring ovulation, in addition to menstrual bleeding, is necessary to enhance knowledge about women's reproductive health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;The menstrual cycle may affect physical fitness in female athletes, but the evidence remains unclear. Hormones such as estrogen and progesterone fluctuate during different phases of the menstrual cycle and can influence performance. However, menstrual bleeding does not always indicate ovulation","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":"6 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of tripartite motif family-like protein 1 and 2 in early conceptus development and placentation in the pig.","authors":"Emily K Eitel, Mariana Sponchiado, Riley M Sullivan, Caroline G Lucas, Bethany K Redel, Paula R Chen, Kevin D Wells, Randall S Prather, Wesley C Warren, Rodney D Geisert","doi":"10.1530/RAF-24-0107","DOIUrl":"10.1530/RAF-24-0107","url":null,"abstract":"<p><strong>Abstract: </strong>The eutherian placenta is highly complex, evolving to regulate the inflammatory phase of pregnancy during conceptus attachment and placental tissue development. Tripartite motif family-like (TRIMLs) proteins are implicated in downregulating inflammation. In mammals, TRIML1 and TRIML2 show preferential expression in gonads, preimplantation embryos and placenta. TRIML1 domains differ between eutherians and marsupials, while TRIML2 is absent in marsupials, suggesting it may play a unique role in regulating the inflammatory phase during conceptus attachment, critical for establishing and maintaining pregnancy to term. This study aimed to investigate the expression pattern of TRIML1 and TRIML2 in various tissues, as well as during embryo development, conceptus attachment, and placental formation in pigs. Transcripts for TRIML2 were detected in embryos, conceptuses, extraembryonic membranes, ovary and testis but not in any of the other tissues examined. In contrast, TRIML1 expression was only observed in testis. In situ hybridization of TRIML1 and TRIML2 confirmed these results. The specific expression of TRIML2 in immune privileged sites is consistent with it serving as an anti-inflammatory factor to provide immunological protection of the eutherian placenta. To further investigate the role of TRIML2, CRISPR/Cas9 gene editing was employed to knock out either TRIML1 (control) or TRIML2. TRIML1 -/- and TRIML2 -/- porcine fetal fibroblasts were used for somatic cell nuclear transfer, and the resulting embryos were transferred into surrogate gilts. Early conceptus and placental development were not affected by the loss of conceptus TRIML2. Although a tissue-specific expression pattern was found, TRIML1 or TRIML2 are not required for pregnancy establishment in the pig.</p><p><strong>Lay summary: </strong>This study investigates the expression and possible roles of two specific proteins in pigs. These proteins are implicated in regulating inflammation and are thought to be important for the proper development of the placenta, which is essential for a successful pregnancy. TRIML2 was found in embryos and certain tissues, including ovary, testis and placenta, while TRIML1 appears only in the testis. We further used gene-editing techniques to generate pig embryos lacking these proteins to test whether their absence would affect early pregnancy and placental development. Lack of either TRIML1 or TRIML2 did not disrupt the early stages of pregnancy or placental formation, indicating that these proteins may not be critical for these processes in pigs.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High multiple pregnancy rates after double embryo transfers in human: a retrospective cohort study.","authors":"Jens Erik Dietrich, Ingrid Cáceres Valcárcel, Edison Capp, Thomas Strowitzki, Ariane Germeyer","doi":"10.1530/RAF-24-0078","DOIUrl":"10.1530/RAF-24-0078","url":null,"abstract":"<p><strong>Abstract: </strong>To improve clinical outcomes of human medically assisted reproduction, the transfer of multiple embryos is frequently performed. This leads to high rates of multiple pregnancies. In this study we explored if a cohort of patients can be defined, that benefits from the transfer of two embryos while mitigating the odds of multiple pregnancies by considering female patients' age, embryo quality and embryo cohort quality. In this retrospective cohort study, clinical pregnancy rate (CPR), live birth rate (LBR) and multiple pregnancy rate (MPR) after fresh single embryo transfers (SETs, n = 245) were compared to those after double embryo transfer (DET, n = 278). Female patient's age, embryo quality and embryo cohort quality were used to explore clinical outcomes in subgroups. Overall, this study found that compared to SET, DET significantly increased the CPR (33.5 vs 49.6%, adjusted odds ratio (aOR): 2.233, 95% CI: 1.529-3.261, P < 0.001), LBR (24.1 vs 39.2%, aOR: 2.416, 1.605-3.636, P < 0.001) and MPR (0.0 vs 25.4%, P < 0.001). Subgroup analysis based on female age, embryo quality and further stratification based on embryo cohort score revealed that the MPR in all subgroups was high after DET and a subgroup with significantly reduced MPR after DET could not be defined. In conclusion, DETs are associated with high MPRs that cannot be avoided by considering female patients' age, embryo quality and embryo cohort quality. SET is the most effective way to avoid a multiple pregnancy.</p><p><strong>Lay summary: </strong>This study examined whether it is possible to avoid multiple pregnancies in treatments of assisted reproduction when two embryos are transferred to certain patients. Transferring more than one embryo can increase the chances of pregnancy and live birth but also raises the risk of multiple pregnancies. Multiple pregnancies are linked to health risks for both the mother and the children. Using data from a single clinic, this study explored whether there are specific patients who could benefit from the transfer of two embryos while still having a lower risk of multiple pregnancy. However, the researchers found that DETs consistently lead to high rates of multiple pregnancies, even when factors like the mother's age, embryo quality and overall embryo cohort quality are considered. The researchers concluded that transferring a single embryo remains the safest approach to prevent multiple pregnancies.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of vaginal vs oral progesterone supplementation before embryo transfer on live birth rates and levels: a randomized trial.","authors":"Gorka Barrenetxea, Olaia Prego, Ricardo Celis, Edurne Martínez, María De Las Heras, Oihane Gómez, Olaia Aguirre, Sheila Samojluk, Julen Barrenetxea","doi":"10.1530/RAF-24-0094","DOIUrl":"10.1530/RAF-24-0094","url":null,"abstract":"<p><strong>Abstract: </strong>The increase in frozen embryo transfers (FETs) is a consequence of advances in embryo vitrification and the implementation of genetic screening of embryos. There is debate over the best progesterone administration route in substituted cycles and the relationship between progesterone levels on embryo transfer (ET) day and reproductive outcomes. This trial aimed to compare the clinical results of different progesterone supplementation schedules before ET and assess the relationship between plasmatic progesterone levels on transfer day and clinical outcomes. In a prospective, randomized, controlled study, 500 patients were randomly divided into two groups based on the progesterone administration route (oral or vaginal) before ET. Progesterone levels were measured on ET day (PP1) and B-HCG determination (PP2). The primary endpoint was the live birth rate according to different progesterone schedules and levels on transfer day. Despite higher plasmatic progesterone levels with oral administration compared to the vaginal route, there were no significant differences in clinical pregnancy (50.20 vs 47.37%), live birth (43.67 vs 40.89%) or miscarriage rates (13.01 vs 13.68%). Progesterone levels on transfer day were significantly higher among ongoing pregnancies (24.96 ± 1.00 ng/mL) compared to non-ongoing pregnancies (19.39 ± 1.47 ng/mL) and non-pregnancies (17.56 ± 0.99 ng/mL) (P = 0.0001).</p><p><strong>Lay summary: </strong>The use of FET for the treatment of infertility is increasing. There are two key ongoing debates. First, consensus still needs to be reached regarding the most effective method for preparing the endometrial lining regarding maternal and neonatal outcomes. Second, the optimal progesterone level on the day of ET remains unclear. While how progesterone is administered affects its concentration, no significant differences in clinical outcomes have been observed. However, successful pregnancies tend to have higher progesterone levels than others. Given that the way progesterone is administered does not affect pregnancy rates, patient preferences should guide protocol choices, and further research is needed to explore the association between low progesterone levels on the day of ET and poorer reproductive outcomes.</p><p><strong>Trial registration number: </strong>EUDRACT: 2022-000382-41. The clinical trial was approved by the AEMPS (Agencia Española de Productos Sanitarios y Medicamentos; Spanish Agency for Medicines and Health Products) and the local Drugs Research Ethics Committee (CEIm-E). The Institutional Review Board approved the trial.</p><p><strong>Trial registration date: </strong>24 August 2022. Date of first patient's enrolment: 10 September 2022.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum FSH levels can predict sperm identification in semen once diagnosed azoospermia.","authors":"Kei-Ichiro Uemura, Toshiyuki Iwahata, Akiyoshi Osaka, Ippei Hiramatsu, Kouhei Sugimoto, Hiroshi Okada, Kazutaka Saito","doi":"10.1530/RAF-24-0090","DOIUrl":"10.1530/RAF-24-0090","url":null,"abstract":"<p><strong>Graphical abstract: </strong></p><p><strong>Abstract: </strong>Multiple semen analyses are important for identifying patients with severe oligozoospermia (SOS) or cryptozoospermia (CZO). Moreover, clinical predictive factors for CZO and SOS are warranted. Therefore, we aimed to identify predictors of sperm retrieval in patients with a prior diagnosis of nonobstructive azoospermia (NOA) based on repeat semen analysis. We retrospectively included 209 patients diagnosed with NOA. Data regarding age at diagnosis, body mass index, testicular volume, serum luteinizing hormone, follicle-stimulating hormone (FSH) and testosterone levels, smoking history and testicular microlithiasis were analyzed. Patients were classified into the falsely reported azoospermia (FAZO) and true azoospermia (TAZO) groups. Furthermore, FAZO-related factors were evaluated using the Mann-Whitney U test and univariate and multivariate analysis logistic regression models. Regarding FAZO-related factors, the cut-off level was determined using receiver operating characteristic (ROC) curve analysis. Among 209 patients with NOA, 33 (15.8%) had spermatozoa identified in subsequent semen analyses. Multivariate analysis revealed that the FAZO group had significantly lower FSH levels than the TAZO group. ROC curve analysis showed that the cut-off value for the FSH level was 15.3 mIU/mL, with 26 (78.8%) and 29 (16.5%) patients in the FAZO and TAZO groups, respectively, having FSH levels ≤15.3 mIU/mL. In conclusion, the FSH level was a predictive factor for FAZO. In patients diagnosed with azoospermia who have relatively low FSH levels, multiple semen analyses might facilitate identification of sperm in ejaculated semen.</p><p><strong>Lay summary: </strong>We evaluated 209 patients diagnosed with spermless semen at prior medical institutions. After thorough semen analyses at our hospital, sperm were identified in the ejaculates of 33 (15.8%) patients. We performed comparisons between patients with and without identified sperm. The serum FSH level was identified as a significant predictive factor for sperm presence. FSH stimulates testicular growth and function and promotes sperm development. Patients who had relatively low and high FSH levels for patients with spermless semen had an increased and decreased chance, respectively, of having sperm identified in ejaculated semen through repeat thorough semen analyses. Sperm might be identified in ejaculates of patients diagnosed with spermless semen who have relatively low FSH levels.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do women accurately predict their odds of having a child following planned oocyte cryopreservation?","authors":"Matan Friedman, Nadine Jaffe, Daniel Tairy, Maya Torem, Arieh Raziel, Maya Finkelstein, Eran Horowitz, Ariel Weissman, Yossi Mizrachi","doi":"10.1530/RAF-24-0118","DOIUrl":"10.1530/RAF-24-0118","url":null,"abstract":"<p><strong>Graphical abstract: </strong></p><p><strong>Abstract: </strong>Planned oocyte cryopreservation (POC) has become widely available, allowing women to circumvent age-related fertility decline. The aim of our study was to examine whether women who have undergone POC were able to correctly predict the chance of having a child with their cryopreserved oocytes. We conducted a telephone survey with 260 women who underwent POC at our center between January 2017 and December 2023. Participants were asked to estimate their chance of having at least one live birth in case they would use their cryopreserved oocytes. For each participant, we also calculated the chance of achieving at least one live birth based on her age at the last oocyte retrieval and the number of cryopreserved oocytes, according to a model published by Goldman and colleagues in 2017. The median estimated probability of achieving a live birth was 50%, while the median calculated probability was 75% (P < 0.001). Only 28.1% of the participants accurately estimated their chances. In conclusion, a large percentage of women undergoing POC underestimate the probability of achieving a live birth if they use their cryopreserved oocytes. Improved counseling is essential to provide comprehensive information about the probability of live birth and prevent women from undergoing unnecessary treatments.</p><p><strong>Lay summary: </strong>More and more women choose to freeze eggs in order to circumvent age-related fertility decline. In this study, we asked women to estimate their chance of having a child if they used their frozen eggs in the future. For each patient, the chance was also calculated based on a model taking into account the number of eggs she had frozen and her age during egg freezing. Surprisingly, women estimated their chance of having a child as being lower than it actually is. Our results highlight the importance of providing patients with clear information about treatment success to prevent them from undergoing unnecessary additional treatments.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cost analysis of hCG trigger alone versus dual trigger for achieving live birth following in vitro fertilization.","authors":"Esther H Chung, Arian Khorshid, Brindha Bavan, Ruth B Lathi","doi":"10.1530/RAF-24-0095","DOIUrl":"10.1530/RAF-24-0095","url":null,"abstract":"<p><strong>Graphical abstract: </strong></p><p><strong>Lay summary: </strong>In this study, we wanted to explore if adding gonadotropin agonist (GnRHa) to the standard use of human chorionic gonadotropin (hCG) for triggering egg maturation in in vitro fertilization (IVF) could be a more cost-effective option. What that means: Using hCG alone: Traditionally, hCG is the most common hormone used to trigger eggs to mature fully so that they can be collected for fertilization. Adding GnRHa: GnRHa is another medication that mimics a natural hormone produced by the brain. Adding this as a co-trigger may do better than just using hCG alone, by leading to more mature eggs and increasing live birth rates (LBRs). However, concerns about added costs and inconvenience remain. To address this, we created a cost model comparing LBRs and costs between the two strategies. Our analysis found that using this dual trigger increased LBRs by 13%, with a small cost increase of $175. For each 1% higher LBR, the added cost of using GnRHa + hCG was $13. Considering this minimal increase in cost relative to the overall high cost of IVF, using the dual trigger appears to be a cost-effective strategy to improve success rates for patients.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}