Reproduction & fertility最新文献

{"title":"Oxidative Stress in Female Reproductive Health and Infertility: Mechanisms, Biomarkers, Therapeutic Interventions.","authors":"Ndivhuho Beauty Takalani, Sogolo Lucky Lebelo","doi":"10.1530/RAF-26-0067","DOIUrl":"https://doi.org/10.1530/RAF-26-0067","url":null,"abstract":"<p><strong>Lay summary: </strong>Infertility is defined by the World Health Organization as the inability to achieve pregnancy after one year of regular, unprotected sexual intercourse. Female infertility can result from problems with ovulation, hormone imbalances, endometriosis, blocked fallopian tubes, and poor egg quality. One factor linked to these conditions is oxidative stress, which occurs when harmful molecules in the body exceed its natural antioxidant defences. This imbalance may damage reproductive cells and tissues, affecting hormone function, embryo quality, implantation, and pregnancy outcomes. Oxidative stress has been associated with several reproductive disorders, including polyendocrine metabolic ovarian syndrome (PMOS), previously called polycystic ovary syndrome, and endometriosis. As a result, there is growing interest in natural approaches that may help protect reproductive health. Some medicinal plants contain natural antioxidants that may reduce oxidative stress and protect reproductive cells from damage. This review examines the impact of oxidative stress on female reproductive health and explores the potential role of medicinal plants in supporting fertility and reproductive well-being.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229754","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":"Testosterone as part of hormone replacement therapy in menopausal women - what do we know so far? A Narrative Review.","authors":"Ishita Mishra, Lynne Robinson","doi":"10.1530/RAF-26-0146","DOIUrl":"https://doi.org/10.1530/RAF-26-0146","url":null,"abstract":"<p><strong>Lay summary: </strong>Testosterone, widely known as the male hormone, is also produced naturally in women and plays an important role throughout their lifespan. There has been a growing use of testosterone for a range of symptoms in menopausal women, including low sexual desire, low mood, fatigue, poor memory, and heart and bone health. This review brings together the current evidence and guidelines on testosterone as part of hormone replacement therapy (HRT) in menopausal women, including its impact on reproductive and non-reproductive tissues; when it is indicated to be prescribed and in what forms; safety and gaps in existing evidence. We found that there is high-quality evidence to support the use of testosterone for low sexual desire where conventional HRT has not helped. Transdermal preparations are recommended with no serious side effects at testosterone levels normally found in women. There is insufficient evidence to support its use for brain, heart and bone health. This represents an area of focus for future research.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229695","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":"Nutritional Supplements in the Treatment of Endometriosis-Associated Symptoms: A Systematic Review.","authors":"Melissa Seven, Laura Galla, Manuela Gstoettner, René Wenzl","doi":"10.1530/RAF-26-0079","DOIUrl":"https://doi.org/10.1530/RAF-26-0079","url":null,"abstract":"<p><strong>Lay summary: </strong>Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus, which can cause severe chronic pelvic pain, limit quality of life, and lead to infertility. In addition to standard medical treatment (painkillers or hormones), many patients with endometriosis use additional supplements, such as vitamins or antioxidants, to alleviate symptoms, but it is unclear how well these approaches work. In this study, we reviewed 24 clinical trials involving 2,019 women with endometriosis to evaluate the effects of dietary supplements. Some trials reported improvements in pain and quality of life, particularly with specially formulated curcumin or selenium, alone or alongside dienogest. Studies on fertility found improvements in some fertility-related measures, but these did not lead to higher pregnancy rates. Evidence on progression was limited: some combination treatments reduced ovarian endometriosis, but supplements did not reduce recurrence after surgery. Supplements may therefore support standard treatment but should not replace it.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229714","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":"The Mitochondrial-Derived Peptide MOTS-c Improves Bioenergetics in Aging-Associated Granulosa Cells and Oocytes.","authors":"Kuan-Hao Tsui, Shih-Hsuan Cheng, Li-Te Lin, Pei-Hsuan Lin, Boyang Wang, Zhi-Hong Wen, Chia-Jung Li","doi":"10.1530/RAF-26-0161","DOIUrl":"https://doi.org/10.1530/RAF-26-0161","url":null,"abstract":"<p><strong>Lay summary: </strong>As women age, the quality of their eggs declines, which is a major contributor to age-related infertility. Eggs are supported by neighboring \"helper\" cells called granulosa cells, which act like a support crew that supplies the egg with the energy it needs to mature. These helper cells contain mitochondria, tiny energy-generating structures often called the cell's \"powerhouses,\" and with age these powerhouses become less efficient, leaving eggs with less support than they need. This study tested whether MOTS-c, a small molecule naturally produced by mitochondria, could restore the function of these aging helper cells. In laboratory experiments using aged human granulosa cells and eggs from aged mice, MOTS-c boosted energy production and helped maintain cell structure, and was associated with improved egg maturation compared with untreated aged eggs, although treated eggs did not fully reach the maturation levels seen in young mice. These findings are from laboratory and animal experiments, not from women, and this study did not test whether MOTS-c affects fertilization, embryo development, or live birth. Further research is needed before any conclusions can be drawn about its relevance to human fertility.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221294","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":"Association between the total dosage of gonadotropin-releasing hormone antagonist during controlled ovarian stimulation and pregnancy outcomes.","authors":"Fen Tian, Bin Xu, Yanping Li, Jing Zhao","doi":"10.1530/RAF-26-0049","DOIUrl":"https://doi.org/10.1530/RAF-26-0049","url":null,"abstract":"<p><strong>Lay summary: </strong>Gonadotropin-releasing hormone antagonist (GnRH-ant) protocols are widely used for ovarian stimulation in fertility treatments, such as in vitro fertilization. Some research suggested GnRH-ant might affect endometrial receptivity. This could reduce the chances of embryo implantation and pregnancy. Our study included 3,764 women undergoing embryo transfer using the GnRH-ant protocol. Women were grouped by the total GnRH-ant dose they received. We compared implantation, pregnancy, and miscarriage rates across the groups. We found that pregnancy outcomes were similar regardless of the total dose used. Also, higher doses did not reduce the chances of pregnancy after embryo transfer. This suggests doctors can adjust the dose based on each patient's needs without lowering the chance of success.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208455","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":"Multi-site characterization of reproductive tract and gut microbiota in unexplained recurrent pregnancy loss: a case control study.","authors":"Oshri Barel, Becky Arbiv, Maria Maslenko, Moran Bitton, Yair Motro, Jacob Moran-Gilad","doi":"10.1530/RAF-26-0095","DOIUrl":"https://doi.org/10.1530/RAF-26-0095","url":null,"abstract":"<p><p>This cross-sectional case-control study aimed to characterize microbial communities across multiple anatomical sites in women with unexplained recurrent pregnancy loss compared with healthy controls. Forty women aged 18-40 years, including 20 with unexplained recurrent pregnancy loss and 20 healthy controls, were enrolled at Samson Assuta University Hospital in Ashdod, Israel. Swab samples from the cervix, posterior fornix, lower vagina, and feces were analyzed using 16S ribosomal ribonucleic acid amplicon sequencing. Microbial community composition, diversity, differences in taxon abundance, and concordance between anatomical sites were assessed. Microbial communities were dominated by Lactobacillus across all reproductive-tract sites in both groups. Faith's phylogenetic diversity was significantly higher in women with recurrent pregnancy loss in the cervix (P=0.0139) and posterior fornix (P=0.0492), whereas Shannon diversity did not differ between groups. Beta-diversity analysis revealed significant compositional separation at the posterior fornix (R2=0.104, P=0.029). The Lactobacillus to Bifidobacterium log-ratio was significantly lower in women with recurrent pregnancy loss in the posterior fornix (P=0.037), with similar trends at other reproductive-tract sites. No individual taxa reached significance after multiple-testing correction. Microbial communities showed strong concordance among reproductive-tract sites and modestly greater gut-genital concordance in women with recurrent pregnancy loss. These findings suggest that unexplained recurrent pregnancy loss is associated with subtle, site-specific microbial differences, with the posterior fornix showing the clearest differences between groups.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208441","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":"Paternal metabolic dysfunction and pregnancy loss following assisted reproduction: A cross-sectional study.","authors":"Andrew Peel, Rashmi Baid, Andrew D Vincent, David Jesudason, Lachlan M Moldenhauer, Leanne Pacella-Ince, Nicole O McPherson, Gary Wittert, M Louise Hull","doi":"10.1530/RAF-26-0089","DOIUrl":"https://doi.org/10.1530/RAF-26-0089","url":null,"abstract":"<p><strong>Lay summary: </strong>We studied whether a man's metabolic health around the time of undergoing assisted reproduction was linked to pregnancy outcomes (conception and pregnancy loss). Men's weight and metabolic blood tests including cholesterol, triglyceride, insulin and glucose were assessed in 363 couples, of which 41% became pregnant. More than half of all men had at least one abnormal metabolic result. We found that male body mass index and overall metabolic problems were not associated with the likelihood of conceiving, however among couples who conceived, abnormalities in male metabolic blood tests were linked to more than twice the risk of pregnancy loss. High triglyceride levels and insulin resistance were most closely associated with pregnancy loss. Overall, the study suggests that father's metabolic health may affect the risk of losing a pregnancy, however further research is needed to confirm this.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207427","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":"Giving a diagnosis of premature ovarian insufficiency: the importance of good communication: insights from a qualitative study.","authors":"Kate Pleace, Caroline Law, Cathy Herbrand, Nicky Hudson","doi":"10.1530/RAF-26-0076","DOIUrl":"10.1530/RAF-26-0076","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objectives of this paper are to explore the communication of a diagnosis of premature ovarian insufficiency (POI) and to examine how the way this diagnosis is communicated affects women with the condition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a qualitative study using semi-structured interviews and thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Participants were recruited from across the UK and interviewed remotely using Microsoft Teams.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Sixteen women aged 18 and above with a diagnosis of POI were included in this study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants took part in in-depth interviews exploring their experiences of living with POI, including receiving a POI diagnosis. Interviews were recorded, transcribed, and analysed thematically. This paper reports on data concerning the experience of receiving a diagnosis specifically.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Three key themes were identified: i) lack of information and support during the diagnosis communication, ii) emotional impact of diagnosis, and iii) framing POI as just a fertility issue. Participants reported considerable distress when diagnoses were delivered abruptly, digitally, or without appropriate support. Conversely, face-to-face, empathetic communication was described as validating and empowering. A consistent concern was the narrow clinical framing of POI as a fertility issue, with insufficient attention paid to long-term health risks, HRT, and emotional wellbeing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Communicating a diagnosis of POI requires a compassionate, holistic, and person-centred approach. There is an urgent need for healthcare professionals to embrace updated international guidelines, prioritise multidisciplinary care, and address existing disparities in access and support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;Premature ovarian insufficiency (POI) occurs when the ovaries stop working normally before the age of 40. Although it is often associated with infertility, POI is also a long-term health condition that can affect bone health, heart health, menopause symptoms, emotional wellbeing, and quality of life. Receiving this diagnosis can, therefore, have a profound impact on a woman's life. This study explored how women experienced being told they had POI. Sixteen women from across the UK took part in in-depth interviews about their experiences. Many described receiving their diagnosis in ways that felt rushed, impersonal, or lacking in compassion. Some were informed by telephone, through an online patient portal, or via printed test results without the opportunity to ask questions or receive immediate support. Women consistently reported that face-to-face consultations with clear explanations and empathy were more helpful and supportive. Participants also felt that healthcare professionals often focused mainly on fertility, with insufficient discussion about hormone replacement therapy (HRT), ","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066629","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":"A decade of semen quality trends in Libya: nonlinear temporal patterns, age effects, and WHO 2010-2021 reclassification.","authors":"Mohammed Abugilah, Majduldeen Alhlafi, Ahmed Milad, Alsadeq Amhareb, Hamza Shuaib","doi":"10.1530/RAF-26-0113","DOIUrl":"10.1530/RAF-26-0113","url":null,"abstract":"<p><strong>Abstract: </strong>Reports of declining sperm concentration, count, and motility remain contested amid methodological heterogeneity, geographic bias, and reference-limit changes, and data from the Middle East and North Africa are scarce. We conducted a retrospective single-center cohort study of 3,078 men undergoing first diagnostic semen analysis at the National Fertility Teaching Center, Eastern Libya, between 2016 and 2025/26, with stable personnel, equipment, and protocols. Multivariable regression adjusted for age and semen volume assessed temporal trends, using restricted cubic splines for nonlinearity, robust sensitivity analyses, and Benjamini-Hochberg correction; samples were classified under both WHO 2010 and WHO 2021 reference limits. Calendar year showed small but statistically significant associations with semen volume (-0.028 mL/year, P = 0.005), normal morphology (-1.7%/year, P = 0.012), and total motility (+0.43 percentage points/year, P = 0.014); declines in sperm concentration and total sperm count were directionally similar but nonsignificant after correction, and effect sizes were modest throughout (adjusted R2 ≤ 0.033). All five non-volume parameters followed a nonlinear trajectory, peaking around 2019-2020, declining through 2022-2023, and partially recovering; the decline appeared more pronounced in men under 45 years, with older men comparatively stable - an exploratory finding discussed further below. Applying WHO 2021 criteria reduced asthenozoospermia prevalence from 53.8 to 48.6% and increased oligozoospermia prevalence from 35.7 to 37.0%. In this Eastern Libyan clinical population, semen parameters changed modestly and nonlinearly rather than declining uniformly, with age-specific divergence and measurable WHO reclassification; findings should not be generalized to Libyan men overall but offer novel data from an underrepresented population and support continued surveillance and multicenter collaboration.</p><p><strong>Lay summary: </strong>This study investigated trends in male fertility by analyzing semen data from 3,078 men in Libya over a 10-year period (2016-2026). The researchers evaluated essential factors, including sperm count, movement, and shape. The findings revealed that sperm quality did not experience a straightforward decline but rather fluctuated unevenly over the decade. Furthermore, the data confirmed that older age is steadily linked to lower sperm quality. Finally, the study demonstrated that switching from older medical criteria to the updated 2021 World Health Organization guidelines changes how many men are classified as having fertility issues. These results highlight the critical need for clinics to adopt the latest global diagnostic standards, ensuring more accurate fertility assessments and better-tailored patient care.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979038","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":"Self-reported fertility problems and their socio-demographic and health correlates: a cross-sectional online survey of 8,000 Polish adults.","authors":"Renata Pilarczyk, Anna Zimny-Zając, Mateusz Dróżdż, Beata Jankowska-Polańska, Grzegorz Mazur, Siddarth Agrawal","doi":"10.1530/RAF-26-0056","DOIUrl":"10.1530/RAF-26-0056","url":null,"abstract":"<p><strong>Abstract: </strong>While biological and lifestyle determinants of reproductive health are well documented globally, comprehensive data integrating socio-demographic, lifestyle, and health correlates within a contemporary Polish context remain limited. This study aimed to estimate the prevalence and identify correlates of self-reported fertility problems among adults completing a 2024 online survey in Poland (the National Fertility Test). Of the 8,000 respondents surveyed, the analytical sample comprised 5,532 (3,316 women and 2,216 men) who had attempted to conceive. Sex-specific, age-adjusted, Holm-Bonferroni-corrected logistic regression assessed associations between socio-demographic, lifestyle, and health variables and fertility problems. Within the analytical sample, 28.9% of respondents reported fertility problems (36.6% of women and 17.4% of men). In women, the strongest associations were observed for fallopian tube obstruction (OR = 23.0), polycystic ovary syndrome (OR = 5.35), and endometriosis (OR = 2.82), whereas a history of prior pregnancy (OR = 0.26) and better self-rated mental health (OR = 0.76) were associated with lower odds. In men, associations were limited to the use of reproductive supplements (OR = 4.06), varicocele or epididymal cysts (OR = 3.08), and a history of sexually transmitted infection (OR = 4.60). In both sexes, associations with behaviours such as supplement use and specific conception strategies likely reflect reverse causation, marking active help-seeking rather than causal risk factors. Given the self-selected sampling method, these findings should not be interpreted as population-level prevalence estimates for Poland, but confirm established clinical correlates alongside distinct socio-demographic and lifestyle patterns, underscoring the need for targeted reproductive health education.</p><p><strong>Lay summary: </strong>This study examined the frequency of fertility struggles among 8,000 Polish adults through the 2024 National Fertility Test, a nationwide online survey. Of the 5,532 participants who had attempted to conceive, 28.9% reported such difficulties.Factors linked to these struggles differed by sex.Due to the self-selected online nature of this cohort, results likely reflect participation bias from people currently attempting to conceive. Overall, the study underscores significant reproductive challenges in Poland, highlighting a strong, critical need for better health education and support tailored specifically to the Polish public.</p>","PeriodicalId":101312,"journal":{"name":"Reproduction & fertility","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922389","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}