European journal of obstetrics, gynecology, and reproductive biology最新文献

{"title":"Concurrent vNOTES risk reducing bilateral salpingo-oophorectomy at the time of mastectomy in women with breast cancer and BReast CAncer (BRCA) gene mutation","authors":"Wai Yoong ,&nbsp;Sarah Wylie ,&nbsp;Jasdeep Gahir ,&nbsp;Joachim Ho","doi":"10.1016/j.ejogrb.2025.114761","DOIUrl":"10.1016/j.ejogrb.2025.114761","url":null,"abstract":"<div><h3>Objective</h3><div>Women with breast cancer and BRCA gene mutation should be offered bilateral risk reducing salpingo-oophorectomy (RRBSO) due to lifetime ovarian cancer risk. Laparoscopic BSO, either concurrently or following index mastectomy, is benchmark but vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) gaining traction as an alternative route. We report three novel cases of simultaneous “dual site” surgery in women with breast cancer and BRCA inheritance.</div></div><div><h3>Methods</h3><div>vNOTES RRBSO is performed prior to breast surgery during the “dual site” procedure. As recommended by National Comprehensive Cancer Network, salpingectomy was completed to the level of cornu and ovarian pedicle was excised distally to include 2 cm margin. Peritoneal cytology was obtained and bowel, omentum, appendix and pelvic organs were inspected. Data collected included age, BMI, Ca-125 levels, duration of surgery, estimated blood loss, length of stay, 24 hour VAS, peri-operative complications, sexual function (FSFI-6), and recovery status (RI-10).</div></div><div><h3>Results</h3><div>Three women underwent concomitant vNOTES RRBSO and mastectomy. Median operative time and postoperative stay were 45 mins and 26 hours and there were no complications. Sexual function appeared unaffected by the vNOTES approach (FSFI-6 median score 6 <em>vs</em> 4) and normal activity resumed within 23 days. Histology of fallopian tubes and ovaries was benign.</div></div><div><h3>Conclusion</h3><div>Concomitant vNOTES RRBSO and mastectomy avoids a second surgical admission and repeat anaesthesia and does not appear to delay recovery. Findings support adoption of vNOTES as a patient-friendly alternative which can be performed concurrently with mastectomy.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114761"},"PeriodicalIF":1.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent vNOTES risk reducing bilateral salpingo-oophorectomy at the time of mastectomy in women with breast cancer and BReast CAncer (BRCA) gene mutation","authors":"Wai Yoong ,&nbsp;Sarah Wylie ,&nbsp;Jasdeep Gahir ,&nbsp;Joachim Ho","doi":"10.1016/j.ejogrb.2025.114761","DOIUrl":"10.1016/j.ejogrb.2025.114761","url":null,"abstract":"<div><h3>Objective</h3><div>Women with breast cancer and BRCA gene mutation should be offered bilateral risk reducing salpingo-oophorectomy (RRBSO) due to lifetime ovarian cancer risk. Laparoscopic BSO, either concurrently or following index mastectomy, is benchmark but vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) gaining traction as an alternative route. We report three novel cases of simultaneous “dual site” surgery in women with breast cancer and BRCA inheritance.</div></div><div><h3>Methods</h3><div>vNOTES RRBSO is performed prior to breast surgery during the “dual site” procedure. As recommended by National Comprehensive Cancer Network, salpingectomy was completed to the level of cornu and ovarian pedicle was excised distally to include 2 cm margin. Peritoneal cytology was obtained and bowel, omentum, appendix and pelvic organs were inspected. Data collected included age, BMI, Ca-125 levels, duration of surgery, estimated blood loss, length of stay, 24 hour VAS, peri-operative complications, sexual function (FSFI-6), and recovery status (RI-10).</div></div><div><h3>Results</h3><div>Three women underwent concomitant vNOTES RRBSO and mastectomy. Median operative time and postoperative stay were 45 mins and 26 hours and there were no complications. Sexual function appeared unaffected by the vNOTES approach (FSFI-6 median score 6 <em>vs</em> 4) and normal activity resumed within 23 days. Histology of fallopian tubes and ovaries was benign.</div></div><div><h3>Conclusion</h3><div>Concomitant vNOTES RRBSO and mastectomy avoids a second surgical admission and repeat anaesthesia and does not appear to delay recovery. Findings support adoption of vNOTES as a patient-friendly alternative which can be performed concurrently with mastectomy.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114761"},"PeriodicalIF":1.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel genetic variants of sperm chromatin compaction regulators are associated with non-obstructive azoospermia in Indian men","authors":"Saurav Dutta ,&nbsp;Pranab Paladhi ,&nbsp;Samudra Pal ,&nbsp;Papiya Ghosh ,&nbsp;Ratna Chattopadhyay ,&nbsp;Sujay Ghosh","doi":"10.1016/j.ejogrb.2025.114762","DOIUrl":"10.1016/j.ejogrb.2025.114762","url":null,"abstract":"<div><h3>Background</h3><div>The genetic basis of idiopathic male infertility remains largely elusive and multifactorial. Sperm cells undergo distinct chromatin compaction during spermiogenesis, primarily driven by sperm-specific nuclear proteins—protamines (PRMs) and transition proteins (TNPs). Genetic variations in protamine clusters due to polymorphisms may contribute to male infertility. However, their impact on sperm DNA integrity and fertility outcomes across ethnic groups remains inconsistent and unclear. However, these gene variants have not been studied among the Indian men in the context of male infertility.</div></div><div><h3>Methods</h3><div>This case-control study include collection of blood samples from non-obstructive azoospermic men from Bengali speaking population of West Bengal, India followed by genotyping with Sanger’s sequencing of <em>PRM1</em>, <em>PRM2</em>, <em>TNP1</em> and <em>TNP2</em> genes among 445 non-obstructive azoospermic individuals (negative for Y-chromosome microdeletions) and 375 fertile controls. Suitable statistical methods were used to examine variant association. Additionally, in silico analyses were employed to predict the potential deleterious effects of the identified variants.</div></div><div><h3>Results</h3><div>A total of 15 variants were identified, of which 10 showed significant association with azoospermia among the cases. In silico analyses predicted five variants to be potentially deleterious to the gene’s function or disease-causing: rs75245770C&gt;A and the novel variant OQ266297C&gt;A in <em>PRM1</em>; the novel variants OQ507618A&gt;T and OQ557494G&gt;T in <em>PRM2</em>; and rs11640138C&gt;T in <em>TNP2</em>.</div></div><div><h3>Conclusion</h3><div>Variants in protamine gene cluster may contribute to an increased risk of azoospermia among men in Bengali population. The novel variants identified in this study hold potential as genetic markers for male infertility screening in routine assisted reproductive techniques (ART) practice.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114762"},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel genetic variants of sperm chromatin compaction regulators are associated with non-obstructive azoospermia in Indian men","authors":"Saurav Dutta ,&nbsp;Pranab Paladhi ,&nbsp;Samudra Pal ,&nbsp;Papiya Ghosh ,&nbsp;Ratna Chattopadhyay ,&nbsp;Sujay Ghosh","doi":"10.1016/j.ejogrb.2025.114762","DOIUrl":"10.1016/j.ejogrb.2025.114762","url":null,"abstract":"<div><h3>Background</h3><div>The genetic basis of idiopathic male infertility remains largely elusive and multifactorial. Sperm cells undergo distinct chromatin compaction during spermiogenesis, primarily driven by sperm-specific nuclear proteins—protamines (PRMs) and transition proteins (TNPs). Genetic variations in protamine clusters due to polymorphisms may contribute to male infertility. However, their impact on sperm DNA integrity and fertility outcomes across ethnic groups remains inconsistent and unclear. However, these gene variants have not been studied among the Indian men in the context of male infertility.</div></div><div><h3>Methods</h3><div>This case-control study include collection of blood samples from non-obstructive azoospermic men from Bengali speaking population of West Bengal, India followed by genotyping with Sanger’s sequencing of <em>PRM1</em>, <em>PRM2</em>, <em>TNP1</em> and <em>TNP2</em> genes among 445 non-obstructive azoospermic individuals (negative for Y-chromosome microdeletions) and 375 fertile controls. Suitable statistical methods were used to examine variant association. Additionally, in silico analyses were employed to predict the potential deleterious effects of the identified variants.</div></div><div><h3>Results</h3><div>A total of 15 variants were identified, of which 10 showed significant association with azoospermia among the cases. In silico analyses predicted five variants to be potentially deleterious to the gene’s function or disease-causing: rs75245770C&gt;A and the novel variant OQ266297C&gt;A in <em>PRM1</em>; the novel variants OQ507618A&gt;T and OQ557494G&gt;T in <em>PRM2</em>; and rs11640138C&gt;T in <em>TNP2</em>.</div></div><div><h3>Conclusion</h3><div>Variants in protamine gene cluster may contribute to an increased risk of azoospermia among men in Bengali population. The novel variants identified in this study hold potential as genetic markers for male infertility screening in routine assisted reproductive techniques (ART) practice.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114762"},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-rich plasma therapy enhances endometrial receptivity in thin endometrium patients undergoing frozen embryo transfer cycles: results from a prospective cohort observational study","authors":"Kanad Dev Nayar,&nbsp;Shweta Arora,&nbsp;Sabina Sanan,&nbsp;Manika Sachdeva,&nbsp;Ankita Sethi,&nbsp;Gaurav Kant,&nbsp;Kapil Nayar","doi":"10.1016/j.ejogrb.2025.114758","DOIUrl":"10.1016/j.ejogrb.2025.114758","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of intrauterine instillation of autologous platelet-rich plasma (PRP) on women with thin endometrium undergoing frozen embryo transfer.</div></div><div><h3>Methods</h3><div>A prospective cohort observational study was carried out at Akanksha IVF Centre, New Delhi, from 1st August 2023 to 31st July 2024. The study included 100 patients under 40 years with thin endometrium (&lt;7 mm on transvaginal sonography). Participants received hormone replacement therapy (sequential incremental dosage of estradiol valerate) from day 2 of the menstrual cycle. Among them, 70 patients received intrauterine PRP instillation on days 7, 9, and 11 of the cycle, while the remaining 30 patients did not undergo this treatment. Endometrial thickness was monitored, and progesterone was initiated on day 14 or once endometrial thickness surpassed 7 mm, followed by blastocyst transfer on day 6 of progesterone. Pregnancy outcomes were assessed using urine pregnancy tests or serum beta human chorionic gonadotropin levels followed by ultrasound to confirm fetal viability. The main outcomes assessed were improvement in endometrial thickness and clinical pregnancy rate.</div></div><div><h3>Results</h3><div>The administration of PRP through intrauterine instillation significantly increased mean endometrial thickness in the PRP group compared to the non-PRP group (p = 0.032). The clinical pregnancy rate was 35.71 % in the PRP group versus 10 % in the non-PRP group (p = 0.0251). No adverse reactions were observed.</div></div><div><h3>Conclusions</h3><div>PRP therapy significantly enhances endometrial receptivity and improves pregnancy outcomes in patients with refractory thin endometrium. It offers a promising adjunctive treatment for patients facing repeated cycle cancellations in frozen embryo transfer.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114758"},"PeriodicalIF":1.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-rich plasma therapy enhances endometrial receptivity in thin endometrium patients undergoing frozen embryo transfer cycles: results from a prospective cohort observational study","authors":"Kanad Dev Nayar,&nbsp;Shweta Arora,&nbsp;Sabina Sanan,&nbsp;Manika Sachdeva,&nbsp;Ankita Sethi,&nbsp;Gaurav Kant,&nbsp;Kapil Nayar","doi":"10.1016/j.ejogrb.2025.114758","DOIUrl":"10.1016/j.ejogrb.2025.114758","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of intrauterine instillation of autologous platelet-rich plasma (PRP) on women with thin endometrium undergoing frozen embryo transfer.</div></div><div><h3>Methods</h3><div>A prospective cohort observational study was carried out at Akanksha IVF Centre, New Delhi, from 1st August 2023 to 31st July 2024. The study included 100 patients under 40 years with thin endometrium (&lt;7 mm on transvaginal sonography). Participants received hormone replacement therapy (sequential incremental dosage of estradiol valerate) from day 2 of the menstrual cycle. Among them, 70 patients received intrauterine PRP instillation on days 7, 9, and 11 of the cycle, while the remaining 30 patients did not undergo this treatment. Endometrial thickness was monitored, and progesterone was initiated on day 14 or once endometrial thickness surpassed 7 mm, followed by blastocyst transfer on day 6 of progesterone. Pregnancy outcomes were assessed using urine pregnancy tests or serum beta human chorionic gonadotropin levels followed by ultrasound to confirm fetal viability. The main outcomes assessed were improvement in endometrial thickness and clinical pregnancy rate.</div></div><div><h3>Results</h3><div>The administration of PRP through intrauterine instillation significantly increased mean endometrial thickness in the PRP group compared to the non-PRP group (p = 0.032). The clinical pregnancy rate was 35.71 % in the PRP group versus 10 % in the non-PRP group (p = 0.0251). No adverse reactions were observed.</div></div><div><h3>Conclusions</h3><div>PRP therapy significantly enhances endometrial receptivity and improves pregnancy outcomes in patients with refractory thin endometrium. It offers a promising adjunctive treatment for patients facing repeated cycle cancellations in frozen embryo transfer.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114758"},"PeriodicalIF":1.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonographic characteristics associated with early pregnancy loss in pregnancies conceived via in vitro fertilization","authors":"Nguyen Thao Thi Nguyen ,&nbsp;Lester Watch ,&nbsp;Carmen Rauh Garrido ,&nbsp;Alexandra Bickett ,&nbsp;Shakthi Unnithan ,&nbsp;Tracy Truong ,&nbsp;Alaattin Erkanli ,&nbsp;Shelby Neal","doi":"10.1016/j.ejogrb.2025.114759","DOIUrl":"10.1016/j.ejogrb.2025.114759","url":null,"abstract":"<div><h3>Research Question</h3><div>Can gestational age–based sonographic criteria with near 100% positive predictive value (PPV) for early pregnancy loss (EPL) be established in pregnancies conceived via in vitro fertilization (IVF)?</div></div><div><h3>Design</h3><div>A retrospective cohort study was conducted at a single academic IVF clinic, including all patients with a positive pregnancy test following embryo transfer between 2014 and 2021. Logistic regression assessed associations between gestational age and presence of sonographic markers (gestational sac, embryo, cardiac activity) with EPL. Youden’s Index identified optimal gestational age cut-points for each marker.</div></div><div><h3>Results</h3><div>The study included 913 patients (mean age 35.5 ± 4.8 years; mean BMI 27.6 ± 6.5 kg/m²). Most underwent frozen single embryo transfer at the blastocyst stage; 15.1 % had preimplantation genetic testing for aneuploidy (PGT-A). Outcomes included 727 live births (79.6 %), 176 EPLs (19.3 %), 3 stillbirths, and 7 terminations. Absence of a gestational sac or embryo by 44 days, or cardiac activity by 46 days, yielded PPVs for EPL of 100 %, 100 %, and 97 %, respectively. Logistic regression confirmed increased odds of EPL with absent markers at the specified gestational age cut-points: absence of a gestational sac at 44 days (OR 5.52, 95 % CI [3.40–8.94]), absence of an embryo at 44 days (OR 5.88, CI [3.64–9.49]), and absence of cardiac activity at 46 days (OR 2.86, CI [1.99–4.12]).</div></div><div><h3>Conclusions</h3><div>In IVF pregnancies, known gestational age may allow for earlier diagnosis of EPL, as compared to traditional criteria, which are based upon sonographic markers alone. Larger studies are needed to validate these proposed criteria and compare them to traditional criteria for diagnosis of EPL.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114759"},"PeriodicalIF":1.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-port robotic versus conventional laparoscopic vNOTES hysterectomy: a propensity score-matched comparison of surgical outcomes and literature review","authors":"Kiyoshi Kanno,&nbsp;Ryo Taniguchi,&nbsp;Naofumi Higuchi,&nbsp;Tomoka Kashiwabara,&nbsp;Yuto Onishi,&nbsp;Taisuke Iwata,&nbsp;Yudai Sawai,&nbsp;Sayaka Masuda,&nbsp;Hiroshi Onji,&nbsp;Yoshifumi Ochi,&nbsp;Yoshiko Kurose,&nbsp;Mari Sawada,&nbsp;Shiori Yanai,&nbsp;Tsutomu Hoshiba,&nbsp;Masaaki Andou","doi":"10.1016/j.ejogrb.2025.114757","DOIUrl":"10.1016/j.ejogrb.2025.114757","url":null,"abstract":"<div><h3>Purpose</h3><div>Robotic-assisted (RA) surgery has gained traction for transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and has been applied across a range of gynecologic procedures. The da Vinci SP (SP) system, a recently developed single-port robotic platform, was designed to advance minimally invasive surgery, enabling precise surgery in deep, narrow spaces, such as the vagina. However, perioperative outcomes of RA-vNOTES hysterectomy using SP vaginal-assisted NOTES hysterectomy (SP-VANH) have not been compared with those of conventional laparoscopic (CL)-VANH.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted involving 184 patients who underwent VANH between January 2023 and December 2024. After propensity score matching (PSM), 130 patients (1:1 ratio) were included in the analysis. Perioperative outcomes were compared between the SP-VANH and CL-VANH. Potential confounding bias related to patient characteristics was minimized through the PSM analysis.</div></div><div><h3>Results</h3><div>The mean operative time, estimated blood loss, hemoglobin drop, length of postoperative hospital stay, perioperative complications, and visual analog score (VAS) for postoperative pain at 24 h were 75.4 vs. 83.8 min (p = 0.05), 94.5 vs. 82.2 mL (p = 0.60), −1.2 vs. −1.3 g/dL (p = 0.60), 4.0 vs. 4.0 days (p = 0.72), 4.6 vs. 0 % (p = 0.24), and 16.1 vs. 17.5 mm (p = 0.68) for the SP-VANH and CL-VANH groups, respectively, with no significant differences. All cases in both groups were completed without requiring blood transfusions or conversion to laparotomy or transabdominal laparoscopy.</div></div><div><h3>Conclusion</h3><div>SP-VANH offers a safe and feasible alternative to CL-VANH for the surgical management of benign gynecologic conditions.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114757"},"PeriodicalIF":1.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonographic characteristics associated with early pregnancy loss in pregnancies conceived via in vitro fertilization","authors":"Nguyen Thao Thi Nguyen ,&nbsp;Lester Watch ,&nbsp;Carmen Rauh Garrido ,&nbsp;Alexandra Bickett ,&nbsp;Shakthi Unnithan ,&nbsp;Tracy Truong ,&nbsp;Alaattin Erkanli ,&nbsp;Shelby Neal","doi":"10.1016/j.ejogrb.2025.114759","DOIUrl":"10.1016/j.ejogrb.2025.114759","url":null,"abstract":"<div><h3>Research Question</h3><div>Can gestational age–based sonographic criteria with near 100% positive predictive value (PPV) for early pregnancy loss (EPL) be established in pregnancies conceived via in vitro fertilization (IVF)?</div></div><div><h3>Design</h3><div>A retrospective cohort study was conducted at a single academic IVF clinic, including all patients with a positive pregnancy test following embryo transfer between 2014 and 2021. Logistic regression assessed associations between gestational age and presence of sonographic markers (gestational sac, embryo, cardiac activity) with EPL. Youden’s Index identified optimal gestational age cut-points for each marker.</div></div><div><h3>Results</h3><div>The study included 913 patients (mean age 35.5 ± 4.8 years; mean BMI 27.6 ± 6.5 kg/m²). Most underwent frozen single embryo transfer at the blastocyst stage; 15.1 % had preimplantation genetic testing for aneuploidy (PGT-A). Outcomes included 727 live births (79.6 %), 176 EPLs (19.3 %), 3 stillbirths, and 7 terminations. Absence of a gestational sac or embryo by 44 days, or cardiac activity by 46 days, yielded PPVs for EPL of 100 %, 100 %, and 97 %, respectively. Logistic regression confirmed increased odds of EPL with absent markers at the specified gestational age cut-points: absence of a gestational sac at 44 days (OR 5.52, 95 % CI [3.40–8.94]), absence of an embryo at 44 days (OR 5.88, CI [3.64–9.49]), and absence of cardiac activity at 46 days (OR 2.86, CI [1.99–4.12]).</div></div><div><h3>Conclusions</h3><div>In IVF pregnancies, known gestational age may allow for earlier diagnosis of EPL, as compared to traditional criteria, which are based upon sonographic markers alone. Larger studies are needed to validate these proposed criteria and compare them to traditional criteria for diagnosis of EPL.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114759"},"PeriodicalIF":1.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ending preventable maternal deaths in Europe – Position statement of the European Board and College of Obstetrics and Gynaecology (EBCOG)","authors":"Mehreen Zaigham ,&nbsp;Frank Louwen ,&nbsp;Sambit Mukhopadhyay ,&nbsp;Tahir Mahmood","doi":"10.1016/j.ejogrb.2025.114750","DOIUrl":"10.1016/j.ejogrb.2025.114750","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114750"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}