Fertility and sterility最新文献

{"title":"Serum total testosterone and testicular histology help predicting positive sperm retrieval in non-mosaic Klinefelter patients undergoing testicular sperm extraction: real-life data from a large multicenter cohort.","authors":"Massimiliano Raffo,Luca Boeri,Massimo Iafrate,Fausto Negri,Gabriele Birolini,Riccardo Ramadani,Marco Falcone,Edoardo Pozzi,Mirko Preto,Valentina Parolin,Federica Passarelli,Giorgio Ivan Russo,Giordana Ferraioli,Alessandro Pizzato,Claudio Marino,Andrea Cocci,Nicola Arrighi,Donato Dente,Giorgio Gentile,Alessandro Franceschelli,Alessandro Palmieri,Marco Magliocchetti,Emanuele Montanari,Paolo Gontero,Andrea Salonia","doi":"10.1016/j.fertnstert.2025.07.040","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.040","url":null,"abstract":"OBJECTIVETo study real-life rates and predictors of sperm retrieval (SR) in men with non-mosaic Klinefelter syndrome (KS) seeking medical help for primary male factor couple's infertility.DESIGNMulticenter, retrospective, cohort study.SUBJECTSData analysis from 383 non-Finnish, white-European, non-mosaic KS men with non-obstructive azoospermia (NOA) undergoing TESE between 2008 and 2024 at 12 tertiary referral centers in Italy.EXPOSUREAll patients received a comprehensive diagnostic work-up, including hormonal/genetic tests and testicular ultrasound. Semen analysis followed 2021 World Health Organization criteria. Testicular histology was recorded. Either conventional testicular sperm extraction (cTESE) or microsurgical TESE (mTESE) was used, depending on surgeon preference. Descriptive statistics and logistic regression assessed predictors of positive SR (+SR).MAIN OUTCOME MEASURESPositive sperm retrieval rate (+SRR) in non-mosaic KS men undergoing cTESE or mTESE for NOA, and the identification of clinical and histological predictors associated with +SR.RESULTSMedian (IQR) age was 31 years (25-36) and testicular volume was 3.8 ml (3-5) ml. Baseline follicle-stimulating hormone and total testosterone (tT) levels were 31.2 mUI/mL (21.5-41.8) and 3.6 ng/mL (2.7-5.1), respectively. Of 383, 50 (13.1%) patients have been on continuous testosterone therapy (TTh) prior to surgery, which has been interrupted at least 6 months before c/mTESE. Of all, 246 (64.2%) men underwent cTESE and a bilateral c/mTESE procedure was carried out in 345 (90.1%) men. Histologic reports showed Sertoli cell-only syndrome (SCOS), maturation arrest (MA) and hypospermatogenesis (HS) in 350 (91.4%), 20 (5.2%) and 13 (3.4%) patients, respectively. Overall, +SR was found in 114 (29.8%) men. Patients with +SR had higher tT values (3.8 vs. 3.6 ng/ml, p=0.03) than those with -SR. SCOS histology was more frequently associated with -SR compared to both MA and HS (p<0.001). Multivariable logistic regression analysis confirmed that higher baseline tT values (OR 1.1, 95% CI 1.02-3.45, p=0.03) and HS histology (8.8, 95% CI 2.96-15.76, p<0.001) were independently associated with +SR.CONCLUSIONSOne third of non-mosaic KS men had +SR at c/mTESE. Higher preoperative tT and testicular histology emerged to be independently associated with SR outcomes. These findings can be clinically useful for a tailored counselling before c/mTESE in non-mosaic KS men with NOA.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"10 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Mesentery-sparing NOSE Bowel Resection for Endometriosis: When and How?","authors":"Dong Bach Nguyen,Debbie Woo,Sohayb Faleh,Jessica Papillon Smith,Fady Mansour,Srinivasan Krishnamurthy,Andrew Zakhari","doi":"10.1016/j.fertnstert.2025.07.038","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.038","url":null,"abstract":"OBJECTIVETo describe the peri-operative considerations and surgical steps for a laparoscopic segmental resection for colorectal endometriosis, using a nerve-sparing, mesentery-sparing and natural orifice specimen extraction technique1-3.DESIGNNarrated surgical video within a tertiary care hospital. IRB approval was not necessary for this article in accordance with the Tri-Council Policy Statement of Canada, article 2.5.SUBJECTSRecorded case of a 5-cm deep rectal nodule requiring resection.EXPOSURELaparoscopic segmental resection.MAIN OUTCOME MEASURESOverview of bowel endometriosis, surgical approaches, peri-operative care and surgical steps.RESULTSThe surgical approach is illustrated in eight steps: (1) mobilization of the adnexa and cul-de-sac; (2) bilateral ureterolysis; (3) dissection of the pararectal and rectovaginal spaces; (4) mesenteric dissection +/- sigmoid mobilization; (5) enterotomies and anvil placement; (6) segmental resection and natural orifice specimen extraction; (7) re-anastomosis; (8) rigid sigmoidoscopy. Peri-operative care should align with the ERAS pathway for colorectal surgery4.CONCLUSIONIn cases of multi-organ endometriosis, gynecologic surgeons must remain at the forefront of clinical decision making and surgical care coordination. The standardization of the surgical approach allows for a safe and reproducible performance of the intervention.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"13 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to natural vs modified natural frozen thawed embryo transfer cycles.","authors":"Noemie Ranisavljevic,Tal Anahory,Stéphanie Huberlant","doi":"10.1016/j.fertnstert.2025.06.039","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.06.039","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"25 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian stimulation with follitropin delta is safe and effective: Results from the RITA randomized, double-blind, placebo-controlled trials.","authors":"Michael D Scheiber, Kevin J Doody, Eric D Foster, Sarah A Grover, Patrick W Heiser","doi":"10.1016/j.fertnstert.2025.07.032","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.032","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the efficacy and safety of follitropin delta (recombinant follicle-stimulating hormone produced from the human cell line PER.C6®) for ovarian stimulation in patients aged 18-34 years and 35-42 years undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment in the United States (US).</p><p><strong>Design: </strong>Two randomized, double-blind, placebo-controlled, parallel group, multicenter trials (RITA-1 and RITA-2).</p><p><strong>Setting: </strong>US reproductive medicine clinics SUBJECTS: A total of 1,165 patients (578 women aged 18-34 years in RITA-1, and 587 women aged 35-42 years in RITA-2), randomized 10:1 to follitropin delta or placebo.</p><p><strong>Intervention: </strong>Ovarian stimulation with follitropin delta at a fixed starting dose (12 μg/day for patients <35 years, 15 μg/day for patients ≥35 years) for the first four stimulation days and subsequent dose adjustments as needed, or placebo as a reference group, in a GnRH antagonist cycle.</p><p><strong>Main outcome measure: </strong>Cumulative ongoing pregnancy rate after fresh and cryopreserved cycles initiated within 12 months from start of ovarian stimulation.</p><p><strong>Results: </strong>Cumulative ongoing pregnancy rates with follitropin delta were 64.0% in patients aged <35 years (RITA-1) and 43.9% in patients aged ≥35 years (RITA-2) versus 0% with placebo, thus establishing superiority of follitropin delta to placebo (RITA-1: difference 64.0% [95% confidence interval (CI), 56.9% to 68.1%]; RITA-2: difference 43.9% [95% CI, 37.0% to 48.2%]). The cumulative live birth rate with follitropin delta was 62.5% in patients <35 years and 42.4% in patients ≥35 years. In the fresh transfer cycle, the ongoing pregnancy rate with follitropin delta was 49.5% in patients <35 years and 34.8% in patients ≥35 years, and the live birth rate was 48.2% and 33.9%, respectively. In cryopreserved transfer cycles, the ongoing pregnancy rate with follitropin delta was 44.2% in patients <35 years and 31.2% in patients ≥35 years, and the live birth rate was 42.8% and 29.9%, respectively. The incidence of OHSS in the fresh cycle was 3.8% in patients <35 years and 2.4% in patients ≥35 years after treatment with follitropin delta.</p><p><strong>Conclusion: </strong>Follitropin delta, dosed based on maternal age, is an effective and safe therapeutic for ovarian stimulation in IVF/ICSI patients.</p><p><strong>Trial registration: </strong>For RITA-1: NCT03740737 (clinicaltrials.gov), registered on 24 Oct 2018, first subject enrolled on 26 Oct 2018. For RITA-2: NCT03738618 (clinicaltrials.gov), registered on 24 Oct 2018, first subject enrolled on 29 Oct 2018.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Careers and Motherhood: Infertility and Pregnancy Outcomes Among Canadian Female Physicians and Residents.","authors":"Sahra Nathoo, Aikansha Chawla, Irina Oltean, Mehrnoosh Faghih","doi":"10.1016/j.fertnstert.2025.07.031","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.031","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving Two Live Births from One Ovarian Stimulation Cycle: The One-and-Done Approach Revisited.","authors":"Alexandra Huttler, Daniel Duvall, Denny Sakkas, Quetrell Heyward, Riwa Sabbagh, Michael Alper, Denis Vaughan","doi":"10.1016/j.fertnstert.2025.07.029","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.029","url":null,"abstract":"<p><strong>Objective: </strong>To identify the proportion of patients who would achieve ≥2 live births following a single in vitro fertilization (IVF) stimulation/embryo creation cycle.</p><p><strong>Design: </strong>Retrospective cohort study at a university-affiliated infertility practice SUBJECTS: Patients undergoing their first IVF cycle between January 1, 2014 and December 31, 2023 EXPOSURE: Index oocyte retrieval cycle and subsequent autologous embryo transfer cycles MAIN OUTCOME MEASURES: Live births following autologous embryo transfer cycles from the index oocyte retrieval were analyzed, with additional live birth potential estimates extrapolated using age and oocyte number for those that had remaining frozen high-quality embryos. Univariable and multivariable logistic regression models were used to evaluate the association of known fertility factors with the outcome.</p><p><strong>Results: </strong>16,474 patients were included who underwent 20,710 total transfers during the study period. 8,223 patients (49.9%) achieved ≥ 1 live birth and 1,857 patients (11.3%) achieved ≥ 2 live births. Of note, 6,662 patients (40.4%) had a total of 24,067 remaining frozen high-quality embryos. Including estimates of additional live births resulting from use of remaining frozen embryos, 9,599 (58.3%, 95% confidence interval [CI] 57.6%-59.1%) patients would achieve ≥ 1 live birth and 4,511 (27.3%, 95% CI 26.8%-28.0%) patients would achieve ≥ 2 live births. The proportion of patients achieving ≥2 live births progressively increased across groups of increasing oocyte yield and decreased with advancing age. Predictors of the odds of achieving ≥ 2 live births included age and number of oocytes retrieved. 5,105 (31.0%) patients utilized pre-implantation genetic testing for aneuploidy (PGT-A). Those that utilized PGT-A had a lower odds of achieving ≥ 2 live births (p<0.001).</p><p><strong>Conclusion: </strong>With current IVF practices, over 1/4 of patients could complete their families by achieving ≥2 live births from a single IVF stimulation cycle. Increasing number of oocytes retrieved and age <35 years increased the odds of achieving this result. Providers can utilize these values as a counseling tool to guide shared decision-making to avoid additional stimulation cycles.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temsirolimus and anti-Müllerian hormone protect fertility and the ovarian reserve against chemotherapy-induced damage in a murine model.","authors":"Lara Houeis, Graziella van der Plancke, Luciana Cacciottola, Apolline Goudmaeker, Candice Kluyskens, Margherita Zipponi, Jean-Paul Dehoux, Jacques Donnez, Marie-Madeleine Dolmans","doi":"10.1016/j.fertnstert.2025.07.030","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.030","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of temsirolimus and recombinant anti-Müllerian hormone (AMH) on fertility and the ovarian reserve when associated with chemotherapy.</p><p><strong>Design: </strong>Thirty-seven female mice were assigned to one of three treatment groups: (i) control group; (ii) chemotherapy group; and (iii) gonadoprotection group. Five weeks after treatment, the mice underwent ovarian stimulation and were mated with males to evaluate residual fertility. Two days after mating, the animals were euthanized for embryo collection, and ovaries were retrieved to assess the ovarian reserve and follicle damage.</p><p><strong>Setting: </strong>Academic research center.</p><p><strong>Subject: </strong>Thirty-seven Naval Medical Research Institute mice.</p><p><strong>Exposure: </strong>The control group (n=10) was given a 100 μL injection of phosphate-buffered saline. The chemotherapy group (n=13) received a single 100 μL injection of chemotherapy (120 mg/kg cyclophosphamide and 12 mg/kg busulfan). The gonadoprotection group (n=14) was administered five injections of 5mg/kg temsirolimus over one week prior to chemotherapy, followed by a chemotherapy injection, then five injections of 5μg recombinant AMH over the next 24 hours.</p><p><strong>Main outcome measures: </strong>Embryo count, follicle count and morphology, and immunostaining for apoptosis (cleaved caspase-3), follicle activation (phospho-Akt), and proliferation (Ki67).</p><p><strong>Results: </strong>The control group showed the highest mean number of retrieved embryos (41.40 ± 14.74), closely followed by the gonadoprotection group (36.27 ± 17.22), while the chemotherapy group exhibited a significant reduction (20.63 ± 12.12) compared to both groups. Regarding the ovarian reserve, the control group showed the highest total follicle count (897.4 ± 392.8), with no difference compared to the gonadoprotection group (714.4 ± 283.9), but there was a significant decline in the chemotherapy group (320.7 ± 145.5) compared to both groups. In terms of follicle apoptosis and activation, no significant difference was observed between groups. Follicle proliferation rates were significantly higher in the chemotherapy group (59.38% ± 14.67%) than in the control group (20.72% ± 10.52%), but gonadoprotective treatment did curtail follicle proliferation (42.23% ± 18.37%) compared to the chemotherapy group.</p><p><strong>Conclusion: </strong>Our findings suggest that temsirolimus and AMH show promise as gonadoprotective agents, potentially protecting the ovarian reserve against chemotherapy and thereby preserving fertility. This could offer patients who cannot benefit from currently available techniques brand new fertility preservation options.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do not measure AMH to predict women's fecundity.","authors":"D de Ziegler,S Sokteang,Pirtea Paul","doi":"10.1016/j.fertnstert.2025.07.025","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.025","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"704 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflection on \"International Committee for Monitoring Assisted Reproductive Technologies world report: assisted reproductive technology, 2019\".","authors":"Nick Pyskar, Micah Hill","doi":"10.1016/j.fertnstert.2025.07.027","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.027","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Fertility Preservation Surgery: Perfusion Monitoring Using Indocyanine Green for Uterine Transposition Prior to Pelvic Radiotherapy.","authors":"Elizabeth J Klein,Ariella Yazdani,Mindy S Christianson","doi":"10.1016/j.fertnstert.2025.07.026","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.026","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"8 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}