Fertility and sterility最新文献

{"title":"Low doses of alkylating agents do not harm human ovarian tissue destined for cryopreservation.","authors":"Lara Houeis, Graziella van der Plancke, Catherine Poirot, Luciana Cacciottola, Alessandra Camboni, Isabelle Brocheriou, Jacques Donnez, Marie-Madeleine Dolmans","doi":"10.1016/j.fertnstert.2024.12.016","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.016","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of non-gonadotoxic doses of alkylating agents on human ovarian cortex.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Academic research center.</p><p><strong>Subject: </strong>Biopsies from 78 patients who had undergone ovarian tissue cryopreservation were retrieved and analyzed. Among them, 42 had previously been treated with chemotherapy (alkylating agents, dose <3400mg/m²), making up the chemotherapy group, while 36 had not been given any chemotherapy, constituting the control group.</p><p><strong>Mean outcome measures: </strong>Follicle count and classification, morphology study, immunostaining for apoptosis (cleaved caspase-3), immunostaining for activation (phospho-Akt), fibrosis (Masson's trichrome) and vascularization (von Willebrand factor and smooth muscle actin).</p><p><strong>Results: </strong>In the prepubertal group, 271 follicles/mm³ were detected in control patients and 501 follicles/mm³ in chemotherapy-exposed subjects. In the adult group, 4916 follicles/mm³ were found in control patients and 6570 follicles/mm³ in chemotherapy-exposed patients. No difference in follicle density was observed between the two groups in any age category. Neither did we encounter any significant difference in follicle viability according to chemotherapy exposure or age. Proportions of non-growing follicles were >76 % in all age groups, irrespective of chemotherapy exposure, and higher, though not significantly, in the chemotherapy group compared to the control group. There were significantly fewer secondary follicles in the adult chemotherapy group than in the adult control group (p=0.009). Concerning apoptosis, no significant difference was observed between control and chemotherapy subjects in any age groups. Numbers of activated follicles were systematically higher in all age categories in the chemotherapy group than the control group. Areas of atypical follicles were noted in 4 out of 14 prepubertal patients in the chemotherapy group. In these areas, follicle density was 84570 ± 8837 follicles/mm³ and all follicles appeared non-viable but showed no sign of apoptosis.</p><p><strong>Conclusion: </strong>Low-dose chemotherapy had no major impact on ovarian tissue, suggesting that ovarian tissue exposed to some chemotherapy prior to cryopreservation is comparable to ovarian tissue free of any chemotherapy, as clinically demonstrated by high pregnancy rates after ovarian tissue transplantation in women exposed to chemotherapy. Previous chemotherapy should therefore no longer be a contraindication to ovarian tissue cryopreservation.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863774","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":"Preconception Chlamydia trachomatis seropositivity and fecundability, live birth, and adverse pregnancy outcomes.","authors":"Yajnaseni Chakraborti, Stefanie N Hinkle, Jørgen Skov Jensen, Catherine L Haggerty, Toni Darville, Sunni L Mumford, Enrique F Schisterman, Robert M Silver, Brandie DePaoli Taylor","doi":"10.1016/j.fertnstert.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.017","url":null,"abstract":"<p><strong>Objective: </strong>To study the impact of preconception Chlamydia trachomatis seropositivity on fecundability, live birth, and pregnancy loss and to assess the effect of low-dose aspirin therapy (81 mg/day) on live birth and pregnancy loss.</p><p><strong>Design: </strong>Preconception cohort study conducted using data and specimens from the Effects of Aspirin in Gestation and Reproduction (EAGeR) study - a randomized placebo-controlled trial.</p><p><strong>Subjects: </strong>1228 individuals with proven fecundity and a history of 1-2 pregnancy losses.</p><p><strong>Exposure: </strong>Preconception C. trachomatis seropositivity determined using an ELISA based synthetic peptide assay at baseline.</p><p><strong>Main outcome measures: </strong>Time-to pregnancy (fecundability) was defined as number of menstrual cycles to β-hCG-detected pregnancy; live birth status was determined from medical record abstraction; pregnancy loss was defined as any loss post positive β-hCG test.</p><p><strong>Results: </strong>After adjusting for confounders (baseline demographic and reproductive history variables), C. trachomatis seropositivity (n=134/1228, 11%) was associated with a reduced live birth likelihood (RR: 0.77, 95% CI: 0.59, 0.99) and an increased risk of pregnancy loss (RR: 1.16, 95% CI: 1.04, 1.29), but was not associated with fecundability (FOR: 0.92, 95% CI: 0.71, 1.20). Among a subset of C. trachomatis seropositive individuals with chronic inflammation indicated by increased C-reactive protein levels ≥ 1.95 but ≤ 10 mg/L (n = 50/134, 37.3%), low-dose aspirin therapy improved live birth rates (RR: 1.68, 95% CI: 0.96, 2.92) and reduced the risk of pregnancy loss (RR: 0.83, 95% CI: 0.65, 1.10). However, the sample size reduced precision.</p><p><strong>Conclusions: </strong>Prior exposure to C. trachomatis among women with a history of pregnancy loss may impact risk of pregnancy loss. Our results indicate the need for future studies exploring mechanisms by which C. trachomatis may influence long-term reproductive function, as this may identify treatments to improve outcomes among those with a history of infection.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863776","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":"(Not) My body, my choice?","authors":"Eve C Feinberg","doi":"10.1016/j.fertnstert.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.11.012","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827697","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":"Perinatal Outcomes in Siblings from Different Conception Methods: In Vitro Fertilization with Autologous Oocyte or Donor Egg vs. Unassisted Medical Conception.","authors":"Hila Shalev-Ram, Anat Hershko Klement, Einat Haikin-Herzberger, Mattan Levi, Roni Rahav-Koren, Amir Wiser, Netanella Miller","doi":"10.1016/j.fertnstert.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.012","url":null,"abstract":"<p><strong>Objective: </strong>To study the perinatal outcomes of children born from different conception methods: in vitro fertilization (IVF) with autologous oocytes or IVF with donor egg versus those conceived without medical assistance by using a sibling analysis.</p><p><strong>Design: </strong>Retrospective cohort study conducted using electronic medical record data from 2000 through 2018, of a national healthcare organization.</p><p><strong>Subjects: </strong>The cohort included mothers who had two pregnancies and their children. Cohort A compared women with two medically unassisted conceptions with those with an unassisted first conception followed by an IVF conception. Cohort B compared women with two medically unassisted conceptions with those with an unassisted conception followed by a second pregnancy from oocyte donation.</p><p><strong>Exposure: </strong>None MAIN OUTCOME MEASURES: Perinatal outcomes, including small for gestational age (SGA) and preterm birth (PTB) <37weeks were investigated. Secondary outcomes included low birth weight (LBW), very low birth weight (VLBW), and large for gestational age (LGA).</p><p><strong>Results: </strong>Cohort A comprised women who had 2 medically unassisted pregnancies and those with 1 medically unassisted pregnancy followed by IVF (n=1080 in each). Gestational age at delivery for the second conception was significantly lower in the unassisted + IVF group compared to the medically unassisted group (38.1 ± 2.1 weeks vs. 39.1 ± 1.4 weeks, p=0.001). The unassisted + IVF group had higher rates of prematurity <37 weeks (12% vs. 3.5%, p=0.001) and SGA compared to the medically unassisted group (5.4% vs. 3.4%, p=0.048). The adjusted OR (aOR) for PTB was 3.32 (95% CI, 2.11 to 5.29) and for SGA aOR 1.88 (95% CI, 1.07 to 3.32.) Cohort B included 94 women in each group. No differences were found between the medically unassisted and medically unassisted + donor egg groups regarding PTB <37 weeks (p=0.52) and SGA (p=0.32). The rate of LGA was higher in the egg donation group (24% vs. 16.5%, p=0.02).</p><p><strong>Conclusions: </strong>This sibling analysis suggests that IVF pregnancies with autologous eggs are more susceptible to PTB, LBW, VLBW, and SGA, while donor egg pregnancies appear relatively unaffected, except for higher rate of LGA.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827758","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":"Comment on: Similar accuracy and patient experience with different one-step ovulation predictor kits.","authors":"Sarah C Cromack, Jessica R Walter","doi":"10.1016/j.fertnstert.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.013","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827642","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":"The Benefit Of Ovary Cortex Allotransplantation Using Immunosuppression.","authors":"Sherman J Silber, Sierra Goldsmith, Benjamin Rubinoff, Eduardo Kelly, Rowena Delos Santos, Anibal Melo, Daniel Brennan","doi":"10.1016/j.fertnstert.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.014","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824087","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":"Using National IVF Registries to Validate Clinical Outcomes Following IVF Covered by Health Insurance.","authors":"David Suh, Phyllis Yan, Rodney L Dunn, Edward C Norton, Vanessa K Dalton, Erica E Marsh, Marissa S Weiss, James M Dupree","doi":"10.1016/j.fertnstert.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.015","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate in vitro fertilization (IVF) cycles covered by health insurance using a national commercial claims database and to validate key clinical events against national IVF registries.</p><p><strong>Design: </strong>Retrospective cohort study SUBJECTS: US women aged 20-44 who underwent IVF from 2005 to 2020 in Optum's de-identified Clinformatics® Data Mart Database (CDM).</p><p><strong>Exposure: </strong>Undergoing IVF MAIN OUTCOME MEASURES: IVF cycles and rates of pregnancies (inclusive of losses and terminations), live births, and live birth types (e.g., singleton, twin, and triplet or higher order).</p><p><strong>Results: </strong>We identified more than 3,000 IVF cycles in each year from 2005 to 2020 within CDM. When comparing our rates of clinical outcomes to external benchmark data, the results were similar across all the years of our study. For example, in 2020 the percentage of pregnancies after first embryo transfer was 62.03% (95% CI: 59.48-64.47) in CDM and 64.96% in data from the Society for Assisted Reproductive Technology (SART). The rate of live birth after first embryo transfer was 44.58% (95% CI: 41.90-47.21) in CDM in 2020 and 46.95% in SART in 2020. The rate of singleton births was 94.17% (95% CI: 92.24-96.10) in CDM in 2020; and this rate was 94.37% in SART in 2020. For twin births, the rate was 5.48% (95% CI: 3.60-7.35) in CDM in 2020 and 5.46% in SART in 2020. The rate of triplet or higher order births was 0.35% (95% CI: 0.00-0.84) in CDM in 2020 and 0.17% in SART in 2020.</p><p><strong>Conclusion: </strong>We found CDM can be used to accurately identify IVF cycles covered by insurance and key clinical outcomes such as rates of pregnancies, live births, and live birth types, and our reported rates were similar to national IVF clinical registry data. Our findings support that CDM is a robust data source to conduct research about IVF insurance coverage and can accurately evaluate clinical outcomes resulting from IVF. Policymakers who are considering insurance coverage for IVF can use CDM to model and measure the impact of new or existing policies for IVF insurance coverage.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824091","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":"Effects of preimplantation genetic testing for aneuploidy on embryo transfer outcomes in women of advanced reproductive age with no more than three retrieved oocytes.","authors":"Zhanhui Ou, Nengqing Liu, Ang Chen, Qingni Li, Jieliang Li, Xiaojun Wen, Junye Huo, Xiaowu Fang, Jing Du, Xiufeng Lin","doi":"10.1016/j.fertnstert.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.010","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether preimplantation genetic testing for aneuploidy (PGT-A) benefits women of advanced reproductive age (≥38 years old) with a diminished ovarian reserve (DOR; not more than three retrieved oocytes).</p><p><strong>Design: </strong>A retrospective analysis comparing two groups: (a) PGT-A group: women who chose PGT-A and subsequent single re-warmed embryo transfers (ETs) and (b) non-PGT-A group: women who chose not to genetically test their embryos and underwent subsequent fresh or re-warmed ETs of one to two embryos on days 3 or 5.</p><p><strong>Subjects: </strong>Two hundred and thirty patients underwent PGT-A therapy, with 49 of these individuals undergoing more than one PGT-A cycle. Meanwhile, 309 patients received non-PGT-A treatment, among whom 89 underwent more than one cycle of this type. Collectively, this study encompassed a total of 298 PGT-A cycles and 429 non-PGT-A cycles from a single center (April 2019-June 2023). All women had a DOR and advanced reproductive age.</p><p><strong>Exposure: </strong>The exposure variable was the use of PGT-A.</p><p><strong>Main outcome measures: </strong>The primary outcome was live birth rates (per cycle and retrieval). Secondary outcomes were clinical pregnancy rates (per cycle and retrieval), miscarriage rates (per pregnancy and retrieval).</p><p><strong>Results: </strong>While PGT-A cycles had lower transfer rates (14.1% vs. 73.2%), they achieved significantly higher pregnancy (66.7% vs. 12.4%) (adjusted odds ratio [aOR] = 11.474; 95% confidence interval [95% CI], 5.462, 24.102; p < 0.001) and live birth rates (57.1% vs. 7.5%) per transfer (aOR = 13.065; 95% CI, 5.987, 28.510; p < 0.001). The PGT-A group also had lower miscarriage rates (14.3% vs. 40.0%) (aOR = 0.142; 95% CI, 0.030, 0.661; p = 0.013). However, overall pregnancy and live birth rates were similar, and the PGT-A group required fewer cycles for live birth (p = 0.023).</p><p><strong>Conclusion: </strong>While PGT-A improved clinical pregnancy and live birth rates per transfer cycle in women of advanced reproductive age with a low oocyte yield, it did not impact these rates per retrieval.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822058","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":"Sexual response in women with Polycystic Ovary Syndrome: a case control study.","authors":"Hester Pastoor, Ellen Laan, Joop Laven, Stephanie Both","doi":"10.1016/j.fertnstert.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.009","url":null,"abstract":"<p><strong>Objective: </strong>To study genital response and sexual arousal in women with and without PCOS and to assess associations with sex steroid levels.</p><p><strong>Design: </strong>This observational prospective case control study was conducted from March 2017 until March 2020.</p><p><strong>Subjects: </strong>Heterosexual women with (n=68) and without PCOS (n=67), aged 18-40 years, in a steady relationship and without any comorbidities.</p><p><strong>Exposure: </strong>All participants underwent an extensive medical and endocrine screening as well as assessment of genital blood flow (vaginal pulse amplitude (VPA)), assessed with photoplethysmography), and sexual arousal and affect (Likert scale questionnaire) in response to erotic and vibrotactile stimulation.</p><p><strong>Main outcome measures: </strong>Vaginal pulse amplitude, lubrication, subjective sexual arousal and affect.</p><p><strong>Results: </strong>There were no significant differences in genital blood flow response and self-reported lubrication between women with and without PCOS. After adjusting for confounders, women with PCOS did report significantly lower positive affect in the fantasy and vibrotactile condition compared to women without PCOS. Regression analyses adjusted for confounders showed only few and weak associations of sexual responses with androgen levels explaining only a maximum of 6% of variance in all models in women with and those without PCOS. The PCOS group showed only weak associations between subjective sexual arousal and DHEA (fantasy: β=1.719, P=0.049, Adj R²=0.020), and SHBG (fantasy: β=-1.728, P=0.020, Adj R²=0.044).</p><p><strong>Conclusion: </strong>Women with PCOS show similar genital sexual response and lubrication, but lower positive affect compared to women without PCOS, however, only few, and weak associations with androgen levels were found. Androgen levels are not indicative of genital response and subjective arousal. Sexual function should be discussed in clinical care and psychosexual counseling should be offered.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822065","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":"Mood lability and depression limit oral contraceptive therapy in endometriosis.","authors":"Esma Cansu Cevik, Hugh S Taylor","doi":"10.1016/j.fertnstert.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.011","url":null,"abstract":"<p><strong>Objective: </strong>To determine the impact of oral contraceptive (OC) induced mood lability/depression on treatment maintenance in women with endometriosis.</p><p><strong>Design: </strong>Women with endometriosis were retrospectively identified through International Classification of Diseases-10 codes and then a comprehensive electronic medical record review was conducted, identifying mood lability/depression as a reason for treatment discontinuation with the use of combined or progestin-only oral contraceptives.</p><p><strong>Subjects: </strong>2,682 women with endometriosis, between the ages of 18-45 treated in a university affiliated hospital between 2012-2024.</p><p><strong>Exposure: </strong>Use of combined or progestin-only oral contraceptives in patients with endometriosis.</p><p><strong>Main outcome measures: </strong>The primary outcome was oral contraceptive discontinuation due to mood lability/depression in women with endometriosis. The secondary outcome assessed whether patients with a documented diagnosis of depression were more prone to discontinuing OC use due to mood lability.</p><p><strong>Results: </strong>Mood lability/depression as a side effect of OC use was more common in women with endometriosis and increased the likelihood of discontinuing OCs. Overall, 44.2% of women with endometriosis and treated with OCs discontinued their use. The depression prevalence in our study cohort was 33.6%. Among those who discontinued, 33.9% attributed their discontinuation to mood lability/depression. Of those who discontinued OC use due to mood lability, 52.7% had a diagnosis of depression, a higher rate than those who discontinued OC use for other reasons or did not stop using OCs. There was no difference in OC discontinuation due to side effects comparing combination oral contraceptives to progestin-only oral contraceptives. Similarly, the type of progestin prescribed did not influence the OC discontinuation among those who experienced mood lability/depression.</p><p><strong>Conclusion: </strong>Women with endometriosis had an increased incidence of depression and a greater likelihood of discontinuing OCs when they experienced mood lability or depression. Mood lability played a significant role in OC discontinuation. The effect of oral contraceptive on mood lability/depression did not differ by the type of progestin. In patients with endometriosis at risk of depression, or who develop mood changes on oral contraceptives, other therapies that are typically considered second line should be considered early in the course of treatment.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822060","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}