Fertility and sterility最新文献

{"title":"Evaluating the feasibility of hyperspectral endometrial analysis as a less invasive technique for endometrial evaluation: a pilot study (118/125 characters).","authors":"Diana Marti-Garcia,Patricia Sebastian-Leon,Pilar Alamá,Laura Caracena,Antonio Parraga-Leo,Elena Perez-Rico,Antonio Pellicer,Patricia Diaz-Gimeno","doi":"10.1016/j.fertnstert.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.004","url":null,"abstract":"OBJECTIVEEvaluate the feasibility of using hyperspectral imaging for endometrial evaluation as a potential minimally-invasive method to identify the window of implantation within the same embryo transfer cycle.DESIGNProspective study.SUBJECTSHealthy and normo-ovulatory volunteers aged ≤ 35 years with proven fertility who voluntarily agreed to participate in the study between September 2021 and February 2023 at a private fertility clinic in Spain.INTERVENTIONSHyperspectral samples were captured throughout a modified natural menstrual cycle in which ovulation was induced and controlled with human chorionic gonadotropin. A microfiberscope inside an embryo transfer catheter coupled with a hyperspectral camera was introduced into the uterine cavity to capture the endometrial spectra at the fundus level.MAIN OUTCOME MEASURE(S)The endometrial hyperspectral visible light wavelength signature (in the 400-1,000 nm spectral range) was evaluated as a potential technique to identify the endometrial secretory-phase stages.RESULT(S)Comparison of the early- and mid-secretory stages identified 290 significantly different wavelengths (97.3% of the total number measured), 66 with differences of more than 50% intensity (intensity ratio>1.5); in turn, the late- and mid-secretory comparison resulted in 286 significantly different wavelengths (96%), 9 of them with an intensity ratio of > 1.5 between them; finally, the comparison of the early- and late-secretory stages found in 287 significantly different wavelengths (96.3%), 69 with and intensity ratio of >1.5 between them. A total of 26 wavelengths were identified as a signature that could distinguish the three different secretory stages. Using this signature, the prediction model performance discriminated the three secretory stages with a mean accuracy of 87.60% (IC95%: [87.08%-88.11%]) and a mean AUC of 79.41% (IC95%: [78.32%-80.50%]).CONCLUSION(S)This present study has shown, for the first time, the feasibility of using hyperspectral endometrial analysis specifically to evaluate the molecular changes that occur in the endometrium during the secretory phase. Thus, given the minimally invasive nature of this technology, the window of implantation could be discriminated in this way. Further prospective studies with infertile patients will be required to evaluate the clinical utility of this technique in patient stratification.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"15 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035546","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":"From Repair to Risk: Maternal-Fetal Outcomes after Hysteroscopic Treatment of Asherman Syndrome.","authors":"Rebecca Zhuo,Miriam A Andrusier,Phillip A Romanski","doi":"10.1016/j.fertnstert.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.002","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"21 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035547","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":"Recent Advances in CAPA-IVM for PCOS: Exploring Gonadotropin-Free Protocols and Artificial Intelligence Personalization.","authors":"Tania Carrión,Marcos Meseguer","doi":"10.1016/j.fertnstert.2025.08.041","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.08.041","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"72 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035549","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":"Elevated triglyceride-glucose body mass index increases risk of miscarriage in women undergoing in vitro fertilization and embryo transfer.","authors":"Ziyi Song,Fang Fang,Zhenteng Liu,Rong Liang,Ye Pan,Wenjia Meng,Fanwei Meng,Shuyi Zhang,Lihong Pang,Hongchu Bao,Qun Lu","doi":"10.1016/j.fertnstert.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.001","url":null,"abstract":"OBJECTIVETo explore the effects of triglyceride-glucose body mass index (TyG-BMI) on pregnancy outcome of in vitro fertilization and embryo transfer (IVF-ET).DESIGNRetrospective cohort study.SUBJECTSThis study included clinical data from 17365 patients across three reproductive medicine centers in China, encompassing both fresh embryo transfer (ET) cycles and subsequent frozen-thaw embryo transfer (FET) cycles.EXPOSUREThe subjects were categorized into four groups according to the TyG-BMI quartiles measured prior to cycle initiation: Quartile 1 (Q1): < 166.9, Quartile 2 (Q2): 166.9-188.8, Quartile 3 (Q3): 188.8-218.8, Quartile 4 (Q4): ≥ 218.8.MAIN OUTCOME MEASURESPrimary outcome: cumulative live birth rate (CLBR). Second outcome: biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate and live birth rate.RESULTSA higher TyG-BMI was significantly associated with increased miscarriage rates (fresh ET cycles: Q4 vs Q1: OR=1.41, 95%CI: 1.09-1.83, P=0.008; FET cycles: Q2 vs Q1: OR=1.24, 95%CI: 1.06-1.45, P<0.001; Q3 vs Q1: OR=1.36, 95%CI: 1.17-1.60, P<0.001; Q4 vs Q1: OR=1.57, 95%CI: 1.34-1.84, P<0.001) in both fresh ET and FET cycles. Additionally, a higher TyG-BMI was associated with lower live birth rate (Q4 vs Q1: OR=0.88, 95%CI: 0.80-0.97, P=0.011) in FET cycles. In cumulative cycles, patients with a higher TyG-BMI exhibited a significantly lower CLBR (Q2 vs Q1: OR=0.90, 95%CI: 0.82-0.99, P=0.025; Q3 vs Q1: OR=0.87, 95%CI: 0.79-0.95, P=0.003; Q4 vs Q1: OR=0.78, 95%CI: 0.71-0.85, P<0.001). The linear negative correlation between the TyG-BMI and CLBR was further confirmed by the restricted cubic splines (P-non-linear = 0.159, P-overall < 0.001). Subgroup analyses based on age and ovarian reserve revealed that a high TyG-BMI had a more pronounced adverse impact on younger women (<35y) and those with polycystic ovary syndrome (PCOS) or normal ovarian reserve. However, this association was not observed in older patients (≥35y) or those with diminished ovarian reserve (DOR).CONCLUSIONSAs TyG-BMI increased, the miscarriage rates in fresh ET and FET cycles increased, while live birth rates in FET cycles and cumulative live birth rates declined. These findings suggest that TyG-BMI may serve as a practical marker for identifying patients at increased metabolic risk for adverse pregnancy outcomes prior to IVF treatment.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"58 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035550","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 IMPACT OF PHYSICAL ACTIVITY AND STRESS ON FROZEN EMBRYO TRANSFER CYCLES: THE STEP AND STRESS TRACKING TO ESTIMATE PREGNANCY (SSTEP) TRIAL.","authors":"Emily Jacobs,Karen Summers,Brad Van Voorhis","doi":"10.1016/j.fertnstert.2025.08.039","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.08.039","url":null,"abstract":"OBJECTIVETo investigate the impact of objectively measured physical activity and stress on programmed hormone replacement therapy (HRT) frozen embryo transfer (FET) outcomes.DESIGNObservational cohort study SUBJECTS: Patients undergoing standard HRT FET at a single academic center.EXPOSUREAverage daily step counts before and after FET as measured by FitBit Charge 5 wearable activity tracker.MAIN OUTCOME MEASURESThis longitudinal study involved 82 women undergoing a programmed HRT FET. Each participant wore a FitBit Charge 5 health tracker for the duration of their FET cycle. Variables tracked included daily average steps, activity zone minutes, daily calories burned, heart rate, and sleep duration. Participants were also asked to complete the Fertility Problem Inventory (FPI) at the start of their cycle to measure infertility-related perceived stress. Lastly, 6 salivary cortisol samples were obtained at three time points two days before embryo transfer. We then divided patients into 2 groups by those who conceived a pregnancy from the FET (n=51) versus those who did not (N=31) and compared FitBit variables and cortisol levels using Students t-tests and Poisson regression analysis.RESULTSOn average, approximately 40 days of continuous health data was collected from subjects. When comparing those who conceived a pregnancy versus those who did not, there were no differences in average daily steps for the full study period, nor pre- or post- embryo transfer. Activity zone minutes, daily heart rate, daily calories burned, and sleep duration did not differ between the two groups pre- and post- embryo transfer. There was no difference in awakening cortisol, 30-minute post awaking cortisol, bedtime cortisol, or average cortisol awakening response between the two groups. Perceived stress measured by the FPI was largely the same when comparing the 2 groups.CONCLUSIONSIn one of the first studies using wearable health trackers to examine in vitro fertilization outcomes, physical activity and stress did not influence the pregnancy rate in programmed HRT FET cycles.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"13 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008732","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":"Improving access to care and delivery to marginalized and vulnerable populations: a committee opinion.","authors":" ","doi":"10.1016/j.fertnstert.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.08.003","url":null,"abstract":"It has been estimated that only a quarter of persons with infertility in the United States can sufficiently access infertility care. Against this backdrop of disparity, specific populations, including persons of color, sexual and gender minorities, immigrants, and lower-income persons, face barriers that further constrain access to care. This document outlines these communities' barriers and reviews best practice recommendations to extend inclusive access to care for marginalized populations. This reference is intended to support health professionals with knowledge of barriers that limit access to care and to provide practical strategies to improve access and optimize healthcare delivery.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"25 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007091","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":"Factors affecting quality of life in women with diminished ovarian reserve.","authors":"Sebastian J Leathersich,Sandra García Martínez,Christophe Blockeel,Francisca Martínez,Antonio Gosálvez,Peter Humaidan,Laura de la Fuente,Francesc Fàbregues,Anja Pinborg,Dominic Stoop,Pedro Barri,Nikolaos P Polyzos","doi":"10.1016/j.fertnstert.2025.08.038","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.08.038","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"31 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003199","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":"Effect of collagen scaffold versus intrauterine device on preventing recurrence of intrauterine adhesions: a multicenter randomized controlled trial.","authors":"Huiyan Wang,Xiaoyan Gu,Taishun Li,Xiaoyu Niu,Hong Zhang,Qing Yang,Yuanjing Hu,Feng Xu,Biyun Xu,Hui Zhu,Zhipeng Tian,Meining Song,Yali Hu","doi":"10.1016/j.fertnstert.2025.08.035","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.08.035","url":null,"abstract":"OBJECTIVETo evaluate the efficacy of collagen scaffold versus intrauterine device (IUD) in prevention of adhesion recurrence in moderate intrauterine adhesions (IUA) following hysteroscopic adhesiolysis.DESIGNA multicenter, open-label, randomized controlled, two-arm superiority clinical trial.SETTINGSix tertiary university hospitals from February 2023 to September 2024.SUBJECTSParticipants aged 20-40 years with moderate IUAs (based on American Fertility Society [AFS] score 5-8) planned to accept hysteroscopic adhesiolysis.INTERVENTIONParticipants were randomly allocated to collagen scaffold group or IUD group (1:1) and received hormonal therapy after surgery. A second-look hysteroscopy (SLH) was scheduled at 2 months after the adhesiolysis.MAIN OUTCOMEThe primary outcome was the rate of no IUA recurrence at SLH. The secondary outcomes included AFS score at SLH, decrease of AFS score at SLH, and menstrual pattern improvement at 1-month and 2-month post-operation.RESULTSA total of 195 patients were randomized to collagen scaffold group (n = 98) or IUD group (n = 97). The rate of no IUA recurrence at SLH in collagen scaffold group was significantly higher than that in IUD group (78.6% vs. 58.8%; risk ratio, 1.4; 95% confidence interval, 1.1-1.6; P=0.003). There was no significant difference in AFS score and decrease of AFS score at SLH between the two groups. The incidence of adverse events did not differ between the two groups and no serious adverse events were reported.CONCLUSIONCollagen scaffold is superior to IUD in preventing adhesion recurrence after hysteroscopic adhesiolysis in moderate IUAs.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"30 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995661","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 a golden ticket, but one way to get to our destination.","authors":"David Boedeker,Eric Widra","doi":"10.1016/j.fertnstert.2025.08.034","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.08.034","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"24 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995635","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":"Similar Outcomes, Different Timings: Luteal versus Follicular Stimulation in IVF.","authors":"Barbara Lawrenz,Sara Peralta,Erkan Kalafat,Laura Marqueta Marques,Laura Melado,Ibrahim ElKhatib,Raquel Del Gallego,Baris Ata,Human Fatemi","doi":"10.1016/j.fertnstert.2025.08.032","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.08.032","url":null,"abstract":"OBJECTIVETo compare the impact of luteal-phase ovarian stimulation on embryo count, embryo ploidy, and embryo quality to that of follicular-phase stimulation.DESIGNRetrospective cohort study between 03/2017 and 11/2024.SUBJECTSWomen who underwent an ovarian stimulation, commenced either in the follicular or the luteal phase of the menstrual cycle.EXPOSURELuteal-phase ovarian stimulation MAIN OUTCOME MEASURES: Counts of euploid embryos and embryo quality.RESULTSThe initial cohort included 3524 cycles follicular-phase - and 552 luteal-phase cycles. Following 2:1 propensity score matching on age, BMI, AMH, AFC, origin of semen, stimulation medication used, 1058 follicular-phase cycles were matched to 550 luteal-phase cycles. Luteal-phase stimulations required a significantly longer duration (median 11.0 vs 10 days, p<0.001) and higher total gonadotropin dose (median 4050 IU vs 3300 IU, p<0.001). Median counts of Cumulus-oocyte-complexes (COC), mature (MII) and fertilized oocytes, total-, biopsied- and euploid blastocysts did not differ significantly between groups before regression adjustment. Multivariable regression analyses on the matched cohort showed adjusted Incidence Rate Ratios (IRRs) for MII-count (luteal-phase vs. follicular-phase) of 1.04 (95%Confidence Interval (CI):1.00-1.09, p=0.062), for blastocyst-count 1.05 (95%CI:0.99-1.11, p=0.116), and for euploid blastocyst-count 1.04 (95%CI:0.94-1.14, p=0.459). Embryo quality distribution did not differ significantly between follicular-phase (N=3831: 8.4% top, 49.5% good, 22.1% fair, 20.0% poor) and luteal-phase (N=2110: 9.4% top, 51.1% good, 20.9% fair, 18.6% poor) groups (p=0.231). One-hundred-and-forty-seven women with a luteal-phase and follicular-phase cycle within one year underwent a paired analysis. Again, luteal-phase cycles required significantly longer stimulation (median 11 vs 10 days, p<0.001) and higher gonadotropin doses (median 4050 IU vs 3600 IU, p<0.001). No statistically significant differences were found in the median number of COCs, MIIs, fertilized oocytes, total-, biopsied-, or euploid blastocysts between the paired luteal-phase and follicular-phase cycles for these women (p>0.05 for all).CONCLUSIONOvarian stimulation initiated in the luteal phase has no detrimental impact on ploidy number or embryo quality. The key advantage of luteal-phase stimulation is an extended duration for initiating ovarian stimulation, which can be useful for couples with time constraints.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"22 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995659","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}