Fertility and sterility最新文献

{"title":"Trends in Use of Preimplantation Genetic Testing for Aneuploidy Before Dobbs, After Dobbs Leak, and After Dobbs Final Ruling.","authors":"Kiley Hunkler, David Boedeker, Kerry Flannagan, Arielle Yeshua, Elizabeth Gill, Kate Devine, Phillip Romanski, Trimble Spitzer","doi":"10.1016/j.fertnstert.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.017","url":null,"abstract":"<p><strong>Objective: </strong>To determine if utilization of preimplantation genetic testing for aneuploidy (PGT-A) increased following the Dobbs decision leak on May 2^nd, 2022, and after the Dobbs final ruling on June 24^th, 2022, compared to prior to the Dobbs decision.</p><p><strong>Design: </strong>Retrospective cohort study SUBJECTS: Patients that underwent in vitro fertilization (IVF) within a large fertility network geographically distributed across six states from June 2021 through June 2023. PGT-A cycles were defined as cycles with at least one embryo biopsied.</p><p><strong>Exposure: </strong>IVF cycles were grouped by cycle start date. Cycles starting between May 3^rd, 2022 and June 24^th, 2022 were considered Post-Dobbs leak. These were compared to cycles starting within the year leading up to the leak and those starting within the year following the final ruling.</p><p><strong>Main outcome measures: </strong>Percentage of cycles utilizing PGT-A, defined as number of IVF cycles utilizing PGT-A divided by total number of IVF cycles during the study period. We stratified by age, socioeconomic status, and state abortion access legislation.</p><p><strong>Results: </strong>We analyzed 9,371 IVF cycles prior to Dobbs, 1,581 IVF cycles after Dobbs leak, and 11,536 IVF cycles after Dobbs final ruling, totaling 22,488 IVF cycles. Age, BMI, AMH, parity, and number of embryos obtained per cycle were similar across time periods, but differences existed among race and infertility diagnoses. There were no differences in the primary outcome of percentage of cycles utilizing PGT-A between study time periods (57.2% pre-Dobbs, 56.8% post-Dobbs leak, 56.2% post-Dobbs final ruling); a finding which remained when adjusting for confounders. There was no association between the Dobbs decision and PGT-A use in subgroups stratified by age and socioeconomic status. A slight decrease in PGT-A use was noted in states with protective abortion legislation after the Dobbs final ruling (RR 0.96, 95% CI 0.93-0.99), with overall PGT-A use higher in states with restrictive policies (66.8%) than protective states (52.4%) across all time periods using Guttmacher's institute's protective vs. restrictive classifications.</p><p><strong>Conclusions: </strong>There is no association between Dobbs decision timing and patients' pursuit of PGT-A, but PGT-A use was more common in restrictive states across all included time periods.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440431","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":"Current quantitative methodologies for pre-implantation genetic testing frequently misclassify meiotic aneuploidies as mosaic.","authors":"Teodora Popa, Colin Davis, Leoni Xanthopoulou, Evangelia Bakosi, Chloe He, Helen O'Neill, Christian Ottolini","doi":"10.1016/j.fertnstert.2025.02.018","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.018","url":null,"abstract":"<p><strong>Objective: </strong>To study the biological origin of chromosomal abnormalities in embryos reported as mosaic following next-generation sequencing (NGS)-based preimplantation genetic testing for aneuploidy (PGT-A) and to assess the accuracy of current NGS-based methods in distinguishing meiotic from mitotic errors.</p><p><strong>Design: </strong>Retrospective cohort study utilizing single nucleotide polymorphism (SNP) genotyping and Karyomapping to identify meiotic aneuploidy in clinically reported mosaic embryos.</p><p><strong>Subjects: </strong>A total of 146 embryos from 87 patients who underwent IVF cycles with NGS-based PGT-A between 2018 and 2020 at The Evewell, London, UK.</p><p><strong>Exposure: </strong>Embryos underwent clinical NGS-based PGT-A to identify chromosomal abnormalities. Haplotype-based methods such as SNP-based genotyping and Karyomapping were performed on the same amplified material used for NGS-based PGT-A to determine the origin of the chromosomal errors.</p><p><strong>Main outcome measures: </strong>The proportion of embryos reported as mosaic by NGS that contained meiotic errors, and the distribution of meiotic versus mitotic origin among chromosomal abnormalities identified in the mosaic range.</p><p><strong>Results: </strong>Of the 141 embryos identified as mosaic following NGS-based PGT-A, 32.6% (n=46/141) contained an error of meiotic origin, challenging their classification as 'mosaic embryos'. In total, 191 individual chromosomal errors were reported in the mosaic range by NGS-based PGT-A. Of those, 29.3% (56/191) errors (both below and above the 50% copy number threshold) were found to be of meiotic origin. The majority (94.6%) of meiotic errors were maternal in origin. Embryos with multiple chromosomal abnormalities were significantly more likely to have at least one meiotic error. Higher intermediate copy number values correlated with an increased probability of an error being of meiotic origin.</p><p><strong>Conclusion: </strong>This study presents the first direct evidence that a third of embryos reported as mosaic (both low- and high-level mosaic) by NGS-based PGT-A contain meiotic errors, highlighting the potential misclassification of aneuploid embryos as mosaic by current NGS-based PGT-A methods which cannot accurately distinguishing between meiotic and mitotic errors. SNP genotyping provides essential information for accurately determining the origin of chromosomal abnormalities and should be integrated with NGS-based copy number analysis to enhance diagnostic accuracy. Further studies are needed to refine mosaicism classification and to better understand its true implications in IVF treatment.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440428","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":"Standardization of Back-Table Technique for Uterus Transplantation.","authors":"Masato Tamate, Giuliano Testa, Johanna Bayer, Liza Johannesson","doi":"10.1016/j.fertnstert.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.016","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440429","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":"A novel holding pipette applied in blastocyst biopsy: avoiding sliding and improving efficiency.","authors":"Zhiqiang Wang, Yan Chen, Junxian Jiang, Bo Yan, Lin Zhang, Jinwei Yang, Yali Ni","doi":"10.1016/j.fertnstert.2025.02.019","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.019","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432802","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":"Reassessing Endometriosis as a Heterogeneous Condition in ART Outcomes.","authors":"Allison A Eubanks, Combs Josh","doi":"10.1016/j.fertnstert.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.015","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424609","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":"Preimplantation genetic testing for aneuploidy does not benefit couples with male factor infertility.","authors":"Weilin Wang, Juanjuan Lu, Zhe Li, Wei Zhou, Qian Zhang, Tianxiang Ni, Junhao Yan","doi":"10.1016/j.fertnstert.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.014","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424606","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":"Use of assisted reproductive technologies for male and female infertility and perinatal outcomes.","authors":"Maria C Magnus, Karoline H Skåra, Ellen Ø Carlsen, Miriam Gjerdevik, Cecilia H Ramlau-Hansen, Miko Myrskyla, Liv-Bente Romundstad, Siri E Håberg","doi":"10.1016/j.fertnstert.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.013","url":null,"abstract":"<p><strong>Objective: </strong>To compare adverse perinatal outcomes between naturally conceived and pregnancies conceived by assisted reproductive technologies (ART) according to underlying male, female or unexplained infertility.</p><p><strong>Design: </strong>Registry-based study.</p><p><strong>Setting: </strong>Norway.</p><p><strong>Participants: </strong>All singleton births in Norway between 2000 and 2021 recorded in the national birth registry.</p><p><strong>Exposure(s): </strong>We compared ART pregnancies with underlying male (N=9,957), female (N=10,031), mixed (N=3,287), or unexplained (N=7,178) infertility to naturally conceived pregnancies (N=1,210,709). Information on underlying causes were reported from fertility clinics.</p><p><strong>Main outcomes and measure(s): </strong>We compared the birthweight and pregnancy length using robust linear regression, and the risk of pre-eclampsia, caesarean section, stillbirth, preterm birth, low birthweight, small-for-gestational age and transfer to neonatal unit using logistic regression, adjusting for parental age, maternal parity, cohabitation, country of birth and year of delivery.</p><p><strong>Result(s): </strong>Pregnancy length and birthweight were lower in all ART groups compared to the naturally conceived. The shorter pregnancy length was less pronounced in ART deliveries resulting from male infertility (adjusted difference -1.24 days; 95% CI: -1.43 to -1.05) than ART deliveries resulting from female infertility (adjusted difference -1.92 days; 95% CI: -2.12 to -1.73). Similarly, the lower birthweight in ART deliveries was less pronounced in those resulting from male (adjusted difference -29 grams; 95% CI: -39 to -18) than female (adjusted difference -49 grams; 95% CI: -59 to -39) infertility. We also observed a higher risk of most adverse perinatal outcomes in all ART groups, with the magnitude being lower for ART deliveries resulting from male infertility.</p><p><strong>Conclusion(s): </strong>The increased risk of adverse perinatal outcomes in pregnancies conceived by ART was less pronounced if used for male infertility than female infertility. This suggests that the risks in ART pregnancies are a combination of underlying factors related to female infertility and the ART procedures. However, whether underlying male infertility also increases the risks cannot be excluded.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424538","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":"Perceived stress in relation to testicular function markers among men attending a fertility center.","authors":"Akshay G Reddy, Paige L Williams, Irene Souter, Jennifer B Ford, Ramace Dadd, Ramy Abou-Ghayda, Russ Hauser, Jorge E Chavarro, Lidia Mínguez-Alarcón","doi":"10.1016/j.fertnstert.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.012","url":null,"abstract":"<p><strong>Objective: </strong>To study whether self-reported psychological stress was associated with impaired semen parameters and reproductive hormones.</p><p><strong>Design: </strong>An observational study including men aged 18-55 who attended the Massachusetts General Hospital Fertility Clinic.</p><p><strong>Subjects: </strong>A total of 718 men who attended the clinic, provided semen and serum blood samples and completed the short version of the Cohen Perceived Stress Scale (PSS-4).</p><p><strong>Exposure: </strong>Scores from completed the short version of the Cohen Perceived Stress Scale (PSS-4) were used to quantify perceived psychological stress.</p><p><strong>Main outcome measures: </strong>WHO semen analysis parameters including ejaculate volume, sperm count, concentration, motility and morphology were ascertained. Further analysis of sperm DNA damage by the Comet Assay was performed. Serum concentrations of luteinizing hormone, follicle stimulating hormone, prolactin, inhibin, testosterone and estrogen were measured. Linear regression models were used to evaluate associations between self-reported stress and testicular function outcomes, adjusting for age, BMI, abstinence time, year of semen sample collection and time to blood sampling. Parameters with skewed distributions were natural log transformed for analysis where appropriate to minimize the influence of outliers.</p><p><strong>Results: </strong>Compared to the lowest quartile of PSS-4 scores, men in the highest had significantly lower adjusted mean total sperm count, 118 mil/ejaculate (95% CI 101, 139) versus 153 mil/ejaculate (95% CI 133, 175) and lower adjusted mean normal morphology count, 5.97 mil/ejaculate (95% CI 4.73, 7.55) versus 9.13 mil/ejaculate (95% CI 7.43, 11.0). Higher perceived stress showed consistent trends with lower mean levels of sperm concentration, total motile count, percentage of normal sperm morphology, and number of cells with high DNA damage in adjusted models. No associations were observed between self-reported stress and other outcomes of sperm DNA damage and reproductive hormone concentrations.</p><p><strong>Conclusion: </strong>Greater perceived stress was negatively associated with certain semen quality parameters and spermatic cell DNA damage, whereas no associations were found for additional makers of sperm DNA damage or reproductive hormone levels.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424603","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":"How Many Babies Have Been Born with the Help of Assisted Reproductive Technology?","authors":"G D Adamson, P Creighton, J de Mouzon, F Zegers-Hochschild, S Dyer, G M Chambers","doi":"10.1016/j.fertnstert.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.009","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to estimate the total number of babies born globally between 1978 and 2018 following assisted reproductive technology (ART). Estimates are based on epidemiological data systematically and uniquely collected by the International Committee for Monitoring Assisted Reproductive Technology (ICMART) over 40 years.</p><p><strong>Design: </strong>ICMART has been reporting global results from country and regional registries since 1991. These observational cohort reports were collated and analyzed to obtain the number of babies born. Since reporting of outcomes is inconsistent, and clinics, countries and regions report incompletely, sporadically or not at all, statistical estimates were used to estimate the additional number of babies born from non-reporting clinics, countries and regions. Upper and lower estimates were based on assumptions about the number of births from non-reporting clinics.</p><p><strong>Subjects: </strong>Patients starting an ART cycle between 1978 to 2018. All clinics reporting their outcomes to national and regional registries, or directly to the International Committee for Monitoring Assisted Reproductive Technologies.</p><p><strong>Exposure: </strong>Assisted reproductive technologies.</p><p><strong>Main outcome measures: </strong>The total number of babies born from ART annually from 1978 through 2018, including the estimated number from non-reporting clinics, countries and regions.</p><p><strong>Results: </strong>The global lower and upper estimates of babies born from ART from 1978 through 2018 are 9,829,668 and 13,019,331 CONCLUSIONS: Ten million and up to 13 million or more babies have been born from ART in the forty years since the first ART-conceived baby was born in 1978. This large number of babies born from both conventional and innovative applications of ART, confirms that ART has helped millions of people realize parenthood, is now mainstream medicine, has had significant societal impact, including novel family formation, and highlighted inequities regarding reproductive rights and access to care.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413893","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":"Clinical practice guidelines for reproductive health care.","authors":"R J Norman","doi":"10.1016/j.fertnstert.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.02.010","url":null,"abstract":"<p><p>Amidst the rapidly changing landscape of diagnosis and management in reproductive medicine, it has become increasingly difficult to evaluate the usefulness of many clinical practices. Clinical practice guidelines are a way to incorporate the best evidence-based research with clinical experience, cost effectiveness and patient demands. However there may be problems with the development, maintenance and implementation of such guidelines. This series of papers describes existing guidelines in ASRM and internationally and provides clinician comment on how they should be used.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413890","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}