Fertility and sterility最新文献

{"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}

{"title":"A blastocyst's implantation potential is linked to its originating oocyte cohort's blastulation rate: evidence for a cohort effect.","authors":"David Huang, Justina Hyunjii Cho, Michael Fanton, Eleni Jaswa, Marcelle I Cedars, Mitchell P Rosen","doi":"10.1016/j.fertnstert.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.006","url":null,"abstract":"<p><strong>Objective: </strong>To investigate if blastocysts originating from different follicular cohorts have variable implantation rates, adjusted for oocyte age, morphology and/or ploidy DESIGN: Retrospective cohort SETTING: Academic center SUBJECTS: Patients who underwent one or more cycles of autologous ovarian stimulation and in vitro fertilization/intracytoplasmic sperm injection, followed by elective single frozen blastocyst transfer EXPOSURE: Blastocyst progression rate of a follicular cohort; defined as the total number of expanded blastocyst, euploid blastocyst, Day 5 blastocyst, or Day 5 euploid blastocyst(s) divided by the number of 2 pronuclei (2PN) zygote(s) MAIN OUTCOME MEASURES: Implantation, defined as serum human chorionic gonadotropin >5mIU/ml following elective single embryo transfer (eSET) RESULTS: A total of 4,292 blastocysts were tracked from their follicular cohort origin to their outcome following eSET. The mean age±standard deviation of the study population was 36.2±3.6 years old. The median (interquartile range; IQR) number of oocytes and 2PN zygotes per cohort was 17 (12-24) and 11 (8-16), respectively. The median (IQR) number of total expanded blastocysts and Day 5 blastocysts per cohort was 6 (4-9) and 2 (1-4), respectively. Preimplantation genetic testing for aneuploidy (PGT-A) utilization rate was 63.0%. The median (IQR) number of total euploid blastocysts and Day 5 euploid blastocysts were 2 (1-4) and 1 (0-2), respectively. Median (IQR) overall blastocyst progression rate was 60.0% (43.5-75.0%), euploid blastocyst progression rate 21.4% (13.3-33.3%), Day 5 blastocyst progression rate 20.0% (8.7-35.2%), and Day 5 euploid blastocyst progression rate 9.1% (0.0-18.2%). All blastocyst progression parameters inversely correlated with increasing age. Multivariable mixed-effects logistic regression analyses, adjusting for oocyte age, number of oocytes retrieved, embryo morphology, and PGT-A status, showed a positive association between overall blastocyst progression (adjusted OR 1.04 [95% CI 1.01-1.08], p=0.02), Day 5 blastocyst progression (adjusted OR 1.05 [95% CI 1.01-1.09], p=0.01), and Day 5 euploid blastocyst progression (adjusted OR 1.10 [95% CI 1.03-1.18], p=0.01) and implantation rates.</p><p><strong>Conclusions: </strong>Adjusting for age, oocytes retrieved, morphology, and ploidy status, blastocysts from follicular cohorts with high blastocyst progression rates demonstrate superior implantation potential compared to those from cohorts with lower blastocyst progression rates. This observation suggests the presence of a cohort effect, and offers valuable information for patient counseling on an embryo's implantation potential beyond ploidy/morphology.</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":"142822043","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 and infant outcomes following ART treatment for endometriosis alone compared with other causes of infertility: a data linkage cohort study.","authors":"Xian Zhang, Georgina M Chambers, Christos Venetis, Stephanie K Y Choi, Brigitte Gerstl, Cecilia H M Ng, Jason A Abbott","doi":"10.1016/j.fertnstert.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.007","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether perinatal and infant outcomes differ between singleton births following assisted reproductive technology (ART) in women with endometriosis alone and those with other causes of infertility.</p><p><strong>Design: </strong>Population-based data linkage cohort study.</p><p><strong>Subjects: </strong>A total of 29,152 ART-conceived singleton births from 24,116 mothers, 2010-2017, New South Wales, Australia.</p><p><strong>Exposure: </strong>Endometriosis, identified from the Australian and New Zealand Assisted Reproduction Database (ANZARD), hospital admissions and dispensed medication records. Cause of infertility was categorised as: endometriosis alone, endometriosis plus other cause(s) of infertility, infertility other than endometriosis, and unstated cause of infertility. The endometriosis alone group was further classified using ICD-10 codes (N80.0-80.9) into superficial, ovarian, deep, and other endometriosis.</p><p><strong>Main outcome measures: </strong>Perinatal and infant outcomes, including preterm birth (< 37 weeks), very preterm birth (< 32 weeks), small-for-gestational-age (SGA), large-for-gestational-age (LGA), admission to neonatal intensive care unit, perinatal death, and infant hospitalisation up to 2 years of age. Generalized estimating equations (GEE) were used to investigate independent associations between endometriosis and study outcomes.</p><p><strong>Results: </strong>Of the 29,152 ART-conceived singleton births, 19.9% (5,806/29,152) were from mothers with a diagnosis of endometriosis. Among these, 23.8% (1,379/5,806) from mothers with an endometriosis alone diagnosis and 76.2% (4,427/5,806) from mothers with endometriosis plus other cause(s) of infertility. There were 74.8% (21,795/29,152) births from mothers without endometriosis and 5.3% (1,551/29,152) from mothers with an unstated cause of infertility. After adjusting for maternal age at the time of birth, parity, ART treatment characteristics, gestational hypertension and diabetes, smoking, and socioeconomic status, there was no overall association between endometriosis and perinatal and infant outcomes. However, compared to women without endometriosis, those with deep endometriosis had a higher risk of preterm birth (adjusted relative risk [aRR] 1.75, 95% confidence interval [CI] 1.12-2.75) and SGA (aRR=1.58, 95% CI 1.05-2.37).</p><p><strong>Conclusion: </strong>Reassuringly, perinatal and infant outcomes are generally comparable for ART-conceived infants born to mothers with endometriosis alone and those with other causes of infertility when considered as a singular disease entity. Larger studies are needed to confirm the differential risk associated with endometriosis phenotypes but for patients with deep endometriosis undergoing ART, the risks of preterm birth and SGA may be increased. Clinicians should be aware of the potential of these risks.</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":"142822062","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 re-look at the relevance of TSH and thyroid autoimmunity for pregnancy outcomes: Analyses of RCT data from PPCOS II and AMIGOS.","authors":"Satu Kuokkanen, Aimee Seungdamrong, Nanette Santoro, Harry Lieman, Fangbai Sun, Robert Wild, Heping Zhang, Lubna Pal","doi":"10.1016/j.fertnstert.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.005","url":null,"abstract":"<p><strong>Objective: </strong>We examined if thyroid autoimmunity is relevant to the relationship between maternal TSH levels and pregnancy outcomes.</p><p><strong>Design: </strong>Retrospective cohort analysis of data from two randomized controlled trials (RCTs).</p><p><strong>Subjects: </strong>Participants of the Pregnancy in Polycystic Ovary Syndrome (PPCOS II, n = 746) and the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS, n = 832 with unexplained infertility) RCTs.</p><p><strong>Exposure: </strong>Pre-trial intervention levels of thyroid stimulating hormone (TSH) at threshold of ≥2.0 mU/L and thyroid peroxidase antibody (TPO-Ab) at titer threshold of ≥30 U/mL.</p><p><strong>Main outcome: </strong>Live birth (primary outcome), pregnancy loss and preterm birth (secondary outcomes). Generalized linear model (GLM) analyses examined the relationship between exposure to TSH and TPO-Ab at specified thresholds with the specified outcomes; covariates adjusted for included age, body mass index, race, ethnicity, education, smoking, duration of infertility, PCOS (versus unexplained infertility) and randomized intervention arm in the respective RCTs.</p><p><strong>Results: </strong>On adjusted analyses, live birth was significantly reduced in the exposed population (those with TSH ≥2.0 mU/L and TPO-Ab ≥30 U/mL, n= 117/1578, 7.4%, adjusted risk ratio [ARR] 0.55, 95% CI 0.35- 0.87) compared to the unexposed (those with TSH <2.0 mU/L and TPO-Ab <30 U/mL, n=865/1578, 54.8%). Furthermore, the risk of pregnancy loss and of early preterm birth (<32 weeks) was significantly higher in the exposed compared to the unexposed (ARR for pregnancy loss was 1.66, 95% CI 1.14- 2.42, and ARR for early preterm birth was 4. 82 (95% CI 1.53- 15.19).</p><p><strong>Conclusions: </strong>In women with TPO-Ab titers ≥30 U/mL, pregnancy outcomes may be compromised at TSH threshold of ≥2 mU/L. These findings of an interaction between TSH and TPO for pregnancy outcomes merit further investigation in prospective studies.</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":"142822056","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":"Systematic review and Meta-analysis of the impact of the re-freezing and re- biopsy embryos on reproductive outcomes in patients undergoing freeze-thaw embryo transfer.","authors":"Yuan Yang, Dan Li, Yongmei Liu, Yuxin Qi, Hongrui Li, Zhe Wang, Bin Ma","doi":"10.1016/j.fertnstert.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.008","url":null,"abstract":"<p><strong>Importance: </strong>During FET cycles in IVF/ICSI patients (including PGT patients), transfer of embryos that have been thawed may be abandoned for medical or personal reasons, resulting in the need to refreeze embryos. Typically, embryos from patients undergoing preimplantation genetic testing (PGT) are cryopreserved after biopsy, pending test results. However, in the absence of a clear result, another biopsy is required and the embryo is frozen again to await the results for future use.</p><p><strong>Objective: </strong>To explore whether refreezing and re-biopsy affect reproductive outcomes DATA SOURCES: Computer search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, CBM, CNKI, WanFang Data, and VIP databases and searched until May, 2023.</p><p><strong>Study selection and synthesis: </strong>STATA/MP software was utilized for conducting data analysis. Dichotomous outcome data were pooled to calculate odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Continuous outcome data were combined using an inverse variance model to determine the mean difference (MD) between the two groups. Random-effects and fixed-effects meta-analysis models were employed to assess heterogeneity. Subgroup analysis was conducted based on different freezing methods and various embryo types.</p><p><strong>Main outcomes: </strong>The primary outcome measure was the live birthrate, with secondary indicators including clinical pregnancy rate, implantation rate, miscarriage rate, ectopic pregnancy, preterm delivery, average birth weight of neonates, and neonatal malformation.</p><p><strong>Results: </strong>This study included 19 retrospective studies with a total of 11,024 FET cycles. Across the FET cycles, re-cryopreservation, compared to once-cryopreservation demonstrated reduced live birthrates (OR=0.79; 95% CI: 0.60 to 0.92; I²=21.7%, P=0.000), reduced clinical pregnancy rates (OR=0.74; 95% CI: 0.60 to 0.92, I²=56.9%, P=0.006), and increased miscarriage rates (OR=1.27; 95% CI: 1.03 to 1.55, I²=37.1%, P=0.024). Pregnancy outcomes following re-biopsies, revealing significantly lower live birth rates after re-biopsies compared with single biopsy (OR = 0.65; 95%CI: 0.45 to 0.94, I²=43.5%; P=0.024). Similarly, re-biopsies were associated with reduced clinical pregnancy rates (OR = 0.75; 95%CI: 0.54 to 1.03, I²=29.6%) and increased miscarriage rates (OR= 1.54; 95%CI: 0.89 to 2.66, I²=13.0%) compared to single-biopsy.</p><p><strong>Conclusion and relevance: </strong>Re-frozen embryos compared to once-frozen embryos suggests a decrease in live birth rates and clinical pregnancy rates, coupled with an increase in miscarriage rates, with negligible influence on neonatal outcomes. Similarly, re-biopsy yields comparable results, leading to a reduction in live birth rates.</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":"142822067","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":"Should physicians be facilitating gestational carrier arrangements in the absence of medical indication?","authors":"Brian Levine, Alexis L Cirel, Kate D Schoyer, Arthur R Derse, Robert T Rydze, Eve C Feinberg","doi":"10.1016/j.fertnstert.2024.11.013","DOIUrl":"10.1016/j.fertnstert.2024.11.013","url":null,"abstract":"","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":"142812544","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":"To Be Frank: Is it Time to Say Goodbye to Abbe-McIndoe and Vecchietti?","authors":"Marisa Imbroane, Allison Bosch, Elliott G Richards","doi":"10.1016/j.fertnstert.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.004","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817118","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":"Evidence-based guideline: Premature Ovarian Insufficiency.","authors":"Nick Panay, Richard A Anderson, Amy Bennie, Marcelle Cedars, Melanie Davies, Carolyn Ee, Claus H Gravholt, Sophia Kalantaridou, Amanda Kallen, Kimberly Q Kim, Micheline Misrahi, Aya Mousa, Rossella E Nappi, Walter A Rocca, Xiangyan Ruan, Helena Teede, Nathalie Vermeulen, Elinor Vogt, Amanda J Vincent","doi":"10.1016/j.fertnstert.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.11.007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;How should premature/primary ovarian insufficiency (POI) be diagnosed and managed, based on the best available evidence from published literature?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;The current guideline provides 145 recommendations on symptoms, diagnosis, causation, sequelae and treatment of POI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Premature ovarian insufficiency (POI) presents a significant challenge to women's health, with far-reaching implications, both physically and emotionally. The potential implications include adverse effects on quality of life; fertility; and bone, cardiovascular and cognitive health. Although hormone therapy (HT) can mitigate some of these effects, many questions still remain regarding the optimal management of POI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;The guideline was developed according to the structured methodology for development of ESHRE guidelines. Key questions were determined by a group of experts and informed by a scoping survey of women and health care professionals. Literature searches and assessment were then performed. Papers published up to January 30&lt;sup&gt;th&lt;/sup&gt;, 2024, and written in English were included in the guideline. An integrity review was conducted for the randomised controlled trials (RCTs) on POI included in the guideline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;Based on the collected evidence, recommendations were formulated and discussed within the guideline development group until consensus was reached. Women with lived experience of POI informed the recommendations in general, and particularly on those on provision of care. A stakeholder review was organised after finalisation of the draft. The final version was approved by the guideline development group and the ESHRE Executive Committee.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;New data indicate a higher prevalence of POI, 3.5%, than was previously thought. This guideline aims to help health care professionals to apply best practice care for women with POI. The recent update of the POI guideline covers 40 clinical questions on diagnosis of the condition, the different sequelae, including bone, cardiovascular, neurological and sexual function, fertility and general well-being, and treatment options, including hormone therapy. The list of clinical questions was expanded from the previous iteration of the guideline (2015) based on the scoping survey and appreciation of emerging knowledge of POI. Questions were added on the role of anti-Müllerian hormone (AMH) in the diagnosis of POI, fertility preservation, muscle health, and specific considerations for HT in iatrogenic POI. Additionally, the topic on complementary treatments was extended with specific focus on non-hormonal treatments and lifestyle management options. Significant changes from the previous 2015 guideline include the recommendations that only one elevated FSH &gt;25 IU ","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799986","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":"Impact of corpus luteum number on maternal pregnancy and birth outcomes: the Rotterdam Periconception Cohort.","authors":"Joni J Koerts, Lotte W Voskamp, Melek Rousian, Régine P M Steegers-Theunissen, Rosalieke E Wiegel","doi":"10.1016/j.fertnstert.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2024.12.002","url":null,"abstract":"<p><strong>Objective: </strong>To investigate associations between assisted reproductive technology (ART) -induced alterations in corpus luteum (CL) number during implantation, and maternal pregnancy and birth outcomes. Pregnancies conceived through ART are associated with increased risks of adverse obstetric and perinatal outcomes, with discrepancies in outcomes between different ART treatment protocols. We hypothesize this is due to the periconceptional hormonal environment regulated by the CL. ART protocols affect CL quantity at conception resulting in CL absence or a supraphysiological number of CL.</p><p><strong>Design: </strong>This study is embedded in the Rotterdam Periconceptional Cohort, an ongoing tertiary center prospective cohort at the Erasmus University Medical Center in Rotterdam, the Netherlands.</p><p><strong>Subjects: </strong>Women with a singleton pregnancy with data on CL.</p><p><strong>Exposure: </strong>The number of CL, based on mode of conception: 0 CL (artificial cycle frozen embryo transfer (AC-FET), n=72); >1 CL (ovarian stimulated fresh embryo transfer, n=462) and 1 CL (natural cycle frozen embryo transfer (NC-FET) and natural conceptions, n=1327).</p><p><strong>Main outcome measures: </strong>Hypertensive disorders of pregnancy, gestational diabetes, gestational age at birth and birthweight, derived from medical records.</p><p><strong>Results: </strong>We included 1,861 pregnancies. The results were adjusted for maternal age, maternal body mass index, nulliparity and obstetric history. In comparison with natural conceptions (1 CL), a pregnancy with CL absence (0 CL) was associated with a higher risk of gestational diabetes (aOR 2.59 [95% CI 1.31;5.15]), and a higher risk of preeclampsia, albeit non-significantly (aOR 2.02 [95% CI 0.91;4.51]). In comparison with pregnancies with >1 CL the risk of preeclampsia was significantly lower (aOR 0.36 [95% CI 0.18;0.72]). Post hoc analyses revealed that in male neonates, >1 CL was associated with a lower birthweight percentile (aβ -6.18 [95% CI -11.16;-1.20]). In contrast, female neonates showed no association with >1 CL, whereas CL absence was associated with a higher birthweight percentile (aβ 12.93 [95% CI 2.52;23.34]).</p><p><strong>Conclusion: </strong>Risks of hypertensive disorders of pregnancy, gestational diabetes and relative birthweight differ between CL groups. These findings support the hypothesis that an aberrant number of CL impacts maternal pregnancy and or birth outcomes. Additional studies need to be conducted to investigate causes and underlying pathophysiology.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791468","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}