Fertility and sterility最新文献

{"title":"Does Isolated Teratozoospermia = Normozoospermia?","authors":"Nicholas Sellke, Liesl Nel-Themaat, Michael L Eisenberg","doi":"10.1016/j.fertnstert.2026.04.014","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.04.014","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812772","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 Time of Men\": Can their involvement in the domestic sphere revive birth rates?","authors":"Dominique de Ziegler, Sokteang Sean, James P Toner","doi":"10.1016/j.fertnstert.2026.04.018","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.04.018","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812743","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":"Adolescent Varicocele: A Surgical Conundrum.","authors":"Leah E Beland, Meghan F Davis, Sanjay Aiyar, Jason van Batavia, Thomas F Kolon, Sameer Mittal","doi":"10.1016/j.fertnstert.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.04.015","url":null,"abstract":"<p><p>Adolescent varicocele is a common yet clinically complex condition, affecting up to 15% of post-pubertal boys. The natural history and long-term reproductive implications in adolescents are not as well understood as the association of varicocele with infertility in the adult population. As such, the primary challenge in the management of adolescent varicocele lies in identifying the subset of boys at risk for impaired spermatogenesis while avoiding unnecessary intervention in those who may normalize testicular development as puberty progresses. The pathophysiology of varicocele-related testicular dysfunction is thought to be multifactorial, involving increased scrotal temperature, oxidative stress, and associated germ cell apoptosis. There is also an element of genetic factors that may have implications in the development of varicocele and susceptibility to spermatogenic injury. Regardless of history, we have taken an institutional algorithmic approach whereby boys are evaluated at the time of initial presentation using a longitudinal, biologically informed process incorporating physical exam, serial assessment of total and relative testicular volume, scrotal ultrasound, endocrine evaluation, and semen analysis in appropriate Tanner V patients. Indications for surgical intervention in adolescents are guided by surrogate markers of testicular dysfunction such as persistent testicular volume asymmetry, abnormal semen parameters, and hormonal abnormalities. The preferred technique for intervention when indicated is a subinguinal microsurgical varicocele repair as this is associated with low recurrence and few complications. Surgical repair has been shown to improve testicular growth and semen parameters. However, the long-term impact of surgical repair on paternity is particularly challenging to assess in the adolescent population and requires continued long-term study. An algorithmic, longitudinal approach to the evaluation and management of adolescent varicocele that allows for the early identification of at-risk patients and avoidance of overtreatment is presented. Ultimately, management should be individualized, with the goal of preserving testicular function and optimizing future reproductive potential.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812780","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":"Young adults born from mothers with polycystic ovary syndrome carry their epigenetic inputs and phenotypic traits.","authors":"Fernando M Reis, Fabio V Comim, Karina B Gomes","doi":"10.1016/j.fertnstert.2026.04.019","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.04.019","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812827","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":"Recurrent pregnancy loss: a committee opinion.","authors":"","doi":"10.1016/j.fertnstert.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.03.001","url":null,"abstract":"<p><p>Current strategies for the assessment and treatment of recurrent pregnancy loss are discussed. This replaces the previous document, titled, ‟Evaluation and treatment of recurrent pregnancy loss: a committee opinion,\" last published in 2012.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812839","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":"Application of Intraluminal Indocyanine Green in Advanced Endometriosis Surgery.","authors":"Gaby Moawad, Youssef Youssef, Jean Marc Ayoubi, Anis Feki","doi":"10.1016/j.fertnstert.2026.04.012","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.04.012","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the step-by-step application of intraluminal indocyanine green (ICG) in endometriosis and adenomyosis surgery, including mucosa-sparing shaving of deep bladder and rectal nodules and excision of superficial tubal endometriosis.</p><p><strong>Design: </strong>Description of surgical technique with narrated video footage.</p><p><strong>Subjects: </strong>First case: A 36-year-old patient with chronic pelvic pain, urinary frequency, and dysuria. Preoperative MRI revealed a bladder endometriosis nodule measuring 1.7 × 1.5 cm. The patient underwent robotic-assisted excision of endometriosis with total hysterectomy.</p><p><strong>Second case: </strong>A 34-year-old patient with chronic pelvic pain and dyschezia. Preoperative MRI revealed a rectal endometriosis nodule measuring 2.7 × 1.8 cm, located 8 cm from the anal verge. The patient underwent robotic-assisted excision of endometriosis with total hysterectomy. Additional applications of intraluminal ICG highlighted in the video include superficial tubal endometriosis and intrauterine ICG use during adenomyosis excision.</p><p><strong>Exposure: </strong>In the first case, cystoscopy was performed to exclude bladder mucosal involvement. The bladder was backfilled with diluted ICG, and mucosa-sparing shaving of the bladder nodule was performed under fluorescence guidance. In the second case, ICG was administered transrectally, and the rectal nodule was shaved using monopolar energy under fluorescence guidance. In the third case, ICG was used for real-time identification of the tubal lumen during excision of tubal endometriosis. In the fourth case, intrauterine ICG was used to guide the depth of excision during adenomyosis resection.</p><p><strong>Main outcome measures: </strong>Demonstration of robotic-assisted excision of endometriosis and adenomyosis using intraluminal ICG guidance.</p><p><strong>Results: </strong>All procedures were completed without intraoperative or postoperative complications, and patients were discharged on the same day of surgery. Bladder mucosal integrity was preserved, allowing avoidance of prolonged catheterization. A voiding trial was successfully completed prior to discharge. At 6-week follow-up, patients reported no complaints.</p><p><strong>Conclusion: </strong>Intravenous ICG is well established for assessing bowel perfusion and anastomotic viability [1]. Its use for ureteral perfusion has been described in limited reports, while pelvic nerve visualization has only been reported in isolated case reports [2,3]. Intraluminal injection of ICG into the ureters is commonly used to aid ureteral identification [4]. In this video, we highlight intraluminal ICG as a valuable adjunct in advanced endometriosis and adenomyosis surgery. When combined with the advantages of robotic surgery, it enables precise, mucosa-sparing excision of deep endometriotic lesions and may reduce surgical morbidity.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812811","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":"High-Throughput Imaging Cytometry paired with Artificial Intelligence Identifies Ultra-Rare Sperm in Men previously Diagnosed with Clinical Azoospermia.","authors":"Blair Stocks,Aidan Boyne,Amelia Oppenheimer,Katelynn Salmon,Taylor Kohn,Gal Saffati,Beatriz Hernandez,Justin Badal,Mohit Khera,Larry Lipshultz","doi":"10.1016/j.fertnstert.2026.04.011","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.04.011","url":null,"abstract":"OBJECTIVETo determine whether a novel diagnostic platform which pairs high-throughput imaging cytometry with Artificial Intelligence (AI) assisted image analysis can identify ultra-rare sperm in ejaculatory samples deemed clinically azoospermic.DESIGNA retrospective cohort review of remnant biobanked ejaculatory samples processed by high-throughput imaging cytometry and AI assisted image analysis.SUBJECTSRemnant ejaculatory samples (n=148) biobanked from December 2024 to September 2025 at a single high-volume male infertility clinic.EXPOSUREImage-based Flow Cytometry and Convolutional Neural Network (CNN) driven image analysis for diagnostic classification.MAIN OUTCOME MEASURESDiagnostic reclassification rate of a remnant ejaculatory samples initially deemed clinically azoospermic using CNN-based morphologic assessment and corollary sperm specific protein expression.RESULTSWithin the 83 azoospermic samples analyzed, 40 samples (48%) were found to have sperm using this high-fidelity diagnostic platform.CONCLUSIONWe propose a new classification of sperm concentration - microzoospermia - a sperm concentration so low that only advanced image-based search technologies can reliably identify ultra-rare sperm.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"34 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751278","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":"Revisiting the diagnostic criteria and surgical management of an accessory cavitated uterine mass (ACUM).","authors":"Anne E Kim, Aimee Morrison, Samantha Pfeifer","doi":"10.1016/j.fertnstert.2026.04.010","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.04.010","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the diagnostic criteria of an accessory cavitated uterine mass (ACUM) and to describe the clinical presentation, diagnosis, and surgical management of two patients with an ACUM.</p><p><strong>Design: </strong>Video presentation describing the diagnostic and surgical management of an ACUM.</p><p><strong>Setting: </strong>Academic hospital setting.</p><p><strong>Patients: </strong>Two patients who presented with severe unilateral pelvic pain secondary to an ACUM.</p><p><strong>Interventions: </strong>Laparoscopic excision of the ACUM.</p><p><strong>Main outcome measures: </strong>Diagnostic criteria to identify an ACUM and surgical techniques to safely excise the rare mass.</p><p><strong>Results: </strong>We present two clinical cases of patients diagnosed with an ACUM. The patients included in this video gave consent for publication of the video and posting of the video online including social media, the journal website, scientific literature websites, and other applicable sites. Case 1 is a 14-year-old female with a history of severe right-sided dysmenorrhea who was admitted for management of acute right lower quadrant abdominal pain. She was diagnosed with an ACUM located on the right anterior aspect of the uterus on magnetic resonance imaging (MRI) of the pelvis. She underwent a laparoscopic excision of the ACUM during her hospital admission. Case 2 is a 23-year-old female who presented to clinic with cyclic lower left-sided pain. She was initially diagnosed with a left hematosalpinx and was later diagnosed with an ACUM located on the left anterior uterine aspect on MRI. She subsequently underwent a laparoscopic excision of the ACUM at an ambulatory surgical center.</p><p><strong>Conclusions: </strong>An ACUM is a rare Müllerian anomaly that may present with severe unilateral dysmenorrhea. There are no clear diagnostic criteria; thus, ACUMs are often misclassified in the already scant literature and their diagnosis and management are delayed due to the lack of recognition by clinicians (1,2). We highlight key features of an ACUM and present its newly established diagnostic criteria, which will be incorporated into the American Society of Reproductive Medicine (ASRM) Müllerian Anomalies Classification (MAC) tool version 2 (3). Our goal is to highlight its distinct features from other Müllerian anomalies and guide providers to promptly diagnose and appropriately manage patients with this condition. The surgical techniques presented will help to provide a framework for safe and efficient excision of an ACUM, which is imperative in the management of these patients.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766795","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":"Supplement Use Among Couples Seeking Fertility Treatment and Associations with Live Birth and Pregnancy Loss.","authors":"Naria R Z Sealy,Sunni L Mumford,Ellen C Caniglia,Julia D DiTosto,Erica Boiman Johnstone,Jim Hotaling,Bradley J Van Voorhis,Ginny Ryan,Pauline Mendola,Enrique F Schisterman,Stefanie N Hinkle","doi":"10.1016/j.fertnstert.2026.04.008","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.04.008","url":null,"abstract":"OBJECTIVETo assess the supplement use patterns among couples seeking fertility treatment and to assess the association between supplement use and live birth and pregnancy loss.DESIGNA secondary analysis using Folic Acid and Zinc Supplementation Trial (FAZST) and Impact of Diet, Exercise, and Lifestyle on Fertility Study (IDEAL) of couples seeking fertility treatment, followed for up to 18 months.SUBJECTSCouples seeking fertility treatment.EXPOSURE(S)Multivitamin and five most common supplements used among females (calcium, fish oil, folic acid, vitamin B12, vitamin C) and males (coenzyme Q10, fish oil, vitamin B12, vitamin C, and zinc) collected at baseline.MAIN OUTCOME MEASURE(S)Live birth and pregnancy loss were ascertained via self-report and medical records. Poisson models with robust variance estimates were used to estimate risk ratios (RR) and 95% CI, adjusting for confounders and weighted for selection bias.RESULTSAmong 2370 couples, 37% of males and 67% of females used a multivitamin at baseline. Overall, 35% of couples achieved a live birth. Multivitamin use in female (adjusted RR=1.22; 95% CI: 1.05-1.41), but not the male (aRR=1.00; 0.89-1.12) partner was associated with an increased chance of live birth. When stratified by fertility treatment, female multivitamin use was associated with live birth only amongst partners who underwent no treatment (aRR = 1.44; 1.00-2.08). Among females, folic acid (aRR=1.18; 0.95-1.48) and fish oil (aRR=1.09; 0.86-1.36) showed no live-birth association; males showed null findings for fish oil and vitamin C. 1054 (44%) conceived and of those, 218 (21%) had a pregnancy loss. There was no association between multivitamin use in either partner and pregnancy loss.CONCLUSIONAmong couples seeking infertility treatment, supplement use was common among both female and male partners, with the majority taking a multivitamin. There was evidence that multivitamin use in female partners was associated with increased likelihood of live birth.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"20 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147739107","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":"BMI and Oocyte Yield in Diminished Ovarian Reserve: More is more?","authors":"Caroline J Violette,Andrey V Dolinko","doi":"10.1016/j.fertnstert.2026.04.009","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2026.04.009","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"95 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147739105","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}