Alexandra Huttler, Daniel Duvall, Denny Sakkas, Quetrell Heyward, Riwa Sabbagh, Michael Alper, Denis Vaughan
{"title":"Achieving Two Live Births from One Ovarian Stimulation Cycle: The One-and-Done Approach Revisited.","authors":"Alexandra Huttler, Daniel Duvall, Denny Sakkas, Quetrell Heyward, Riwa Sabbagh, Michael Alper, Denis Vaughan","doi":"10.1016/j.fertnstert.2025.07.029","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.029","url":null,"abstract":"<p><strong>Objective: </strong>To identify the proportion of patients who would achieve ≥2 live births following a single in vitro fertilization (IVF) stimulation/embryo creation cycle.</p><p><strong>Design: </strong>Retrospective cohort study at a university-affiliated infertility practice SUBJECTS: Patients undergoing their first IVF cycle between January 1, 2014 and December 31, 2023 EXPOSURE: Index oocyte retrieval cycle and subsequent autologous embryo transfer cycles MAIN OUTCOME MEASURES: Live births following autologous embryo transfer cycles from the index oocyte retrieval were analyzed, with additional live birth potential estimates extrapolated using age and oocyte number for those that had remaining frozen high-quality embryos. Univariable and multivariable logistic regression models were used to evaluate the association of known fertility factors with the outcome.</p><p><strong>Results: </strong>16,474 patients were included who underwent 20,710 total transfers during the study period. 8,223 patients (49.9%) achieved ≥ 1 live birth and 1,857 patients (11.3%) achieved ≥ 2 live births. Of note, 6,662 patients (40.4%) had a total of 24,067 remaining frozen high-quality embryos. Including estimates of additional live births resulting from use of remaining frozen embryos, 9,599 (58.3%, 95% confidence interval [CI] 57.6%-59.1%) patients would achieve ≥ 1 live birth and 4,511 (27.3%, 95% CI 26.8%-28.0%) patients would achieve ≥ 2 live births. The proportion of patients achieving ≥2 live births progressively increased across groups of increasing oocyte yield and decreased with advancing age. Predictors of the odds of achieving ≥ 2 live births included age and number of oocytes retrieved. 5,105 (31.0%) patients utilized pre-implantation genetic testing for aneuploidy (PGT-A). Those that utilized PGT-A had a lower odds of achieving ≥ 2 live births (p<0.001).</p><p><strong>Conclusion: </strong>With current IVF practices, over 1/4 of patients could complete their families by achieving ≥2 live births from a single IVF stimulation cycle. Increasing number of oocytes retrieved and age <35 years increased the odds of achieving this result. Providers can utilize these values as a counseling tool to guide shared decision-making to avoid additional stimulation cycles.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717837","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}
Lara Houeis, Graziella van der Plancke, Luciana Cacciottola, Apolline Goudmaeker, Candice Kluyskens, Margherita Zipponi, Jean-Paul Dehoux, Jacques Donnez, Marie-Madeleine Dolmans
{"title":"Temsirolimus and anti-Müllerian hormone protect fertility and the ovarian reserve against chemotherapy-induced damage in a murine model.","authors":"Lara Houeis, Graziella van der Plancke, Luciana Cacciottola, Apolline Goudmaeker, Candice Kluyskens, Margherita Zipponi, Jean-Paul Dehoux, Jacques Donnez, Marie-Madeleine Dolmans","doi":"10.1016/j.fertnstert.2025.07.030","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.030","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of temsirolimus and recombinant anti-Müllerian hormone (AMH) on fertility and the ovarian reserve when associated with chemotherapy.</p><p><strong>Design: </strong>Thirty-seven female mice were assigned to one of three treatment groups: (i) control group; (ii) chemotherapy group; and (iii) gonadoprotection group. Five weeks after treatment, the mice underwent ovarian stimulation and were mated with males to evaluate residual fertility. Two days after mating, the animals were euthanized for embryo collection, and ovaries were retrieved to assess the ovarian reserve and follicle damage.</p><p><strong>Setting: </strong>Academic research center.</p><p><strong>Subject: </strong>Thirty-seven Naval Medical Research Institute mice.</p><p><strong>Exposure: </strong>The control group (n=10) was given a 100 μL injection of phosphate-buffered saline. The chemotherapy group (n=13) received a single 100 μL injection of chemotherapy (120 mg/kg cyclophosphamide and 12 mg/kg busulfan). The gonadoprotection group (n=14) was administered five injections of 5mg/kg temsirolimus over one week prior to chemotherapy, followed by a chemotherapy injection, then five injections of 5μg recombinant AMH over the next 24 hours.</p><p><strong>Main outcome measures: </strong>Embryo count, follicle count and morphology, and immunostaining for apoptosis (cleaved caspase-3), follicle activation (phospho-Akt), and proliferation (Ki67).</p><p><strong>Results: </strong>The control group showed the highest mean number of retrieved embryos (41.40 ± 14.74), closely followed by the gonadoprotection group (36.27 ± 17.22), while the chemotherapy group exhibited a significant reduction (20.63 ± 12.12) compared to both groups. Regarding the ovarian reserve, the control group showed the highest total follicle count (897.4 ± 392.8), with no difference compared to the gonadoprotection group (714.4 ± 283.9), but there was a significant decline in the chemotherapy group (320.7 ± 145.5) compared to both groups. In terms of follicle apoptosis and activation, no significant difference was observed between groups. Follicle proliferation rates were significantly higher in the chemotherapy group (59.38% ± 14.67%) than in the control group (20.72% ± 10.52%), but gonadoprotective treatment did curtail follicle proliferation (42.23% ± 18.37%) compared to the chemotherapy group.</p><p><strong>Conclusion: </strong>Our findings suggest that temsirolimus and AMH show promise as gonadoprotective agents, potentially protecting the ovarian reserve against chemotherapy and thereby preserving fertility. This could offer patients who cannot benefit from currently available techniques brand new fertility preservation options.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717840","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":"Do not measure AMH to predict women's fecundity.","authors":"D de Ziegler,S Sokteang,Pirtea Paul","doi":"10.1016/j.fertnstert.2025.07.025","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.025","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"704 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701373","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}
Elizabeth J Klein,Ariella Yazdani,Mindy S Christianson
{"title":"Advancing Fertility Preservation Surgery: Perfusion Monitoring Using Indocyanine Green for Uterine Transposition Prior to Pelvic Radiotherapy.","authors":"Elizabeth J Klein,Ariella Yazdani,Mindy S Christianson","doi":"10.1016/j.fertnstert.2025.07.026","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.026","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"8 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701238","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}
Jessica Y Shim,Ava Scatoni,Marc R Laufer,Elizabeth R Boskey
{"title":"Surgical management of endometriosis in adolescents versus adults: a National Surgical Quality Improvement Program study.","authors":"Jessica Y Shim,Ava Scatoni,Marc R Laufer,Elizabeth R Boskey","doi":"10.1016/j.fertnstert.2025.07.020","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.020","url":null,"abstract":"OBJECTIVETo compare the postoperative diagnoses and the types of surgical intervention, excluding hysterectomy, between adolescents and adults receiving endometriosis surgery.DESIGNRetrospective cohort.SUBJECTSAdolescents (aged <18 years) and adults (aged 18-50) with a postoperative diagnosis of endometriosis (excluding adenomyosis/endometriosis of the uterus) based on International Classification of Diseases codes, who received endometriosis surgery in hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program adult and pediatric databases (2012-2021).EXPOSUREEndometriosis surgery excluding hysterectomy, identified by Current Procedural Terminology codes.MAIN OUTCOME MEASURESPostoperative diagnoses, uterine-sparing endometriosis procedures, and 30-day postoperative complications between age groups.RESULTSWe identified 291 adolescents, median age 17 years (IQR 15-17), and 8785 adults, median age 34 years IQR 28-39), who underwent uterine-sparing surgery with a postoperative diagnosis of endometriosis. The majority of adolescents (78%) and adults (60%) were White, although adults were significantly more diverse across racial groups (p<0.001) and ethnic groups (6% vs 10% p=.006). A higher proportion of surgeries in adolescents were for peritoneal endometriosis (65% vs. 35%), whereas more adults underwent surgery for endometrioma (10% vs. 26%) or other endometriosis subtypes (25% vs 39%) (p<0.001). Laparoscopic excision/destruction of lesions was the most common procedure performed in adolescents (75%). While this remained the most common procedure in adults (59%), their endometriosis diagnoses were associated with a more diverse range of procedures. Diagnostic laparoscopy was more commonly performed in adolescents and rarely in adults (20% vs 2%) (p<0.001). 30-day complications were rare in both groups.CONCLUSIONAdolescents were more likely to undergo diagnostic laparoscopy or laparoscopic excision/destruction of lesions and be diagnosed with peritoneal endometriosis, whereas adults underwent a more diverse range of procedures for varied subtypes. Complications for endometriosis procedures were rare. Our findings support the notion of distinct variation in endometriosis between these age groups.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"17 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693314","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}
Leila Momtazi-Mar BS, Bryan D. Naelitz MD MS, Andrea Mucci MD, Rossella Cannarella MD PhD, Scott D. Lundy MD PhD
{"title":"Surgical Sperm Retrieval in Patients with Non-Mosaic Klinefelter Syndrome (47, XXY) May be Safely Delayed Until Adulthood: A Systematic Review and Meta-Analysis","authors":"Leila Momtazi-Mar BS, Bryan D. Naelitz MD MS, Andrea Mucci MD, Rossella Cannarella MD PhD, Scott D. Lundy MD PhD","doi":"10.1016/j.fertnstert.2025.07.021","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.021","url":null,"abstract":"Klinefelter Syndrome (KS) is the most common genetic cause of azoospermia due to germ cell apoptosis, seminiferous tubule hyalinization, and testicular interstitial hyperplasia. It remains controversial whether surgical sperm retrieval should be performed soon after puberty or may be safely delayed until adulthood.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"24 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665121","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}
José Bellver MD, Antonio Pellicer MD, Nicolás Garrido PhD
{"title":"The reproductive journey of obese women undergoing ART: an analysis of 48,595 in vitro fertilization cycles in 31,829 women.","authors":"José Bellver MD, Antonio Pellicer MD, Nicolás Garrido PhD","doi":"10.1016/j.fertnstert.2025.07.022","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.022","url":null,"abstract":"To study cumulative live birth rates in <ce:italic>in vitro</ce:italic> fertilization per oocyte used, per embryo transferred and per embryo transfer according to female body mass index in a cohort in which all the ovarian stimulation cycles performed until a live born was achieved or drop out were considered.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"10 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665098","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":"Non-randomised studies should be done well…and sparingly","authors":"Darren L. Dahly, Jack Wilkinson","doi":"10.1016/j.fertnstert.2025.07.019","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.019","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"52 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665142","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}
Yili Teng,Peipei Pan,Haiyan Yang,Xuefeng Huang,Chang Liu
{"title":"GnRH antagonist protocol is associated with higher oocyte yield in young women at high risk for low oocyte retrieval: a retrospective study using three statistical methods.","authors":"Yili Teng,Peipei Pan,Haiyan Yang,Xuefeng Huang,Chang Liu","doi":"10.1016/j.fertnstert.2025.07.018","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.07.018","url":null,"abstract":"OBJECTIVETo study whether gonadotropin-releasing hormone (GnRH) antagonist protocol is associated with improved oocyte retrieval outcomes compared to progestin-primed ovarian stimulation (PPOS) protocol in young women at high predicted risk for low oocyte yield.DESIGNRetrospective cohort study applying Bayesian analysis before and after propensity score matching (PSM), and risk-based stratified subgroup analysis SUBJECTS: A total of 2,068 women aged ≤35 years undergoing their first IVF/ICSI cycle between January 2023 and April 2025, identified as high risk for low oocyte retrieval (predicted score ≥0.41) using a validated nomogram incorporating age, AMH, AFC, basal FSH, and FSH/LH ratio.EXPOSUREOvarian stimulation with either a GnRH antagonist protocol or a PPOS protocol, with protocol selection based on clinical judgment and patient characteristics.MAIN OUTCOME MEASURESIncidence of low oocyte retrieval (<10 oocytes), and the number of oocytes retrieved.RESULTSAmong 2,068 young women at high predicted risk for low oocyte yield, the GnRH antagonist protocol resulted in significantly better ovarian stimulation outcomes compared to the PPOS protocol. After PSM, the antagonist group had a higher mean number of oocytes retrieved (8.3 vs. 5.3; BF10 > 1028) and a higher oocyte retrieval rate (88.2% vs. 81.2%; BF10 > 103). The incidence of low oocyte retrieval (<10 oocytes) was significantly lower in the antagonist group (65.2% vs. 86.0%; BF10 > 1019). No significant differences were observed in embryo quality or fertilization rates. Risk-based stratified analysis showed that the GnRH antagonist protocol significantly reduced the incidence of low oocyte retrieval in low- to mid-risk groups (median OR 0.30-0.57, BF10 up to 647.8), while in the highest risk subgroup, PPOS showed a potential advantage.CONCLUSIONThe GnRH antagonist protocol is superior to PPOS in maximizing oocyte retrieval among young women at high predicted risk for poor ovarian response, highlighting the value of individualized risk-based stimulation strategies to improve clinical outcomes.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"3 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664282","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}