{"title":"Not All Mosaic Embryos Are the Same: Time to Refine How We Report Mosaicism in PGT.","authors":"Mili Thakur","doi":"10.1016/j.fertnstert.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.007","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"136 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831626","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 Clomiphene Citrate on Multiple Gestation Births and Perinatal Outcomes: A Nationwide Cohort Study.","authors":"Mathilde Bourdon,Pietro Santulli,Nathanaël Beeker,Mathis Collier,Jean-Marc Treluyer,Vassilis Tsatsaris,Pierre Pinson,Laurent Chouchana","doi":"10.1016/j.fertnstert.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.005","url":null,"abstract":"OBJECTIVETo evaluate the occurrence of multiple gestation birth and perinatal adverse outcomes in pregnancies resulting from clomiphene citrate (CC) treatment compared to non-exposed pregnancies.DESIGNNationwide cohort study in an university hospital-based research center.SUBJECTSPregnancies lasting more than 22 weeks of gestation, in women aged between 18-43 years between 2013 to 2019, recorded in the French health data warehouse (SNDS).EXPOSURE(S)Pregnancies exposed to CC were assigned to a 1:5 unexposed control cohort based on maternal age, calendar year of childbirth, French social deprivation index, history of hypertension and diabetes. Exclusion criteria were IVF/ICSI treatment or gonadotrophins within 12 months before pregnancy and pregnancies occurring in women with the dispensing of CC between 12 to 2 months, and/or less 11days before the beginning of the pregnancy.MAIN OUTCOME MEASURE(S)Multiple gestation birth rate and perinatal outcomes RESULTS: Of 3,173,013 pregnancies, 32,010 (1%) occurred in women exposed to CC, of which 31,934 were assigned to 159,670 unexposed control pregnancies. The multiple pregnancy rate was significantly higher in CC-exposed pregnancies (5.2% versus 1.4%; odds ratio (OR) 3.9, 95% CI [3.7-4.1]) such as twin pregnancies ( 5.1% versus 1.4%; OR 3.9, 95% CI [3.7-4.1]) and triple or more pregnancies (0.13% versus 0.03%; OR 4.3, 95% CI [2.9-6.5]) compared to the unexposed control cohort. Women exposed to CC presented significantly more adverse obstetrical and perinatal outcomes, including stillbirths, premature delivery threats, premature rupture of membranes, gestational diabetes, placenta previa, gravid hypertension, pre-eclampsia, preterm birth, small for gestational age (SGA) and C-section rate. After stratification on multiple pregnancy and adjustment on confounders (history of psychiatric disease, obesity and embryo reduction during pregnancy), exposure to CC remains associated with adverse outcomes in both singleton and multiple pregnancies.CONCLUSIONA four-fold risk of multiple gestation births was found in pregnancies exposed to CC, along with perinatal adverse events, even in singletons. Although it remains uncertain whether these adverse events are due to the medication itself or to the treated medical condition, these findings should provide awareness of practitioners and patients about its use. It also underscores the importance of attentively monitoring follicular growth during the treatment process to avoid multiple pregnancies.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"108 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831683","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}
Yael Eliner,Bridget Foley,Steven R Bayer,Kim L Thornton,Alan S Penzias,Denny Sakkas,Denis A Vaughan
{"title":"The impact of PGT-A on time to live birth in IVF.","authors":"Yael Eliner,Bridget Foley,Steven R Bayer,Kim L Thornton,Alan S Penzias,Denny Sakkas,Denis A Vaughan","doi":"10.1016/j.fertnstert.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.006","url":null,"abstract":"OBJECTIVETo determine if utilizing pre-implantation genetic testing for aneuploidy (PGT-A) impacts time to pregnancy resulting in a live birth.DESIGNRetrospective cohort study.SETTINGSingle, large, university-affiliated fertility center in the United States.SUBJECTSPatients who underwent their first oocyte retrieval between January 1st, 2014, and December 31st, 2022, were included. Patients were categorized into a PGT-A group and a non-PGT-A group based on the use of PGT-A at the time of the first oocyte retrieval. Patients were then stratified by age: women <38 years old and women ≥38 years old at the time of the first retrieval. Propensity score matching was performed using nine criteria, matching 2,158 PGT-A patients to 2,158 non-PGT-A patients in the younger age group, and 1,343 PGT-A patients to 1,343 non-PGT-A patients in the older age group.EXPOSUREUse of PGT-A.MAIN OUTCOME MEASURESThe positive pregnancy rate leading to a live birth over a one-year period following the initial egg retrieval. This was used as an indicator of time to successful pregnancy.RESULTSFollowing the matching process, there were no statistically significant differences in the examined characteristics between PGT-A and non-PGT-A patients. The Kaplan-Meier curves showed that there was no significant difference in the probability of having a live birth in the younger group, with a live birth hazard ratio for the full year of 0.97 (95% CI 0.90-1.04), but was significantly shorter for PGT-A patients, with a live birth hazard ratio of 1.46 (95% CI 1.30-1.64) in the older group. Patients in the ≥38 age group who used PGT-A had a higher live birth rate over a one-year period, compared to non-PGT-A patients (51.2% versus 36.4%). In contrast, PGT-A and non-PGT-A patients in the <38 age group had similar cumulative one-year live birth rates (69.5% versus 67.1%). In both age groups, miscarriage rates and mean number of transfers were lower for PGT-A patients.CONCLUSIONPGT-A is associated with a shorter time to pregnancy resulting in a live birth for patients who are at least 38 years old but does not affect time to successful pregnancy in younger patients over a one-year period.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"40 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831680","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":"Reproductive Treatment in Restrictive Times: Utilization of Pre-Implantation Genetic Testing After Dobbs.","authors":"Alexandra Herweck,Heather S Hipp","doi":"10.1016/j.fertnstert.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.002","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"33 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824818","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 role of stress in male infertility.","authors":"Peter N Schlegel","doi":"10.1016/j.fertnstert.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.04.003","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"27 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824754","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":"Cesarean sections: too much of a good thing?","authors":"Dominique de Ziegler, Anuja Dokras","doi":"10.1016/j.fertnstert.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.03.004","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788257","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 Approach for Cesarean Scar Defect Repair: Translating Hysteroscopic Markings into Laparoscopic Precision with the Taurus T Method.","authors":"Yusuke Sako, Tetsuya Hirata","doi":"10.1016/j.fertnstert.2025.03.034","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.03.034","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795084","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}
Parker L Bussies, Allison Bosch, Mindy S Christianson
{"title":"Timing of Assisted Hatching Prior to Embryo Biopsy and Mosaicism Rates in Preimplantation Genetic Testing for Aneuploidy Cycles: Not All It's Cracked Up to Be.","authors":"Parker L Bussies, Allison Bosch, Mindy S Christianson","doi":"10.1016/j.fertnstert.2025.03.033","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.03.033","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795034","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":"Inguinal Canal Endometriosis.","authors":"Robyn A Lipschultz, Ted T Lee","doi":"10.1016/j.fertnstert.2025.03.035","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.03.035","url":null,"abstract":"<p><strong>Objective: </strong>Demonstrate a successful laparoscopic removal of endometriosis from within the inguinal canal via a step-by-step video explanation, underscore the importance of pre-operative MRI imaging, and provide education on anatomy and surgical technique.</p><p><strong>Design: </strong>Video case presentation of a successful laparoscopic removal of endometriosis from within the inguinal canal.</p><p><strong>Subjects: </strong>A single patient with MRI imaging revealing endometriosis invasion into the inguinal canal and local vasculature. The patient 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 (such as PubMed, ScienceDirect, Scopus, etc.) and other applicable sites.</p><p><strong>Exposure: </strong>The patient's abdomen was entered and vasculature was identified to prevent major bleeding. Appropriate exposure was achieved by transecting the round ligament to provide a landmark for the inguinal canal. The endometriosis was identified and dissected off the external iliac vasculature and the abdominal wall using the squeeze technique. The endometriosis was then dissected out of the inguinal canal, off the femoral artery, and then removed from the abdomen. Post-operatively, the patient was started on norethindrone acetate to suppress any residual disease and prevent recurrence.</p><p><strong>Main outcome measure: </strong>Patient's pain and quality of life post-operatively.</p><p><strong>Results: </strong>The patient noted immediate pain relief in the recovery room. One year post-operatively, the patient continued to endorse pain relief and no signs of hernia.</p><p><strong>Conclusion: </strong>Inguinal canal endometriosis is of rare occurrence. It typically presents as a groin lump or pain that is worse with menstruation. As the endometriosis is in close proximity to the abdominal wall and local vasculature, MRI imaging, as well as general surgery and vascular surgery consultation, are necessary for proper surgical planning. These are difficult operations that require proper understanding of pelvic and inguinal canal anatomy.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795091","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}
J B Maxwell, D J Kelm, L Rust, C C Paff Shenoy, H P Sviggum, A J Ainsworth
{"title":"Special considerations in assisted reproductive technology for patients with pulmonary disease.","authors":"J B Maxwell, D J Kelm, L Rust, C C Paff Shenoy, H P Sviggum, A J Ainsworth","doi":"10.1016/j.fertnstert.2025.03.032","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.03.032","url":null,"abstract":"<p><p>ART for patients with pulmonary disease requires multidisciplinary collaboration to optimize patient safety and ART outcomes. We present a review of pulmonary pathology which includes obstructive and restrictive lung diseases, vascular lung disease, and mediastinal masses which may require alterations in the approach to controlled ovarian hyperstimulation or anesthesia at time of oocyte retrieval. Optimization of pulmonary function prior to initiation of ART is of critical importance and further highlights the need for interprofessional collaboration.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795097","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}