Fertility and sterility最新文献

{"title":"Progestin prime ovarian stimulation provides comparable outcomes to GnRH antagonist in donor cycles with vitrified oocytes","authors":"Lucía Murria M.Sc. , Juan Giles M.D. , Lorena Bori Ph.D. , José Remohí M.D. , Ana Cobo Ph.D.","doi":"10.1016/j.fertnstert.2025.05.154","DOIUrl":"10.1016/j.fertnstert.2025.05.154","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effectiveness and safety of medroxyprogesterone acetate<span> (MPA) and gonadotropin-releasing hormone antagonist (GnRHant) protocols in vitrified donor oocyte cycles and expand the current evidence on their clinical outcomes.</span></div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Subjects</h3><div>This study included 14,981 recipients who received vitrified oocytes coming from 3,599 donors stimulated with MPA and 4,998 donors stimulated with GnRHant.</div></div><div><h3>Exposure</h3><div>Pituitary suppression during ovarian stimulation with either MPA or GnRHant protocols.</div></div><div><h3>Main Outcome Measures</h3><div><span>Clinical metrics included implantation, clinical pregnancy rate, ongoing pregnancy rate and cumulative live birth rate. Nonclinical metrics included artificial intelligence (AI)-based oocyte and </span>embryo quality scores.</div></div><div><h3>Results</h3><div><span><span>The MPA group demonstrated significantly higher oocyte survival rates postwarming (90.17% vs. 88.41%) and </span>blastocyst formation rates (57.58% vs. 53.99%) compared with the GnRHant group. Artificial intelligence-based evaluations revealed no significant differences in oocyte (5.9 ± 2.8 vs. 6.0 ± 2.9) or embryo (5.0 ± 2.6 vs. 5.1 ± 2.7) scores between the 2 groups. Clinical outcomes, including implantation rate (57.68% vs. 55.82%), clinical pregnancy rate (58.17% vs. 58.14%), ongoing pregnancy rate (49.40% vs. 48.15%) and cumulative live birth rate (65.60% vs. 65.50%), were comparable between MPA and GnRHant protocols. The paired analysis of donors stimulated with both protocols supported these findings, showing no significant differences in clinical outcomes. Finally, the Generalized Estimating Equations (GEEs) model identified significant predictors of live birth, including recipient age, recipient </span>body mass index (BMI), number of metaphase II (MII) oocytes, embryo quality, and the number of warmed MII oocytes, whereas the type of pituitary suppression protocol (MPA vs. GnRHant) did not significantly impact live birth rates (odds ratio: 1.09 [95% confidence interval: 0.97–1.23]).</div></div><div><h3>Conclusion</h3><div>Medroxyprogesterone acetate and GnRHant protocols yielded comparable clinical outcomes in vitrified donor oocyte cycles. Artificial intelligence-based assessments showed consistency with clinical outcomes, detecting no significant differences in oocyte or embryo quality between protocols. These results support the use of MPA as a cost-effective, patient-friendly alternative in donor oocyte vitrification cycles, providing robust evidence for its clinical application.</div></div><div><div>Estimulación ovárica con progesterona proporciona resultados comparables con antagonistas de GnRH en ciclos ovocitos de donantes vitrificados</div></div><div><h3>Objetivo</h3><div>Comparar la eficacia y seguridad del acetato de medroxiprogesterona (MPA) frente a lo","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Pages 701-710"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122129","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":"Shifting the focus for fertility and reproductive health to medical students: a survey study building on lessons from surgical trainees","authors":"Sylvie Bowden M.D. , Maitri Panchal B.Sc. , Angela Pochakom B.Sc. , Selphee Tang B.Sc. , Amy Metcalfe Ph.D. , Shu Foong M.D., F.R.C.S.","doi":"10.1016/j.fertnstert.2025.04.021","DOIUrl":"10.1016/j.fertnstert.2025.04.021","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Pages 769-771"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885131","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":"Reply of the authors: Perinatal outcomes of siblings: are they different across conception methods?","authors":"Hila Shalev-Ram M.D. , Anat Hershko Klement M.D. , Einat Haikin-Herzberger M.D. , Mattan Levi Ph.D. , Roni Rahav-Koren M.D. , Amir Wiser M.D. , Netanella Miller M.D.","doi":"10.1016/j.fertnstert.2025.06.017","DOIUrl":"10.1016/j.fertnstert.2025.06.017","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Page 791"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505304","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":"Day 7 embryos: looking beneath the surface of embryo quality","authors":"Isabelle Mason M.D., Rachel Weinerman M.D.","doi":"10.1016/j.fertnstert.2025.07.036","DOIUrl":"10.1016/j.fertnstert.2025.07.036","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Page 659"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850964","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":"Unassisted pregnancy rates and outcomes in cancer survivors: a systematic review","authors":"Nivedita R. Potapragada M.D., M.B.A. ,&nbsp;Molly Beestrum M.L.I.S. ,&nbsp;Kara N. Goldman M.D.","doi":"10.1016/j.fertnstert.2025.08.016","DOIUrl":"10.1016/j.fertnstert.2025.08.016","url":null,"abstract":"<div><h3>Importance</h3><div>This systematic review investigates outcomes for unassisted pregnancies in cancer survivors. Although prior studies have examined pregnancy outcomes for cancer survivors, clarifying the outcomes specifically for unassisted pregnancies can help guide patient and provider expectations and improve fertility preservation counseling.</div></div><div><h3>Objective</h3><div>The primary objective of this systematic review was to identify the impacts of cancer and its treatment on fertility, measured as the live birth rate among cancer survivors with an unassisted pregnancy. Secondary objectives included identifying parental and fetal outcomes of unassisted pregnancies in cancer survivors.</div></div><div><h3>Evidence Review</h3><div>We searched MEDLINE (PubMed), Embase (Elsevier), Cochrane Library (Wiley), and Scopus (Elsevier) from inception through April 24, 2025. After de-duplication, 1,185 unique citations were subject to blinded independent review by two investigators. Full-text screening was performed on 300 reports and 64 secondary citations. Data extraction was completed for 43 articles for the primary outcome of live birth rates and secondary outcomes.</div></div><div><h3>Findings</h3><div>This review consolidates the available data on the outcomes of unassisted pregnancies in cancer survivors compared with individuals without cancer. Live birth rates were significantly lower in survivors of breast cancer and individuals who underwent hematopoietic stem cell transplant or abdominopelvic radiation therapy during their cancer treatment. Survivors of breast and gynecologic cancers had higher rates of pregnancy loss, although there were no differences in rates of hypertensive disorders of pregnancy, gestational diabetes, placental abnormalities, or cancer recurrence. Survivors exposed to radiation therapy were more likely to have infants who were small for gestational age or had low birth weight, and survivors of breast cancer were more likely to experience iatrogenic or spontaneous preterm birth. The effects of other types of cancers or treatments were not associated with significant differences in live birth rates or any secondary outcomes in included studies.</div></div><div><h3>Conclusion and Relevance</h3><div>Although unassisted pregnancy is possible for patients diagnosed with cancer, certain cancers and treatments are associated with decreased live birth rates and increased obstetric and neonatal complications. Individualized fertility preservation counseling throughout the cancer diagnosis and treatment process is an important aspect of comprehensive cancer care that helps patients make informed decisions about their future fertility.</div></div>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Pages 593-603"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144901867","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":"Corrigendum to ‘Trustworthiness criteria for meta-analyses of randomized controlled studies: OBGYN journal guidelines’ [Fertil Steril 2024;122:965−9]","authors":"The OBGYN Editors’ Integrity Group (OGEIG)","doi":"10.1016/j.fertnstert.2025.08.008","DOIUrl":"10.1016/j.fertnstert.2025.08.008","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Page 799"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035545","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":"International Committee for Monitoring Assisted Reproductive Technologies world report: assisted reproductive technology, 2019","authors":"Silke Dyer M.D. ,&nbsp;Georgina M. Chambers Ph.D. ,&nbsp;Seung Chik Jwa M.D., Ph.D., M.P.H. ,&nbsp;Valerie L. Baker M.D., M.P.P. ,&nbsp;Manish Banker M.D., M.B.B.S. ,&nbsp;Jacques de Mouzon M.D., M.P.H. ,&nbsp;Eman Elgindy M.D., Ph.D. ,&nbsp;Bai Fu M.D., Ph.D. ,&nbsp;Osamu Ishihara M.D., Ph.D. ,&nbsp;Markus S. Kupka M.D., Ph.D. ,&nbsp;Fernando Zegers-Hochschild M.D. ,&nbsp;G. David Adamson M.D.","doi":"10.1016/j.fertnstert.2025.06.003","DOIUrl":"10.1016/j.fertnstert.2025.06.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To report the utilization, effectiveness, and safety of assisted reproductive technologies (ARTs) in 2019.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A retrospective, cross-sectional survey derived from cycle and pregnancy outcome data submitted by national and regional registries.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Subjects&lt;/h3&gt;&lt;div&gt;Patients undergoing ART procedures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Intervention&lt;/h3&gt;&lt;div&gt;Assisted reproductive technology.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Outcomes on country, regional, and global levels.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;There were 3,544,683 cycles with 783,073 infants born reported. There were an estimated ≥3,855,694 cycles with &gt;865,914 infants in reporting countries including nonreporting clinics. The reported number of cycles and infants increased by approximately 8% from 2018. Autologous frozen-thawed transfers accounted for 61.8% of all autologous transfers without preimplantation genetic testing (PGT), up from 14.8% in 2015. Among all reporting countries, the percentage of freeze-all cycles was 38.4% in 2019, up from 24.6% in 2015. There were 233,833 initiated PGT cycles reported from 44 countries, representing 6.6% of reported cycles vs. 2.6% in 2015. The delivery rate for autologous oocytes was 22.9% per aspiration, with a cumulative delivery rate of 38.6% per aspiration (excluding PGT). Per transfer, the delivery rates were 31.3% for autologous fresh transfers, 31.9% for autologous frozen transfers, 48.7% for transfers using PGT, and 34.6% for transfers after oocyte donation&lt;span&gt; (combined fresh and frozen transfers).In fresh autologous cycles (excluding PGT), the mean number of transferred embryos was 1.51, the proportion of single embryo transfers was 55.6%, and the multiple delivery rate was 17.7%. In autologous frozen-thawed cycles (excluding PGT), the mean number of transferred embryos was 1.26, the proportion of single embryo transfers was 74.1%, and the multiple delivery rate was 13.0%. With oocyte donation (combined fresh and frozen transfers), the multiple delivery rate was 10.8%. The multiple delivery rate for cycles using PGT was 4.2%.&lt;/span&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;&lt;span&gt;The International Committee for Monitoring Assisted Reproductive Technologies report is the most comprehensive summary of global ART utilization, effectiveness, and safety currently available. The report documents an increase in reported cycles and infants born from previous years, growing utilization of embryo cryopreservation and single embryo transfers, increasing numbers of PGT cycles, and a reduction in multiple deliveries. It also provides a benchmark for the impact of the &lt;/span&gt;coronavirus disease 2019 pandemic in 2020.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;Reporte mundial del Comité Internacional para el Monitoreo de Tecnologías en Reproducción Asistida&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objetivo&lt;/h3&gt;&lt;div&gt;Informar el uso, eficacia, y seguridad de las tecnologías en reproducción asistida (ARTs) en ","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Pages 679-693"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293617","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":"All our eggs in one basket: the false dichotomy of parenthood and a medical career","authors":"Katherine G. Unger B.S. ,&nbsp;Gwendolyn P. Quinn Ph.D.","doi":"10.1016/j.fertnstert.2025.07.006","DOIUrl":"10.1016/j.fertnstert.2025.07.006","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Pages 660-661"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612821","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":"Reflection on “International Committee for Monitoring Assisted Reproductive Technologies world report: assisted reproductive technology, 2019”","authors":"Nick Pyskir M.D.,&nbsp;Micah Hill D.O.","doi":"10.1016/j.fertnstert.2025.07.027","DOIUrl":"10.1016/j.fertnstert.2025.07.027","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Page 648"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706931","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":"Commentary on “Puberty progression in girls with Turner syndrome after ovarian tissue cryopreservation”","authors":"Shashank Dokania B.H.M.S.,&nbsp;Parth Aphale Ph.D.,&nbsp;Himanshu Shekhar B.H.M.S.","doi":"10.1016/j.fertnstert.2025.05.170","DOIUrl":"10.1016/j.fertnstert.2025.05.170","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"124 4","pages":"Page 789"},"PeriodicalIF":7.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208100","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}