Fertility and sterility最新文献

{"title":"Racial disparities in the outcomes of euploid single frozen-thawed embryo transfer cycles - analysis of the Clinical Outcome Reporting System of the Society for Assisted Reproductive Technology 2016-2018 data.","authors":"Xiomara Brioso, Satu Kuokkanen, Meredith Akerman, Lubna Pal","doi":"10.1016/j.fertnstert.2024.07.031","DOIUrl":"10.1016/j.fertnstert.2024.07.031","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate if in pregnancies conceived with the transfer of single genetically tested embryos, maternal race and ethnicity relate to pregnancy outcome.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Data available in the Clinical Outcome Reporting System of the Society for Assisted Reproductive Technology (SART-CORS) for years 2016-2018.</p><p><strong>Patient(s): </strong>Autologous frozen-thaw embryo transfer (FET) cycles with transfer of single genetically tested embryo in SART-CORS for years 2016-2018; cycles associated with diagnoses of recurrent pregnancy loss, gestational carrier, donor egg and donor embryo were excluded.</p><p><strong>Intervention(s): </strong>Information on race and ethnicity linked with in vitro fertilization and FET cycles available in SART-CORS.</p><p><strong>Main outcome measure(s): </strong>Multivariable analyses using generalized estimating equation examined the relationship between categories of race and ethnicity with the following outcomes: Pregnancy positive β hCG (human chorionic gonadotropin), clinical pregnancy, pregnancy loss (early [at gestation <13 weeks] and late [loss between ≥13 and <20 weeks]), preterm (<37 weeks), term (≥37 weeks) and live birth. Covariates adjusted for included age, body mass index, anti-Mullerian hormone, infertility diagnosis and smoking history.</p><p><strong>Result(s): </strong>Seventy-nine thousand four hundred and sixteen FET cycles met the eligibility criteria. Information on race and ethnicity was specified for 50,820 (64.0%) and was not known in 28,723 (36%) of the cycles. The population was predominantly non-Hispanic White (44%); non-Hispanic Black comprised 2.7%, Asian 12.3%, Hispanic 3.4%, and American Indian, Pacific Islander, Hawaiian, and Alaskan comprised 0.2% of the population. Nearly 1.0 % self-identified with more than one race. On multivariable analyses, pregnancies in non-Hispanic Black and in Hispanic women (compared with non-Hispanic Whites') were significantly more likely to result in in preterm birth. Compared with non-Hispanic White women, the likelihood of live birth was significantly lower in non-Hispanic Blacks, Asian, Hispanic, American Indian, Pacific Islander, Hawaiian, and Alaskan women. The likelihood for delivery by Cesarean was also disproportionately higher in the non Hispanic Black and, Hispanic women and in those identifying with more than one race (0.023) compared with non-Hispanic White women.</p><p><strong>Conclusion(s): </strong>Racial and ethnic differentials are apparent in the outcomes of FET conceived pregnancies resulting from the transfer of single genetically tested embryos.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":"1026-1036"},"PeriodicalIF":6.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787677","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":"Aneuploidy rates and likelihood of obtaining a usable embryo for transfer among in vitro fertilization cycles using preimplantation genetic testing for monogenic disorders and aneuploidy compared with in vitro fertilization cycles using preimplantation genetic testing for aneuploidy alone.","authors":"Rachel A Martel, Mabel B Lee, Alessia Schadwell, Mehrnaz Siavoshi, Lorna Kwan, Jenna Miller, Chelsea Leonard, Robert A Roman, Abigail Armstrong, Lindsay Kroener","doi":"10.1016/j.fertnstert.2024.07.030","DOIUrl":"10.1016/j.fertnstert.2024.07.030","url":null,"abstract":"<p><strong>Objective: </strong>To compare aneuploidy rates among in vitro fertilization (IVF) cycles using preimplantation genetic testing for monogenic disorders (PGT-M) and aneuploidy (PGT-A) compared with IVF cycles using PGT-A alone, and to determine the likelihood of obtaining at least one usable embryo in cycles using PGT-M+PGT-A compared with cycles using PGT-A alone.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single genetics laboratory.</p><p><strong>Patient(s): </strong>All IVF cycles for patients aged 18-45 undergoing PGT-A with or without concurrent PGT-M at a single genetics laboratory from November 2019 to March 2023.</p><p><strong>Intervention(s): </strong>Use of PGT-M+PGT-A vs. use of PGT-A alone.</p><p><strong>Main outcome measure(s): </strong>Per cycle aneuploidy rate stratified by age, and per cycle likelihood of obtaining at least one usable embryo stratified by age and inheritance pattern of monogenic disease.</p><p><strong>Result(s): </strong>A total of 72,522 IVF cycles were included; 4,255 cycles (5.9%) using PGT-M+PGT-A and 68,267 cycles (94.1%) using PGT-A alone. The PGT-M+PGT-A group was younger than the PGT-A alone group (<35 years old: 56.1% vs. 30.5%). The majority of PGT-M cycles were performed for autosomal dominant pathogenic variants (42.4%), followed by autosomal recessive (36.5%), X-linked dominant (13.3%), and X-linked recessive (7.5%). The median number of embryos biopsied was higher in PGT-A alone compared with PGT-M+PGT-A cycles for patients aged <35, but it was equivalent in all other age groups. Age stratified aneuploidy rates did not significantly differ between PGT-M+PGT-A compared with PGT-A alone cycles. The probability of having a usable embryo declined with increasing age across all inheritance patterns. Compared with PGT-A alone, PGT-M+PGT-A cycles for patients aged ≤40 across all inheritance patterns were significantly less likely to yield a usable embryo, except in cycles for autosomal recessive diseases in the 38-40 age group and X-linked recessive diseases in the 35-37 age group. There were no consistent differences seen between groups in patients over 40. Cycles for patients with autosomal dominant diseases had the lowest likelihood of yielding a usable embryo for patients aged <43.</p><p><strong>Conclusion(s): </strong>In vitro fertilization cycles using PGT-M+PGT-A have similar age-specific aneuploidy rates to those using PGT-A alone. Cycles for patients ≤40 using PGT-M+PGT-A are significantly less likely to yield a usable embryo compared with those using PGT-A alone.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":"993-1001"},"PeriodicalIF":6.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787673","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":"Investigating the influence of oral contraceptive pill use on multiple sclerosis risk using UK Biobank data.","authors":"Andrea Nova, Giovanni Di Caprio, Giulia N Baldrighi, Davide Galdiolo, Luisa Bernardinelli, Teresa Fazia","doi":"10.1016/j.fertnstert.2024.07.999","DOIUrl":"10.1016/j.fertnstert.2024.07.999","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between oral contraceptive (OC) pill use and the risk of developing multiple sclerosis (MS), attempting to address the limitations present in previous studies that produced conflicting results.</p><p><strong>Design: </strong>A population-based cohort study using data from the UK Biobank.</p><p><strong>Patients: </strong>The study included 181,058 women of white ethnicity born in England between 1937 and 1970, among which 1,131 had an MS diagnosis.</p><p><strong>Intervention: </strong>Oral contraceptive use, considering the self-reported age of initiation and discontinuation. The exposures of interest include the following: ever-use, current use, duration of current use in years, and age and year at initiation.</p><p><strong>Main outcome measures: </strong>Multiple sclerosis diagnosis (International Classification of Disease, 10th revision: G35) was used as an outcome of interest, and the associations with the exposures of interest were investigated using marginal structural models with a time-to-event approach. To adjust for confounding, we included in the models several variables, including MS polygenic risk score, education level, parity, smoking, fertility problems, obesity, and mononucleosis. We further aimed to evaluate the influence of parity using a mediation analysis.</p><p><strong>Results: </strong>The association of both ever and current OC use did not result in a statistically significant MS hazard increase (ever vs. never-users, hazard ratio [HR] = 1.30 [95% confidence interval {CI}: 0.93,1.82]; current vs. never-users, HR = 1.35 [95% CI: 0.81, 2.25]). However, we highlighted parity as an effect modifier for this association. In nulliparous women, ever and current use resulted in a significant twofold and threefold MS hazard increase (HR = 2.08 [95% CI: 1.04, 4.17] and HR = 3.15 [95% CI: 1.43, 6.9]). These associations were supported by significant MS hazard increases for a higher duration of current use and for an earlier age at initiation. We further highlighted genetic MS susceptibility as another effect modifier, as a stronger OC-MS hazard association was found in women with a low MS polygenic risk score.</p><p><strong>Conclusion: </strong>Our findings highlighted how the association between OC use and MS varies on the basis of individual characteristics such as parity and genetic MS susceptibility. Importantly, current use in nulliparous women was found to be associated with a threefold increase in MS hazard. We acknowledge the need for cautious causal interpretation and further research to validate these findings across diverse populations and OC types.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":"1094-1104"},"PeriodicalIF":6.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888907","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: Enhancing women's health management for predicting miscarriage risk: a call for broader inclusivity and holistic approaches.","authors":"Jennifer J Yland, Zahra Zad, Ioannis Ch Paschalidis, Lauren A Wise","doi":"10.1016/j.fertnstert.2024.08.329","DOIUrl":"10.1016/j.fertnstert.2024.08.329","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":"1161"},"PeriodicalIF":6.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035606","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":"Live birth after transmyometrial embryo transfer in a patient with radical trachelectomy.","authors":"Claire A Jones, Justin Tan, Pat Chronis-Brown, Amy Zhu, Nigel Pereira","doi":"10.1016/j.fertnstert.2024.08.346","DOIUrl":"10.1016/j.fertnstert.2024.08.346","url":null,"abstract":"<p><strong>Objective: </strong>To report the successful utilization of transmyometrial embryo transfer (TMET) in a patient with a history of radical trachelectomy.</p><p><strong>Design: </strong>Video article.</p><p><strong>Setting: </strong>Academic fertility center.</p><p><strong>Patient(s): </strong>A 39-year-old, para 1, woman with a history of radical trachelectomy and abdominal cerclage presented with secondary infertility. Her previous pregnancy was conceived naturally. Her first in vitro fertilization (IVF) cycle yielded only one day 7 euploid blastocyst. All attempts at performing mock embryo transfers, cervical dilatation, and hysteroscopy were unsuccessful because of absence of clinically identifiable cervical tissue. The euploid embryo was transferred into a gestational carrier; however, this resulted in a biochemical pregnancy. She underwent a second IVF cycle that yielded one day 5 euploid blastocyst. Given her history, TMET was planned. 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 (e.g., PubMed, ScienceDirect, and Scopus) and other applicable sites.</p><p><strong>Intervention(s): </strong>Transmyometrial embryo transfer using the Towako catheter.</p><p><strong>Main outcome measure(s): </strong>Implantation, clinical pregnancy, and live birth.</p><p><strong>Result(s): </strong>After institutional and Health Canada approval of the Towako catheter, a transvaginal ultrasound-guided TMET was performed under sedation with intravenous midazolam and fentanyl. The day 5 euploid blastocyst from the second IVF cycle was transferred, and the patient's β-human chorionic gonadotropin levels 9 and 11 days after TMET were 86 and 262 IU/L, respectively. A single intrauterine pregnancy with cardiac activity of 119 beats/min was noted at a gestational age of 7 weeks and 2 days. The patient delivered a live singleton at 35 weeks and 2 days weighing 2,182 g.</p><p><strong>Conclusion(s): </strong>Transmyometrial embryo transfer is a useful clinical technique for transferring embryos in patients with acquired or congenital cervical issues in whom transcervical embryo transfer is either very difficult or impossible.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":"1152-1153"},"PeriodicalIF":6.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105959","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":"Endometriosis, adenomyosis, and nonpregnant uterine contractility.","authors":"Demetrios A Arvanitis","doi":"10.1016/j.fertnstert.2024.09.032","DOIUrl":"10.1016/j.fertnstert.2024.09.032","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":"1016"},"PeriodicalIF":6.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282730","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":"Trustworthiness criteria for meta-analyses of randomized controlled studies: OBGYN journal guidelines.","authors":"","doi":"10.1016/j.fertnstert.2024.08.351","DOIUrl":"10.1016/j.fertnstert.2024.08.351","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":"965-969"},"PeriodicalIF":6.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461575","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 ethics of egg sharing.","authors":"Meera Shah, Samuel Pang, Lydia Hughes, Katie Watson, Eve C Feinberg, Eric A Widra","doi":"10.1016/j.fertnstert.2024.10.003","DOIUrl":"10.1016/j.fertnstert.2024.10.003","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":"984-990"},"PeriodicalIF":6.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617804","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":"Functional determinants of uterine contractility in endometriosis and adenomyosis: a systematic review and meta-analysis.","authors":"Noemi Salmeri, Giorgia Di Stefano, Paola Viganò, Pamela Stratton, Edgardo Somigliana, Paolo Vercellini","doi":"10.1016/j.fertnstert.2024.07.026","DOIUrl":"10.1016/j.fertnstert.2024.07.026","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Evidence suggests that aberrant uterine contractility in nonpregnant women with endometriosis and adenomyosis contributes to symptoms and potentially heralds their pathogenesis. However, uterine peristalsis remains understudied, inconsistently measured, and poorly understood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To summarize evidence on uterine contractility across the menstrual cycle phases in women with endometriosis and adenomyosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;PubMed/MEDLINE, Embase, and Scopus databases searched up to May 2, 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study selection and synthesis: &lt;/strong&gt;Observational studies compared quantitative measures of uterine contractility using magnetic resonance imaging, ultrasound, electrophysiology, or direct intrauterine pressure recording across different menstrual cycle phases between women with endometriosis/adenomyosis and controls on the basis of predefined problem/population, intervention, comparison, and outcome criteria. Study quality was assessed using the Newcastle-Ottawa Scale. Pooled estimates for primary (risk ratios with 95% confidence intervals [CIs]) and secondary (mean difference [MD] with 95% CIs) outcomes were calculated using random-effects models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes: &lt;/strong&gt;Pooled risk of retrograde menstruation uterine contraction pattern in cases vs. controls; pooled MD in continuous measures of uterine contractility (frequency, amplitude, and velocity of contractions) across all the menstrual cycle phases in cases vs. controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nine studies met the inclusion criteria; most were studies that evaluated women with endometriosis. An increased risk of retrograde uterine contractions during menstruation was observed in women with endometriosis compared with that in controls (risk ratio, 8.63; 95% CI, 3.24-22.95; I&lt;sup&gt;2&lt;/sup&gt;, 0). The pooled MDs in contraction frequency between cases and controls were 0.82 (95% CI, 0.13-1.52; I&lt;sup&gt;2&lt;/sup&gt;, 18.61%) in the menstrual phase and 0.52 (95% CI, 0.22-0.83; I&lt;sup&gt;2&lt;/sup&gt;, 27.18%) in the luteal phase. Results for the follicular and periovulatory phases were more heterogeneous. Higher contraction amplitudes in women with endometriosis or adenomyosis were reported across all menstrual cycle phases. Because of the paucity of data, especially for adenomyosis, evidence certainty was graded as low for most comparisons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion and relevance: &lt;/strong&gt;The approximately ninefold increased risk of retrograde pattern during menstruation in endometriosis supports the potential role of retrograde menstruation in its etiopathogenesis. Abnormal uterine contractility, likely not limited to the menstrual phase, may be a mechanical factor contributing to development of endometriosis and related symptoms, including menstrual pain and infertility, with limited, mostly concordant evidence for adenomyosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Registration number: &lt;/strong&gt;PROSPERO ID CRD42024512273-accept","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":"1063-1078"},"PeriodicalIF":6.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embryoscopy with hysteroscopy for a more full-scope assessment and management of early miscarriage.","authors":"Salomeh Salari, Steven R Lindheim","doi":"10.1016/j.fertnstert.2024.11.022","DOIUrl":"10.1016/j.fertnstert.2024.11.022","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767629","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}