Fertility and sterility最新文献

{"title":"A core outcome set for future male infertility research: development of an international consensus.","authors":"Michael P Rimmer, Ruth A Howie, Richard A Anderson, Christopher L R Barratt, Kurt T Barnhart, Yusuf Beebeejaun, Ricardo Pimenta Bertolla, Pietro Bortoletto, Robert E Brannigan, Astrid E P Cantineau, Ettore Caroppo, Barbara L Collura, Kevin Coward, William Colin Duncan, Michael L Eisenberg, Steven A Gellatly, Christian De Geyter, Dimitrios G Goulis, Ralf R Henkel, Vu N A Ho, Alayman F Hussein, Carin Huyser, Jozef H Kadijk, Mohan S Kamath, Shadi Khashaba, Hajra Khattak, Yoshitomo Kobori, Julia Kopeika, Tansu Kucuk, Saturnino Luján, Thabo Christopher Matsaseng, Raj S Mathur, Kevin McEleny, Rod T Mitchell, Ben W Mol, Alfred M Murage, Ernest H Y Ng, Allan Pacey, Antti H Perheentupa, Stefan Du Plessis, Nathalie Rives, Ippokratis Sarris, Peter N Schlegel, Majid Shabbir, Maciej Śmiechowski, Venkatesh Subramanian, Sesh K Sunkara, Basil C Tarlarzis, Frank Tüttelmann, Andy Vail, Madelon van Wely, Mónica H Vazquez-Levin, Lan N Vuong, Alex Y Wang, Rui Wang, James M N Duffy, Cindy M Farquhar, Craig Niederberger","doi":"10.1016/j.fertnstert.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.03.009","url":null,"abstract":"<p><strong>Objective: </strong>To develop a core outcome set for male infertility trials.</p><p><strong>Design: </strong>A two-round Delphi survey and consensus development workshop were undertaken with healthcare professionals, researchers and clinicians globally.</p><p><strong>Subjects: </strong>334 participants from 39 countries participated in the Delphi Survey, while 44 participants from 21 countries participated in the consensus development workshop.</p><p><strong>Intervention or exposure: </strong>NA MAIN OUTCOME MEASURES: The core outcome set for male infertility trials has been developed by the inclusion of specific male-factor outcomes in addition to the general infertility core outcome set which focuses on female-factor outcomes.</p><p><strong>Results: </strong>The outcomes identified include assessment of semen using the World Health Organisation recommendations for semen analysis; viable intrauterine pregnancy confirmed by ultrasound (accounting for singleton, twin and higher multiple pregnancies); pregnancy loss (accounting for ectopic pregnancy, miscarriage, stillbirth and termination of pregnancy); live birth; gestational age at delivery; birthweight; neonatal mortality; and major congenital anomaly. Although not a requirement as part of the core outcome set, other outcomes were identified as potentially useful in certain study settings.</p><p><strong>Conclusion: </strong>Embedding the core outcome set within RCTs and systematic reviews should ensure the comprehensive selection, collection and reporting of core outcomes, which are inconsistently reported at present. Research funding bodies, the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement, and over 80 specialty journals, including the Cochrane Gynaecology and Fertility Group, Fertility and Sterility and Human Reproduction, have committed to implementing this core outcome set for male infertility trials.</p><p><strong>Trial registration number: </strong>Core Outcome Measures in Effectiveness Trials (COMET) initiative registration No: 1586. Available at www.comet-initiative.org/Studies/Details/1586.</p>","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001054","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 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":"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}

{"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":"10.1016/j.fertnstert.2025.03.034","url":null,"abstract":"<p><strong>Objective: </strong>To present the \"Taurus T Method,\" a novel 3-step approach that simplifies our previously reported nonperfusion hysteroscopy technique for cesarean scar defect (CSD) repair by eliminating the need for simultaneous screen monitoring.</p><p><strong>Design: </strong>A technical video introducing the laparoscopic repair of CSD using the \"Taurus T Method.\" This study was approved by the institutional review board (approval number: R22-093).</p><p><strong>Setting: </strong>A tertiary care gynecology center.</p><p><strong>Patients: </strong>A 35-year-old woman presented with secondary infertility after a cesarean section performed 3 years ago at 38 weeks of gestation because of breech presentation. She underwent 4 cycles of intrauterine insemination and 4 embryo transfers via in vitro fertilization for unexplained infertility, but none resulted in pregnancy. During infertility treatment, she experienced irregular bleeding, and ultrasonography revealed blood pooling in the CSD.</p><p><strong>Interventions: </strong>The \"Taurus T Method\" involves 3 key surgical steps: Step 1: Under hysteroscopic guidance, mark the cephalad and caudal ends of the defect with straight needles. Step 2: Insert a Hegar dilator into the defect and bend the uterine fundus dorsally to achieve a retroverted position. This procedure generates the \"Taurus sign,\" ensuring optimal uterine positioning for the resection of the CSD lesion within the laparoscopic field of view. Step 3: Perform a T-shaped excision between the needles: a vertical incision followed by a horizontal cut along the cephalad margin. The needle markings translate hysteroscopic findings into a laparoscopic view, allowing surgeons to focus on the laparoscopic screen during the excision phase.</p><p><strong>Primary outcome measure(s): </strong>Complete excision of the CSD and improvement in patient symptoms through the 3-step surgical technique.</p><p><strong>Results: </strong>The \"Taurus T Method\" achieved accurate CSD excision, although recognizing both the vertical and lateral extent through the laparoscopic view minimizing unnecessary tissue removal.</p><p><strong>Conclusion(s): </strong>The \"Taurus T Method\" is a systematic approach for accurately identifying and removing the CSD. The \"Taurus sign\" enables recognition of the defect's vertical extent, whereas the T-shaped incision allows precise visualization of its lateral extent, ensuring complete excision.</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":"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}

{"title":"Timing of assisted hatching before embryo biopsy and mosaicism rates in preimplantation genetic testing for aneuploidy cycles: not all it is cracked up to be.","authors":"Parker L Bussies, Allison Bosch, Mindy S Christianson","doi":"10.1016/j.fertnstert.2025.03.033","DOIUrl":"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":"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>Subject: </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. Postoperatively, the patient was started on norethindrone acetate to suppress any residual disease and prevent recurrence.</p><p><strong>Main outcome measures: </strong>Patient's pain and quality of life postoperatively.</p><p><strong>Results: </strong>The patient noted immediate pain relief in the recovery room. One year postoperatively, 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 a 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}

{"title":"Special considerations in assisted reproductive technology for patients with pulmonary disease.","authors":"John B Maxwell, Diana J Kelm, Laura M Rust, Chandra Paff Shenoy, Hans P Sviggum, Alessandra J Ainsworth","doi":"10.1016/j.fertnstert.2025.03.032","DOIUrl":"10.1016/j.fertnstert.2025.03.032","url":null,"abstract":"<p><p>Assisted reproductive technology (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 before 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}