Fertility and sterility最新文献

{"title":"Introduction to the Views and Reviews series on fertility decline Coping with fertility decline: Tackling the new reproductive challenge.","authors":"Dominique de Ziegler,Sokteang Sean,James P Toner","doi":"10.1016/j.fertnstert.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.026","url":null,"abstract":"Fertility decline and global depopulation are on everyone's lips. The numbers are indeed dire, particularly in Asia, where fertility decline is not mitigated by immigration. Demographic predictions are often shortsighted, and course corrections may be possible if solutions are thoughtfully designed and holistically implemented.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"94 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134134","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":"Are Obstructive Mullerian Anomalies an Experimental Model of Sampson's Theory for Endometriosis in Vivo?","authors":"Ceana Nezhat,Jennifer Dietrich,Nassif Joseph","doi":"10.1016/j.fertnstert.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.027","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"18 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134133","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":"Is Endometriosis a Progressive Disease? Examining Age-Related Trends in disease Severity and Surgical Complexity.","authors":"Yael Yagur,Rebecca Schneyer,Kacey Hamilton,Ogechukwu Ezike,Katharine Ciesielski,Margot Barker,Camelita Thrift,Kasey Fitzsimmons,Gabriel Levin,Raanan Meyer,Kelly Wright,Matthew Siedhoff","doi":"10.1016/j.fertnstert.2025.09.024","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.024","url":null,"abstract":"OBJECTIVETo study the relationship between age and the phenotypic expression and surgical complexity of endometriosis using the AAGL classification.DESIGNRetrospective cohort study.SUBJECTSPatients aged 18-51 years with pathology-confirmed stage III-IV endometriosis.EXPOSUREWe analyzed patients who underwent laparoscopic or robotic-assisted endometriosis surgery between 2013 and 2023 at a quaternary care institution in the United States. Patients were stratified into four age groups (≤25, 25-35, 35-45, >45).MAIN OUTCOME MEASURESThe primary outcome was age related differences in disease severity (AAGL Classification), surgical complexity (AAGL Level A-D), the presence of endometrioma and bowel endometriosis. Secondary outcomes included association with clinical presentation, imaging findings, and surgical complications.RESULTSA total of 1,293 patients met inclusion criteria. AAGL stage III-IV prevalence increased with age, peaking at 50.5% in the 35-45 age group, then stabilizing at 47.0% in the >45 year group (p<.001). AAGL surgical complexity continued to rise steadily with Level C increasing from 21.1% (≤25 years) to 58.3% (>45 years). In multivariable regression, compared to patients aged <25 years, those aged 25-35, 35-45, and >45 had significantly higher odds of AAGL Stage III-IV disease (adjusted odds ratio [aOR] 2.47, 95% CI 1.35-4.49; 2.54, 95% CI 1.40-4.61; and 2.84, 95% CI 1.42-5.66, respectively). Surgical complexity (AAGL Level C-D) significantly increased beyond age 35, with aOR of 2.13 (95% CI 1.22-3.72) for ages 35-45 and 4.46 (95% CI 2.32-8.59) for patients >45. The odds of having endometriomas was higher for all age groups compared to age <25 (aOR 3.05, 95% CI 1.73-5.39 for ages 25-35, aOR 3.24, 95% CI 1.84-5.70 for ages 35-45, and aOR 2.58, 95% CI 1.34-4.96 for ages >45). No significant association between age and bowel endometriosis was found.CONCLUSIONSAAGL disease stage peaks around ages 25-35 and subsequently plateaus, while surgical complexity continues to increase beyond this age, reaching the highest odds in patients over 45, likely reflecting cumulative fibrosis, adhesions, and anatomical remodelling. These findings highlight the importance of individualized, age-specific treatment approaches to reduce surgical complexity later in life. Future research should further refine these age-based management strategies.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"17 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093550","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":"Neuropsychological Profile of Polycystic Ovary Syndrome: Past, Present and Future.","authors":"Martina Emma Bernstein,Anuja Dokras,Claire Flaherty","doi":"10.1016/j.fertnstert.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.019","url":null,"abstract":"Polycystic ovary syndrome is a reproductive, endocrine, and metabolic condition affecting 6- 10% of reproductive age women worldwide. Beyond infertility, PCOS may be associated with effects on the neuropsychological profile. Notwithstanding studies attesting to the adverse effects of hyperandrogenism on cognition, few well controlled studies have explored the PCOS neuropsychological profile. We performed a review of current approaches to evaluation of cognition in PCOS in comparison to healthy controls and present our findings organized by cognitive domain. Recent reviews of studies comparing women with PCOS and healthy controls demonstrate increased risk of cognitive decline in areas that include fluency, short term memory, and executive functioning. Cognitive decline is defined as test results greater than 1.5 standard deviations below the mean on objective, validated psychometric tests in comparison to a normative sample. However, findings have been equivocal, with multiple factors considered to potentially be underlying the cognitive changes seen, including functional neuroimaging evidence of fluctuations entrained with the menstrual cycle, as well as the comorbidities of BMI, insulin resistance and depression. Overall, literature dedicated to characterizing the PCOS neuropsychological profile is scant, primarily consisting of small, underpowered, poorly controlled studies. In the future, there is a need for well controlled longitudinal studies incorporating neuropsychological assessment and neuroimaging. Such an approach could better guide the development of future treatment approaches.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"22 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089866","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":"Dual trigger versus GnRH-a trigger for elective fertility preservation. A randomized controlled trial.","authors":"Valeria Donno,Ana Raquel Neves,Sandra García-Martinez,Ignacio Rodriguez,Nikolaos P Polyzos","doi":"10.1016/j.fertnstert.2025.09.016","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.016","url":null,"abstract":"Structured Abstract OBJECTIVE: The study aims to compare the efficacy, in terms of mature oocytes, of dual trigger vs. agonist alone in good prognosis patients undergoing elective fertility preservation.DESIGNRandomized, controlled, single-center, superiority clinical trial SUBJECTS: A total of 109 women were enrolled in this study between October 2021 and April 2023 with a 1:1 allocation. Eligible patients were ≤40 years old, with an antral follicular count <20 and anti-Mullerian hormone ≤3 ng/ml undergoing elective fertility preservation cycles.INTERVENTIONControlled ovarian stimulation was performed using 225-300IU/day of follitropin alfa or beta or 15-20 μg of follitropin delta, tailored to ovarian reserve and weight. LH surge was suppressed through a progestin-primed ovarian stimulation protocol, with oral administration of micronized progesterone (200mg daily) from the beginning of ovarian stimulation until the trigger day. As soon as at least three follicles ≥ 18 mm were observed by ultrasound, patients were randomization to the intervention group (Triptorelin 0.2 mg + 250 mcg rhCG) or the control group trigger with GnRH-a alone (Triptorelin 0,2 mg).MAIN OUTCOME MEASURESThe primary endpoint was the number of MII oocytes retrieved after final oocyte maturation with dual trigger and GnRH-a trigger in patients undergoing elective fertility preservation.RESULTSOverall, 109 patients were analyzed, 55 in the Dual trigger group and 54 in the control arm (GnRH-a). No statistically significant differences were found regarding the total number of oocytes nor MII oocytes retrieved between the Dual Trigger and GnRH-a groups (9.22 ± 5.11vs.9.56 ± 5.16, (EMD-0.34 [95%CI: -2.29;1.61]) and 7.31 ± 4.63vs.7.94 ± 4.39 group (EMD -0.64 [95%CI: -2.07;0.80], respectively). Likewise, no statistically significant differences were found regarding estradiol, progesterone, LH and FSH levels on the day following the trigger. Notably, neither group exhibited any case of Ovarian Hyperstimulation Syndrome (OHSS).CONCLUSIONIn patients undergoing fertility preservation, adding hCG to GnRH-a for triggering final oocyte maturation is not superior to the administration of GnRH-a alone in terms of MII oocytes. Therefore, the selection of the trigger method should be based on both patients' and clinicians' preferences, with a focus on patients' safety and convenience.TRIAL REGISTRATION NUMBERNCT04992468.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"100 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083301","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":"Microfluidic organ-on-chip device: a unique platform for investigating implantation and placentation.","authors":"Sneha Mani,Se-Jeong Kim,Rosemary Flock,Dongeun Huh,Monica Mainigi","doi":"10.1016/j.fertnstert.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.020","url":null,"abstract":"Disruption of critical processes during early placentation is associated with several pregnancy disorders, leading to high rates of morbidity and mortality globally. However, we are unable to detect or modify the course of these disorders because the fundamental mechanisms underlying their development remain incompletely described. This stems from an inability to ethically study these processes in vivo and a lack of technology to model early placentation in vitro in a physiologically relevant manner.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"18 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083477","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":"Gut Feelings - The gut microbiome as a regulator of mental health in polycystic ovary syndrome.","authors":"Riikka K Arffman,Bárbara A Folch,Irene Leonés-Baños,Signe Altmäe","doi":"10.1016/j.fertnstert.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.014","url":null,"abstract":"IMPORTANCEPolycystic ovary syndrome (PCOS) is a common endocrine disorder associated with reproductive, metabolic, and mental health comorbidities. The exact mechanisms of PCOS-related psychological distress and the role of the microbiome in the process remain unclear.OBJECTIVETo systematically review the current literature on the gut microbiome's association with mental health in women with PCOS and to review the possible mechanisms.EVIDENCE REVIEWA comprehensive literature search across the PubMed database until July 2025. Studies were included if they met the following criteria: 1) observational / intervention studies, 2) assessing microbiome through 16S rRNA amplicon / 16S rRNA gene sequencing / metagenomics, 3) comparing microbiome between women with and without PCOS, 4) published from 2007 until 2025, and 5) articles available online. The exclusion criteria were: 1) language other than English or Spanish, 2) reviews, 3) abstracts/posters, 4) case reports, 5) full text not available, and 6) duplicates. Two independent reviewers screened all titles and abstracts to determine eligibility, and discrepancies were resolved through discussion. The methodological quality and the potential risk of bias were assessed following the Joanna Briggs Institute Critical Appraisal Checklist for Case-Control Studies.FINDINGSA total of 159 studies were identified and screened for title, abstract, and full text. Eight studies met the criteria (2 rodent; 6 human studies). The quality assessment indicated that half of the studies (4/8) presented a high risk of bias. Regardless of the limited number of studies and the low quality scores, all the studies highlighted the association of the gut microbiome in PCOS with mental health problems.CONCLUSIONS AND RELEVANCEOur review provides the first summary of the studies performed today on the Gut-Brain axis in PCOS. Our review highlights that the current state of the research is rather preliminary, and the existing studies possess various limitations and often lack rigorous study design. Nevertheless, all the studies indicated an association between changes in gut microbiome and mental health indicators in PCOS. We also noted a consistent increase in Gram-negative bacteria in women with PCOS and mental health issues. More research is needed on humans with a bigger sample size, different ethnicities, and wider age groups to clarify the microbial patterns involved, and in parallel, the field should move from descriptive studies to mechanistic approaches. Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with reproductive, metabolic, and mental health comorbidities. The exact mechanisms of PCOS-related psychological distress and the role of the microbiome in the process remain unclear. In this review, we systematically screen the current literature on the gut microbiome's association with mental health in women with PCOS and describe possible mechanisms. We did a comprehensive literature search acr","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"2 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083308","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":"Donor Embryo versus Double Gamete Donation: How do Outcomes Compare?","authors":"Zachary Anderson,Jennifer F Kawwass","doi":"10.1016/j.fertnstert.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.018","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083299","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 Across Ages: Uncovering Differences Between Teens and Adults.","authors":"John B Maxwell,Zoe Fanning,Michael F Neblett","doi":"10.1016/j.fertnstert.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.022","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"4 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083304","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":"Same corpus luteum, same result: Modifying Natural Cycle FETs for Convenience's Sake.","authors":"Alexandra M Poch,Kate Devine","doi":"10.1016/j.fertnstert.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.011","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"79 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083300","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}