Fertility and sterility最新文献

{"title":"Cine MRI of uterine peristalsis in patients with endometrial fibrosis.","authors":"Huanhuan Liang,Nan Zhou,Yucan Chen,Kaibo Sun,Hui Zhu,Peipei Jiang,Huanhuan Wang,Qing Hu,Kefeng Zhou,Yali Hu,Zhengyang Zhou","doi":"10.1016/j.fertnstert.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.017","url":null,"abstract":"OBJECTIVETo assess uterine peristalsis using cine magnetic resonance imaging (MRI) in patients with different degrees of endometrial fibrosis.DESIGNA prospective observational cohort study.SUBJECTSA total of 75 patients with severe endometrial fibrosis, 40 patients with mild-to-moderate endometrial fibrosis, and 45 healthy women without uterine pathologies were included in the study. All patients of severe endometrial fibrosis and mild-to-moderate endometrial fibrosis were diagnosed by hysteroscopy.EXPOSUREEligible women underwent MRI examination during the late proliferative phase.MAIN OUTCOME MEASURESUterine static parameters including junctional zone thickness and its ratio to the total myometrial thickness, and cine parameters including peristaltic condition, frequency (/4min), intensity, and direction, were measured and analyzed. The study aimed to investigate the differences in uterine peristalsis across patients with different degrees of endometrial fibrosis using cine MRI.RESULTSJunctional zone thickness and its ratio to the total myometrial thickness were significantly higher in severe patients (6.1 mm, 95% Confidence Interval [CI]: 5.2-6.7 mm; 0.37±0.08) and mild-to-moderate patients (5.2 mm, 95% CI: 4.4-6.4 mm; 0.36±0.07) than in healthy women (3.9mm, 95% CI: 3.2-4.8 mm; 0.32±0.08) (all p <0.05). The percentage of detectable uterine peristalsis was significantly higher in healthy women (100%) than in severe patients (88.0%). Peristaltic frequency (/4min) and intensity were significantly higher in healthy women (10 times, 95% CI: 8-12 times; 3) than in mild-to-moderate patients (6 times, 95% CI: 4-9 times; 2) and severe patients (5 times, 95% CI: 4-7 times; 2) (all p <0.05).Mild-to-moderate patients and severe patients showed a higher percentage of the reverse and mixed peristaltic waves than healthy women (p <0.001). The degree of endometrial fibrosis was negatively correlated with peristaltic frequency and intensity but positively correlated with junctional zone thickness and its ratio to the total myometrial thickness (all p <0.05). The concordance of uterine static and cine parameters was excellent.CONCLUSIONCine MRI is particularly effective for assessing abnormalities in uterine peristalsis in patients with different degrees of endometrial fibrosis.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"6 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083478","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 \"Baby Bust\": Awareness of the gap between desired and actual family size and review of practical options.","authors":"Dominique de Ziegler,Natascha Braumann,Sokteang Sean,James P Toner","doi":"10.1016/j.fertnstert.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.012","url":null,"abstract":"Decreasing birth rates are a worldwide phenomenon with potentially alarming consequences. This decline results either from women choosing not to have children or from couples ending up with a smaller family size than initially intended, a phenomenon called the fertility gap. In the latter case, delaying parenthood plays a key role in not achieving the desired reproductive objective. This review will examine age-related fertility decline, couple awareness, and factors contributing to the postponement of parenthood. We will also review potential strategies to prevent fertility gaps in couples wishing to conceive and how family values can be revived. Efforts to assess current levels of fertility awareness and identify ways to improve this knowledge will be highlighted. We will critically evaluate measures implemented worldwide for enhancing fertility and explore their relative effectiveness based on reported experience. Finally, we will analyze potential signs of fertility rebounds - some of which may already be emerging - and critically assess possible means to amplify these effects.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"143 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059168","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":"Polycystic ovary syndrome and elevated body mass index independently increase type 2 diabetes risk with obesity-mediated risk dominating: a real-world data analysis of US patients.","authors":"Konstantin Sharafutdinov,Jan Hilpert,Rolf Burghaus,Christian Diedrich,Jörg Lippert,Christian Scheerans,Steffen Schaper","doi":"10.1016/j.fertnstert.2025.09.013","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.013","url":null,"abstract":"OBJECTIVETo study the relationship between polycystic ovary syndrome (PCOS) and type 2 diabetes mellitus (T2DM) in a retrospective US cohort.DESIGNLongitudinal case-control study.SUBJECTSThe study utilized data from the IBM Explorys database, a comprehensive real-world dataset containing de-identified, longitudinal patient-level electronic health records (EHRs) from approximately 400 hospitals across the United States (US). The study population consisted of women diagnosed with PCOS between 2000 and 2020, aged 25 to 55 years (n = 42,030) and control women without PCOS (n = 84,060), matched 1:2 by ethnicity, geographic region, age, and BMI. Additionally, a secondary control group (n = 42,030) was employed, matched on all covariates except BMI.EXPOSUREPCOS status was identified using ICD-coded diagnoses, while T2DM diagnosis was determined using ICD-coded diagnoses as well as Hemoglobin A1c (HbA1c) levels.MAIN OUTCOME MEASURESThe incidence of T2DM.RESULTSThe 3-year cumulative incidence rates of T2DM in the PCOS and non-PCOS cohorts were 9.2% (95% Confidence Interval: 8.9% - 9.5%) and 6.0% (5.8% - 6.2%), respectively. The 15-year cumulative incidence rates were 34.3% (31.4% - 37.4%) and 22.6% (21.2% - 24.1%), respectively. The adjusted hazard ratio (HR) of T2DM in women with PCOS was 1.47 (1.41 - 1.53) compared to control individuals. HRs for PCOS were found to be consistent in different BMI strata ranging from 1.37 in the obese class III subgroup to 1.78 in the subgroup with normal weight. The median BMI in the PCOS cohort was 34.86 kg/m2, in contrast to 27.26 kg/m2 in non-PCOS controls not matched for BMI. The additional HR for T2DM associated with this BMI difference of 7.6 kg/m2 is estimated to be 1.87 (1.82 - 1.92).CONCLUSIONSIn the current analysis, PCOS was independently associated with increased T2DM incidence across all BMI categories. Moreover, the elevated BMI in PCOS patients confers additional T2DM risk mediated by excess adiposity. This BMI-mediated risk exceeds the risk associated with PCOS through other mechanisms, such as hyperandrogenism.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"69 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059198","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":"Update on diagnosis of polycystic ovary syndrome during adolescence.","authors":"Alexia Sophie Peña,Selma Feldman Witchel","doi":"10.1016/j.fertnstert.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.006","url":null,"abstract":"Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic condition beginning during the peripubertal years. The international evidence-based guidelines and the update in 2023 have clearly defined the diagnostic criteria during adolescence with the goal of decreasing controversies and challenges with the diagnosis during this critical life stage. In this narrative review we aimed to examine the recent available data related to the diagnosis of PCOS during adolescence. Specifically, we evaluated publications from August 2022 (date when the last searches were run for the update of the international evidence-based guidelines on PCOS) to May 2025. Current evidence supports the use of two main diagnostic criteria for adolescents: irregular menstrual cycles, well defined according to time post-menarche, and hyperandrogenism, either clinical or biochemical, after excluding other conditions that mimic PCOS. In contrast to adult PCOS diagnostic criteria, polycystic ovary morphology on pelvic ultrasound and/or antimullerian hormone levels should not be used for adolescent PCOS diagnosis. Accurate and timely diagnosis of PCOS during adolescence enables early screening and management of PCOS and its associated comorbidities. Equally important is the early identification of adolescents considered \"at risk\" of PCOS (those who only meet one diagnostic criterion) as emerging evidence indicated increased metabolic risks and reinforces the need for long-term follow-up. Novel cluster analysis in well-defined adolescent cohorts is beginning to clarify threshold values for diagnostic features and may further refine adolescent-specific criteria. Specific PCOS diagnostic criteria avoiding polycystic ovary morphology and antimullerian hormone; and using of clearly defined irregular menstrual cycles and hyperandrogenism should be applied during adolescence. Early recognition of adolescents both with PCOS and those \"at risk\" is critical to ensure timely metabolic screening and appropriate follow-up. Health care professionals should be aware that different PCOS diagnostic criteria are necessary for adolescents.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"17 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056662","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":"\"IVF patients pursuing genetic testing of embryos need better education: Are we up to the challenge?\"","authors":"Julia T Woodward","doi":"10.1016/j.fertnstert.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.010","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"31 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056654","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":"Improved outcomes in euploid single embryo transfer: let \"natural\" takes its course for endometrial preparation?","authors":"Sean Kelly,Jennifer Hirshfeld-Cytron","doi":"10.1016/j.fertnstert.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.007","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056653","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":"Soy, Estrogen and Endometriosis: Bridging nutritional research with clinical practice.","authors":"Shelby Howard,Laurel Stadtmauer","doi":"10.1016/j.fertnstert.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.008","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"691 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043753","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":"Polycystic ovary syndrome is a risk factor for preterm birth and fetal growth restriction, but is antimüllerian hormone the link?","authors":"Fernando M Reis,Caio R V Leal,Poli Mara Spritzer","doi":"10.1016/j.fertnstert.2025.09.009","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.009","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"31 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043754","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":"Comparative Outcomes of In Vitro Fertilization and Frozen Embryo Transfer Cycles in Non-Major Thalassemia Spectrum and Non-Thalassemia Patients: A Propensity Score-Matched Cohort Study.","authors":"Wenjie Huang,Xiaohua Wei,Liuyan Wei,Ni Tang,Zhetao Li,Wugao Li,Liuying Nong,Jingjing Li,Li Fan","doi":"10.1016/j.fertnstert.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.fertnstert.2025.09.005","url":null,"abstract":"OBJECTIVETo assess whether oocyte yield, embryo development and pregnancy rates differ between the non-major thalassemia spectrum (NMTS) and non-thalassemia (NT) patients undergoing in vitro fertilization (IVF) or frozen embryo transfer (FET) cycles.DESIGNA propensity score-matched retrospective cohort study.SUBJECTSA total of 41,804 patients who underwent IVF (18,215 cycles) or FET (23,589 cycles) between January 2013 and December 2022 were included in the study. Patients were matched 1:2 for the NT (n = 5,816 IVF, n = 8,004 FET) and NMTS (n = 2,908 IVF, n = 4,002 FET) groups. Within the NMTS group, thalassemia carriers (TC) accounted for 80.7% of IVF cases and 74.9% of FET cases, while non-transfusion-dependent thalassemia (NTDT) patients represented 19.3% and 25.1%, respectively.EXPOSUREStandard ovarian stimulation protocols (GnRH agonist, GnRH antagonist, and minimal stimulation) were used for all patients. Clinical outcomes, including embryo development, clinical pregnancy, live birth, and miscarriage rates, were compared between the groups.MAIN OUTCOME MEASURESIVF cycle outcome (e.g., oocyte retrieval rate, fertilization rate, and blastocyst formation rate) and pregnancy outcomes (e.g., clinical pregnancy rate, live birth rate, and miscarriage rate).RESULTSAfter matching, the baseline characteristics, including age and body mass index, were comparable between the NT and NMTS groups. No significant differences were observed in oocyte yield and embryo development, including blastocyst formation (NT: 0.54 vs. NMTS: 0.56). In IVF cycles, the clinical pregnancy rate (adjust relative risk [aRR] = 1.03, 95% confidence interval [CI] = 0.96-1.09), live birth rate (aRR = 1.02, 95% CI = 0.95-1.09), and miscarriage rate (aRR = 1.07, 95% CI = 0.92-1.25) were similar. In FET cycles, the clinical pregnancy rate (aRR = 1.01, 95% CI = 0.96-1.07), live birth rate (aRR = 1.03, 95% CI = 0.97-1.10), and miscarriage rate (aRR = 0.92, 95% CI = 0.81-1.04) were comparable. Interaction analysis showed that baseline hormonal levels and ovarian stimulation protocols significantly influenced embryo development but did not affect pregnancy outcomes.CONCLUSIONNo significant differences in embryo development or pregnancy outcomes were found between NMTS and NT patients undergoing IVF or FET cycles. These findings suggest that NMTS patients do not face additional reproductive challenges in assisted reproductive technology. This study may help reduce reproductive anxiety in NMTS patients and has important public health relevance in resource-limited and high-prevalence regions, where it can support clinical decisions and inform equitable ART care delivery.","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"41 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035548","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":"Optimal gonadotropin-releasing hormone agonist dosage for oocyte maturation in low-prognosis patients: interim analysis of a randomized controlled trial in Patient-Oriented Strategies Encompassing IndividualizeD Oocyte groups 3 and 4.","authors":"Anjali Gahlan, Matheus Roque, Akanksha Jangid, Amrita Das, Pawan Yadav, Shashank Sangoudar, Kshitiz Murdia, Amol Lunkad, Vipin Chandra, Nitiz Murdia, Isha Suwalka, Walmik Mistari","doi":"10.1016/j.fertnstert.2025.09.003","DOIUrl":"10.1016/j.fertnstert.2025.09.003","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039452","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}