Human reproduction最新文献

{"title":"A randomized controlled trial comparing embryo vitrification with slush nitrogen to liquid nitrogen in women undergoing frozen embryo transfer: embryology and clinical outcomes","authors":"A M Klimczak, E Osman, M Esbert, R M Yildirim, C Whitehead, N S Herlihy, B M Hanson, L M Roberts, E Seli, R T Scott","doi":"10.1093/humrep/deaf003","DOIUrl":"https://doi.org/10.1093/humrep/deaf003","url":null,"abstract":"STUDY QUESTION Does the use of slush nitrogen (SN) for embryo vitrification improve embryo transfer outcomes compared to liquid nitrogen (LN)? SUMMARY ANSWER SN is a safe method for embryo preservation and significantly improves post-warming survival rates during repeated vitrification–warming cycles; however, after a single freeze–thaw cycle, pregnancy outcomes are not improved when embryos are vitrified with SN compared to LN. WHAT IS KNOWN ALREADY SN is a combination of solid and LN, with a temperature lower than regular LN, and it is an alternative to conventional LN in achieving a faster cooling speed. Studies have shown that SN improves survival in non-human embryos and human oocytes. However, it is unknown whether the use of SN reduces blastocyst damage in humans during vitrification—as indicated by increased survival across multiple vitrification–warming cycles—or whether it enhances pregnancy outcomes in a single vitrification–warming cycle. STUDY DESIGN, SIZE, DURATION Following the pre-clinical trial assessing embryo survival after repeated freeze–thaw cycles using SN and LN on 50 donated embryos per group, a randomized controlled trial was performed, where 253 patients were enrolled between September 2020 and January 2022, and 245 underwent an IVF stimulation, which resulted in at least one blastocyst for cryopreservation. Of those, 121 were allocated to the SN (study), and 124 were allocated to the LN (control) group. Randomization occurred on the day of blastocyst biopsy using a computer-generated block schema. Groups were assigned via opaque envelopes, opened by the embryologist on vitrification day. The patient, physician, and clinical team were blinded to the intervention. PARTICIPANTS/MATERIALS, SETTING, METHODS All couples with female aged between 18 and 42 years old undergoing IVF stimulation at one university-affiliated infertility center, with plan for preimplantation genetic testing for aneuploidy and subsequent single, frozen embryo transfer (FET) were eligible for inclusion in this study. MAIN RESULTS AND THE ROLE OF CHANCE The pre-clinical trial demonstrated significant improvements in blastocyst survival, with the SN group achieving a mean of 7.5 survived vitrification–warming cycles (range: 3–22), significantly surpassing the mean of 3.0 cycles (range: 0–10) in the LN group (P < 0.0001). Following the pre-clinical trial, 223 patients randomized to SN or LN underwent single FET. Baseline characteristics were similar between groups, as were embryology outcomes, including the number of oocytes retrieved, mature oocytes, fertilization rate, and total blastocysts biopsied. No significant differences were observed between the two groups in pregnancy rate, clinical pregnancy rate, sustained implantation rate, or miscarriage rate (P = 0.16, 0.80, 0.49, and 0.74, respectively, using Student’s t-test). A futility analysis indicated no value in continuing recruitment and therefore the study was closed. LIMITATIONS, REASONS","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"32 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992172","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":"Beyond the disclosure debate in donor-conception: how do we help families to discuss origin stories with their children?","authors":"Javiera Navarro-Marshall","doi":"10.1093/humrep/deaf004","DOIUrl":"https://doi.org/10.1093/humrep/deaf004","url":null,"abstract":"Families have been subject to enormous transformations with the emergence of artificial reproductive technology and the appearance of donor-conceived children. These new families are challenged to disclose origins with their children and parents feel concern that conception stories might have an emotional impact on their children. Fertility counsellors still feel ill-equipped on what to recommend to parents because developmental psychology has not designed systematic evidence-based guidelines to address a three-dimensional matter: 'what', 'when', and 'how' to discuss conception stories. The argument developed herein is that professionals working with families in fertility clinics, could benefit from understanding these new family conversational processes of origin storytelling from these three perspectives, not only on 'what' and 'when' but also on the less elaborated 'how' to talk about it. For this purpose, understanding elaborative reminiscing as a specific way of talking about the past that helps children to build autobiographical memories and develop their identity might be key.","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"6 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991729","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 and risk of depression among oral contraceptive users: a pooled analysis of cohort studies from 13 countries","authors":"P De Corte, I Milhoranca, A S Oberg, T Kurth, S Mechsner, K Heinemann","doi":"10.1093/humrep/deae299","DOIUrl":"https://doi.org/10.1093/humrep/deae299","url":null,"abstract":"STUDY QUESTION Does endometriosis affect the mental health of women using oral contraceptives? SUMMARY ANSWER Among oral contraceptive users, women with endometriosis have a higher risk of depression compared to those without endometriosis, although the absolute risk increase is small. WHAT IS KNOWN ALREADY Previous studies have suggested a potential link between endometriosis and mental health issues, but the impact of endometriosis on depression among oral contraceptive users remains unclear. STUDY DESIGN, SIZE, DURATION A secondary pooled cohort study utilizing data from two longitudinal patient-centric studies (INAS-VIPOS and PRO-E2) was conducted across 11 European countries, Colombia and Australia. The study included 93 541 women newly prescribed oral contraceptives, with or without endometriosis, and without a self-reported history of depression. PARTICIPANTS/MATERIALS, SETTING, METHODS Participant’s mental health was captured using self-administered questionnaires at baseline and every 6–12 months thereafter, asking about any newly occurred episodes of depression. Incidence rates (IRs) of self-reported depression were calculated per 10 000 woman-years. Absolute risk difference (ARD) and number needed to harm (NNH) were calculated with 95% CIs. The association between endometriosis and self-reported depression was estimated through crude and adjusted hazard ratios (HRs) with 95% CI, using stabilized inverse probability of treatment weighting (IPTW). MAIN RESULTS AND THE ROLE OF CHANCE Of the included 93 541 women, 21 090 had endometriosis (49 541 woman-years) and 72 451 had no endometriosis (137 137 woman-years.) Of those with endometriosis, 308 (1.5%) reported an episode of depression (IR: 62.2/10 000, 95% CI: 55.4–69.5) compared to 535 (0.7%) of women without endometriosis (IR 39.0/10 000, 95% CI: 35.8–42.5). The ARD and NNH were 23.2 per 10 000 (95% CI: 15.2–30.9) and 431 (95% CI: 323.7–657.0) respectively. The HR of depression in women with endometriosis was 1.85 (95% CI: 1.60–2.13) using stabilized IPTW to control for age, BMI, smoking, education, and age at menarche. Subgroup and sensitivity analyses showed similar results. LIMITATIONS, REASONS FOR CAUTION While efforts were made to control for confounding factors, residual confounding may still exist. Additionally, the results can only be generalized to users of oral contraceptives. WIDER IMPLICATIONS OF THE FINDINGS These results highlight the importance of considering the mental health implications of endometriosis among women using oral contraceptives. Further research is needed to explore additional contributing factors and potential interventions. STUDY FUNDING/COMPETING INTEREST(S) No funding was received for this study. No competing interests apply for this research. TRIAL REGISTRATION NUMBER N/A.","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"82 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142968236","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":"Human fallopian tube organoids provide a favourable environment for sperm motility","authors":"Nicolas Gatimel, Guillaume Perez, Eloïse Bruno, David Sagnat, Corinne Rolland, Yan Tanguy-Le-Gac, Emeline Di Donato, Claire Racaud, Roger Léandri, Célia Bettiol, Céline Deraison, Jean-Paul Motta, Eric Huyghe, Nathalie Vergnolle","doi":"10.1093/humrep/deae258","DOIUrl":"https://doi.org/10.1093/humrep/deae258","url":null,"abstract":"STUDY QUESTION Does a human fallopian tube (HFT) organoid model offer a favourable apical environment for human sperm survival and motility? SUMMARY ANSWER After differentiation, the apical compartment of a new HFT organoid model provides a favourable environment for sperm motility, which is better than commercial media. WHAT IS KNOWN ALREADY HFTs are the site of major events that are crucial for achieving an ongoing pregnancy, such as gamete survival and competence, fertilization steps, and preimplantation embryo development. In order to better understand the tubal physiology and tubal factors involved in these reproductive functions, and to improve still suboptimal in vitro conditions for gamete preparation and embryo culture during IVF, we sought to develop an HFT organoid model from isolated adult stem cells to allow spermatozoa co-culture in the apical compartment. STUDY DESIGN, SIZE, DURATION Over a 2-year period, fallopian tube tissues were collected for organoid culture purposes from 10 ‘donor’ patients undergoing bilateral salpingectomy by laparoscopy for definitive sterilization. After tissue digestion, isolated cells from the isthmus and ampulla regions were separately seeded in 3D Matrigel and cultured with conventional growth factors for organoid culture and specific factors for differentiation of the female genital tract. PARTICIPANTS/MATERIALS, SETTING, METHODS HFT organoids were characterized by light microscopy, scanning and transmission electron microscopy, immunofluorescence, and transcriptome analysis. Following simultaneous organoid culture on specific inserts, spermatozoa from five donors were placed either in control media or in the apical compartment of colon or HFT organoids (isthmus and ampulla separately) for 96 h. Vitality and motility and kinematic parameters were assessed at 0, 48, and 96 h on 200 spermatozoa in each condition and in duplicate and compared using the Wilcoxon test. MAIN RESULTS AND THE ROLE OF CHANCE Specific fallopian tube differentiation of our model was confirmed by immunofluorescence, transcriptome analysis, and electron microscopy observations that exhibited ciliated and secretory cells. We succeeded in releasing spermatozoa in the apical compartment of HFT organoids and in recovering them for sperm analysis. Sperm vitality values were similar in HFT organoids and in commercial sperm media. We demonstrated a superiority of the HFT organoid apical compartment for sperm motility compared with other controls (colon organoids, organoid culture media, and conventional commercial sperm fertilization media). At 48 h of incubation, progressive sperm motility was higher in the apical compartment of HFT organoids (ampulla 31% ± 17, isthmus 29% ± 15) than in commercial fertilization media (15% ± 15) (P < 0.05) and compared with all other conditions. At 96 h, progressive sperm motility was almost nil (<1%) in all conditions except for spermatozoa in HFT organoids (P < 0.05): 12% ± 15 and","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"129 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961638","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 reproductive tract microbiome in women with polycystic ovary syndrome and across different menstrual cycle phases","authors":"S Lee, O Aasmets, R K Arffman, J Laru, H R Rossi, A Salumets, T T Piltonen, E Org","doi":"10.1093/humrep/deae270","DOIUrl":"https://doi.org/10.1093/humrep/deae270","url":null,"abstract":"STUDY QUESTION Do polycystic ovary syndrome (PCOS), menstrual cycle phases, and ovulatory status affect reproductive tract (RT) microbiome profiles? SUMMARY ANSWER We identified microbial features associated with menstrual cycle phases in the upper and lower RT microbiome, but only two specific differences in the upper RT according to PCOS status. WHAT IS KNOWN ALREADY The vaginal and uterine microbiome profiles vary throughout the menstrual cycle. Studies have reported alterations in the vaginal microbiome among women diagnosed with PCOS. STUDY DESIGN, SIZE, DURATION This prospective case-control study included a cohort of 37 healthy control women and 52 women diagnosed with PCOS. Microbiome samples were collected from the vagina as vaginal swabs (VS) and from the uterus as endometrial flushing (EF) aspirate samples, and compared according to PCOS diagnosis, the menstrual cycle phases, and ovulatory status, at Oulu University Hospital (Oulu, Finland) from January 2017 to March 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 83 VS samples and 80 EF samples were collected. Age and body mass index (BMI) were matched between women with and without PCOS. Clinical characteristics were assessed using blood samples collected between cycle days 2 and 8, and microbial DNA was sequenced on the Ion Torrent platform. Microbial alpha diversity (i.e. the observed number of unique genera and Shannon diversity index) was analysed across sample types, PCOS diagnosis and menstrual cycle phases. Linear mixed-effects models were utilised to identify microbial features in relation to PCOS and the menstrual cycle phases. Associations between the beta diversity of the RT microbiome and PCOS- and cycle-related clinical features were calculated using PERMANOVA. MAIN RESULTS AND THE ROLE OF CHANCE Microbial alpha diversity showed no difference with PCOS (VS: Pobserved feature = 0.836, Pshannon = 0.998; EF: Pobserved feature = 0.366, Pshannon = 0.185), but varied with menstrual cycle phases (VS: Pobserved feature = 0.001, Pshannon = 0.882; EF: Pobserved feature = 0.026, Pshannon = 0.048). No difference was observed in beta diversity based on either PCOS or the menstrual cycle phases (VS: PPCOS = 0.280, Pcycle = 0.115; EF: PPCOS = 0.234, Pcycle = 0.088). In the endometrial flushing samples, we identified two novel microbial features, characterised by the ratio of differential abundance of two genera, associated with PCOS (FDR ≤ 0.1) and 13 novel features associated with the menstrual cycle phases (FDR ≤ 0.1). LIMITATIONS, REASONS FOR CAUTION Although this was the first study to simultaneously analyse, the lower and upper RT microbiome in women with and without PCOS, the limited sample size of anovulatory cases may hinder the detection of differences related to PCOS and ovulatory status. WIDER IMPLICATIONS OF THE FINDINGS The main finding suggests that PCOS and the menstrual cycle phases are associated with specific microbial features in the upper RT, indicating th","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"7 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961644","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":"Artificial intelligence-driven analysis of embryo morphokinetics in singleton, twin, and triplet pregnancies","authors":"E Gómez, A Brualla, N Almunia, A Zepeda-Hernández, M Valcárcel, I Torres, I Burgos, R Jiménez, A M Villaquirán, L Parmegiani","doi":"10.1093/humrep/deae300","DOIUrl":"https://doi.org/10.1093/humrep/deae300","url":null,"abstract":"In recent years, the transfer of more than one embryo has become less frequent to diminish multiple pregnancies. Even so, there is still a risk of one embryo splitting into two or even three. This report presents the case of a triamniotic monochorionic gestation in a 35-year-old woman, obtained after the transfer of a single day 5 embryo that had been previously hatched with a laser and subsequently transferred in a fresh IVF cycle. The morphokinetics of this embryo as well as another eight that produced monozygotic twins were compared with nine embryos that achieved singleton gestations. An artificial intelligence (AI) system was used to perform this analysis objectively. Embryo divisions leading to multiple gestations were slower across all analysed parameters. This was most evident in the time taken to reach the 5-cell stage (t5) (48.74 ± 3.21 versus 44.69 ± 5.61 h) and the morula stage (tM) (85.08 ± 10.00 versus 78.13 ± 5.35 h). Moreover, blastocyst diameter (161.80 ± 26.50 versus 179.10 ± 25.88 μm) and area (21 684 ± 7267.4 versus 26 516 ± 7254.8 μm2) were smaller in these embryos, but the differences did not reach statistical significance. This is the first report, to our knowledge, to use AI to analyse and compare morphokinetic parameters between singleton pregnancies and a group of embryos that produced twin and triplet pregnancies.","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"45 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961643","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":"Elevated plasma molybdenum level increases the risk of premature ovarian insufficiency through vascular endothelial injury","authors":"Lulu Wang, Qian Wang, Junyan Sun, Yuanxin Huang, Qiuwan Zhang, Liutong Wei, Shengju Yin, Dongmei Lai","doi":"10.1093/humrep/deae297","DOIUrl":"https://doi.org/10.1093/humrep/deae297","url":null,"abstract":"STUDY QUESTION Is elevated plasma molybdenum level associated with increased risk for idiopathic premature ovarian insufficiency (POI)? SUMMARY ANSWER Elevated plasma molybdenum level is associated with an increased risk of idiopathic POI through vascular endothelial injury and inhibition of granulosa cell proliferation. WHAT IS KNOWN ALREADY Excessive molybdenum exposure has been associated with ovarian oxidative stress in animals but its role in the development of POI remains unknown. STUDY DESIGN, SIZE, DURATION Case-control study of 30 women with idiopathic POI and 31 controls enrolled from August 2018 to May 2019. In vitro experimentation. Animal studies using distilled water containing sodium molybdate. PARTICIPANTS/MATERIALS, SETTING, METHODS Logistic regression analysis of the association between plasma concentrations of molybdenum and calcium and POI odds ratio. Plasma samples were from 30 patients with idiopathic POI and 31 controls. Both groups were comparable in terms of age and body mass index. Proliferation assay, flow cytometry analyses for cell cycle, nitric oxide and calcium, gene expression, and protein analysis using human umbilical vein endothelial cells and KGN (human ovarian granulosa-like tumor cell line) cells. Sexual hormones, ovarian function, vascular injury, and platelet activation were evaluated in mice exposed to excessive molybdenum. MAIN RESULTS AND THE ROLE OF CHANCE Case-control study showed that the elevation of plasma concentrations of molybdenum and calcium was positively associated with the POI odds ratio. In vitro study showed that molybdenum treatment increased the permeability of human umbilical vein endothelial cells through enhancing nitric oxide generation and cytosolic calcium influx. In vivo study showed that increased vascular permeability induced by molybdenum resulted in platelet activation and serotonin release within mouse ovaries. Serotonin decreased granulosa cell proliferation by inducing cellular quiescence. Molybdenum also directly inhibited granulosa cell proliferation by downregulating isocitrate dehydrogenase (IDH1). Inhibition of granulosa cell proliferation ultimately led to ovarian dysfunction in mice, including altered estrus cycles, serum sex hormone concentrations, ovarian morphology, and ovarian reserve. LIMITATIONS, REASONS FOR CAUTION There are two limitations in the current study. First, it remains unclear whether the elevation of plasma molybdenum content is due to environmental exposure or altered metabolism. Second, rigorous and multicenter studies, with a larger sample size, should be carried out to confirm the elevation of plasma molybdenum and calcium concentrations in patients with idiopathic POI. WIDER IMPLICATIONS OF THE FINDINGS Our findings highlight an association between elevated plasma concentrations of molybdenum and calcium and increased risk of idiopathic POI. This discovery offers crucial insights into the pathogenesis of idiopathic POI and the search for effec","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"42 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935192","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":"Global, regional, and national prevalence and trends of infertility among individuals of reproductive age (15–49 years) from 1990 to 2021, with projections to 2040","authors":"Yuanhao Liang, Jing Huang, Qiang Zhao, Haixin Mo, Zhaohong Su, Suihua Feng, Shuzhen Li, Xiaohong Ruan","doi":"10.1093/humrep/deae292","DOIUrl":"https://doi.org/10.1093/humrep/deae292","url":null,"abstract":"STUDY QUESTION What is the prevalence and trend of infertility among individuals of childbearing age at global, regional, and national levels by sex and socio-demographic index (SDI) across 21 regions and 204 countries and territories? SUMMARY ANSWER Our findings reveal a growing prevalence of infertility among individuals aged 15–49 years worldwide from 1990 to 2021, with an expected continued increase through 2040. WHAT IS KNOWN ALREADY Infertility is a persistent global reproductive health issue, leading to significant societal and health consequences. No study has specifically described the current prevalence of infertility, its secular trend, or the variations between regions or countries with different SDI levels. STUDY DESIGN, SIZE, DURATION A sex- and SDI-stratified systematic analysis of the prevalence of infertility across 21 regions and 204 countries and territories from 1990 to 2021 has been performed. PARTICIPANTS/MATERIALS, SETTING, METHODS We retrieved data from the Global Burden of Disease Study (GBD) 2021 on the count and crude rate of infertility prevalence for individuals aged 15–49 years across 204 countries and territories from 1990 to 2021. In the GBD 2021 framework, infertility is defined as the absence of a live birth in a couple who have been in a union for at least 5 years and are actively trying to conceive, or in a couple who have been in a union for at least 5 years since their last live birth, with no use of contraceptives during this period. Estimated annual percent change was calculated to quantify the temporal trend in age-standardized prevalence rates (ASPRs) for infertility by sex, age, and SDI. The Bayesian age-period-cohort model was used to project the ASPRs from 2022 to 2040. MAIN RESULTS AND ROLE OF CHANCE In 2021, an estimated 55 000 818 men and 110 089 459 women were living with infertility worldwide, corresponding to approximately 1820.6 cases per 100 000 population (1.8%) for males and 3713.2 cases per 100 000 population (3.7%) for females. Regionally, the highest infertility prevalence was observed in middle SDI regions, such as East and South Asia and Eastern Europe. Infertility primarily affected the age group of 35–39 years and females in most regions, with some notable exceptions. Between 1990 and 2021, the global ASPRs of infertility increased by an average of 0.49% (95% CI 0.34–0.63) for males and 0.68% (0.51–0.86) for females. Additionally, the fastest increase in female infertility occurred in high SDI regions, while the most significant rise in male infertility was seen in low-middle SDI areas. Furthermore, the global ASPR of male infertility is projected to rise more rapidly than that of female infertility from 2022 to 2040. LIMITATIONS, REASONS FOR CAUTION The primary data sources for the infertility burden in the GBD 2021 are population-based surveys; however, less-developed regions often lack complete population-based statistics, leading to potential reporting bias of the infertility burde","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"82 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142925009","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":"Psychosocial and physical wellbeing in women and male partners undergoing immediate versus postponed modified natural cycle frozen embryo transfer after ovarian stimulation and oocyte pick-up: a sub-study of a randomized controlled trial.","authors":"Sara Bergenheim, Marte Saupstad, Clara Colombo, Julie Elkjær Møller, Jeanette Wulff Bogstad, Nina la Cour Freiesleben, Ida Behrendt-Møller, Lisbeth Prætorius, Birgitte Oxlund, Bugge Nøhr, Merete Husth, Ellen Løkkegaard, Negjyp Sopa, Anja Pinborg, Kristine Løssl, Lone Schmidt","doi":"10.1093/humrep/deae260","DOIUrl":"10.1093/humrep/deae260","url":null,"abstract":"<p><strong>Study question: </strong>Are there differences in psychosocial and physical wellbeing among women and male partners undergoing modified natural cycle (mNC) frozen embryo transfer (FET) in immediate compared to postponed cycles after ovarian stimulation (OS) and oocyte pick-up (OPU)?</p><p><strong>Summary answer: </strong>Significantly more women in the immediate group reported physical symptoms than women in the postponed group whilst fewer were emotionally affected by waiting time, although the latter difference lost statistical significance after adjustment for multiple testing.</p><p><strong>What is known already: </strong>Infertility and fertility treatment are known to cause psychosocial distress in women and couples longing for a child. The treatment may be long-term and delayed for various reasons, such as the elective postponement of FET after a fresh transfer without pregnancy or an elective freeze-all cycle, possibly further increasing the level of distress.</p><p><strong>Study design, size, duration: </strong>Sub-study of an ongoing multicentre randomized controlled, non-inferiority trial assessing the optimal timing for mNC-FET treatment after OS and OPU. Participants were randomized 1:1 to mNC-FET in the cycle immediately following OS or mNC-FET in a subsequent cycle. The study is based on data from the first women (N = 300) and male partners (N = 228) invited to answer a self-reported questionnaire assessing psychosocial and physical wellbeing. Data were collected from April 2021 to March 2024.</p><p><strong>Participants/materials, setting, methods: </strong>Questionnaires were distributed to all randomized women and their male partners on cycle day 2-5 of mNC-FET cycles and returned before the administration of ovulation trigger. The questionnaire consisted of validated items originating from the Copenhagen Multicentre Psychosocial Infertility-Fertility Problem Stress Scale (COMPI-FPSS) and Marital Benefit Measure (COMPI-MBM). Emotional reactions to waiting time in fertility treatment, mental health, general quality-of-life, and physical symptoms were also assessed.</p><p><strong>Main results and the role of chance: </strong>Questionnaire response rates were 90.3% for women and 80.0% for male partners in the immediate group, and 82.3% for women and 57.3% for male partners in the postponed group. Approximately 90% of all women worried to some or a great extent about whether the treatment would be successful. More women in the postponed group reported that they were emotionally affected by the waiting time from OPU to blastocyst transfer to some or to a great extent (57.4% versus 73.9% in the immediate versus postponed group, P = 0.014), but the results were not significant after adjustment for multiple testing (P = 0.125). For male partners, no difference in emotional reactions to waiting time between groups was found. There was no significant difference in total infertility-related stress or symptoms of severe depression","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"96-109"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824291","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":"Endometrioma patients are under-treated with endocrine endometriosis therapy.","authors":"C Cirkel, H Göbel, C Göbel, I Alkatout, A Khalil, N Brüggemann, A Rody, A Cirkel","doi":"10.1093/humrep/deae257","DOIUrl":"10.1093/humrep/deae257","url":null,"abstract":"<p><strong>Study question: </strong>Is there a difference in the use of endocrine endometriosis therapy in endometriosis patients with and without endometrioma?</p><p><strong>Summary answer: </strong>Patients with endometriomas received significantly less endocrine endometriosis treatment (present intake in 42.5%) compared to patients with other forms of endometriosis and without endometriomas (present intake in 52.1%).</p><p><strong>What is known already: </strong>Endocrine endometriosis therapy in patients with endometriomas reduces the risk of recurrence and therefore the risk of further surgery and subsequent irreversible damage to ovaries which results into reduced antral follicle counts (AFC), anti-Mullerian hormone levels (AMH), and early menopause. However, there is evidence of increasing rejection of endocrine endometriosis treatment in this population.</p><p><strong>Study design, size, duration: </strong>A total of 838 premenopausal woman with dysmenorrhea and/or endometriosis (mean age 30.7 ± 6.9 years, range 15-54 years) were included in this observational cross-sectional multicenter study. Data including the extent of dysmenorrhea, prevalence of other comorbidities like migraine with aura and migraine never with aura, diagnosis of endometriosis, history of endometriosis surgery, and hormone therapy, were collected in a retrospective online survey from May to November 2023.</p><p><strong>Participants/materials, setting, methods: </strong>Patients visiting two university hospital endometriosis centers between January 2017 and March 2023, and with available email address, were invited for study participation by email in May 2023. Further recruitment of participants was achieved through the website and social medial channels of the German Endometriosis Association. Participation in the online survey was open between May and November 2023.</p><p><strong>Main results and the role of chance: </strong>In the subgroup of women (with dysmenorrhea) without surgically confirmed endometriosis (SCE) (n = 277), 95 (34.3%) were currently undergoing endocrine treatment for dysmenorrhea and contraceptional purposes. On the contrary, in the subgroup of patients with SCE (n = 561), 275 (49.0%) were currently undergoing hormonal treatment. Subjects with SCE therefore significantly more commonly took endocrine treatment (F = 16.587, P < 0.001) compared to those without SCE. Endometriomas were present in 254 patients (45.2% of all SCE patients), and these patients were significantly less likely to have used hormonal treatment (i) in the present and (ii) in the past (i. n = 113 42.5%, ii. n = 187, 73.9%) compared to patients with other forms of endometriosis (n = 261) (i. n = 139, 52.1%, ii. n = 220, 84.3%) (i. F = 3.976, P = 0.047, ii. F = 8.297, P = 0.004). Various reasons for rejection of endocrine endometriosis treatment were analyzed, when comparing endometrioma subjects to patients with other types of endometriosis, but no statistical differences were","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"69-76"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695477","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}