Human reproduction最新文献

{"title":"Immune system regulation of physiological and pathological aspects of the ovarian follicle pool throughout the female reproductive lifespan.","authors":"L Cacciottola, A Camboni, M M Dolmans","doi":"10.1093/humrep/deae254","DOIUrl":"10.1093/humrep/deae254","url":null,"abstract":"<p><p>The immune system plays a major role in ovarian physiology by regulating the ovarian follicle pool through complex signaling of different growth factors, cytokines, and chemokines. These may promote follicle activation and further growth but could also trigger follicle atresia and clearance of aging or damaged cells within the ovarian cortex. Moreover, extraglandular steroidogenesis potentially occurring in different immune cells like macrophages and natural killer cells might be another way of modulating follicle growth. Ovarian macrophages have recently been found to contain two different populations, namely resident macrophages and monocyte-derived cells, with potentially different roles. The immune system also plays a role in the development of pathological conditions, including premature ovarian insufficiency (POI). Indeed, autoimmune activation against various ovarian antigen targets results in lymphocytic oophoritis mainly targeting early growing follicles, but later leading to complete follicle pool depletion. Immune-mediated ovarian damage may also be caused by viral infection or be the consequence of iatrogenic damage. Certain novel cancer immunotherapies like checkpoint inhibitors have recently been shown to induce ovarian reserve damage in a murine model. Studies are needed to corroborate these findings and further investigate the potential of newly developed immunotherapies to treat POI. Technological advances such as single-cell analyses of less represented cell populations like immune cells inside the ovary are now contributing to valuable new information, which will hopefully lead to the development of new therapeutic strategies for women with fertility issues.</p>","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"12-22"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750774","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":"Novel application of metabolic imaging of early embryos using a light-sheet on-a-chip device: a proof-of-concept study.","authors":"E Vargas-Ordaz, H Newman, C Austin, S Catt, R Nosrati, V J Cadarso, A Neild, F Horta","doi":"10.1093/humrep/deae249","DOIUrl":"10.1093/humrep/deae249","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Is it feasible to safely determine metabolic imaging signatures of nicotinamide adenine dinucleotide [NAD(P)H] associated auto-fluorescence in early embryos using a light-sheet on-a-chip approach?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;We developed an optofluidic device capable of obtaining high-resolution 3D images of the NAD(P)H autofluorescence of live mouse embryos using a light-sheet on-a-chip device as a proof-of-concept.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Selecting the most suitable embryos for implantation and subsequent healthy live birth is crucial to the success rate of assisted reproduction and offspring health. Besides morphological evaluation using optical microscopy, a promising alternative is the non-invasive imaging of live embryos to establish metabolic activity performance. Indeed, in recent years, metabolic imaging has been investigated using highly advanced microscopy technologies such as fluorescence-lifetime imaging and hyperspectral microscopy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;The potential safety of the system was investigated by assessing the development and viability of live embryos after embryo culture for 67 h post metabolic imaging at the two-cell embryo stage (n = 115), including a control for culture conditions and sham controls (system non-illuminated). Embryo quality of developed blastocysts was assessed by immunocytochemistry to quantify trophectoderm and inner mass cells (n = 75). Furthermore, inhibition of metabolic activity (FK866 inhibitor) during embryo culture was also assessed (n = 18).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;The microstructures were fabricated following a standard UV-photolithography process integrating light-sheet fluorescence microscopy into a microfluidic system, including on-chip micro-lenses to generate a light-sheet at the centre of a microchannel. Super-ovulated F1 (CBA/C57Bl6) mice were used to produce two-cell embryos and embryo culture experiments. Blastocyst formation rates and embryo quality (immunocytochemistry) were compared between the study groups. A convolutional neural network (ResNet 34) model using metabolic images was also trained.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;The optofluidic device was capable of obtaining high-resolution 3D images of live mouse embryos that can be linked to their metabolic activity. The system's design allowed continuous tracking of the embryo location, including high control displacement through the light-sheet and fast imaging of the embryos (&lt;2 s), while keeping a low dose of light exposure (16 J · cm-2 and 8 J · cm-2). Optimum settings for keeping sample viability showed that a modest light dosage was capable of obtaining 30 times higher signal-noise-ratio images than images obtained with a confocal system (P &lt; 0.00001; t-test). The results showed no significant differences between the control, illuminated and non-illuminat","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"41-55"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619215","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":"Endometrial extracellular vesicles regulate processes related to embryo development and implantation in human blastocysts.","authors":"Marina Segura-Benítez, Maria Cristina Carbajo-García, Alicia Quiñonero, María José De Los Santos, Antonio Pellicer, Irene Cervelló, Hortensia Ferrero","doi":"10.1093/humrep/deae256","DOIUrl":"10.1093/humrep/deae256","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;What is the transcriptomic response of human blastocysts following internalization of extracellular vesicles (EVs) secreted by the human endometrium?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;EVs secreted by the maternal endometrium induce a transcriptomic response in human embryos that modulates molecular mechanisms related to embryo development and implantation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;EVs mediate intercellular communication by transporting various molecules, and endometrial EVs have been postulated to be involved in the molecular regulation of embryo implantation. Our previous studies showed that endometrial EVs carry miRNAs and proteins associated with implantation events that can be taken up by human blastocysts; however, no studies have yet investigated the transcriptomic response of human embryos to this EV uptake, which is crucial to demonstrate the functional significance of this communication system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;A prospective descriptive study was performed. Primary human endometrial epithelial cells (pHEECs), derived from endometrial biopsies collected from fertile oocyte donors (n = 20), were cultured in vitro to isolate secreted EVs. Following EV characterization, Day 5 human blastocysts (n = 24) were cultured in the presence or absence of the EVs for 24 h and evaluated by RNA-sequencing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;EVs were isolated from the conditioned culture media using ultracentrifugation, and characterization was performed using western blot, nanoparticle tracking analysis, and transmission electron microscopy. Human blastocysts were devitrified, divided into two groups (n = 12/group), and cultured in vitro for 24 h with or without previously isolated EVs. RNA-sequencing analysis was performed, and DESeq2 was used to identify differentially expressed genes (DEGs) (FDR &lt; 0.05). QIAGEN Ingenuity Pathway Analysis was used to perform the functional enrichment analysis and integration with our recently published data from the pHEECs' EV-miRNA cargo.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Characterization confirmed the isolation of EVs from pHEECs' conditioned culture media. Among the DEGs in blastocysts co-cultured with EVs, we found 519 were significantly upregulated and 395 were significantly downregulated. These DEGs were significantly enriched in upregulated functions related to embryonic development, cellular invasion and migration, cell cycle, cellular organization and assembly, gene expression, and cell viability; and downregulated functions related to cell death and DNA fragmentation. Further, the intracellular signaling pathways regulated by the internalization of endometrial EVs were previously related to early embryo development and implantation potential, for their role in pluripotency, cellular homeostasis, early embryogenesis, and implantation-related processes. Final","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"56-68"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686865","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":"Targeting and missing conceptions.","authors":"Cornelis Nils B Lambalk","doi":"10.1093/humrep/deae282","DOIUrl":"https://doi.org/10.1093/humrep/deae282","url":null,"abstract":"","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"40 1","pages":"1-2"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931629","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":"'To keep your balance, you must keep moving'†: a new chapter for Human Reproduction.","authors":"Chris Barratt, Kirstine Kirkegaard","doi":"10.1093/humrep/deae279","DOIUrl":"https://doi.org/10.1093/humrep/deae279","url":null,"abstract":"","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"40 1","pages":"3"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931633","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 'golden fleece of embryology' eludes us once again: a recent RCT using artificial intelligence reveals again that blastocyst morphology remains the standard to beat.","authors":"Denny Sakkas","doi":"10.1093/humrep/deae263","DOIUrl":"10.1093/humrep/deae263","url":null,"abstract":"<p><p>Grading of blastocyst morphology is used routinely for embryo selection with good outcomes. A lot of effort has been placed in IVF to search for the prize of selecting the most viable embryo to transfer ('the golden fleece of embryology'). To improve on morphology alone, artificial intelligence (AI) has also become a tool of interest, with many retrospective studies being published with impressive prediction capabilities. Subsequently, AI has again raised expectations that this 'golden fleece of embryology' was once again within reach. A recent RCT however was not able to demonstrate non-inferiority using a deep learning algorithm 'iDAScore version 1' for clinical pregnancy rate when compared to standard morphology. Good blastocyst morphology has again proven itself as a high bar in predicting live birth. We should however not give up on the development of further approaches which may allow us to identify extra features of viable embryos that are not captured by morphology.</p>","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"4-8"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739481","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":"Intracytoplasmic sperm injection versus conventional in vitro fertilization in infertile couples with normal total sperm count and motility: does sperm morphology matter?","authors":"Toan D Pham, Vinh Q Dang, Vu N A Ho, Cam T Tran, Dung T P Nguyen, Lan N Vuong, Tuong M Ho, Ben W Mol, Rui Wang","doi":"10.1093/humrep/deae252","DOIUrl":"10.1093/humrep/deae252","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Among couples with infertility and normal total sperm count and motility, can sperm morphology be used as a biomarker to identify couples who benefit more from ICSI over conventional IVF (c-IVF) on fertility outcomes?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Based on this secondary analysis of a large randomized clinical trial (RCT), sperm morphology has limited value as a biomarker to identify couples who benefit more from ICSI over c-IVF on live birth, ongoing pregnancy, clinical pregnancy or total fertilization failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Our recent RCT showed that ICSI did not result in higher live birth rates in couples with normal total sperm count and motility. It is unclear whether sperm morphology can be used as a biomarker to identify couples who benefit more from ICSI over c-IVF in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;This was a secondary analysis of an open-label, multi-centre, RCT comparing ICSI versus c-IVF in 1064 couples with infertility and normal total sperm count and motility. In this secondary study, we evaluated the effectiveness of ICSI over c-IVF in relation to sperm morphology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;Couples were eligible if they had ≤2 previous IVF/ICSI attempts, and the male partner had normal total sperm count and motility according to the fifth edition of the WHO laboratory manual for the examination and processing of human semen. Sperm morphology was measured from samples obtained during the first consultation and data for sperm morphology were available in partners of all participants in this trial. The outcomes of interest were live birth, ongoing pregnancy, clinical pregnancy, and total fertilization failure. We first conducted a logistic regression analysis with an interaction term (sperm morphology as a continuous variable by treatment (ICSI versus c-IVF)) on the four outcomes. We also used restricted cubic spline analysis to evaluate non-linear interaction and plotted the treatment effects of ICSI over c-IVF at different sperm morphology levels and the predicted probability of these outcomes in both ICSI and c-IVF groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;The median proportion of sperm with normal morphology in both groups was 3% (Interquartile range 1-6%). Live birth rates were (184/532) 34.6% for ICSI versus (166/532) 31.2% for c-IVF. No significant interaction was found between sperm morphology and treatment effect of ICSI versus c-IVF on the rates of live birth, ongoing pregnancy, clinical pregnancy, and total fertilization failure (P = 0.181, 0.153, 0.168, and 0.788 respectively). In the analyses using restricted cubic splines, no evidence of interaction between sperm morphology and the treatment effect was found. Interaction figures showed that the treatment effect of ICSI over c-IVF at different sperm morphology levels was fluctuating around no e","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"23-29"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Particulate air pollution at the time of oocyte retrieval is independently associated with reduced odds of live birth in subsequent frozen embryo transfers.","authors":"S J Leathersich, C S Roche, M Walls, E Nathan, R J Hart","doi":"10.1093/humrep/deae259","DOIUrl":"10.1093/humrep/deae259","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Does exposure to particulate matter (PM) air pollution prior to oocyte retrieval or subsequent frozen embryo transfer (FET) affect the odds of live birth?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Live birth rates are lower when particulate matter (PM2.5 and PM10) levels are higher prior to oocyte retrieval, regardless of the conditions at the time of embryo transfer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Exposure to air pollution is associated with adverse reproductive outcomes, including reduced fecundity and ovarian reserve, and an increased risk of infertility and pregnancy loss. It is uncertain whether the effect on ART outcomes is due to the effects of pollution on oogenesis or on early pregnancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;This retrospective cohort study included 3659 FETs in 1835 patients between January 2013 and December 2021, accounting for all FETs performed at a single clinic over the study period. The primary outcome was the live birth rate per FET. Outcome data were missing for two embryo transfers which were excluded. Daily levels of PM2.5, PM10, nitric oxide, nitrogen dioxide, sulphur dioxide, ozone and carbon monoxide were collected during the study period and calculated for the day of oocyte retrieval and the day of embryo transfer, and during the preceding 2-week, 4-week, and 3-month periods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;Clinical and embryological outcomes were analysed for their association with pollution over 24 hours, 2 weeks, 4 weeks, and 3 months, with adjustment for repeated cycles per participant, age at the time of oocyte retrieval, a quadratic age term, meteorological season, year, and co-exposure to air pollutants. Multi-pollutant models were constructed to adjust for co-exposures to other pollutants. Median concentrations in pollutant quartiles were modelled as continuous variables to test for overall linear trends; a Bonferroni correction was applied to maintain an overall alpha of 0.05 across the four exposure periods tested.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Increased PM2.5 exposure in the 3 months prior to oocyte retrieval was associated with decreased odds of live birth (linear trend P = 0.011); the odds of live birth when PM2.5 concentrations were in the highest quartile were reduced by 34% (OR 0.66, 95% CI 0.47-0.92) when compared to the lowest quartile. A consistent direction of effect was seen across other exposure periods prior to oocyte retrieval, with an apparent dose-dependent relationship. Increased exposure to PM10 particulate matter in the 2 weeks prior to oocyte retrieval was associated with decreased odds of live birth (linear trend P = 0.009); the odds of live birth were decreased by 38% (OR 0.62, 95% CI 0.43-0.89, P = 0.010) when PM10 concentrations were in the highest quartile compared with the lowest quartile. Consistent trends were not seen across other exposure perio","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":"110-118"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824274","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":"Hypophosphatemia is a frequent finding in infertile men and is associated with low motile sperm count","authors":"Sam Kafai Yahyavi, Gustav Wall-Gremstrup, Benedicte Probst-Drejer, Frederikke Bay Toft, Mads Joon Jorsal, Rune Holt, Lise Aksglaede, Niels Jørgensen, Anders Juul, Martin Blomberg Jensen","doi":"10.1093/humrep/deae293","DOIUrl":"https://doi.org/10.1093/humrep/deae293","url":null,"abstract":"STUDY QUESTION Is serum phosphate linked with semen quality and reproductive hormones in infertile men? SUMMARY ANSWER Hypophosphatemia is a frequent finding in infertile men and is associated with lower number of motile sperm. WHAT IS KNOWN ALREADY Phosphate is available in fluid from all segments of the male reproductive tract in concentrations manyfold higher than in serum. However, the role of phosphate in male fertility is largely unknown. STUDY DESIGN, SIZE, DURATION This cross-sectional study included 1242 men referred due to infertility between January 2017 and May 2020 at the Department of Growth and Reproduction, Rigshospitalet, Copenhagen. PARTICIPANTS/MATERIALS, SETTING, METHODS Each man underwent a physical examination, had semen parameters assessed, and had blood analyzed prospectively for concentrations of phosphate, ionized calcium, alkaline phosphatase, parathyroid hormone, serum 25-hydroxyvitamin D (25OHD), and reproductive hormones. After 246 men were excluded due to serious comorbidities, 1242 were included in the analyses. MAIN RESULTS AND THE ROLE OF CHANCE Infertile men have a high prevalence of mild (25.5%, 0.66–0.80 mmol/l) and moderate hypophosphatemia (10.9%, 0.32–0.65 mmol/l). The percentages of motile spermatozoa and progressively motile spermatozoa were lower in men with moderate hypophosphatemia than in men with mild hypophosphatemia or normophosphatemia (44%, 49%, 51%, P = 0.040, and 32%, 35%, 41%, P = 0.036, respectively). The total numbers of motile and progressively motile spermatozoa were also lower (13, 12, 18 million, P = 0.009, and 10, 9, 14 million, P = 0.006, respectively). Serum concentrations of total and free estradiol were highest in men with moderate hypophosphatemia (97.5, 96.2, 92.1 pmol/l, P = 0.004, and 2.4, 2.3, 2.2 pmol/l, P = 0.034, respectively). LIMITATIONS, REASONS FOR CAUTION The study question is compromised by the descriptive study design. It remains to be shown whether there exist a causal link between serum phosphate and semen quality in infertile men WIDER IMPLICATIONS OF THE FINDINGS As fertility stands as a critical concern in the world, there is a need to find regulators of fertility during adulthood to identify possible treatments. Therefore, the precise mechanisms through which hypophosphatemia may impact sperm motility remain needs to be further clarified. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by Novo Nordisk Foundation, Beckett Foundation, Medical doctor Sofus Carl Emil Friis and spouse Olga Doris Friis’s Grant, Candys Foundation, and The Innovation Foundation. There was no influence from any sponsor on the study design, and the authors have nothing to declare. TRIAL REGISTRATION NUMBER N/A.","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"26 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908302","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":"Comparison of fresh testicular sperm aspiration and use of either thawed pre-frozen sperm or oocyte freezing: impact on cumulative live birth rates for couples experiencing ejaculation failure","authors":"Shaoquan Zhan, Geng An, Jiayu Gan, Hongzi Du, Xin Fu, Chunyan Wang, Yuling Mao, Xiangjin Kang, Jianqiao Liu, Hanyan Liu","doi":"10.1093/humrep/deae290","DOIUrl":"https://doi.org/10.1093/humrep/deae290","url":null,"abstract":"STUDY QUESTION Is there a difference in the cumulative live birth rate (CLBR) after fresh testicular sperm aspiration (TESA) compared with the use of either pre-frozen sperm or oocyte freezing for couples experiencing ejaculation failure on the day of oocyte retrieval? SUMMARY ANSWER After adjusting for confounding factors, the use of pre-frozen sperm or the freezing and thawing of oocytes appeared to be as effective as TESA in achieving CLBRs for couples experiencing temporary ejaculation failure. WHAT IS KNOWN ALREADY Male patients may be concerned about experiencing temporary ejaculation failure on the day of their partner’s oocyte retrieval, in which case they may choose surgical sperm retrieval, oocyte freezing on the day, or have their sperm frozen in advance. However, the clinical efficacy of these three options has not yet been evaluated. STUDY DESIGN, SIZE, DURATION A retrospective data analysis was conducted on 65 178 oocyte retrieval cycles at a university-affiliated IVF center from January 2012 to May 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS The overall characteristics, completed cycle characteristics, and clinical outcomes were analyzed among couples with ejaculation failure who underwent three distinct clinical interventions, with those receiving TESA serving as the control group. The primary outcome measure was the CLBR, and the secondary outcome measures were the clinical pregnancy rate (CPR) and live birth rate (LBR) per embryo transfer. A robust (modified) Poisson regression model was used to evaluate the association between the three clinical options for ejaculation failure and CLBRs. MAIN RESULTS AND ROLE OF CHANCE Of the eligible oocyte retrieval cycles, 756 cycles (1.2%) experienced ejaculation failure, with 640 cycles completing treatment. These treatments included 325 cycles using TESA, 227 cycles utilizing pre-frozen sperm, and 88 cycles involving frozen–thawed oocytes. The CLBRs for the TESA, thawed-sperm and thawed-oocyte groups were 36.9%, 48.9%, and 34.1%, respectively, showing a statistically significant difference (P = 0.007). Specifically, the thawed-sperm group demonstrated a significantly higher CLBR compared to the TESA group, while no significant difference was observed between the TESA and thawed-oocyte groups. Similarly, the CPRs and LBRs per embryo transfer for the three groups were 37.4%, 50.0%, and 41.8%, respectively (P = 0.005), and 29.9%, 39.6%, and 33.0%, respectively (P = 0.030). Again, the thawed-sperm group showed a significantly higher CPR and a significantly higher LBR, but no significant differences for the thawed-oocyte group, compared to the TESA group. Notably, the significant differences in both CLBR and LBR emerged after the second embryo transfer. However, after adjusting for multiple factors, including female age at oocyte retrieval, type and duration of infertility, female body mass index, number of previous IVF cycles, ovarian stimulation protocol, endometrial thickness on the last","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"34 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908279","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}