Human reproduction最新文献

{"title":"Effectiveness and safety of consecutive single embryo transfer compared to double embryo transfer: results from the UK HFEA registry.","authors":"Jack Tighe, Sophie Broughton, Rachel Roberts, Lorraine S Kasaven, Rachel Cutting, Elliot Bridges, Abigail Ng, Amanda Evans, Efstathios Theodorou, Jara Ben Nagi, Benjamin P Jones","doi":"10.1093/humrep/deaf028","DOIUrl":"https://doi.org/10.1093/humrep/deaf028","url":null,"abstract":"<p><strong>Study question: </strong>How does two-consecutive single embryo transfer (2xSET) affect reproductive outcomes of IVF and ICSI compared to double embryo transfer (DET)?</p><p><strong>Summary answer: </strong>Two-consecutive SET may provide greater or comparable live birth rate (LBR); with lower multiple birth, preterm birth, and pregnancy loss or neonatal death rates compared to DET.</p><p><strong>What is known already: </strong>Elective SET in IVF/ICSI is widely encouraged over DET to minimize the risk of multiple births and associated morbidities. Despite this, multiple birth rates following IVF remain higher than the 10% target across Europe and the USA. Currently, the majority of evidence regarding SET and DET is based on various studies assessing outcomes such as LBR per treatment cycle, as opposed to per oocyte retrieval. As such, the representation of SET is mostly unfavourable. Analysis of cumulative LBR following the transfer of two embryos over consecutive cycles, rather than in one transfer event (DET) is more effective at distinguishing the two methods and will therefore provide more valuable information relevant to clinical practice.</p><p><strong>Study design, size, duration: </strong>This retrospective cohort study was conducted using Human Fertilisation and Embryology Authority (HFEA) register data, which encompasses national data from all IVF clinics in the UK. All women who underwent their first oocyte retrieval and IVF or ICSI treatment cycle with subsequent SET, DET, or 2xSET between 2010 and 2019 using blastocyst embryos were included (N = 71 807).</p><p><strong>Participants/materials, setting, methods: </strong>The rate of live birth, liveborn baby rate, multiple birth, preterm birth, and pregnancy loss or neonatal death was compared between SET, DET, and 2xSET IVF/ICSI pregnancies using blastocyst-stage embryos, where data were stratified by maternal age. Data analysis was conducted in RStudio v4.2, alpha equals 0.05.</p><p><strong>Main results and the role of chance: </strong>Blastocyst-stage 2xSET achieved a greater median LBR of 0.47 (interquartile range [IQR] 0.13) than SET, 0.41 (IQR 0.13), and DET, 0.38 (IQR 0.13) (P < 0.05). Using SET as the reference standard, 2xSET was associated with a significantly lower odds of multiple births compared to DET ((odds ratio [OR] 6.87, 95% CI 6.14-7.68) vs 28.20, 95% CI 25.20-31.57). The odds of preterm birth were also lower following 2xSET (OR 1.11, 95% CI 1.06-1.15) compared to DET (OR 2.80, 95% CI 2.67-2.94). Similarly, the odds of pregnancy loss or neonatal death were lower following 2xSET (OR 1.14, 95% CI 1.08-1.21) compared to DET (OR 2.11, 95% CI 1.98-2.24). LBR was consistently higher following 2xSET than DET and SET in women aged 39 years and under (P < 0.05). However, results were comparable in women over 39 years (P > 0.05). Across all age groups, DET pregnancies had the highest multiple birth rate (P < 0.05). In women aged 39 years and under, DET was associate","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500417","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":"Real-time monitoring reveals the effects of low concentrations of volatile organic compounds in the embryology laboratory","authors":"Jiali Cai, Liying Zhou, Lanlan Liu, Zhenfang Liu, Jinghua Chen, Kaijie Chen, Xiaolian Yang, Xiaoming Jiang, Jianzhi Ren","doi":"10.1093/humrep/deaf008","DOIUrl":"https://doi.org/10.1093/humrep/deaf008","url":null,"abstract":"STUDY QUESTION Could real-time monitoring of volatile organic compounds (VOCs) in the embryology laboratory provide meaningful early warning for potential harm from the environment? SUMMARY ANSWER Even in a laboratory environment with a total VOC concentration lower than the recommendation of the Cairo Consensus, the real-time monitored VOC concentrations are associated with changes in embryo morphological parameters. WHAT IS KNOWN ALREADY VOCs have been considered a key environmental detriment in embryology laboratories. However, the current VOC thresholds established by the Cairo consensus were based on the practical experience of air pollution cases, and a scientifically derived threshold is lacking. STUDY DESIGN, SIZE, DURATION The study included 7076 oocyte collection (OPU) cycles carried out between June 2020 and December 2022 in the Center for Reproductive Medicine of the affiliated Chenggong Hospital of Xiamen University, 6306 of which resulted in at least one embryo transfer (ET) attempt during the study. VOC monitoring data were recorded every 10 min. The average and peak concentrations of total VOCs and formaldehyde during culture were associated with embryo parameters and implantation following the first ET attempt of the cycle in generalized estimating equations and generalized additive models. MAIN RESULTS AND THE ROLE OF CHANCE Real-time monitoring of VOCs showed a dynamic of VOC concentration in the laboratory. The concentration reached peaks during the working hours of the days and working days of the week and fell quickly at night and on weekends. The average concentrations of VOCs during the culture period were linearly associated with decreased early cleavage (OR 0.92, 95% CI: 0.85, 0.99), decreased Day 3 compaction (OR 0.51, 95% CI: 0.32, 0.83), increased asymmetry (OR 1.13, 95% CI: 1.01, 1.25), and increased grade C trophectoderm (TE) (OR 1.99, 95% CI: 1.32, 3.01). On the other hand, increased Day 3 arrest, delayed blastocyst formation, and decreased grade A TE showed a non-linear association with VOCs, suggesting a possible threshold of effect. In the first transfer attempt, negative associations were observed between maximal formaldehyde concentrations and pregnancy in both fresh transfer (RR 0.971, 95% CI: 0.94, 0.99) and freeze-all frozen-thawed ET (RR 0.959, 95% CI: 0.92, 0.99) cycles. LIMITATIONS, REASONS FOR CAUTION The sensitivity and specificity of the monitor are not comparable to the standard protocols, such as chromatography-mass spectroscopy. Due to the lack of ability to identify the chemical nature of the components of VOCs, the toxicity and source of the VOCs were largely unknown. The representative sampling of the laboratory air may not necessarily reflect the exposure of embryos. WIDER IMPLICATIONS OF THE FINDINGS While the environment of the embryology laboratory has been significantly improved, the data suggested that a low VOC level could still be a concern. Due to the dynamic of VOC concentration in the","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"15 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495161","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":"Mapping the way to successful euploid frozen embryo transfer: a prospective pilot study of uterine elastography","authors":"Cheri Margolis, Nicolás Garrido, Leah Roberts, Andres Reig, Pavan Gill, Stephanie Willson, Haley Genovese, Francesca Barrett, Caroline Zuckerman, Christine Whitehead, Paul Bergh, Emre Seli, Marie Werner","doi":"10.1093/humrep/deaf029","DOIUrl":"https://doi.org/10.1093/humrep/deaf029","url":null,"abstract":"STUDY QUESTION Does the objective and quantitative assessment of uterine tissue stiffness via ultrasound shear wave elastography (SWE) predict the outcome after single euploid frozen embryo transfer (FET)? SUMMARY ANSWER Uterine SWE data might be predictive of clinical pregnancy in good prognosis patients undergoing single euploid FET. WHAT IS KNOWN ALREADY Few prior studies have evaluated the usefulness of strain uterine elastography in assessing the likelihood of conception in an infertile patient population following IUI or FET. These studies suggest that elastography parameters may be predictive of pregnancy following ART treatments. However, these studies are limited based on their use of strain uterine elastography, which provides a relative measurement between two areas of interest. No prior study has evaluated the more robust technology of SWE, which provides quantitative and objective measurements, on likelihood of conception following infertility treatment. STUDY DESIGN, SIZE, DURATION This is a prospective pilot study of 153 patients with no known uterine pathology undergoing single euploid FET at a university-affiliated center between June 2022 and December 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients scheduled for upcoming single euploid blastocyst FET during the study period were evaluated for study participation. On the day prior to embryo transfer, SWE assessment of 15 regions of interest of the sagittal uterus measuring 6 mm in diameter was performed on included participants. Regions of interest included the cervix, anterior/posterior distal myometrium, anterior/posterior lower uterine segment, fundus, endometrium, and the anterior myometrial/endometrial interface. The elastography data points generated were collected in a standardized fashion by a single investigator blinded to patient outcome. The elasticity parameters analyzed included the mean, SD, minimum, and maximum values in kilopascals and meters per second. These data were assessed for relationship to clinical pregnancy, defined as discharge from fertility care at 9 weeks’ gestation. MAIN RESULTS AND THE ROLE OF CHANCE There were 22 uterine elastography parameters that showed a significant relationship to clinical pregnancy with P < 0.10 using univariant analyses. Regions of interest that were predictive of clinical pregnancy with P < 0.10 included the cervix, the anterior myometrium, the posterior myometrium, the fundus, and the anterior myometrial/endometrial interface. Increased mean (stiffer elastography metrics) in the posterior myometrium and anterior myometrial/endometrial interface was associated with increased likelihood of clinical pregnancy in comparison to FETs that did not result in clinical pregnancy. These values were then subjected to a multivariable logistic regression model to estimate areas under the curves and predictive values with and without clinical parameters. Using elastography data only, the model for predicting clinic","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"82 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495159","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":"Patterns of health service use before and after diagnosis of endometriosis: a data linkage prospective cohort study","authors":"Gita D Mishra, Dereje G Gete, Mohammad R Baneshi, Grant Montgomery, Jessica Taylor, Jenny Doust, Jason Abbott","doi":"10.1093/humrep/deaf026","DOIUrl":"https://doi.org/10.1093/humrep/deaf026","url":null,"abstract":"STUDY QUESTION What are the patterns of health service use (HSU) before and after endometriosis diagnosis? SUMMARY ANSWER Women with endometriosis had higher rates of visits to general practitioners (GPs), specialists, and diagnostic imaging before and after diagnosis compared to those without the condition; however, after diagnosis, their visits to GPs and specialists other than obstetricians/gynaecologists decreased compared to before, while visits to obstetricians/gynaecologists and use of diagnostic imaging increased. WHAT IS KNOWN ALREADY Women with endometriosis have higher rates of healthcare use compared to those without the condition; however, no longitudinal study has examined patterns of HSU over a prolonged period before and after diagnosis. STUDY DESIGN, SIZE, DURATION The Australian Longitudinal Study on Women’s Health linked to a national administrative health record. A total of 30 473 women, born in 1973–1978 and 1989–1995, from two cohorts with data collected from 1996 to 2021, as online or postal questionnaires. PARTICIPANTS/MATERIALS, SETTING, METHODS Women with endometriosis were identified using the self-report surveys and their administrative health records. A control group of women without endometriosis was randomly selected and age-matched with women with endometriosis. The final sample included 9545 women from the 1973–1978 cohort (1909 cases, 7636 controls) and 7510 from the 1989–1995 cohort (1502 cases, 6008 controls). Women’s HSU was assessed using the Medicare Benefits Schedule database. A random intercept zero-inflated negative binomial model was used to compare outcomes between cases and controls, addressing skewed data, over-dispersion, and excess zeros. MAIN RESULTS AND THE ROLE OF CHANCE In both cohorts, women with endometriosis had a higher level of HSU, both before and after diagnosis, compared with those without the condition. For the 1973–1978 cohort, women with endometriosis had a higher rate of visits to GPs before and after diagnosis (adjusted incidence rate ratio: 1.19, 95% CI 1.14, 1.23 and 1.24, 95% CI 1.19, 1.30, respectively), specialists other than obstetricians/gynaecologists (1.50, 95% CI 1.40, 1.61, and 1.36, 95% CI 1.27, 1.46), and for diagnostic imaging (1.15, 95% CI 1.10, 1.21, and 1.20, 95% CI 1.15, 1.26). The average number of these visits remained consistent in the early years, peaked around 3 years before diagnosis, and then partly declined post-diagnosis, to later stabilize at a higher level than those without the condition. Following the diagnosis, women with endometriosis had a higher number of visits to obstetricians/gynaecologists (1.11, 95% CI 1.05, 1.17) than their matched controls, with a marked increase in the first 6 years post-diagnosis, but gradually returned to same levels as the control group. After diagnosis, women with endometriosis had a lower rate of visits to GPs (0.95, 95% CI 0.93, 0.98) and specialists other than obstetricians/gynaecologists (0.88, 95% CI 0.82, 0.93) co","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"774 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473455","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":"Does gonadotoxic chemotherapy deplete the ovarian reserve through activation of primordial follicles?","authors":"Murat Erden, Kutluk H Oktay","doi":"10.1093/humrep/deaf024","DOIUrl":"https://doi.org/10.1093/humrep/deaf024","url":null,"abstract":"Despite significant advances in fertility preservation, no proven pharmacological options exist to protect ovarian primordial follicle reserve from chemotherapy-induced damage. Developing targeted gonadoprotective treatments will require an improved understanding of the molecular mechanisms underlying chemotherapy-induced primordial follicle depletion. While there is robust evidence that gonadotoxic chemotherapy induces primordial follicle death by causing DNA double-strand breaks which trigger apoptotic death, follicle activation leading to ‘burn-out’ of the ovarian reserve has been suggested as an alternative mechanism. Here, we critically evaluated whether primordial follicle activation is a significant mechanism of chemotherapy-induced ovarian reserve depletion in humans. We assessed the causal relationship between chemotherapy exposure and primordial follicle activation by applying the Bradford Hill criteria.","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"35 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473474","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":"Burden of somatic morbidity associated with a surgically verified diagnosis of endometriosis at a young age: a register-based follow-up cohort study in Finland","authors":"Elina Rasp, Kristiina Rönö, Anna But, Mika Gissler, Päivi Härkki, Oskari Heikinheimo, Liisu Saavalainen","doi":"10.1093/humrep/deaf032","DOIUrl":"https://doi.org/10.1093/humrep/deaf032","url":null,"abstract":"STUDY QUESTION How does the burden of somatic disorders compare between women with surgically verified endometriosis diagnosed in adolescence or early adulthood, and matched women without a history of endometriosis? SUMMARY ANSWER Women with endometriosis diagnosed at a young age had a higher incidence of several somatic disorders and a higher number of hospital visits compared to women without endometriosis. WHAT IS KNOWN ALREADY Endometriosis is associated with an increased risk of several somatic disorders, including autoimmune, inflammatory, and pain-related disorders with higher utility of health care resources. There may be differences in the experience of pain relating to the subtypes of endometriosis. Depression and anxiety are linked to endometriosis and increase overall somatic comorbidity. STUDY DESIGN, SIZE, DURATION Longitudinal retrospective register-based cohort study utilizing episode data from specialized care; 2680 women under 25 years with a surgical of diagnosis endometriosis in 1998–2012, and 5338 reference women of the same age and municipality followed up from the index day to the end of 2019, emigration, death or the outcome of interest. PARTICIPANTS/MATERIALS, SETTING, METHODS We analysed incidence rates, cumulative incidence rates, and crude hazard rate ratios (HR) with 95% CIs across 15 groups of somatic disorders. Subgroup analyses were conducted among women with endometriosis, by (i) type of endometriosis—ovarian only (n = 601) versus combined types (n = 2079), and (ii) pre-existing diagnosis of depression or anxiety (n = 270) versus those without such diagnoses (n = 2410). MAIN RESULTS AND THE ROLE OF CHANCE Women reached a median age of 38 (IQR 34–42) years after a median follow-up of almost 16 (12, 19) years. Compared to the reference cohort, women with endometriosis had a higher incidence of several somatic disorders during the follow-up. By the age of 40 years, 38% of women with endometriosis and 9% of the reference cohort had diagnoses of infertility (HR 5.88 [95% CI 5.24–6.61]). The corresponding figures for genital tract infections were 24% and 6% (4.64 [4.03–5.36]), symptoms and signs of pain 62% and 28% (3.27 [3.04–3.51]), migraine 15% and 6.4% (2.49 [2.13–2.92]), and chronic pain conditions 33% and 19% (2.01 [1.83–2.22]), respectively. In women with endometriosis, a higher incidence was seen also for dyspareunia, uterine myomas, celiac disease, asthma, anaemia, high blood pressure, hypercholesterolemia or cardiovascular diseases; autoimmune diseases, and disorders of the thyroid gland. For women with ovarian endometriosis only, we observed a lower HR of high blood pressure, hypercholesterolemia or cardiovascular diseases, asthma, migraine, and pain-related disorders compared to those with other or combined types of endometriosis. Within the endometriosis cohort, women with pre-existing diagnoses of depression or anxiety had higher HRs of several somatic disorders compared to those without such diagnoses. Th","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"8 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473454","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":"Clinical prediction models for in vitro fertilization outcomes: a systematic review, meta-analysis, and external validation","authors":"C H Tian, L Y Liu, Y F Huang, H J Yang, Y Y Lai, C L Li, D Gan, J Yang","doi":"10.1093/humrep/deaf013","DOIUrl":"https://doi.org/10.1093/humrep/deaf013","url":null,"abstract":"STUDY QUESTION What is the best-performing model currently predicting live birth outcomes for IVF or ICSI? SUMMARY ANSWER Among the identified prognostic models, McLernon’s post-treatment model outperforms other models in both the meta-analysis and external validation of a Chinese cohort. WHAT IS KNOWN ALREADY With numerous similar models available across different time periods and using various predictors in IVF prognostic models, there is a need to summarize and evaluate them, due to a lack of validated evidence distinguishing high-quality from low-quality prediction tools. However, there is a notable dearth of research in the form of meta-analysis or external validation assessing the performance of models in predicting live births in this field. STUDY DESIGN, SIZE, DURATION The researchers conducted a comprehensive literature review in PubMed, EMBASE, and Web of Science, using keywords related to prognostic models and IVF/ICSI live birth outcomes. The search included studies published up to 3 April 2024, and was limited to English language studies. PARTICIPANTS/MATERIALS, SETTING, METHODS The review included studies that developed or validated prognostic models for IVF live birth outcomes while providing clear reports on model characteristics. Researchers extracted and analysed the data in accordance with the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and other model-related guidelines. For model effects in meta-analysis, the choice would be based on the heterogeneity assessed using the I2 statistic and the Cochrane Q test. Model performance was evaluated by assessing their area under the receiver operating characteristic curves (AUCs) and calibration plots in the studies. MAIN RESULTS AND THE ROLE OF CHANCE This review provides a comprehensive summary of data derived from 72 studies with an overall ROB of high or unclear. These studies contained a total of 132 predictors and 86 prognostic models, and then meta-analyses were performed for each of the five selected models. The total random effects of Templeton’s, Nelson’s, McLernon’s pre-treatment and post-treatment model demonstrated AUCs of 0.65 (95% CI: 0.61–0.69), 0.63 (95% CI: 0.63–0.64), 0.67 (95% CI: 0.62–0.71), and 0.73 (95% CI: 0.71–0.75), respectively. The total fixed effects of the intelligent data analysis score (iDAScore) model estimated an AUC of 0.66 (95% CI: 0.63–0.68). The external validation of the initial four models in our cohort produced AUCs ranging from 0.53 to 0.58, and the calibration was confirmed through calibration plots. LIMITATIONS, REASONS FOR CAUTION While the focus on English-language studies and live birth outcomes may constrain the generalizability of the findings to diverse populations, this approach equips clinicians, who view live births as the ultimate objective, with more precise and actionable reference guidelines. WIDER IMPLICATIONS OF THE FINDINGS This study represents the first meta-analysis in the fi","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"17 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470697","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 presence, clarity, and consistency of definitions in pregnancy outcomes in infertility trials: a systematic review","authors":"Qian Feng, Wentao Li, Wanlin Li, Rui Wang, James Crispin, Salvatore Longobardi, Thomas D’Hooghe, Ben W Mol","doi":"10.1093/humrep/deaf022","DOIUrl":"https://doi.org/10.1093/humrep/deaf022","url":null,"abstract":"STUDY QUESTION How frequently do infertility trials report live birth and pregnancy, and how consistently were their definitions reported? SUMMARY ANSWER One-third of 1425 infertility trials published in the last decade reported live birth, with one in eight reporting clinical pregnancy, ongoing pregnancy, and live birth concurrently; absent, ambiguous, or heterogeneous definitions were common. WHAT IS KNOWN ALREADY Absent or inconsistent outcome definitions in randomized controlled trials (RCTs) limit their interpretation and complicate subsequent evidence synthesis. While reporting live birth in infertility trials has been a long-running recommendation, the extent to which this is adhered to, and the temporal trend of adherence, is unclear. Furthermore, it is unknown if outcome reporting in infertility trials is clear and consistent. STUDY DESIGN, SIZE, DURATION We studied all RCTs in infertility published between 2012 and 2023. We aimed to assess (i) whether biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth were reported; the temporal trends in reporting these pregnancy outcomes, and compare the characteristics of trials reporting each type of outcome; (ii) whether and how these pregnancy outcomes were defined. PARTICIPANTS/MATERIALS, SETTING, METHODS We systematically searched Embase, Medline, and CENTRAL for RCTs in infertility from January 2012 to August 2023. RCTs involving infertile women that reported either biochemical pregnancy, clinical pregnancy, ongoing pregnancy, or live birth were eligible. Secondary analyses, interim analyses, or conference abstracts were not eligible. Two authors independently screened articles. We extracted pregnancy definitions and trial characteristics primarily using text mining in R, a programming environment for data analysis, and supplemented by manual checking. The accuracy of extracted data was validated in a random sample of 50 articles, with sensitivity and specificity all at or above 90%. MAIN RESULTS AND THE ROLE OF CHANCE We included 1425 infertility RCTs. Among these, 419 (29.4%) reported biochemical pregnancy. While 1359 (95.4%) RCTs reported clinical pregnancy, 404 (28.4%) reported ongoing pregnancy, and 484 (34.0%) reported live birth, only 174 (12.2%) reported all three outcomes. The proportion of trials reporting live birth increased from 23.1% in 2012 to 33.7% in 2023. Trials reporting up to biochemical pregnancy or clinical pregnancy were more likely to be unregistered, smaller, single-centered, and published in non-first quarter journals. Definitions for biochemical, clinical, ongoing pregnancy, and live birth were provided in 68.5% (287/419), 64.5% (876/1359), 70.5% (285/404), and 41.1% (199/484) of articles reporting on these outcomes. Among 876 clinical pregnancy definitions, 63.4% (n = 555) specified the pregnancy confirmation timing. Of the 220 definitions that reported gestational weeks (ranging from 4 to 16 weeks), the most common cut-off was 6 weeks, used","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"50 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470698","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":"Effect of maternal previous pregnancy on children’s pubertal development: an 8-year pubertal cohort","authors":"Qin Zhang, Jie Zhang, Xinyi Feng, Di Wu, Zixuan Chen, Yan Li, Qin Liu","doi":"10.1093/humrep/deaf015","DOIUrl":"https://doi.org/10.1093/humrep/deaf015","url":null,"abstract":"STUDY QUESTION Does the maternal pregnancy history affect the course of their offspring’s pubertal development? SUMMARY ANSWER Maternal pregnancy history, particularly adverse outcomes, significantly influences the timing of menarche and the tempo of breast development in girls. WHAT IS KNOWN ALREADY Preliminary evidence indicates that parity may affect the onset of puberty, mainly as reflected by changes in the timing of pubic and axillary hair development. STUDY DESIGN, SIZE, DURATION This 8-year cohort, conducted semi-annually, was recruited from four primary schools. The average follow-up duration was 6.09 years (range: 2–8 years). PARTICIPANTS/MATERIALS, SETTING, METHODS The study cohort comprised 1390 children, including 710 girls and 680 boys, with age ranges of 6.58–19.26 years and 5.81–19.28 years, respectively, over an 8-year follow-up period. The primary exposure was whether the mother has a history of pregnancy prior to the birth of the child, including childbearing, miscarriage, and other adverse pregnancy outcomes. Pubertal milestones as assessed by a professional, including breast and genital development, were modeled using logistic regression, and the age of menarche was documented for girls. Associations between maternal pregnancy history and pubertal progression in both genders were analyzed using generalized linear regression models. MAIN RESULTS AND THE ROLE OF CHANCE Girls from non-first pregnancies experienced a delayed age at menarche by 0.22 years (95% CI: 0.05, 0.38) and a more rapid tempo of breast development (0.06; 95% CI: 0.01, 0.11) compared to those from first pregnancies, particularly among girls with a history of maternal adverse pregnancy outcomes. The effect of maternal pregnancy history on pubertal development was less pronounced in boys than in girls. LIMITATIONS, REASONS FOR CAUTION The sample was relatively small, and the cohort also lacks sufficient data due to missing data points and some study participants still maturing. While model fitting aids in describing incomplete pubertal development, the logistic growth mixed-effects model’s assumptions about growth curves may not fully reflect reality. WIDER IMPLICATIONS OF THE FINDINGS Maternal pregnancy history, particularly adverse outcomes, can markedly influence pubertal progression in girls. Previous studies have shown that the timing and tempo of pubertal development impact adolescent psychological and behavioral health, and have implications for reproductive health and diseases in adulthood. Optimal pregnancy planning by mothers is essential for enhancing the well-being of both mother and offspring. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by Chongqing Natural Science Foundation project (CSTB2023NSCQ-MSX0133), National Natural Science Foundation of China (81973067), National Youth Science Fund Project (81502825), and Program for Youth Innovation in Future Medicine, Chongqing Medical University (W0054). This study was conducted accordin","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"9 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of female age on concentrations of reproductive hormones and oocyte-specific growth factors in follicular fluid from human small antral follicles","authors":"N Friis Wang, L S Mamsen, J Cadenas, G Saritas, K T Macklon, J Fedder, E Ernst, M L Johannsen, S G Kristensen, T Kelsey, A Kumar, B Kalra, K Løssl, C Yding Andersen","doi":"10.1093/humrep/deaf017","DOIUrl":"https://doi.org/10.1093/humrep/deaf017","url":null,"abstract":"STUDY QUESTION Does maternal age impact hormonal secretions from granulosa cells, theca cells, and the oocyte in human small antral follicles? SUMMARY ANSWER Major hormones secreted by granulosa and theca cells, as well as the oocyte-specific TGF-β members—GDF9, BMP15, and the GDF9/BMP15 heterodimer cumulin—maintain a consistent concentration within the follicular fluid of human small antral follicles, regardless of maternal age. WHAT IS KNOWN ALREADY It is well established that female fertility declines with increasing age. However, it is not known whether this decline is exclusively due to a reduction in oocyte quality and quantity or also involves a decline in the hormone-secreting capabilities of granulosa cells, theca cells, and the oocyte itself. STUDY DESIGN, SIZE, DURATION This is a retrospective study of follicular fluid obtained from human small antral follicles collected in connection with cryopreservation of ovarian tissue at the Laboratory of Reproductive Biology, University Hospital Copenhagen, Rigshospitalet, Denmark, between 2010 and 2020 as part of the hospital’s fertility preservation program. PARTICIPANTS/MATERIALS, SETTING, METHODS Follicular fluid samples from human small antral follicles measuring 3–13 mm in diameter from macroscopically normal ovaries of 381 patients aged 5–43 years were included in the study, provided that at least one of the following parameters was measured: AMH, Inhibin A, Inhibin B, oestradiol (E2), progesterone (P4), androstenedione, testosterone, and/or the oocyte-specific TGF-β members GDF9, BMP15, or cumulin. MAIN RESULTS AND THE ROLE OF CHANCE In a linear regression analysis adjusted for follicular volume, female age did not predict the follicular fluid concentrations of AMH, Inhibin B, Inhibin A, E2, androstenedione, testosterone, GDF9, BMP15, or cumulin. Although a significant association was observed between female age and follicular fluid P4 levels, the predictive value of age was poor, accounting for at most 5% of the variation in P4. LIMITATIONS, REASONS FOR CAUTION Hormonal levels may vary with the degree of atresia in each follicle; however, the health status of the small antral follicles in this study was not characterized. Additionally, we cannot exclude possible age-related differences in human follicles larger than 10 mm, as very few of these were included. Furthermore, we did not include women above the age of 43, despite the potential for more pronounced age-related effects in these patients. WIDER IMPLICATIONS OF THE FINDINGS Our results support the idea that the age-related decline in female fertility is primarily due to a reduction in oocyte quality and quantity, but further research is needed to confirm this. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was obtained, and the authors have no conflicts of interest to declare in relation to this work. TRIAL REGISTRATION NUMBER N/A.","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"12 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371534","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}