Human reproduction最新文献

{"title":"Vitrification preservation of good-quality blastocysts for more than 5 years reduces implantation and live birth rates.","authors":"Shaoquan Zhan, Chenxing Lin, Qiwang Lin, Jiayu Gan, Chunyan Wang, Yang Luo, Jianqiao Liu, Hongzi Du, Hanyan Liu","doi":"10.1093/humrep/deae150","DOIUrl":"10.1093/humrep/deae150","url":null,"abstract":"<p><strong>Study question: </strong>Does vitrification cryopreservation of embryos for more than 5 years affect the pregnancy outcomes after frozen embryo transfer (FET)?</p><p><strong>Summary answer: </strong>Vitrification cryopreservation of good-quality blastocysts for more than 5 years is associated with a decrease in the implantation rate (IR) and live birth rate (LBR).</p><p><strong>What is known already: </strong>Previous studies have predominantly focused on embryos cryopreserved for relatively short durations (less than 5 years), yet the impact of extended cryopreservation duration on pregnancy outcomes remains a controversial issue. There is a relative scarcity of data regarding the efficacy and safety of storing embryos for 5 years or longer.</p><p><strong>Study design, size, duration: </strong>This retrospective study involved 36 665 eligible vitrified-thawed embryo transfer cycles from 1 January 2016 to 31 December 2022, at a single fertility center in China.</p><p><strong>Participants/materials, setting, methods: </strong>Patients were divided into three groups according to embryo storage time: Group 1 consisted of 31 565 cycles, with storage time of 0-2 years; Group 2 consisted of 4458 cycles, with a storage time of 2-5 years; and Group 3 included 642 cycles, with storage time exceeding 5 years. The main outcome measures were IR and LBR. Secondary outcome variables included rates of biochemical pregnancy, multiple pregnancy, ectopic pregnancy, and miscarriage, as well as neonatal outcomes. Reproductive outcomes were analyzed as binary variables. Multivariate logistic regression analysis was used to explore the effect of preservation time on pregnancy outcomes after correcting for confounding factors. In addition, we also assessed neonatal outcomes, such as large for gestational age (LGA) and small for gestational age (SGA).</p><p><strong>Main results and the role of chance: </strong>IRs in the three groups (0-2, 2-5, and >5 years) were 37.37%, 39.03%, and 35.78%, respectively (P = 0.017), and LBRs in the three groups were 37.29%, 39.09%, and 34.91%, respectively (P = 0.028). After adjustment for potential confounding factors, compared with the 0-2 years storage group, prolonged embryo vitrification preservation time (2-5 years or >5 years) did not affect secondary outcomes such as rates of biochemical pregnancy, multiple pregnancy, ectopic pregnancy, and miscarriage (P > 0.05). But cryopreservation of embryos for more than 5 years reduced the IR (adjusted odds ratio (aOR) 0.82, 95% CI 0.69-0.97, P = 0.020) and LBR (aOR 0.76, 95% CI 0.64-0.91, P = 0.002). Multivariate stratified analysis also showed that prolonging the cryopreservation time of blastocysts (>5 years) reduced the IR (aOR 0.78, 95% CI 0.62-0.98, P = 0.033) and LBR (aOR 0.68, 95% CI 0.53-0.87, P = 0.002). However, no effect on cleavage embryos was observed (P > 0.05). We further conducted stratified analyses based on the number and quality of frozen blastocysts transfer","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497907","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":"Granulosa cell metabolism at ovulation correlates with oocyte competence and is disrupted by obesity and aging.","authors":"Atsushi Morimoto, Ryan D Rose, Kirsten M Smith, Doan T Dinh, Takashi Umehara, Yasmyn E Winstanley, Hiroaki Shibahara, Darryl L Russell, Rebecca L Robker","doi":"10.1093/humrep/deae154","DOIUrl":"10.1093/humrep/deae154","url":null,"abstract":"<p><strong>Study question: </strong>Is oocyte developmental competence associated with changes in granulosa cell (GC) metabolism?</p><p><strong>Summary answer: </strong>GC metabolism is regulated by the LH surge, altered by obesity and reproductive aging, and, in women, specific metabolic profiles are associated with failed fertilization versus increased blastocyst development.</p><p><strong>What is known already: </strong>The cellular environment in which an oocyte matures is critical to its future developmental competence. Metabolism is emerging as a potentially important factor; however, relative energy production profiles between GCs and cumulus cells and their use of differential substrates under normal in vivo ovulatory conditions are not well understood.</p><p><strong>Study design, size, duration: </strong>This study identified metabolic and substrate utilization profiles within ovarian cells in response to the LH surge, using mouse models and GCs of women undergoing gonadotropin-induced oocyte aspiration followed by IVF/ICSI.</p><p><strong>Participants/materials, setting, methods: </strong>To comprehensively assess follicular energy metabolism, we used real-time metabolic analysis (Seahorse XFe96) to map energy metabolism dynamics (mitochondrial respiration, glycolysis, and fatty acid oxidation) in mouse GCs and cumulus-oocyte complexes (COCs) across a detailed time course in the lead up to ovulation. In parallel, the metabolic profile of GCs was measured in a cohort of 85 women undergoing IVF/ICSI (n = 21 with normal ovarian function; n = 64 with ovarian infertility) and correlated with clinical parameters and cycle outcomes.</p><p><strong>Main results and the role of chance: </strong>Our study reveals dynamic changes in GC energy metabolism in response to ovulatory LH, with mitochondrial respiration and glycolysis differentially affected by obesity versus aging, in both mice and women. High respiration in GCs is associated with failed fertilization (P < 0.05) in a subset of women, while glycolytic reserve and mitochondrial ATP production are correlated with on-time development at Day 3 (P < 0.05) and blastocyst formation (P < 0.01) respectively. These data provide new insights into the cellular mechanisms of infertility, by uncovering significant associations between metabolism within the ovarian follicle and oocyte developmental competence.</p><p><strong>Limitations, reasons for caution: </strong>A larger prospective study is needed before the metabolic markers that were positively and negatively associated with oocyte quality can be used clinically to predict embryo outcomes.</p><p><strong>Wider implications of the findings: </strong>This study offers new insights into the importance of GC metabolism for subsequent embryonic development and highlights the potential for therapeutic strategies focused on optimizing mitochondrial metabolism to support embryonic development.</p><p><strong>Study funding/competing interest(s): </strong>Nati","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626553","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":"Longitudinal associations between urinary biomarkers of phthalates and replacements with novel in vivo measures of placental health.","authors":"Emma M Rosen, Danielle R Stevens, Erin E McNell, Mollie E Wood, Stephanie M Engel, Alexander P Keil, Antonia M Calafat, Julianne Cook Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K Ferguson","doi":"10.1093/humrep/deae152","DOIUrl":"10.1093/humrep/deae152","url":null,"abstract":"<p><strong>Study question: </strong>What is the longitudinal association between gestational phthalate exposure and in vivo placental outcomes?</p><p><strong>Summary answer: </strong>Phthalates were adversely associated with placental microvasculature, stiffness, and presence of calcification, with different metabolites associated with different outcomes.</p><p><strong>What is known already: </strong>Phthalate exposure is ubiquitous and implicated as a contributor to adverse pregnancy outcomes, possibly through impacts on the placenta.</p><p><strong>Study design, size, duration: </strong>A total of 303 women were recruited in early pregnancy and prospectively followed for up to eight visits across gestation in the Human Placenta and Phthalates study.</p><p><strong>Participants/materials, setting, methods: </strong>At each visit, women provided urine samples and underwent placental ultrasounds. Urine was analyzed for 18 metabolites of phthalates and replacements. We took the geometric mean of repeated measurements to reflect pregnancy-averaged phthalate or replacement exposure for each participant (n = 303). Placental microvasculature, stiffness, and microcalcification presence were quantified from ultrasounds at each visit. Higher scores reflected worse placental function for all measures. Generalized linear mixed models were created to estimate the association between pregnancy-averaged exposure biomarker concentrations and repeated outcome measurements for microvasculature and stiffness. Gestational age at the time of calcification detection was modeled using Cox proportional hazards models.</p><p><strong>Main results and the role of chance: </strong>Monocarboxyisononyl phthalate and summed di(2-ethylhexyl) phthalate metabolites were associated with impaired microvasculature development, such that an interquartile range increase in concentration was associated with 0.11 standard deviation increase in the microvasculature ratio, indicating poorer vascularization (95% CI: 0.00, 0.22); 0.11 [95% CI: -0.01, 0.22], respectively. Monoethyl phthalate was associated with increased placental stiffness (0.09 [95% CI: -0.01, 0.19]) while summed di-iso-butyl phthalate metabolites and monobenzyl phthalate were associated with increased hazard of calcification detection (hazard ratios: 1.18 [95% CI: 0.98, 1.42]; 1.13 [95% CI: 0.96, 1.34]).</p><p><strong>Limitations, reasons for caution: </strong>Outcomes used in this study are novel and further investigation is needed to provide clinical context and relevance.</p><p><strong>Wider implications of the findings: </strong>We found evidence of associations between select phthalate biomarkers and various aspects of in vivo placental health, although we did not observe consistency across placental outcomes. These findings could illustrate heterogeneous effects of phthalate exposure on placental function.</p><p><strong>Study funding/competing interest(s): </strong>This research was supported in part by the Intramura","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544772","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":"Hydroxychloroquine in recurrent pregnancy loss: data from a French prospective multicenter registry.","authors":"Amandine Dernoncourt, Kaies Hedhli, Noémie Abisror, Meryam Cheloufi, Jonathan Cohen, Kamila Kolanska, Chloé McAvoy, Lise Selleret, Eric Ballot, Emmanuelle Mathieu d'Argent, Nathalie Chabbert Buffet, Olivier Fain, Gilles Kayem, Arsène Mekinian","doi":"10.1093/humrep/deae146","DOIUrl":"10.1093/humrep/deae146","url":null,"abstract":"<p><strong>Study question: </strong>What are the outcomes of pregnancies exposed to hydroxychloroquine (HCQ) in women with a history of recurrent pregnancy loss (RPL), and what factors predict the course of these pregnancies beyond the first trimester?</p><p><strong>Summary answer: </strong>In our cohort of pregnancies in women with a history of RPL exposed to HCQ early in pregnancy, we found that the only factor determining the success of these pregnancies was the number of previous miscarriages.</p><p><strong>What is known already: </strong>Dysregulation of the maternal immune system plays a role in RPL. HCQ, with its dual immunomodulating and vascular protective effects, is a potential treatment for unexplained RPL.</p><p><strong>Study design, size, duration: </strong>The FALCO (Facteurs de récidive précoce des fausses couches) registry is an ongoing French multicenter infertility registry established in 2017 that includes women (aged from 18 to 49 years) with a history of spontaneous RPL (at least three early miscarriages (≤12 weeks of gestation (WG)) recruited from several university hospitals.</p><p><strong>Participants/materials, setting, methods: </strong>Spontaneous pregnancies enrolled in the FALCO registry with an exposure to HCQ (before conception or at the start of pregnancy) were included. Pregnancies concomitantly exposed to tumor necrosis factor inhibitors, interleukin-1 and -2 inhibitors, intravenous immunoglobulin, and/or intravenous intralipid infusion, were excluded. Concomitant treatment with low-dose aspirin (LDA), low-molecular weight heparin (LMWH), progesterone, and/or prednisone was allowed. All patients underwent the recommended evaluations for investigating RPL. Those who became pregnant received obstetric care in accordance with French recommendations and were followed prospectively. The main endpoint was the occurrence of a pregnancy continuing beyond 12 WG, and the secondary endpoint was the occurrence of a live birth.</p><p><strong>Main results and the role of chance: </strong>One hundred pregnancies with HCQ exposure in 74 women were assessed. The mean age of the women was 34.2 years, and the median number of previous miscarriages was 5. Concomitant exposure was reported in 78 (78%) pregnancies for prednisone, 56 (56%) pregnancies for LDA, and 41 (41%) pregnancies for LMWH. Sixty-two (62%) pregnancies ended within 12 WG, the other 38 (38%) continuing beyond 12 WG. The risk of experiencing an additional early spontaneous miscarriage increased with the number of previous miscarriages, but not with age. The distributions of anomalies identified in RPL investigations and of exposure to other drugs were similar between pregnancies lasting ≤12 WG and those continuing beyond 12WG. The incidence of pregnancies progressing beyond 12 WG was not higher among pregnancies with at least one positive autoantibody (Ab) (i.e. antinuclear Ab titer ≥1:160, ≥1 positive conventional and/or non-conventional antiphospholipid Ab, and/or ","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467615","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":"Mothers of twins had higher old-age survival than mothers of singletons in Estonian 19th-century birth cohorts.","authors":"R Meitern, M Gortfelder, A Puur, P Hõrak","doi":"10.1093/humrep/deae166","DOIUrl":"10.1093/humrep/deae166","url":null,"abstract":"<p><strong>Study question: </strong>Do the mothers of twins and singletons differ regarding post-partum and old-age mortality?</p><p><strong>Summary answer: </strong>Twin deliveries were associated with higher post-partum maternal mortality than singleton deliveries, but the lifetime post-partum mortality risk was similar for mothers of twins and singletons; survival of twinners was higher than survival of the mothers of singletons after the 67th lifespan percentile.</p><p><strong>What is known already: </strong>Twinning is typically associated with higher post-partum maternal mortality. The evidence about whether twinning incurs long-term survival costs of reproduction or is a trait pertinent to long-lived women is scarce and contradictory.</p><p><strong>Study design, size, duration: </strong>The study is based on the data of the Estonian Family Register (operating from 1926 to 1943) and involves 5565 mothers of twins and 119 613 mothers of singletons born between 1850 and 1899. The subset for comparing maternal lifespans included 1703-1884 mothers of twins and 19 747-36 690 mothers of singletons.</p><p><strong>Participants/materials, setting, methods: </strong>Post-partum maternal mortality was analyzed in the whole sample (including mothers of a single child) by logistic regression. Most of the analyses were performed in samples where each mother of twins was matched against mothers of singletons based on parity (or number of deliveries), urban versus rural and inland versus coastal origin, whether their lifespan was known, date of birth and age at first birth. Lifespans were compared in linear mixed models. Quantile regression was used to analyze age-dependent variations in maternal mortality rates. All models were adjusted for relevant biodemographic covariates.</p><p><strong>Main results and the role of chance: </strong>The twinning rate in the whole sample was 4.4%. During the year after giving birth, maternal mortality for twin deliveries was 0.75% (17/2273) and 0.37% (449/122 750) for singleton deliveries (OR = 2.05, 95% CI = 1.21-3.23). However, the lifetime post-partum mortality risk for mothers of twins (0.51%; 28/5557) and singletons (0.37%; 438/119 466) did not differ significantly (OR = 1.38, 95% CI = 0.91-1.98). The life spans of the mothers of twins and singletons did not differ in matched samples. Past the 67th lifespan percentile, the odds of survival were significantly higher for mothers of twins than mothers of singletons, as indicated by non-overlapping 95% confidence intervals.</p><p><strong>Limitations, reasons for caution: </strong>Relatively low number of individuals (22 802-28 335) with known age at death in matched datasets due to discontinuation of the register after 1943.</p><p><strong>Wider implications of the findings: </strong>The finding that mothers of twins had higher odds of old-age survival than mothers of singletons is consistent with the contention that twinners represent a non-random subset of women whose ","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787910","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":"Perspectives on sperm donor anonymity: insights from donor-conceived adults in Belgium.","authors":"Phyline Casteels, Julie Nekkebroeck, Herman Tournaye","doi":"10.1093/humrep/deae160","DOIUrl":"10.1093/humrep/deae160","url":null,"abstract":"<p><strong>Study question: </strong>Are donor-conceived adults in Belgium interested in obtaining donor information, and do these interests vary based on their family backgrounds?</p><p><strong>Summary answer: </strong>Donor-conceived adults express a significant interest in obtaining donor-related information, with the highest interest reported by offspring from heterosexual couples compared to those from lesbian couple-parented or single-parent families.</p><p><strong>What is known already: </strong>In Belgium, sperm donation is mainly anonymous, but the rise of direct-to-consumer genetic testing challenges this anonymity.</p><p><strong>Study design, size, duration: </strong>This was a cross-sectional study involving an online nationwide survey conducted from July 2022 to October 2023. Participants, aged 18 years and older and being aware of their anonymous sperm donor-conceived status, were recruited through various channels.</p><p><strong>Participants/materials, setting, methods: </strong>A total of 203 participants were included: 62.6% grew up in heterosexual families with infertile fathers, 26.1% with lesbian couples, 8.4% with single parents, and 3.0% in various or diverse family structures. The survey was available in both French and Dutch and consisted of 43 questions, including a mix of yes/no questions and multiple-choice items.</p><p><strong>Main results and the role of chance: </strong>The average age of disclosure was 16.5 years, with notably later disclosure in heterosexual couple-parented households. A substantial 82.8% of donor-conceived individuals expressed a keen interest in obtaining non-personally identifiable donor information, while 69% were curious about personally identifiable donor data. Furthermore, 61.6% conveyed a desire for personal contact with their donors, and 26.6% advocated for the inclusion of the donor's name on their birth certificates. Participants raised in lesbian two-parent families exhibited the lowest level of interest in donor-related information compared with those raised in other family structures. An overwhelming 90.1% wondered about the possibility of having half-siblings from the same sperm donor. Analysis of survey responses on DNA database registration revealed that 55.2% of donor-conceived offspring were already registered, with 68.8% discovering the same donor offspring and 30.4% successfully locating their donors. Compared to individuals from other family structures, those raised in heterosexual couple-parented households exhibit a less positive attitude toward their conception through anonymous sperm donation. About 61.6% of donor-conceived individuals reported experiencing distinct emotions compared to their peers, while 44.1% encountered psychological difficulties related to anonymous sperm donation, primarily attributed to late disclosure. The majority supported the idea of informing the donor about the number of children he facilitated to conceive. Lastly, the study highlighted that 21.","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619866","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":"The nexus of fertility and politics: exploring the influence of social tolerance, religiosity, and political conservatism on the acceptance of assisted reproduction in Spain.","authors":"Maite Aurrekoetxea-Casaus, Lorena Ronda","doi":"10.1093/humrep/deae169","DOIUrl":"10.1093/humrep/deae169","url":null,"abstract":"<p><strong>Study question: </strong>How do individual religious, political, and social tolerance orientations influence the acceptance of ART among Spanish citizens?</p><p><strong>Summary answer: </strong>Social tolerance and religiosity are predictive factors for the acceptance of ART, with more tolerant individuals and those with lower levels of religiosity being more accepting of ART; political conservatism mediates the relationship between social tolerance and acceptance of ART, particularly for left-leaning individuals.</p><p><strong>What is known already: </strong>The rapid advancement of ART has raised questions about its societal acceptance, especially in the context of religious, political, and social beliefs.</p><p><strong>Study design, size, duration: </strong>The analysis utilized data from the combined Europe Values Study and World Values Survey, comprising cross-sectional national surveys from 1981 to 2021. Each country's population was surveyed a maximum of seven times and a minimum of two times during this period. This study uses the cross-sectional data of 2021. After filtering for Spanish citizens and deleting cases with missing key variables, a sample of 1030 valid responses from Spanish citizens was obtained. Quotas were set for sex, age, and educational level, following guidance from the Spanish Statistics Institute.</p><p><strong>Participants/materials, setting, methods: </strong>The study surveyed participants' attitudes towards ART, their religious and political orientations, and collected demographic information. The sample consisted of 51.7% women, most respondents were married or in common-law partnerships, and 61.6% had children. Catholicism was the dominant religion (53.0%) and a majority had completed secondary education (66.2%), with half earning over 1400 euros per month.</p><p><strong>Main results and the role of chance: </strong>Using two linear models to test hypotheses, the study found that social tolerance and religiosity significantly predict acceptance of ART, with more tolerant and less religious individuals being more accepting. Political conservatism mediated the relationship between social tolerance and ART acceptance, particularly among left-leaning individuals.</p><p><strong>Limitations, reasons for caution: </strong>This study is cross-sectional and based on self-reported data, which may have limitations. Additionally, the findings are based on a Spanish sample and may not be universally applicable.</p><p><strong>Wider implications of the findings: </strong>The results have significant implications for policymakers and healthcare professionals in the field of reproductive technologies. They also contribute to public debates on ethical considerations surrounding ART.</p><p><strong>Study funding/competing interest(s): </strong>This work was funded by the Mineco-FrontVida Program, Frontiers of Life, Social Change, and Changing Values Around the Beginning and End of Life (grant number PID2019-106882RB-I00","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792335","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 density of the inner cell mass is a new indicator of the quality of a human blastocyst: a valid supplement to the Gardner scoring system.","authors":"Bo Huang, Zhou Li, Xinling Ren, Jian Bai, Jing Yue, Xiyuan Dong, Liu Yang, Bingxin Ma, Jinzhong Wang, Wenjing Zhou, Xuefeng Wang, Yaxian Guo, Keyi Si, Zhenzhi Shi, Lei Jin","doi":"10.1093/humrep/deae158","DOIUrl":"10.1093/humrep/deae158","url":null,"abstract":"<p><strong>Study question: </strong>Can the density of the inner cell mass (ICM) be a new indicator of the quality of the human blastocyst?</p><p><strong>Summary answer: </strong>The densification index (DI) developed in this study can quantify ICM density and provide positive guidance for ploidy, pregnancy, and live birth.</p><p><strong>What is known already: </strong>In evaluating the quality of ICM, reproductive care clinics still use size indicators without further evaluation. The main disadvantage of this current method is that the evaluation of blastocyst ICM is relatively rough and cannot meet the needs of clinical embryologists, especially when multiple blastocysts have the same ICM score, which makes them difficult to evaluate further.</p><p><strong>Study design, size, duration: </strong>This observational study included data from 2272 blastocysts in 1991 frozen-thawed embryo transfer (FET) cycles between January 2018 to November 2021 and 1105 blastocysts in 430 preimplantation genetic testing cycles between January 2019 and February 2023.</p><p><strong>Participants/materials, setting, methods: </strong>FET, ICSI, blastocyst culture, trophectoderm biopsy, time-lapse (TL) monitoring, and next-generation sequencing were performed. After preliminary sample size selection, the 11 focal plane images captured by the TL system were normalized and the spatial frequency was used to construct the DI of the ICM.</p><p><strong>Main results and the role of chance: </strong>This study successfully constructed a quantitative indicator DI that can reflect the degree of ICM density in terms of fusion and texture features. The higher the DI value, the better the density of the blastocyst ICM, and the higher the chances that the blastocyst was euploid (P < 0.001) and that pregnancy (P < 0.001) and live birth (P = 0.005) were reached. In blastocysts with ICM graded B and blastocysts graded 4BB, DI was also positively associated with ploidy, pregnancy, and live birth (P < 0.05). ROC analysis showed that combining the Gardner scoring system with DI can more effectively predict pregnancy and live births, when compared to using the Gardner scoring system alone.</p><p><strong>Limitations, reasons for caution: </strong>Accurate calculation of the DI value places high demands on image quality, requiring manual selection of the clearest focal plane and exposure control. Images with the ICM not completely within the field of view cannot be used. The association between the density of ICM and chromosomal mosaicism was not evaluated. The associations between the density of ICM and different assisted reproductive technologies and different culture conditions in embryo laboratories were also not evaluated. Prospective studies are needed to further investigate the impact of ICM density on clinical outcomes.</p><p><strong>Wider implications of the findings: </strong>ICM density assessment is a new direction in blastocyst assessment. This study explores new ways of assessi","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626554","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":"Correction to: QUALITY AND SAFETY OF ART THERAPIES.","authors":"","doi":"10.1093/humrep/deae138","DOIUrl":"10.1093/humrep/deae138","url":null,"abstract":"","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748030","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":"No pain relief by virtual reality during hysterosalpingography (HSG): results from a randomized controlled trial.","authors":"K Rosielle, A P van Haaps, E A M Kuijper, N Tonch, D E N B Karim, M A Oskam, R van den IJssel, B W J Mol, C B Lambalk, K Dreyer, V Mijatovic","doi":"10.1093/humrep/deae133","DOIUrl":"10.1093/humrep/deae133","url":null,"abstract":"<p><strong>Study question: </strong>Is virtual reality (VR) an effective non-pharmacological tool to reduce procedural pain during hysterosalpingography (HSG)?</p><p><strong>Summary answer: </strong>An HSG with VR does not reduce procedural pain scores compared to an HSG without VR.</p><p><strong>What is known already: </strong>An HSG is often experienced as painful and uncomfortable. VR has been proven successful to reduce acute procedural pain during a variety of medical procedures and interventions.</p><p><strong>Study design, size, duration: </strong>We performed a two-centre open-label randomized controlled trial between January 2021 and October 2022.</p><p><strong>Participants/materials, setting, methods: </strong>Women scheduled for HSG as part of their infertility work-up were screened for participation. After informed consent, women were randomized between HSG with or without VR. Due to the nature of the intervention, the study was not blinded. VR was administered by a head-mounted device displaying nature movies and/or relaxation exercises. The primary endpoint was procedural pain measured using VAS (scale 0.0-10.0 cm). Procedural pain was divided into overall pain score and peak pain score during the procedure. It was measured immediately after HSG. Secondary endpoints included patient satisfaction, VR preferences, and adverse effects of VR.</p><p><strong>Main results and the role of chance: </strong>We included a total of 134 women, 69 to the intervention group (HSG with VR) and 65 to the control group (HSG without VR). The mean VAS for peak pain was 6.80 cm (SD 2.25) in the intervention group versus 6.60 cm (SD 2.40) in the control group (mean difference 0.28 (95% CI -0.57, 1.12), P = 0.52). The mean VAS for overall pain was 5.00 cm (SD 2.10) in the intervention group versus 4.90 cm (SD 2.13) in the control group (mean difference 0.06 (95% CI -0.71, 0.84), P = 0.88). The expectation that VR would be a good distraction from pain during HSG was correlated with both overall and peak pain scores. When correcting for this expectation, we found that women in the intervention group reported significantly higher scores, both in peak (adjusted MD 0.58 (95% CI -0.81, 1.97), P = 0.021) and overall (adjusted MD 0.43 (95% CI -0.84, 1.71), P = 0.013) pain, compared to the control group. There were no differences in the prevalence of symptoms that were considered as adverse effects of VR.</p><p><strong>Limitations, reasons for caution: </strong>The study was not blinded. Reasons for declining participation in the study were anxiety or wanting full control during HSG, which might have created selection bias. The distraction score possibly indicates that the level of VR immersiveness was not optimal due to the lack of sound and/or the type of VR applications. Future studies should investigate whether more immersive or interactive VR applications could decrease procedural pain scores during HSG.</p><p><strong>Wider implications of the findings: </stro","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305773","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}