Human Fertility最新文献

{"title":"Warnock and its contested legacy in relation to donor conceived families: the case for regulatory reform.","authors":"Caroline A B Redhead, Nicola Barker, Marie Fox, Lucy Frith","doi":"10.1080/14647273.2025.2493252","DOIUrl":"https://doi.org/10.1080/14647273.2025.2493252","url":null,"abstract":"<p><p>A generation on from the Warnock Report, the regulatory system it proposed remains largely intact, despite significant changes in the fertility sector, legal culture and wider society. In this article, we trace Warnock's legacy, focusing on the context of gamete donor conception. Drawing on illustrative examples from the ConnectedDNA research project, we analyse two aspects of Warnock's proposals - its recommendation that gamete donors should be anonymous and its key assumption that only the 'triad' of donor, recipient(s) and donor-conceived people have an interest in receiving information about each other. The jettisoning of donor anonymity coupled with a questioning of Warnock's assumptions about the meaning of 'family', illustrate the challenges inherent in a key Warnock objective: to 'future proof' fertility law. Both the global market in gametes and embryos and the accessibility of Direct-to-Consumer Genetic Testing (DTCGT) technologies were wholly unforeseen by Warnock. Similarly, contemporary understandings of donation, families, kinship and relatedness exist in tension with Warnock's original assumptions and, thus, with the principles underpinning the legislative framework. Given this, we recommend three specific reforms to the regulation of donor conception: (1) an urgent review and reformulation of information-sharing provisions, particularly with regard to donor-siblings; (2) an expansion of counselling and support provisions for those affected by donor conception; and (3) the effective imposition of a global ten-family limit. More generally, we suggest that piecemeal and <i>ad hoc</i> reforms to the Human Fertilisation and Embryology Act 1990 have often appeared contradictory and have failed to grapple with the global nature of fertility practice. Thus, we conclude by arguing that a comprehensive review of the legislative framework is needed to create a system of legal governance which meets the needs of the donor conceived community and remains fit for purpose in the twenty-first century.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2493252"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of vitamin D supplementation on frozen embryo transfer cycle outcomes.","authors":"Nikolaos Christoforidis, Michail Papapanou, Dimitrios Michalakis, Marina Dimitraki, Alexia Chatziparasidou, Charalampos Siristatidis","doi":"10.1080/14647273.2025.2493251","DOIUrl":"https://doi.org/10.1080/14647273.2025.2493251","url":null,"abstract":"<p><p>The role of serum 25-OH D3 (D3) in the physiology and regulation of the female genital system has gained significant research interest. Recent data have suggested that sufficient D3 levels are associated with improved outcomes of <i>in vitro</i> fertilization (IVF), although other studies failed to confirm so. Screening for D3 levels before IVF is becoming common practice in many IVF centres, and D3 insufficiency is treated with supplements before treatment. However, little is known about the effect of this intervention on D3 levels during endometrial preparation for frozen-embryo transfer (FET) cycles, especially regarding clinical outcomes. To examine the effect of vitamin D supplementation and the impact of vitamin D status in women undergoing FET cycles, a prospective study of infertile women undergoing FET cycles was carried out. Initial screening of D3 levels was performed in 252 infertile women before a FET cycle, and where insufficiency was found (<30 ng/mL) [115 (45.6%)], supplements were prescribed according to a standardized protocol. Serum D3 levels were measured at three distinct time-points: at the initiation of endometrial preparation (T1), embryo transfer (T2), and beta-hCG testing (T3). We found no significant difference in ongoing pregnancy [40 (34.8%) <i>vs.</i> 51 (37.2%); odds ratio (OR) 0.90, 95% confidence interval (CI) 0.54-1.51; adjusted OR 1.04, 95% CI 0.58-1.83], live birth, positive β-hCG, clinical pregnancy, miscarriage, and ectopic pregnancy rates between D3-insufficient participants at T1 receiving vitamin D and D3-replete ones not receiving any supplementation (<i>p</i>-values >0.05). We also found no significant difference in ongoing pregnancy [21 (30.9%) <i>vs.</i> 66 (40.2%), and 17 (34.0%) <i>vs.</i> 51 (41.5%)] and the rest of the outcomes between D3-insufficient and replete participants at T2 and T3, respectively (<i>p</i>-values >0.05). In conclusion, this prospective cohort study of women undergoing FET cycles found no significant difference in ongoing pregnancy rates between D3-insufficient participants receiving supplementation at the beginning of endometrial preparation and replete ones receiving no supplementation. Large, high-quality trials are required to further investigate this hypothesis and compare the IVF outcomes between replete participants, insufficient participants receiving no supplementation, and insufficient participants receiving supplementation.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2493251"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of combined oral contraceptive pills (COCs) in preventing persistent corpus luteal cysts following oocyte retrieval: a randomized controlled trial.","authors":"Pavarit Humart, Somsin Petyim, Dittakarn Boriboonhirunsan","doi":"10.1080/14647273.2025.2505634","DOIUrl":"10.1080/14647273.2025.2505634","url":null,"abstract":"<p><p>The objective was to compare the preventive effect of combined oral contraceptive pills (COCs) to the expectant management approach on the incident of corpus luteal cysts following oocyte retrieval in in vitro fertilization (IVF). A total of 130 IVF patients at the Infertility Unit of Siriraj Hospital were randomized into two groups following ovarian stimulation and oocyte retrieval. Participants in the study group received COCs containing 0.15 mg desogestrel and 0.02 mg ethinyl oestradiol per pill for 21 days (<i>n</i> = 65), while the comparison group underwent expectant management (<i>n</i> = 65). Transvaginal ultrasonography was performed to detect corpus luteal cysts (mean cyst diameter ≥ 10 mm) at 2 and 4 weeks after oocyte retrieval. Baseline characteristics were similar between groups. At 2 weeks, the incidence of persistent corpus luteal cysts was 58.4% in the COC group and 69.2% in the expectant management group (<i>p</i> = 0.2). A comparable, non-significant difference was also observed at 4 weeks (26.2% vs. 36.9%, <i>p</i> = 0.19). However, the mean cyst diameter at 4 weeks was significantly smaller in the COC group (5.74 mm vs. 9.39 mm, <i>p</i> < 0.01). The use of COCs does not effectively prevent the formation of corpus luteal cysts at 2 and 4 weeks after oocyte retrieval in the IVF process.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2505634"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The infected blood inquiry report-lessons for gamete donation.","authors":"Sharon Zahra, Marc L Turner","doi":"10.1080/14647273.2024.2438650","DOIUrl":"10.1080/14647273.2024.2438650","url":null,"abstract":"<p><p>Donation of substances of human origin (SoHO) is essential for the treatment of many patients and ranges from the donation of whole organs to the donation of tissue or cell products, including also gamete donation. In order to ensure the safety of recipients of SoHOs there are multiple steps taken in the donation pathway of all such substances to ensure the quality and safety of the donation. However, despite this, there is always a residual risk associated with SoHOs. The recent Infected Blood Inquiry (IBI) report has described in detail the background to the inadvertent transmission of HIV and hepatitis C to many patients in the past and has provided a number of recommendations. While the IBI focused on blood donation and the risk of blood borne virus transmission, the underlying principles are pertinent to all SoHOs, including gamete donation, and to all risks associated with SoHOs not just the risk of blood borne virus transmission.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2438650"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DNA damage in prepared semen is negatively associated with semen quality and fertilisation rate in assisted reproduction technology (ART) treatment.","authors":"Bashar Altakroni, Helen Hunter, Greg Horne, Daniel R Brison, Andrew C Povey","doi":"10.1080/14647273.2024.2442450","DOIUrl":"https://doi.org/10.1080/14647273.2024.2442450","url":null,"abstract":"<p><p>Sperm DNA contains strand breaks and base damage that can potentially affect reproductive health. This study aims to determine to what extent sperm DNA integrity and alkylation is associated with semen quality and assisted reproduction technology (ART) treatment outcomes, in particular fertilisation and cleavage rates. Male partners of couples attending for infertility treatment were recruited. DNA integrity (% tail DNA, sperm with either low (LDD) or high (HDD) damage levels) was measured by a neutral Comet assay and N7-methyldeoxyguanosine (N7-MedG) DNA levels by an immunoslotblot in sperm prepared by density gradient centrifugation. Associations between DNA damage, semen quality and ART treatment outcomes were assessed. N7-MedG levels were lower and the proportion of LDD sperm higher in prepared than in neat sperm samples. The proportion of HDD sperm and % tail DNA were significantly negatively associated and the proportion of LDD sperm positively associated with semen quality. Fertilisation, but not cleavage, rate nor live birth, was significantly negatively associated with N7-MedG levels, the proportion of HDD sperm and % tail DNA and was positively associated with the proportion of LDD sperm. These results confirm that DNA damage, even in prepared sperm, is associated with adverse semen quality and suggest that sperm DNA damage affects the early stages of embryo formation.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2442450"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric and perinatal outcomes in singleton pregnancies following medicated, stimulated and natural, frozen embryo transfer cycles: an updated systematic review and meta-analysis.","authors":"Freya Baird, Emilia Smith, Yusuf Beebeejaun, Venkatesh Subramanian, Mahua Bhaduri, Nick Kametas, Ippokratis Sarris, Sesh K Sunkara","doi":"10.1080/14647273.2024.2448131","DOIUrl":"10.1080/14647273.2024.2448131","url":null,"abstract":"<p><p>Frozen embryo transfer (FET) has been associated with higher risks of hypertensive disorders of pregnancy (HDP), large for gestational age and high birth weight. This systematic review and meta-analysis evaluates obstetric and perinatal outcomes in medicated, stimulated and natural FET cycles. A literature search was performed using MEDLINE, EMBASE, CINAHL and the Cochrane Library database; 152,590 FET cycles were analysed from 31 included studies. Risk ratios (RR) and 95% confidence intervals (CI) were calculated using fixed and random effects models determined by the heterogeneity (I²). There was significantly higher risk of obstetric and perinatal complications, including HDP (RR 1.84, CI:1.48-2.29, I² 87%) and low birth weight (LBW) (RR 1.25, CI:1.12-1.39, I² 57%) following medicated compared to natural FET cycles. A higher risk of HDP (RR 1.50, CI:1.33-1.64, I² 32%) and macrosomia (RR 1.28, CI:1.17-1.40, I² 37%) was noted following medicated compared to stimulated cycles. Natural demonstrated lower risk of HDP (RR 0.77, CI:0.60-0.99, I² 32%), gestational diabetes (RR 0.78, CI:0.68-0.89, I² 43%), LBW (RR 0.78, CI:0.64-0.95, I² 48%) and small for gestational age (RR 0.83, CI:0.70-0.98, I² 12%) than stimulated cycles. These findings indicate that medicated FET cycles convey greater risks of obstetric and perinatal complications than natural or stimulated cycles.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2448131"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#misinformation: The perils of using social media for medical advice regarding infertility.","authors":"Tanveer Dhanoya, Kathleen O'Marcaigh, Tanvi Sambare, Ippokratis Sarris, Kugajeevan Vigneswaran","doi":"10.1080/14647273.2025.2506787","DOIUrl":"10.1080/14647273.2025.2506787","url":null,"abstract":"<p><p>To systematically evaluate the quality, credibility, accuracy, and readability of fertility-related content generated by users providing education, advice, and medical information on Twitter/X and Instagram. We selected Instagram and Twitter/X for data collection, as these platforms are commonly used by women of reproductive age. Using the terms 'fertility' and 'infertility', we collected posts both prospectively and retrospectively between April 21 and 28, 2024, using Keyhole and Brand Mentions. Posts were screened for eligibility, excluding non-English language posts, personal stories, advertisements, non-medical opinions, and peer-support posts. We assessed the accuracy, credibility, quality, and readability of the posts using validated instruments. Accuracy was evaluated based on current guidelines and the authors' expertise in infertility. Credibility was measured using a 10-point system that considered the source, context, currency, and editorial review. Quality was assessed using the 16-item DISCERN criteria with a five-point Likert scale. Readability was measured using the Flesch-Kincaid reading-ease test, which assigns a U.S. grade level to each post. Of the 15,214 posts identified, 939 were included in the final analysis. Fertility doctors generated 29% of the posts; others came from doctors of other specialties (11%), holistic practitioners (17%), and laypeople (39%). Seventy-four percent (74%) of posts did not cite sources or academic references, and 45% of posts contained inaccurate information. Only 11% of the posts were deemed credible. Of posts related to treatment, 19% were of high quality, while 53% of non-treatment posts met the same standard. Most posts (80%) were categorized as difficult to read based on readability scores. Only two posts (0.2%) were accurate, credible, high-quality, and easily readable. Social media posts about fertility often provide incomplete or misleading information, with a significant focus on naturopathy, dietary advice, and unproven theories about the effect of the COVID-19 vaccine on fertility. Clinicians and social media platforms must take responsibility for improving the accuracy and accessibility of health information online.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2506787"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterosexual parents' experiences of their donor-conceived children's search for and/or contact with their donors in New Zealand prior to identity-release provisions.","authors":"Michelle A Duff, Sonja Goedeke","doi":"10.1080/14647273.2025.2510992","DOIUrl":"https://doi.org/10.1080/14647273.2025.2510992","url":null,"abstract":"<p><p>Research suggests that donor conceived persons (DCP) may not only be interested in their genetic information, but in meeting donors and other genetically related individuals. While parental disclosure to donor conceived children (DCC) appears to be increasing, limited research examines the impact of disclosure and donor linking for DCP and parents. This research explores the experiences of nine heterosexual parents in New Zealand who mostly conceived prior to identity-release provisions and whose DCC have searched for or had donor contact. Data was collected via semi-structured interviews and analysed using thematic analysis. Findings suggest that parents valued their children's access to genetic origins and viewed donor linking as a natural outcome of disclosure. Parents positioned themselves as facilitators or supporters of linking, while emphasising that linking should be DCP led. Donor and donor family willingness were noted as key in enabling contact. Early disclosure and support for linking were held to strengthen parent-child relationships, while later disclosure and difficulty in linking were associated with relationship tension. Relationships with donors ranged from distant to familial, with most parents noting that DCC valued connections with siblings. Parents reflected on the significant impacts of family-building through donor conception and the need for ongoing support.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2510992"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of allied health professionals in fertility care: a scoping review.","authors":"Amanda Mackay, Selina Taylor, Emma Anderson, Beverley Glass","doi":"10.1080/14647273.2025.2480074","DOIUrl":"10.1080/14647273.2025.2480074","url":null,"abstract":"<p><p>Infertility significantly impacts people worldwide, with many pursuing medical treatments including Assisted Reproductive Technologies (ART). This scoping review explores the role of allied health professionals (AHPs) in fertility care and their integration into fertility care teams. A search of six databases yielded 12 studies identifying dietitians, nutritionists, counsellors, psychologists, social workers, and physical therapists (physiotherapists) as key AHPs in fertility care. The role of AHPs was broadly divided into two main areas: providing education and monitoring related to lifestyle modifications and fertility risk factors and offering psychological and psychosocial treatment and support. Dietitians educate patients on nutrition and lifestyle modifications to improve fertility. Mental health professionals, including psychologists, social workers, and counsellors, address the emotional stress of infertility and help patients cope with ART. Physical therapists perform therapies to increase chances of conception. The integration of AHPs into fertility care teams vary by location and facility practices with some working within healthcare teams and others independently. Despite guidelines, the incorporation of AHPs into fertility care is inconsistent, highlighting the need for a standardized approach. This review highlights AHP roles in providing education, lifestyle modification guidance, and psychosocial support which are valuable in enhancing patient care and potentially improving ART outcomes.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2480074"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oocyte donation pregnancy: What do women understand about risk? an interview study of women who underwent oocyte donation pregnancy.","authors":"Jacqueline Nicholls, Saibhan Bains, Katherine Maslowski, Melissa Whitten, Anne Lanceley","doi":"10.1080/14647273.2025.2470356","DOIUrl":"10.1080/14647273.2025.2470356","url":null,"abstract":"<p><p>Patient consent is a fundamental legal and professional requirement of any intervention offered to a patient and must include discussion of risks and benefits. The number of women becoming pregnant via oocyte donation has increased markedly in recent years. Such pregnancies are accompanied by different risks to those of naturally conceived pregnancies. Anecdotal evidence suggests that women seeking oocyte donation pregnancy gain limited appreciation of the risks attending oocyte donation during consent discussions. To explore women's understanding of the risks associated with oocyte donation pregnancy a qualitative interview study was conducted in an ante-natal facility in an urban hospital. Sixteen women who had experienced oocyte donation pregnancy participated in semi-structured, audio-recorded interviews exploring their experience of the consent process for oocyte donation and their awareness of pregnancy-related risks once pregnant. Data were analysed using thematic analysis. Our principal finding was that women were unaware that their oocyte donation pregnancy carried higher risks than a typical IVF pregnancy. Three themes emerged: (1) women tended to care most about risks associated with success/failure of oocyte donation; (2) women did not know that oocyte donation pregnancies carry specific risks above and beyond IVF pregnancies; (3) women were ambivalent towards receiving risk information. For women accepting an oocyte donation consent at the time of undergoing IVF should include discussion of the risks of subsequent pregnancy to ensure that women are fully informed. Women's understanding of risks should be routinely checked ante-natally.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2470356"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}