Human Fertility最新文献

{"title":"Does cervical mucus removal before embryo transfer have an effect on cycle outcome in women undergoing ICSI?: A randomised controlled trial.","authors":"Muserref Banu Yilmaz, Belgin Devranoglu, Habibe Ayvacı Tasan, Gulsah Cetin Altıkardes, Enis Ozkaya, Ayse Nur Aksoy, Ali Cenk Ozay, Ali Irfan Guzel","doi":"10.1080/14647273.2026.2649287","DOIUrl":"10.1080/14647273.2026.2649287","url":null,"abstract":"<p><p>The objective was to evaluate the effect of cervical mucus removal before embryo transfer on cycle outcome in women undergoing intracytoplasmic sperm injection (ICSI). A total of 183 patients undergoing embryo transfer (ET) with at least one good quality embryo and adequate endometrial thickness and pattern were enrolled to this randomised controlled study. Patients were divided into three groups according to cervical mucus removal technique: removal <i>via</i> cotton swab, removal <i>via</i> Pipella cannula, and a control group with no mucus removal. Data collection included age and body mass index (BMI), duration of infertility, basal hormonal assessments, antral follicle counts, anti-mullerian hormone (AMH) levels, cycle characteristics, and clinical pregnancy rate. There were no significant differences among groups in terms of age, duration of infertility, and basal hormonal levels; in the dosage of gonadotrophins or duration of administration of antagonist; or in the numbers of oocytes retrieved, MII oocytes, fertilised oocytes, and embryos transferred. In terms of the primary outcome measure, all groups had similar clinical pregnancy rates. This study demonstrates that cervical mucus removal prior to ET, regardless of the method used, does not significantly impact clinical pregnancy rates in ICSI cycles. These findings challenge the necessity of routine cervical mucus removal and suggest that this practice may not confer the benefits previously assumed.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2649287"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580223","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 correlation between maternal expression of miR-146b and repeated failure of frozen-thawed embryo transfer pregnancy.","authors":"Yina Wu, Qingqing Zhou, Xiali Zhao, Wei Wang, Qi Zhang, Zhaopeng Wang, Meiling Tang, Xiaoyan Zhou","doi":"10.1080/14647273.2026.2725675","DOIUrl":"https://doi.org/10.1080/14647273.2026.2725675","url":null,"abstract":"<p><p>Frozen-thawed embryo transfer (FET) failure rates still account for a considerable percentage in assisted reproductive technology (ART) treatment, which seriously hinders the reproductive needs of infertile families. This study investigates the potential role of miR-146b level in repeated failures of FET. 175 patients with repeated implantation failure (RIF) after FET (the RIF population [RIFP]) and 155 patients with successful pregnancy after FET (SP) (the SP population [SPP]) were enrolled. The plasma miR-146b level was measured by RT-qPCR. The ROC curve was utilised to evaluate the predictive value of miR-146b for RIF after FET. The chi-square test was employed to explore the correlation between clinical items and miR-146b expression. Logistic regression analysis was used to identify the risk factors for RIF after FET. The miR-146b expression was higher in the RIFP group than in the SPP group, and miR-146b exerts a higher predictive value for RIF after FET. Endometrial thickness, serum E₂/P, AMH, and 25-hydroxy vitamin-D₃ levels were correlated with miR-146b expression. The endometrial thickness and miR-146b expression were risk factors for RIF after FET. Collectively, these findings indicate that miR-146b may be a potential target for predicting the repeated failures of FET.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2725675"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012206","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":"Poor air quality index on the day of embryo transfer may decrease the rate of embryo transfer success.","authors":"Hannah Hamerman, Alexandra Peyser, Hillary Pearson, Randi Goldman","doi":"10.1080/14647273.2026.2669591","DOIUrl":"10.1080/14647273.2026.2669591","url":null,"abstract":"<p><p>The objective of this retrospective cohort study was to evaluate whether air quality index (AQI) on the day of embryo transfer (ET) is associated with differences in clinical pregnancy rates (CPR). The study included all patients who underwent either fresh or frozen embryo transfer between June 1 - July 31, 2023 at a single academic fertility centre in New York. During this time, smoke originating from wildfires in Eastern Canada caused significant air pollution in New York. Patients who underwent single euploid embryo transfer were included and analysed separately. The main outcome measure was clinical pregnancy rate (CPR). Secondary outcomes included biochemical pregnancy rate, miscarriage rate, ectopic pregnancy rate, and live birth rate (LBR). Outcomes after ET were compared between three groups stratified by AQI category as defined by the EPA: Good: 0-50, Moderate: 51-100, and Unhealthy: >100. Chi square analyses were used to compare outcomes between groups. There were 190 ETs performed: 142 (74%) when the AQI was Good, 37 (19.5%) when the AQI was Moderate, and 11 (5.8%) when the AQI was Unhealthy. Higher CPRs were observed for ETs performed when AQI was Good vs. Unhealthy (62.0% vs. 27.3%, p = 0.02) and when Moderate vs. Unhealthy (64.9% vs. 27.3%, p = 0.03). There were 127 single euploid embryo transfers (SETs) performed: 96 (75.6%) when the AQI was Good, 23 (18.1%) when the AQI was Moderate, and 8 (6.3%) when the AQI was Unhealthy. Higher CPRs were observed when AQI was Good vs. Unhealthy (70.8% vs. 37.5%, p = 0.052,) although this was not statistically significant. The CPR was not significantly different for SET when AQI was Moderate vs. Unhealthy (69.6% vs. 37.5%, p = 0.11). While the LBR was lower when AQI was Unhealthy, statistical significance was not reached (p = 0.21 for the whole cohort and p = 0.28 for SET). This study found that poor air quality on the day of ET is associated with a decreased CPR. Embryo transfers performed when the AQI is Unhealthy results in decreased CPRs compared to ETs performed when the AQI is Good and Moderate.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2669591"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940994","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":"Donor conception and family connection: beyond genetic reductionism in the postgenomic era.","authors":"Ana Bravo-Moreno","doi":"10.1080/14647273.2026.2674709","DOIUrl":"10.1080/14647273.2026.2674709","url":null,"abstract":"<p><p>The aim of this article is to analyse the motivations, expectations, and experiences of information exchange and contact among parties linked through donor conception of solo mothers who had their children with the help of assisted reproduction technology (ART) across donor types (e.g. sperm, egg, embryo) and settings in Spain, where donation is anonymous, and the United Kingdom, where donor anonymity was lifted in 2005. This study draws on ethnographic research that took place in Madrid (Spain) and in London (the United Kingdom), where I conducted 60 in-depth interviews with solo mothers.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2674709"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137834","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":"Psychosocial assessment of interpersonal relationships in altruistic surrogacy counselling.","authors":"M E Montrone, K A Sherman","doi":"10.1080/14647273.2025.2596688","DOIUrl":"10.1080/14647273.2025.2596688","url":null,"abstract":"<p><p>In an altruistic surrogacy arrangement, interpersonal relationships are crucial, particularly as many arrangements may be based on pre-existing relationships between intended parent/s and surrogate (and partner if applicable). Thus, if interpersonal difficulties were to occur, they could adversely impact the surrogacy itself and long-term extended family and friendships. In Australia, surrogacy is altruistic, with legal requirements for independent pre-surrogacy counselling of all parties to the surrogacy. This study aims to describe the application of an implications and assessment counselling protocol (IAC), including validated psychometric testing, and an assessment of suitability of parties legally required for surrogacy in the state of New South Wales (NSW). Pre-surrogacy relationships are assessed using observation, clinical interview, and psychometric measures to highlight potential interpersonal problems. From the comprehensive interpersonal assessment, preventive measures may be recommended by the surrogacy counsellor to ameliorate potential relationship issues during the surrogacy. In total, 87 consecutive arrangements (<i>N</i> = 322), 80 gestational and 7 traditional surrogacies, comprising 61 intended mothers (IM) (5% single), 110 intended fathers (IF) (47% same sex male relationships), 87 surrogates (S) and 64 partners (SP) (94% male) consented to participate. As part of the IAC protocol, two psychometric tests [Personality Assessment Inventory (PAI), Psychological Entitlement Scale (PES)] were completed by 98% of the 322 parties. Findings from the interpersonal scales of the PAI (Warmth and Dominance), five PAI sub scales, and the PES were used to assess interpersonal dimensions. Overall, 97% of the 87 cases were assessed as suitable to proceed, including 29% with qualified approval. However, in 11 cases assessed as suitable to proceed, there were individual interpersonal test scores at least one standard deviation from the mean, indicating possible relationship disparities. The findings of this study demonstrate the application and value of psychometric testing, as an integral part of clinical assessment in surrogacy counselling.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2596688"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258217","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":"Autophagy activation in granulosa cells as a mechanism of astaxanthin action: evidence from a pilot randomised trial in PMOS-associated infertility.","authors":"Arezoo Maleki-Hajiagha, Ashraf Aleyasin, Fardin Amidi","doi":"10.1080/14647273.2026.2689659","DOIUrl":"10.1080/14647273.2026.2689659","url":null,"abstract":"<p><p>Astaxanthin (AST) has been reported to influence oxidative stress, endoplasmic reticulum stress, and apoptosis in women with polyendocrine metabolic ovarian syndrome (PMOS), formerly referred to as polycystic ovary syndrome (PCOS), but its effects on granulosa-cell (GC) autophagy remain unclear. Given the central role of autophagy in follicular development, this triple-blind, placebo-controlled pilot randomised trial evaluated whether AST modulates autophagy-related signalling in GCs and how these molecular effects relate to ovarian response. Fifty women with PMOS-related anovulatory infertility were enrolled between November 2023 and September 2024 and received AST (12 mg/day) or placebo for six weeks prior to oocyte retrieval; forty-four completed the study (21 AST, 23 placebo). Primary exploratory endpoints were molecular markers of adenosine monophosphate-activated protein kinase (AMPK)-autophagy signalling, and primary clinical outcomes included ovarian response indicators and cleavage stage embryo quality. AST supplementation increased autophagy-related gene 7 (ATG7) expression, enhanced autophagy flux, reduced apoptosis, and showed a trend toward increased AMPK activation. Before adjustment, AST improved oocyte maturity rate (OMR) and increased mature (metaphase II; MII) oocyte yield. After adjusting for age, body mass index, and anti-mullerian hormone level, total oocyte and MII oocyte yields remained significantly higher with AST, while OMR became non-significant. Among embryology outcomes, both the top-ranking embryo rate and the number of embryos suitable for cryopreservation were significantly higher with AST after adjustment. Pregnancy outcomes were numerically higher but not statistically significant. This pilot trial suggests that AST activates autophagy- and apoptosis-related pathways in GCs and may enhance oocyte competence and embryo quality in PMOS. Larger studies are needed to confirm these mechanistic and clinical effects.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2689659"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919829","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":"Successful pregnancy after reconstructive surgery for a woman with complete cervical and vaginal agenesis - a case report and literature review.","authors":"Jennifer A Tamblyn, Syed Salahuddin, Lara C Morley, Adam H Balen","doi":"10.1080/14647273.2025.2607206","DOIUrl":"https://doi.org/10.1080/14647273.2025.2607206","url":null,"abstract":"<p><p>Congenital cervical agenesis is a rare but important obstructive cause of primary amenorrhoea. Initial diagnosis is often delayed. With advances in reconstructive surgery, fertility restoration is now a realistic option for some women. We present a case of complete cervical and vaginal agenesis diagnosed in a 16-year-old girl who presented with cyclical pelvic pain and primary amenorrhoea. Following successful vaginoplasty and direct uterovaginal anastomosis, regular, pain-free menses, and later, uncomplicated sexual intercourse was achieved. Following a 10-year period of primary infertility and unsuccessful assisted reproduction treatment, natural pregnancy was achieved with the birth of a healthy male infant by caesarean section at term. This report aims to highlight the potential complexities of both natural and assisted conception following corrective uterine surgery. The importance of an individualised, multi-disciplinary approach to care is also highlighted.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2607206"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889130","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":"Donor profiles, spreadsheets and video calls: un/known donor conception in the digital age.","authors":"Leah Gilman, Alexus Davis","doi":"10.1080/14647273.2025.2604885","DOIUrl":"10.1080/14647273.2025.2604885","url":null,"abstract":"<p><p>This article explores how connections brought about through practices of donor conception are changing in the context of mediatisation and, in particular, how digital technologies shape possibilities for donors and recipient families to know one another. We focus on the growing practice of 'informal' donor conception (IDC) in the UK - donor conceptions which are arranged outside of medical institutions and often facilitated via online platforms. Drawing on interviews with 30 (intended) parents via IDC and 19 informal sperm donors, we show how donors and recipients carefully manage, or attempt to manage, the ways in which they are known and knowable to one another, and to a potential donor-conceived person. We identify four ways of knowing, and being known, within participants' accounts: 1) selective sharing of identifying information; 2) (dis)embedding donation connections within wider communities; 3) communicative forms of knowing; and 4) via the creation and management of digital artefacts. Donors and recipients sought to use and limit these different modes of knowing in varied combinations, shaped by their knowledge of (clinical) assisted reproduction practices, changing digital cultures and the legal marginalisation of IDC practices.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2604885"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do they work, and are they worth it? Proposing a framework of evidence synthesis for guiding the evidence-based use of add-ons in <i>in vitro</i> fertilisation.","authors":"Leying Hou, Qian Feng, Maria Mazi, Sarah Lensen, Abha Maheshwari, Ben W Mol","doi":"10.1080/14647273.2026.2696818","DOIUrl":"https://doi.org/10.1080/14647273.2026.2696818","url":null,"abstract":"<p><p>Add-ons are non-essential interventions offered in addition to standard infertility treatments, mainly <i>in vitro</i> fertilisation (IVF) and associated procedures, aimed at improving chances of pregnancy and live birth. While existing guidelines provide recommendations on the use of add-ons, they often overlook the trustworthiness of the underlying randomised controlled trials (RCTs), which may lead to misleading conclusions. Furthermore, some add-ons that may offer genuine benefits have been dismissed due to misinterpretation of trial results, or they are reserved for repeated implantation failure based on strategic rather than evidence-based arguments. Here, we propose a framework for an evidence synthesis process to guide the rational use of add-ons. The evaluation should begin with establishing effectiveness through systematic reviews of trustworthy RCTs, ignoring RCTs that do not meet trustworthiness criteria. When assessing effectiveness, the evaluation should consider evidence relating to the biological mechanisms targeted by the add-on, in addition to clinical outcomes such as live birth. For diagnostic add-ons, evaluations should focus on the group of patients whose test result leads to a change in clinical management, rather than analysing all test-exposed patients. Once effectiveness is confirmed, evaluating cost-effectiveness becomes crucial. Its cost per additional live birth should be compared to a benchmark (e.g., $27,000 or £20,000 for a live birth <i>via</i> standard IVF). Finally, once proven cost-effective, add-ons should be offered early, rather than delayed until after repeated treatment failures. It might be that effectiveness and cost-effectiveness increase with progression along the continuum of diagnosis or IVF failure such as recurrent implantation failure. In that case, add-ons may be offered as soon as they are considered cost-effective.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2696818"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390480","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":"Enablers and barriers to assisted reproduction and fertility services for Pacific peoples in Aotearoa New Zealand: a qualitative study.","authors":"Cameron D Young, Rebekah G Kennedy, Rhonda M Shaw, Janet L Pitman, Zaramasina L Clark, Edmond S Fehoko","doi":"10.1080/14647273.2026.2656343","DOIUrl":"10.1080/14647273.2026.2656343","url":null,"abstract":"<p><p>The uptake of assisted reproductive technologies (ART) has increased rapidly in recent decades, and yet migrant and ethnic minority communities continue to experience barriers to accessing these services. In Aotearoa New Zealand, the Pacific diaspora have the lowest participation in ART services despite having the highest rates of infertility. The reasons for this phenomenon have yet to be fully explained. In this qualitative cross-sectional study, 13 participants (12 women, one man) self-identifying as Pacific people who had experienced infertility participated in 45-90-minute talanoa (semi-structured interviews) either in-person or online. Talanoa were audio recorded and transcribed verbatim. Transcripts were thematically analysed using a hybrid inductive-deductive approach to identify factors that acted as enablers or barriers to ART services. Three key themes were developed from transcripts. Theme one captures the importance of strong relational ties and support networks for ART service access, and the negative impacts of absent familial support. Theme two highlights the role of health literacy and service awareness in promoting self-efficacy and health-seeking behaviours, but that many participants did not feel they had this. Theme three emphasises the tension between cultural expectations and religious beliefs that influenced participants' perceptions of infertility and decisions to access ART. Altogether, these narratives bring to the forefront the challenges of navigating a sensitive health issue such as infertility in a contemporary society amidst family pressures, cultural obligations, and religious ideals. Importantly, this study also highlights the valuable role that families and churches play in supporting Pacific people to access ART, and the importance of digitally accessible health information so that people can make informed decisions about their reproductive health. This paper contains useful insights for fertility service providers and clinicians working with Pacific peoples and individuals from other communities that are culturally diverse or have high religiosity.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2656343"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689948","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}