Human Fertility最新文献

{"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":"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}

{"title":"Beyond the name: opportunities to optimise reproductive care provision to women with PMOS/PCOS.","authors":"Bassel H Al Wattar, Sophie Clarke, Rebecca Scott, Rima K Dhillon-Smith","doi":"10.1080/14647273.2026.2702137","DOIUrl":"https://doi.org/10.1080/14647273.2026.2702137","url":null,"abstract":"","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2702137"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470421","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":"Mitochondria aggregation patterns during human oocyte maturation.","authors":"Adrian Ellenbogen, Gal Bachar, Paz Gili, Ofer Fainaru","doi":"10.1080/14647273.2026.2635860","DOIUrl":"10.1080/14647273.2026.2635860","url":null,"abstract":"<p><p>Animal studies have demonstrated that mitochondrial distribution within the oocyte is closely associated with nuclear and cytoplasmic maturation. Aberrant mitochondrial localisation patterns have been linked to incomplete cytoplasmic maturation and reduced developmental competence. The aim of this study was to characterise the dynamics of mitochondrial distribution in human oocytes across different stages of maturation. Using discarded oocytes from patients undergoing intracytoplasmic sperm injection (ICSI) we analysed the concentration of mitochondria and their distribution patterns. Homogeneously diffuse, centrally located, and peripheral distributions were detected in mature metaphase II (MII), immature metaphase I (MI) and immature germinal vesicle (GV) oocytes, respectively. Of the MII oocytes, 61% presented an evenly diffuse pattern and of the GV oocytes, 53% presented a peripheral distribution. The mean mitochondrial density increased significantly from 278,501 <b>±</b> 65,989 area units in GV oocytes to 352,340 <b>±</b> 37,942 in MII oocytes (p = 0.003). For cytoplasmic occupancy, which followed a non-normal distribution, the median percentage increased from 73.7% (IQR: 66.9%-78.7%) in GV oocytes to 100.0% (IQR: 84.8%-100.0%) in MII oocytes (p < 0.001). Upon maturation, human oocytes demonstrate an increase in mitochondria density and cytoplasm occupancy. Importantly, the mitochondria tend to be located mainly at the periphery in immature oocytes, achieving a more diffuse homogeneous pattern as the oocyte matures. This pattern of distribution may play an important role in cytoplasmic maturation of human oocytes and their further development.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2635860"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147305234","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":"A longer time interval between operative hysteroscopy and intrauterine insemination is negatively associated with pregnancy outcomes.","authors":"David Boedeker, Meghan Yamasaki, Kiley Hunkler, Kerry Flannagan, Ava Dimmick, Dominique Zarrella, Phillip Romanski, Trimble Spitzer","doi":"10.1080/14647273.2026.2722366","DOIUrl":"https://doi.org/10.1080/14647273.2026.2722366","url":null,"abstract":"<p><p>Intrauterine pathology can create an unfavourable environment for pregnancy. We therefore sought to determine optimal time interval between operative hysteroscopy and intrauterine insemination (IUI) to optimise pregnancy outcomes. This study was a retrospective cohort study of IUI cycles following an operative hysteroscopy performed at our institution between January 2018 and August 2023. Our primary outcome was clinical pregnancy following IUI. Patients were grouped into one of four cohorts based on the number of days between operative hysteroscopy and subsequent IUI. We compared cohorts by estimating risk ratios using modified Poisson regression models, adjusting for female age, subfertility diagnosis, and number of prior IUI cycles and utilised P values. We identified 896 patients undergoing a total of 917 IUI cycles following an operative hysteroscopy in whom clinical pregnancy occurred in 16.4% of all IUI cycles. After adjustment, a longer interval between operative hysteroscopy and IUI was associated with a lower probability of a clinical pregnancy. In a subgroup analysis of 728 hysteroscopic polypectomies, the clinical pregnancy rate following IUI was similar to that for all operative hysteroscopies (16.3% v 16.4%, respectively). In conclusion, delaying IUI after hysteroscopy is not needed to improve pregnancy outcomes.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2722366"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827592","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":"Finance and fertility forty years after Warnock.","authors":"Lucy van de Wiel","doi":"10.1080/14647273.2025.2593381","DOIUrl":"https://doi.org/10.1080/14647273.2025.2593381","url":null,"abstract":"<p><p>In the forty years since the publication of the Warnock Report, the fertility field has changed dramatically-in part due to the growing influence of finance capital. This article examines how private equity (PE) and venture capital (VC) investments are reshaping the organisation, practice and future of assisted reproduction. While Warnock anticipated sufficient provision of IVF through the NHS, contemporary IVF has become one of the most privatised and financialised areas of medicine. PE-backed acquisitions introduce short-term return-on-investment logics centred on scaling up, cost-cutting and revenue expansion-all of which have implications for pricing, labour, clinical practice, research and training. Meanwhile, VC investments in fertility start-ups embed reproductive innovation within Silicon Valley's cultures of disruptive innovation and speculative futures. From AI-driven embryo selection and DIY fertility apps to stem-cell based innovations and automated embryology, the approximation between the tech and fertility industries increasingly frames reproduction as a process to be engineered, optimised and platformised. Together, the financial forces of PE and VC reshape power relations in assisted reproduction and reconfigure the future direction of reproductive medicine within their logics of valuation. Revisiting Warnock in this context highlights the need for regulatory frameworks that address not only the ethics of fertility treatments, but the consequences of the expanding financial infrastructures that now underpin the fertility sector.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2593381"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756374","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":"Building trust in a suspicious network: findings from a one-year digital ethnography of five online sperm donation platforms.","authors":"Lauren Smith, Aleks Krotoski, David Carless, Lucy Eldred, Lucy Frith, Georgina Jones, Allan Anthony Pacey, Tanya Palmer, Francesca Taylor-Phillips, Rhys Turner-Moore","doi":"10.1080/14647273.2026.2707214","DOIUrl":"https://doi.org/10.1080/14647273.2026.2707214","url":null,"abstract":"<p><p>Online sperm donation (OSD) connects prospective parents ('recipients') with donors via digital platforms. While prior research has focused on motivations and experiences, little attention has been given to the norms, identities, and relational dynamics shaping interactions on OSD platforms. Drawing on a year-long digital ethnography of five OSD platforms, this paper reports on a thematic analysis of multi-modal data that show that mistrust was pervasive. Users engaged in ongoing surveillance and scrutiny to 'stay safe' and protect others and future donor-conceived children. Norms about who was 'safe' or a 'good' donor or recipient influenced self-presentation and selection. Experienced donors were often constructed as knowledgeable, legitimising their authority to define what was 'normal'. Platform architectures, including user-driven safety features and gamification, shaped interactions, sometimes paradoxically contributing to harm rather than preventing it. These findings are situated within broader literature on digital sharing economies and connection platforms.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2707214"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590852","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}