Human Fertility最新文献

{"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}

{"title":"Management of endometrial polyps in fertility: British fertility Society policy and practice guideline.","authors":"Phoebe Howells, Kugajeevan Vigneswaran, Ippokratis Sarris, Pedro Melo, Harish Bhandari, Venkatesh Subramanian","doi":"10.1080/14647273.2026.2633925","DOIUrl":"10.1080/14647273.2026.2633925","url":null,"abstract":"<p><p>Endometrial polyps are localised hyperplastic growths of the endometrial lining that project into the uterine cavity. These growths, composed of glandular and stromal tissue formed around a vascular core, are a common finding in reproductive-aged women and have been associated with infertility and reduced efficacy of assisted conception treatment. This guideline aims to synthesise the evidence available for the assessment and management of endometrial polyps in the context of fertility. The guideline addresses the definition, prevalence, diagnosis, fertility prognosis, and treatment options for endometrial polyps.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2633925"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283461","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-conceived adolescents accessing donor information in The Netherlands: their needs, motivations, experiences and available support.","authors":"A Janneke B M Maas, Gwendolyn M M de Kever, Lieke van den Boom, Sophie H Bolt","doi":"10.1080/14647273.2026.2646883","DOIUrl":"10.1080/14647273.2026.2646883","url":null,"abstract":"<p><p>Since the introduction of the Dutch Artificial Fertilisation Donor Data Act (Wdkb) in 2004, individuals conceived through donor conception have had the right to access identifying donor information from the age of 16. The first group became eligible in 2021, yet little is known about how adolescents with identifiable donors navigate this process. Fiom, a Dutch centre of expertise on questions about ancestry, offers counselling to donors and donor-conceived people during the exchange of information and any subsequent contact. The organisation has seen an increase in requests from adolescents, highlighting the need for tailored support. As adolescents are at a critical stage of identity formation and usually live with their families, requests for donor information can affect family dynamics. To improve understanding of these adolescents' specific needs and experiences, this study explores their motivations for seeking sperm donor information, their experiences with information exchange and contact, and the professional support required throughout their journey. Between June 2021 and April 2023, qualitative semi-structured interviews were conducted with 19 donor-conceived people (17-26 years old) to explore these topics. This study highlights the diverse and evolving needs, motivations and experiences of donor-conceived adolescents in their search for donor information and contact. These are shaped by identity development, family dynamics, social support, personal circumstances and broader societal influences. While donor information can foster recognition and a sense of completeness, contact with the donor often involves emotional and practical challenges. Adolescents value tailored counselling that supports them requesting and exchanging donor information at their own pace. They also emphasise the importance of retaining agency as they explore and define the personal meaning of this information. In addition, participants expressed the need for long-term professional support to help them integrate information about the sperm donor, his family and donor siblings into their lives. The findings underscore the importance of open communication, personalised professional support and encouragement of their social network throughout this journey.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2646883"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503686","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":"Investigating the journey and experience of male patients through infertility clinics.","authors":"Kanhai Dalal, Priti Bajaj, Jessica Swainston, Hans Arce Sáenz, John Waterstone, Sarah Martins da Silva","doi":"10.1080/14647273.2026.2705218","DOIUrl":"https://doi.org/10.1080/14647273.2026.2705218","url":null,"abstract":"<p><p>Investigation and management of male infertility is often inconsistent and displaced by female-focused fertility care. This clinical service evaluation aimed to capture the patient journey for male infertility in Ireland. A questionnaire was distributed to men attending two private fertility clinics in the Republic of Ireland to explore referral, investigations, treatment offered, lifestyle advice received and patient perspectives on information provision. A total of 504 men completed the questionnaire. As expected, there was substantial variation in referral pathways. Almost half of respondents were offered no further testing beyond semen analysis, while others underwent repeat analyses or additional investigations. Most men were offered treatment involving their female partner. Lifestyle modification was commonly reported, particularly reduction in alcohol intake and weight loss; however, 27% men reported making no lifestyle changes. Importantly, 79% of respondents felt that more information on male infertility should be provided, with a preference for receiving information via a dedicated website. This study demonstrates marked heterogeneity in the clinical journey for men, alongside a clear unmet need for consistent information and male-focused care. Standardised clinical pathways, improved education and proactive lifestyle counselling represent practical opportunities to enhance patient experience and to optimise care for men affected by infertility.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2705218"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630218","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":"Experiences of insemination fraud: discovering and navigating unexpected and entangled connections.","authors":"Astrid Indekeu, Merel Gootjes, Paul Enzlin, Maria Siermann","doi":"10.1080/14647273.2026.2712350","DOIUrl":"https://doi.org/10.1080/14647273.2026.2712350","url":null,"abstract":"<p><p>The increasing use of direct-to-consumer genetic testing revealed not only more, but also different types of insemination fraud worldwide, making research into the topic urgently needed. This study explores how donor-conceived people and parents experience insemination fraud and their need for and perception of psychosocial support. We conducted a qualitative interview study with 19 participants affected by insemination fraud from the Netherlands and Belgium. Insemination fraud occurs when the doctor uses a different sperm sample for insemination than the (prospective) parents consented to. The study includes eight different cases of insemination fraud. Participants experienced important challenges in fundamental aspects of life, related to reorganizing their identity, changing their family-conception story, navigating dualities regarding the donor, and coping with breaches of trust. Participants described the complex emotional processes they faced and how insemination fraud affected multiple relationships, revealing deeply entangled relational processes. These processes were complicated and/or facilitated by (non-)disclosure of donor conception by parents, type of insemination fraud, presence of heritable disease, the donor/doctor being alive or deceased, the clinic's reaction, and the reaction of the donor's legal family. Participants described short-term and long-term implications and needs for (peer) support. The article concludes with recommendations for clinical practice and policy.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2712350"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759036","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":"Knowledge, attitudes, and practices of patients with diminished ovarian reserve regarding traditional Chinese medicine treatment: structural equation modelling analysis.","authors":"Fan Jiang, Juan Zheng, Lin Su, Jiali Cai, Jingzhen Hong","doi":"10.1080/14647273.2026.2741540","DOIUrl":"https://doi.org/10.1080/14647273.2026.2741540","url":null,"abstract":"<p><p>This study assessed the knowledge, attitudes, and practices (KAP) of patients with diminished ovarian reserve (DOR) regarding Traditional Chinese medicine (TCM) treatments. A cross-sectional study was conducted from November 2023 to August 2024 among patients with DOR to assess their KAP regarding TCM treatments. Data on characteristics and KAP scores were collected via a self-designed questionnaire. Structural equation modelling (SEM) was employed to assess the relationships among the KAP dimensions. A total of 439 valid responses from patients with DOR were included in the final analysis (effective response rate 82.2%). Patients with DOR had a moderate level of knowledge (median [IQR]: 7.00 [5.00-8.00]), generally positive attitudes (median [IQR]: 27.00 [25.00-28.00]), and suboptimal practices (median [IQR]: 31.00 [28.00-33.00]). SEM showed that knowledge had a direct effect on attitude (β = 0.183, <i>P</i> < 0.001) and practice (β = 0.199, <i>P</i> < 0.001), attitude had a direct effect on practice (β = 0.267, <i>P</i> < 0.001), and knowledge indirectly affected practice through attitude (β = 0.049, <i>P</i> = 0.001). Patients with DOR had inadequate TCM knowledge but positive attitudes. Low practice engagement highlights a need for better education to convert attitudes into effective TCM use for managing ovarian decline.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2741540"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193105","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}