Human Fertility最新文献

{"title":"Association of lifetime psychiatric history with psychological distress in women undergoing intrauterine insemination.","authors":"Shimi Barda, Ron Hauser, Noga Fuchs Weizman, Micah Iticovici, Yael Joskowicz, Anat Halevy, Inbar Fried Zaig, Miki Bloch","doi":"10.1080/14647273.2026.2667403","DOIUrl":"10.1080/14647273.2026.2667403","url":null,"abstract":"<p><p>The objective was to examine the prevalence of lifetime psychiatric disorders among women initiating intrauterine insemination (IUI) and their association with psychological distress at treatment onset. Ninety women were evaluated prior to treatment at an academic fertility center. Lifetime psychiatric diagnoses were assessed using the Structured Clinical Interview for DSM-IV-TR. Psychological distress was measured with the Beck Depression Inventory (BDI) and Perceived Stress Scale (PSS), and personality traits with the Eysenck Personality Questionnaire-Revised. Group differences were analyzed using t-tests and chi-square tests, and multivariate logistic regression identified predictors of elevated distress (BDI or PSS > 14). A lifetime Axis I disorder was identified in 36.7% of participants, most commonly mood (28.9%) and anxiety (15.6%) disorders. Women with a psychiatric history reported higher depression scores (10.5 vs. 5.5, <i>p</i> = 0.005), stress levels (18.8 vs. 12.8, <i>p</i> = 0.002), and neuroticism (<i>p</i> < 0.05). Lifetime psychiatric history remained independently associated with elevated distress (OR = 2.83, 95% CI: 1.14-7.01, <i>p</i> = 0.025). Over one-third of women initiating IUI have a lifetime psychiatric history, associated with greater distress at treatment onset. Routine psychiatric screening may help identify at-risk patients and support targeted interventions.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2667403"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874086","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":"Mismatched expectations regarding donor anonymity: the implications of Australians crossing-borders for egg donation in South Africa.","authors":"Cal Volks, Karin Hammarberg, Andrea Whittaker","doi":"10.1080/14647273.2026.2618232","DOIUrl":"10.1080/14647273.2026.2618232","url":null,"abstract":"<p><p>Some Australian women who require donor oocytes to achieve parenthood travel to South Africa, where egg donors are more readily available and egg donation comparatively affordable. In South Africa, egg donation arranged through donor agencies or egg banks is anonymous, whereas Australian las does not permit donor anonymity. This study explored Australian recipients' views on the implications of donor anonymity for their children, including the potential for future donor identification through direct-to-consumer genetic testing and social media. It also examined whether South African infertility counsellors, inform donors about possible future identification. Semi-structured interviews were conducted with twelve Australian egg recipient parents, twelve South African egg donors, and nine South African counsellors between 2021 and 2023, and analysed thematically. Australian recipients commonly hoped their donor-conceived children might learn the donor's identity and some had already engaged in online sleuthing or anticipated future identification through genetic testing. In contrast, South African donors generally expected anonymity to be permanent and expressed mixed feelings about potential future contact. Counsellors reported that identification risks were not consistently discussed with donors. This mismatch in expectations may have psychological consequences for all parties, highlighting the need for more robust implications counselling in cross-border egg donation arrangements.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2618232"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503727","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":"Association between hepatic steatosis index and female infertility: a cross-sectional study using NHANES 2013-2018.","authors":"Yaping Wang, Wenxuan Zhang, Yuxiang Cao, Ping Gong, Qingling Li, Jing Wang, Bing Gao","doi":"10.1080/14647273.2026.2722370","DOIUrl":"https://doi.org/10.1080/14647273.2026.2722370","url":null,"abstract":"<p><p>Female infertility is a major reproductive health concern. Hepatic steatosis index (HSI), a non-invasive marker of liver-related metabolic burden, has not been well studied in relation to infertility across its distribution. We analyzed women aged 20-49 years from three NHANES cycles (2013-2018). HSI was examined as both a continuous variable and in quartiles, and restricted cubic spline models were used to assess potential nonlinearity. Sensitivity analyses using alternative infertility definitions and exploratory interaction analyses were also performed. Among 3,007 women, 416 (13.8%) were classified as having infertility. In the fully adjusted model, women in the highest HSI quartile had higher odds of infertility than those in the lowest quartile (OR 1.66, 95% CI 1.08-2.57; <i>P</i> = 0.031), with a significant trend across quartiles (<i>P</i> for trend = 0.010). Restricted cubic spline analysis showed a nonlinear association between HSI and infertility (<i>P</i> for overall association = 0.005), which was more evident at higher HSI levels. Higher HSI was associated with greater odds of infertility among reproductive-aged women.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2722370"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864714","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 cryo-preservation for fertility preservation: a comparative study of efficacy and cost-effectiveness between progestin-primed and antagonist ovarian stimulation protocol.","authors":"C Alabi, S Kastora, Y Atik, K Sherlock, E Vaughan, N Balachandren, S Lavery, M C Davies, E Yasmin","doi":"10.1080/14647273.2025.2607993","DOIUrl":"https://doi.org/10.1080/14647273.2025.2607993","url":null,"abstract":"<p><p>Suppression of an LH surge is fundamental to successful oocyte retrieval after controlled ovarian stimulation. This study evaluates the efficacy and cost-effectiveness of progestin-primed ovarian stimulation (PPOS) using oral medroxyprogesterone acetate in fertility preservation cycles. The design is a retrospective single-centre study (January 2022-August 2023) comparing two ovarian stimulation protocols: PPOS and the gonadotrophin-releasing hormone antagonist (GnRHant) protocols. Cycles began at any time of the menstrual cycle. The primary outcome was the number of metaphase II oocytes retrieved. Secondary outcomes included total oocytes retrieved, maturity ratio, stimulation duration, incidence of premature LH rise/ovulation events, and the cost of medication used to prevent ovulation. The study included 125 fertility preservation cycles: 54 in the PPOS group and 71 in the GnRHant group. Median body mass index, antral follicle count, and anti-Mullerian hormone levels were comparable between the two groups. The median age was younger in the PPOS group; 28 years vs. 32 years, <i>p</i> = 0.03. Mature oocyte retrieval was similar; mean 9.33 [SD 5.87] vs. 8.97 [SD 5.44], <i>p</i> = 0.73. No premature LH rises occurred in either group. Secondary outcomes showed no significant differences, except for the cost of medication used to prevent ovulation. The PPOS protocol was considerably more cost-effective, by achieving a 98.06% cost reduction (medroxyprogesterone acetate, mean £4.38 [SD, £1.10] <i>vs</i> cetrorelix acetate £226.2 [SD £64.36], <i>p</i>= <0.0001. PPOS is a practical, cost-effective strategy for fertility preservation. Its appeal lies in its patient-centric focus, with a less invasive injection-based administration, while maintaining comparable effectiveness and significant cost reduction compared with the GnRH antagonist ovarian stimulation protocol.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2607993"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889081","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":"Secretory-phase endometrial Ki67 predicts benefit of GnRHa pretreatment in unexplained recurrent implantation failure.","authors":"Yonghong Zhang, Yue Jiang, Hui Zhang, Jie Mei","doi":"10.1080/14647273.2026.2618226","DOIUrl":"10.1080/14647273.2026.2618226","url":null,"abstract":"<p><p>Recurrent implantation failure (RIF) is a major barrier to successful assisted reproduction, often linked to impaired endometrial receptivity. Gonadotropin-releasing hormone agonist (GnRHa) pretreatment may improve outcomes in frozen embryo transfer (FET) cycles, but evidence in unexplained RIF remains inconclusive. Ki67, a marker of cellular proliferation, has been proposed as being associated with receptivity. This retrospective study included 182 women with unexplained RIF who underwent FET at Nanjing Drum Tower Hospital between January 2020 and December 2023. Patients were divided into a GnRHa-HRT group (n = 121) and an HRT group (n = 61). Endometrial tissue was collected during the mid-secretory phase, and Ki67 expression was assessed by immunohistochemistry. Patients were stratified into high and low Ki67 groups according to integrated optical density (IOD fold). The GnRHa-HRT group achieved higher clinical pregnancy rates than the HRT group (68.6% vs. 52.5%, P = 0.033) and showed a trend toward higher live birth rates (57.9% vs. 42.6%, P = 0.052). Importantly, in patients with high Ki67 expression (IOD fold >1.5), GnRHa pretreatment significantly increased the clinical pregnancy rate (P = 0.004), whereas no significant differences were observed in patients with low Ki67 expression. These findings suggest that secretory phase Ki67 expression may serve as a predictive biomarker for tailoring GnRHa pretreatment in unexplained RIF, supporting more individualised strategies to optimise clinical outcomes.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2618226"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503682","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":"Advancing embryo transfer precision: narrative synthesis of four-dimensional versus two-dimensional ultrasound guidance in IVF.","authors":"Aisha Anwar, Vindya Pathiraja, Tharanga Mudalige, Gayathri Delanerolle, Nicola Tempest","doi":"10.1080/14647273.2026.2649286","DOIUrl":"10.1080/14647273.2026.2649286","url":null,"abstract":"<p><p>Infertility is becoming increasingly common and more people are turning to assisted reproductive technologies. However, success rates remain disappointingly low, and improving outcomes for every treatment is a major priority. Accurate embryo placement during embryo transfer (ET) is critical for implantation and livebirth. While two-dimensional (2D) ultrasound-guided embryo transfer (USGET) approaches are standard, evidence for four-dimensional (4D)USGET is limited. This review aimed to determine whether 4DUSGET improves embryo placement accuracy and clinical reproductive outcomes, informing clinical practice and guiding future research. A narrative review of literature across databases was performed. Data extraction included study design, sample size, embryo placement technique, and pregnancy outcomes. 4DUSGET was associated with enhanced accuracy of embryo deposition, particularly in women with abnormal uterine anatomy or when targeting the maximal implantation potential point. Several studies reported higher clinical pregnancy and livebirth with 4D compared to 2D guidance. Evidence base is limited by a small number of studies, heterogeneous outcomes and potential bias inherent to narrative syntheses, making definitive conclusions challenging. Nonetheless, emerging data suggest 4DUSGET may provide meaningful benefit in anatomically complex cases with the potential to improve IVF success rates. Trials are needed to confirm findings and establish generalisability across IVF populations.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2649286"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645109","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":"Atypical presentation of severe ovarian hyperstimulation syndrome complicated by isolated pleural effusions: a case series and literature review.","authors":"Yousef Alebrahim, Karolina Palinska-Rudzka, Lewis Nancarrow, Andrew Drakeley, Raj Mathur","doi":"10.1080/14647273.2026.2654446","DOIUrl":"10.1080/14647273.2026.2654446","url":null,"abstract":"<p><p>Pleural effusion as the predominant manifestation of severe ovarian hyperstimulation syndrome (OHSS) is rare and may occur with minimal or absent ascites. We present a recent retrospective case series from two UK centres describing presentation, investigations, management and outcomes of three patients developing large pleural effusions after medically assisted reproduction (MAR) in 2024-2025. All patients underwent antagonist stimulation with human chorionic gonadotropin (hCG) trigger and single fresh day-5 blastocyst transfer. Pleural effusions were diagnosed within a week of transfer, were predominantly right sided, and occurred despite modest ovarian enlargement and minimal or absent ascites. Patients required ultrasound-guided intercostal drainage with controlled outflow and albumin support. Pleural biochemistry was assessed in one case and this met 'Light's criteria' for exudate effusions. All patients improved rapidly after drainage and supportive management. Two pregnancies continued (one to term, one viable at 7 weeks), and one cycle did not result in pregnancy. In conclusion, pleural-predominant OHSS is a rare, yet recognisable phenotype. Early thoracic ultrasound, with careful interpretation of pleural biochemistry (including the serum-pleural albumin gradient in equivocal cases), avoidance of diuretics, selective albumin for intravascular support, timely ultrasound-guided drainage and venous-thromboembolism prophylaxis can optimise management. These cases also highlight the importance of preventive OHSS measures for future cycles.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2654446"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698701","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":"Population-based age-specific reference percentiles and Z-scores for AMH in women.","authors":"Ronit Machtinger, Rina Hemi, Ehud Barhod, Tomer Ziv-Baran","doi":"10.1080/14647273.2025.2610909","DOIUrl":"10.1080/14647273.2025.2610909","url":null,"abstract":"<p><p>Anti-Müllerian hormone (AMH) is a reliable biomarker for assessing ovarian reserve, offering insight into the quantity of a woman's remaining oocyte pool. As AMH levels naturally decline with age, establishing accurate reference values is crucial for fertility assessment and reproductive planning. While existing nomograms predominantly focus on infertile populations or small cohorts, the current study presents a comprehensive, population-based analysis of AMH levels in 5,230 women aged 25 to under 45 years. Serum samples were obtained through a central laboratory in a large tertiary hospital (Sheba Medical Center) which processes AMH tests collected primarily in the community. This unique setting provides a broadly representative sample of women from a community-based population. Utilizing these community-based serum samples measured using the Elecsys Cobas AMH assay; this cross-sectional study developed age-specific AMH percentiles and z-scores using the general additive model for location, scale and shape (GAMLSS). Participants were randomly split into a learning group (<i>n</i> = 4,000) and a validation group (<i>n</i> = 1,230), with similar median age (34.3 vs. 34.2 years, <i>p</i> = 0.499) and AMH (1.83 vs. 1.85 ng/mL, <i>p</i> = 0.584) levels. Median AMH values demonstrated a clear age-dependent decline, ranging from 3.03 ng/mL at age 25 to 0.31 ng/mL at age 44. The generated reference chart enables interpretation of AMH results in relation to age-matched peers, enhancing the clinical utility of AMH testing for counselling and decision-making in both individual and public health contexts. Importantly, this study addresses a gap in current literature by including a community-based population and avoiding the selection biases inherent in studies limited to women with infertility or polycystic ovary syndrome. The mean z-score in the validation group was approximately zero, confirming the model's robustness. These results reinforce the value of AMH as a tool for fertility assessment, while highlighting variability in AMH across populations and emphasising the need for standardised reference ranges. The newly established percentiles may support timely fertility preservation decisions and inform public health strategies aimed at fertility awareness in reproductive-aged women. As AMH testing becomes increasingly accessible, age-specific interpretation using robust population data will become essential in tailoring personalised reproductive care.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2610909"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018182","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":"Does ICSI timing impact cumulative live birth and perinatal outcomes - a cohort study.","authors":"Haowen Zou, Kelli Peirce, Vincent Chapple, Jay Natalwala, Rui Wang, Yanhe Liu","doi":"10.1080/14647273.2026.2687699","DOIUrl":"10.1080/14647273.2026.2687699","url":null,"abstract":"<p><p>The objective was to investigate whether there are differences in cumulative live birth rate, cumulative clinical pregnancy rate, or perinatal outcomes after delaying ICSI timing. The design was a retrospective cohort study at Fertility North in Australia using 1,969 ICSI cycles with different ICSI timings among 1,078 patients from 2017 to 2022. Cumulative outcomes included cumulative live birth and cumulative clinical pregnancy rates per oocyte retrieval cycle. Perinatal outcomes included preterm birth, low/high birthweight, and small/large for gestational age. Binomial logistic regression and multinomial logistic regression were used. Generalised estimating equation (GEE) was incorporated into the logistic regression analyses to account for the cluster effect from patients undergoing multiple retrieval cycles. ICSI timing was grouped into quartiles: Q1(37.1-41.1h, <i>n</i> = 498), Q2(41.2-42.4h, <i>n</i> = 510), Q3(42.5-43.3h, <i>n</i> = 483), and Q4(43.4-46.8h, <i>n</i> = 478). No significant difference was found in cumulative live birth in Q2 (aOR: 0.79, 95%CI: 0.55-1.14), Q3 (0.87, 0.61-1.25), and Q4 (0.86, 0.58-1.27), compared with Q1, respectively. Similarly, there was no significant difference in cumulative clinical pregnancy rate between the four groups. Furthermore, no significant differences were found in preterm birth, low birth weight, high birth weight, small for gestational age, and large for gestational age in Q4, compared to Q1. Delaying ICSI until 46.8 hours post-trigger does not compromise cumulative clinical pregnancy or live birth rates, or increase adverse perinatal risks.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2687699"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294605","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":"Serum uric acid is associated with ovarian reserve and neonatal outcomes in women undergoing IVF/ICSI: observational and genetic evidence.","authors":"Jialin Wu, Cheng Wang, Yanfang Wang, Tingting Li, Linan Xu, Rui Huang","doi":"10.1080/14647273.2025.2610586","DOIUrl":"10.1080/14647273.2025.2610586","url":null,"abstract":"<p><p>Elevated serum uric acid (SUA) has been linked to adverse outcomes in polycystic ovary syndrome, yet its broader role in female fertility is unclear. This retrospective cohort study of 16,223 women undergoing a first in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) cycle investigated associations between pre-treatment SUA and reproductive parameters. Higher SUA levels were independently associated with elevated luteinizing hormone (LH), testosterone, and anti-Müllerian hormone (AMH), and with lower estradiol and follicle-stimulating hormone. Each 50 µmol/L SUA increase correlated with a 16-gram reduction in neonatal birth weight and a 0.06-week decrease in gestational age, with a threshold effect near 350 µmol/L. Bidirectional Mendelian randomisation analyses supported a causal effect of elevated SUA on increased LH and testosterone, while reverse analysis suggested lower AMH may elevate SUA. These findings identify SUA as a biomarker influencing ovarian reserve and neonatal outcomes through bidirectional mechanisms, including a potential SUA-AMH feedback loop. Routine SUA monitoring in fertility treatment is supported, and interventions for individuals with SUA ≥350 µmol/L warrant clinical investigation.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2610586"},"PeriodicalIF":1.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965871","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}