Human Fertility最新文献

{"title":"Is there a difference in ovarian hyperstimulation syndrome rates in freeze-all treatment cycles in high-risk patients treated with different GnRH agonist triggers?","authors":"Raashi Shah, Jennifer Barcroft, Hannan Al-Lamee, Erna Bayar, Rana Al-Odetalah, Marius Zaharia, Kinjal Shah, Anamika Sakhuja, Danai Balfoussia, Emil Barsoum, Rajendra Rai, Monica Mittal, Sotirios Saravelos","doi":"10.1080/14647273.2026.2733078","DOIUrl":"https://doi.org/10.1080/14647273.2026.2733078","url":null,"abstract":"<p><p>Ovarian hyperstimulation syndrome (OHSS) is a serious complication of assisted reproductive technology (ART). Risk factors for OHSS include female age, polycystic ovarian morphology and high ovarian reserve. The use of a gonadotrophin-releasing hormone (GnRH) agonist trigger in a freeze-all cycle is an effective strategy for reducing the risk of OHSS in suspected high responders. Various GnRH agonist trigger preparations exist but their use is subject to manufacturer availability. The national shortage of Buserelin necessitated a switch to alternative GnRH agonist trigger preparations such as Modified-Release (MR) Triptorelin resulting in a spike in OHSS cases, prompting an urgent review of our local treatment protocols and an immediate switch to Nafarelin (nasal preparation). We performed a retrospective study of freeze-all GnRH antagonist treatment cycles treated with a GnRH agonist (Triptorelin-MR, Nafarelin, and Buserelin) trigger at a London fertility clinic. The high-risk cohort consisted of patients with ≥18 follicles >12mm on ultrasonography. The diagnosis of OHSS was based on the criteria outlined by the Royal College of Obstetricians and Gynaecologists (RCOG). Relevant clinical data were extracted from medical records including female age, antral follicle count (AFC), anti-Mullerian hormone (AMH), ovarian stimulation dose (international units; IU), trigger preparation, oestradiol level on trigger day (pmol/l), oocyte yield, and the diagnosis and management of OHSS. A total of 333 patients underwent a freeze-all GnRH antagonist cycle between January 2023 and September 2024, 224 due to a high-risk of OHSS (≥18 follicles >12mm). The GnRH agonist preparations used included: Triptorelin-MR only (0.75 mg subcutaneous injection, SC; n = 69), Triptorelin-MR (0.375 mg SC) plus Menopur (150 IU SC; n = 49), Buserelin (2 mg SC; n = 69), and Nafarelin (1.6 mg nasal spray; n = 37). Forty-three patients met the RCOG diagnostic criteria for OHSS (mild n = 5, moderate n = 25 and severe n = 13). Six patients required inpatient OHSS management; none required intensive care or a chest/abdominal drain. Of those that developed severe OHSS, 92.3% (n = 12/13) had received Triptorelin-MR only or in combination with Menopur. Based on this cohort, Triptorelin-MR containing triggers are associated with a 12-fold increased risk of severe OHSS compared with other preparations and should not be used as a GnRH agonist trigger in patients at high risk of OHSS.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2733078"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108687","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":"Exploring undergraduates' knowledge, attitude, and perception of male infertility in Osun State University: a mixed method study.","authors":"Kehinde Awodele, Sunday Charles Adeyemo, Adesegun Tajudeen Waliu, Adeniyi Olanipekun Fasanu, Busayo Temilola Akinbowale, Victoria Adenike Adeniyi, Roseline Olufunmilola Folami, Oladayo Damilola Akinwale, Joshua Falade, Eniola Dorcas Olabode","doi":"10.1080/14647273.2026.2743745","DOIUrl":"https://doi.org/10.1080/14647273.2026.2743745","url":null,"abstract":"<p><strong>Background: </strong>Infertility has traditionally been seen as a female problem, causing misconceptions, stigma, and limited attention to male infertility. This study examined undergraduates' knowledge, attitudes, and perceptions of male infertility at Osun State University, Nigeria, and associated factors.</p><p><strong>Methods: </strong>A descriptive cross-sectional mixed-methods design was used. Quantitative data came from 300 undergraduates selected by multistage sampling using a self-administered questionnaire; qualitative data came from focus group discussions. Quantitative analysis used IBM SPSS Statistics 27; qualitative analysis used thematic analysis in NVivo. Findings were integrated through a joint display matrix and narrative synthesis.</p><p><strong>Results: </strong>The mean knowledge score was 7.12 ± 1.88, and the mean attitude score was 1.96 ± 1.12. Formal education on male infertility was a significant positive predictor of both knowledge (p < 0.001) and attitude (p < 0.001). Faculty affiliation (p = 0.009) and level of study (p = 0.012) were significantly associated with attitude scores. Qualitative findings showed functional understanding but culturally shaped attitudes involving marriage, masculinity, and gender roles, with women disproportionately blamed.</p><p><strong>Conclusions: </strong>Understanding was moderate but incomplete. Formal education was a strong modifiable predictor. Comprehensive, gender-inclusive reproductive health education should be integrated into university curricula, with open dialogue to reduce stigma.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"29 1","pages":"2743745"},"PeriodicalIF":2.0,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181467","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":"Risk of adverse pregnancy outcomes after abnormal hysterosalpingography.","authors":"Erika Gandelsman, Leonti Grin, Tamar Wainstock, Roza Berkovitz Shperling, Elena Scherbina, Bozhena Saar-Ryss","doi":"10.1080/14647273.2024.2431109","DOIUrl":"10.1080/14647273.2024.2431109","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between an abnormal hysterosalpingogram (HSG) and obstetrical and neonatal outcomes.</p><p><strong>Design: </strong>A retrospective cohort study comparing outcomes between women with normal versus abnormal tubal patency and uterine cavity on HSG.</p><p><strong>Results: </strong>Among 2181 women included in the study, 494 (22.6%) had an abnormal HSG. Of these, 207 (42%) presented with uterine abnormalities, 336 (68%) with tubal abnormalities and 49 (10%) with both. The study identified 232 clinical pregnancies in the abnormal HSG group and 814 pregnancies in controls. Women with abnormal HSG showed higher rates of preterm labour (PTL) compared to controls (13.6% vs. 7.7%, <i>p</i> < 0.05, <i>n</i> = 1687). Multivariate analysis revealed that any HSG abnormality was associated with an increased risk of PTL (aOR 2.39, 1.04-5.51). When analysing by type of abnormality, uterine abnormalities increased the risk of preeclampsia (aOR 2.86, 1.06-7.7) and low birthweight (aOR 2.31, 1.0-5.35), while tubal abnormalities were specifically associated with increased risk of PTL (aOR 3.87, 1.63-9.19).</p><p><strong>Conclusion: </strong>An abnormal HSG study was associated with adverse obstetrical outcomes. Specifically, uterine abnormalities increased the risk of preeclampsia and birthweight below 10th percentile, while tubal abnormalities were associated with a heightened risk of PTL.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2431109"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143055882","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":"Women, Wombs and Warnock: 40 years after the Warnock Report, is legislation fit for purpose for uterus transplantation?","authors":"Natasha Hammond-Browning","doi":"10.1080/14647273.2025.2492115","DOIUrl":"https://doi.org/10.1080/14647273.2025.2492115","url":null,"abstract":"<p><p>This article examines and evaluates the adequacy of current legislation regarding uterus transplants in light of the Warnock Committee's foundational work on reproductive ethics and technology. With increasing advancements in reproductive technology, the potential for uterus transplants to provide opportunities for cisgender women with absolute uterine factor infertility (AUFI) to gestate has garnered significant attention. However, existing legal frameworks often lag behind medical innovations, leading to disparities in access, regulation, and patient rights. Questions also arise regarding applying existing legislation to novel medical innovations, such as the potential to provide a uterus transplant to transgender women. As uterus transplantation emerges as a viable treatment option for cisgender women with absolute uterine factor infertility, the need for comprehensive legal frameworks becomes increasingly urgent and so this article assesses whether existing assisted reproduction laws are fit for purpose or whether reform is required given advances in reproductive medicine such as uterus transplantation.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2492115"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011523","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":"Expression of Concern: Comparison of macroscopic one-layer over number 1 nylon suture vasovasostomy with the standard two-layer microsurgical procedure.","authors":"","doi":"10.1080/14647273.2025.2480402","DOIUrl":"https://doi.org/10.1080/14647273.2025.2480402","url":null,"abstract":"","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2480402"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002122","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":"Can a lack of knowledge of the ovulatory cycle result in primary infertility? Evidence from selected South Asian countries.","authors":"Pratyashee Ojah, Manas Ranjan Pradhan","doi":"10.1080/14647273.2024.2441832","DOIUrl":"https://doi.org/10.1080/14647273.2024.2441832","url":null,"abstract":"<p><p>Knowledge of ovulatory cycle (KOC) is a crucial factor for successful conception. Despite sizable number of women suffering from infertility, empirical evidence on the relation between infertility and KOC is rare in South Asia. This study assesses the association between primary infertility and KOC. The data of ever-married women aged 20-49 gathered in the recent rounds of Demographic and Health Survey (DHS) for India (2019-2021), Bangladesh (2017-2018), Pakistan (2017-2018) and Nepal (2022) were analyzed. Bivariate analysis and binary logistic regression were conducted through Stata (V.17) with a 5% significance level. Women with no KOC in India [AOR:1.71, C.I.: (1.54, 1.9)] and Bangladesh [AOR:2.6, C.I.: (1.67, 4.06)] had higher odds of primary infertility than their counterparts with correct KOC. The study concludes that correct KOC is a significant predictor of primary infertility in India and Bangladesh and is insignificant in Pakistan and Nepal. Moreover, higher age at marriage and no-visit to healthcare facility were the other significant predictors of primary infertility in all four countries. Women who are struggling to conceive would benefit from education related to the timing and identification of the fertile window, which may be provided through primary healthcare providers.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2441832"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863741","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":"Increased paternal age adversely affects live birth rates in oocyte recipient cycles.","authors":"Yeliz Atik, Stavroula Kastora, Rawad Halimeh, Margot Zomer, Rabi Odia, Holly Exeter, Mina Vasilic, Suzanne Cawood, Wael Saab, Paul Serhal, Srividya Seshadri, Dimitrios Mavrelos, Ephia Yasmin","doi":"10.1080/14647273.2025.2506799","DOIUrl":"https://doi.org/10.1080/14647273.2025.2506799","url":null,"abstract":"<p><p>This retrospective cohort study was conducted in a single center to investigate the influence of paternal age on oocyte recipient cycles. 320 IVF/ICSI oocyte recipient cycles resulting in embryo transfers between 01/2015- 06/2022 and meeting the inclusion criteria: donors ≤35 years, endometrial thickness 6mm and normal endometrial cavity were analyzed. Donor or surgically retrieved sperm or PGT-A cycles were excluded. Paternal and recipient ages were grouped according to previous literature for comparability. Primary outcome was live birth rate, and secondary outcomes were clinical pregnancy and miscarriage rates. The median recipient, paternal and donor ages were 42 (IQR: 19-50), 43 (IQR: 38-46) and 26 years (IQR: 23-29). 55.6% [N=178] of the cycles were fresh and 44.3% [N=142] were frozen embryo transfers. Univariate and multivariate logistic regression, adjusted for semen WHO criteria, recipient age, IVF/ICSI and fresh/frozen cycles highlighted reduced odds of live birth by 79%, OR 0.21 [95%CI 0.11 to 0.38]; P<0.0001, clinical pregnancy by 58%, OR 0.42 [95%CI 0.31 to 0.89]; P<0.0001 and increased odds of miscarriage by 108%, OR 2.08 [95%CI 1.91 to 3.01]; P<0.0001 in those of paternal age 51 years compared to fathers ≤35 years. Our study identifies the negative impact of advanced paternal age.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2506799"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136216","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":"Fertility preservation for transgender and non-binary individuals: a systematic review and thematic synthesis of clinical, psychosocial, and structural challenges.","authors":"Mauro Francesco Pio Maiorano, Gennaro Cormio, Vera Loizzi, Brigida Anna Maiorano, Francesca Arezzo, Erica Silvestris","doi":"10.1080/14647273.2025.2527383","DOIUrl":"10.1080/14647273.2025.2527383","url":null,"abstract":"<p><p>Gender-affirming treatments, including hormone therapy and surgery, can significantly impair fertility in transgender and non-binary (TNB) individuals. Despite growing attention to transgender health, fertility preservation (FP) remains under-addressed. This systematic review synthesizes current evidence on FP strategies, exploring clinical, psychosocial, and structural factors shaping FP decision-making in TNB populations. A systematic review and thematic metasynthesis were conducted following PRISMA guidelines. Qualitative and mixed-methods studies published between 2010 and 2025 were identified via PubMed, Scopus, Web of Science, and Google Scholar. Thematic analysis included perspectives from TNB individuals, parents, and healthcare providers. FP uptake remains low despite many TNB individuals expressing a desire for biological parenthood. Major barriers include procedural dysphoria, financial constraints, limited provider expertise, and inconsistent counselling. Gamete cryopreservation remains the most common FP method, although long-term outcomes are underreported. Early, affirming fertility counselling improves informed decision-making and aligns care with patient values. Access to FP is shaped by healthcare policies, legal frameworks, and social norms. To address persistent underutilization, providers should initiate FP discussions early in the transition process and consider both medical and psychosocial needs. Enhanced training and policy reform are needed to close knowledge gaps and ensure equitable, patient-centred fertility care.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2527383"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145722388","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":"Do very young oocyte donors negatively impact live birth rates in their recipients?","authors":"Luisa Kahn, Sara Aziz, Benjamin Jones, Meen-Yau Thum, James Nicopoullos, Raef Faris, Srdjan Saso, Tim Bracewell-Milnes","doi":"10.1080/14647273.2024.2434524","DOIUrl":"https://doi.org/10.1080/14647273.2024.2434524","url":null,"abstract":"<p><p>To understand whether there was an association between very young oocyte donors and adverse outcomes, this was a single centre retrospective study (Lister Fertility Clinic, London) examining data collected between 1st January 2010 and 31st December 2021. A total of 1,182 oocyte donors were included in the final analysis. Data was categorised by donor age in years; ≤22, 23-25, 26-28, 29-31, 32-34. Statistical analysis was performed using SPSS. Donors aged ≤22 years showed increased live birth rates (LBR) in fresh In Vitro Fertilisation (IVF) cycles when compared to donors aged 26-28 <i>(p</i> < 0.0136), 29-31 (<i>p</i> < 0.0044), and 32-34 (<i>p</i> < 0.0003) years, respectively. There was also an increased positive pregnancy rate in fresh IVF cycles for donor oocytes ≤22 years when compared to all other groups. The LBR and positive pregnancy rates decreased with increasing oocyte age with fresh IVF cycles. There was no significant difference in the LBR with frozen IVF cycles compared to fresh IVF cycles. Our data showed that very young oocyte donors are in fact associated with improved IVF outcomes, especially in fresh IVF cycles.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2434524"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768369","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":"How do coping strategies influence fertility-related information seeking/avoidance?","authors":"Chloe May Smith, Mei Yee Tang, Gavin Clark, Suzanne Madgwick","doi":"10.1080/14647273.2025.2488759","DOIUrl":"https://doi.org/10.1080/14647273.2025.2488759","url":null,"abstract":"<p><p>Despite the rise in discussions around fertility and reproductive health, recent evidence indicates that women's fertility awareness (FA) remains low, with many avoiding essential fertility-related information (FRI). Existing research has linked low awareness to demographic factors, yet psychological and behavioural determinants have received less attention. This study, therefore, explores the influence of coping strategies (avoidant and problem-focused) on FRI-seeking and avoidance behaviours and their effect on FA. A cross-sectional survey gathered data from 216 UK-based female participants aged 18-68 (<i>M</i> = 31.69, <i>SD</i> = 10.42), measuring demographics, FA, FRI-seeking and avoidance, and coping strategies. Data underwent multiple regression and moderation analyses. The average FA score was 17.87/29 (62%). FRI-seeking positively predicted FA (<i>p</i> < 0.001), while FRI-avoidance negatively predicted FA (<i>p</i> < 0.001). Avoidant coping significantly predicted increased FRI-avoidance (<i>p</i> < 0.001), moderating the relationship between FRI-avoidance and FA (<i>p</i> < 0.001). Problem-focused coping significantly predicted FRI-seeking (<i>p</i> < 0.001), moderating the relationship between FRI-seeking and FA (<i>p</i> < 0.001). Results suggest that coping strategies influence motivation to seek and avoid FRI. Future FRI and fertility education should be tailored to suit women's coping strategies to facilitate active engagement, which may enhance awareness and support more informed fertility decision-making.</p>","PeriodicalId":13006,"journal":{"name":"Human Fertility","volume":"28 1","pages":"2488759"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002124","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}