International Journal of Fertility & Sterility最新文献

{"title":"Ethanol Sclerotherapy for Primary and Recurrent Endometrioma Improves <i>In Vitro</i> Fertilization Pregnancy Outcomes: A Randomized Clinical Trial.","authors":"Leila Shahsavari, Vajihe Hazari, Ashraf Aleyasin, Zeinab Samadi","doi":"10.22074/ijfs.2025.2040063.1751","DOIUrl":"10.22074/ijfs.2025.2040063.1751","url":null,"abstract":"<p><strong>Objective: </strong>Alcohol sclerotherapy has been shown to reduce endometrioma recurrence and improve ovarian response, including the number of retrieved oocytes and antral follicle count (AFC), compared with surgical cystectomy. This randomized clinical trial aimed to assess the effect of ethanol sclerotherapy on assisted reproductive outcomes in women with a history of primary and recurrent endometriomas.</p><p><strong>Materials and methods: </strong>This single-blind randomized clinical trial included 80 infertile women aged 20-40 years with either primary or recurrent endometriomas. All participants underwent transvaginal ultrasound to evaluate endometrioma size, AFC, and serum hormone levels (anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH)) in the follicular phase. Patients were randomly assigned to the intervention group (n=40), receiving ethanol sclerotherapy, or the control group (n=40), receiving Dipherelin treatment. The sclerotherapy procedure involved cyst aspiration followed by ethanol instillation, with standard post-procedure care. Ovulation induction was performed, and subsequent reproductive outcomes, including pregnancy rates, were assessed in the same cycle.</p><p><strong>Results: </strong>The mean age of participants was 32.4 ± 4.75 years, and the mean endometrioma size was 41.45 ± 15.9 mm. Baseline characteristics and complications rates did not differ significantly between groups. Endometrioma recurrence was observed in 20% of patients in the intervention group within six months. Embryo quality was not significantly higher in the intervention group (P>0.05). Chemical pregnancy rates were 40% in the intervention group versus 20% in the control group (P=0.025), and clinical pregnancy rates were 32.5 versus 15% (P=0.040). Conception and implantation rates, however, did not differ significantly between groups.</p><p><strong>Conclusion: </strong>Ethanol sclerotherapy significantly improved clinical and chemical pregnancy rates compared to the control, suggesting that it may be a viable alternative to surgical cystectomy in selected patients, particularly those undergoing in vitro fertilization (registration number: IRCT20191206045629N1).</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 Suppl 1","pages":"32-38"},"PeriodicalIF":2.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracytoplasmic Sperm Injection Clinical Outcomes: A Non-Inferiority Comparison of The Novel Felix™ Electrophoretic System and Conventional Density Gradient Centrifugation for Sperm Selection, A Prospective Clinical Trial.","authors":"Bahareh Ghazavi, Marziyeh Tavalaee, Farnaz Shapouri, Niloofar Sadeghi, Mohammad Hasan Najafi, Hassan W Bakos, Robert J Aitken, Mohammad Hossein Nasr-Esfahani","doi":"10.22074/ijfs.2025.2061310.1878","DOIUrl":"10.22074/ijfs.2025.2061310.1878","url":null,"abstract":"<p><strong>Objective: </strong>In intracytoplasmic sperm injection (ICSI), sperm selection has traditionally relied on motility and morphology, often overlooking DNA integrity. This study evaluates the Felix™ Electrophoretic System, which isolates sperm based on membrane surface electric charge, by assessing its effectiveness in selecting motile sperm with intact DNA and comparing ICSI clinical outcomes between the Felix™ system and density gradient centrifugation (DGC) in sibling oocytes.</p><p><strong>Materials and methods: </strong>In this prospective clinical trial study, semen samples from 25 infertile couples were processed using both DGC and the Felix™ sperm preparation system. For ICSI, oocytes were fertilized with sperm prepared by each method. Embryo development was monitored using time-lapse imaging, and embryo quality was assessed on day 5 post-ICSI. The highest-quality embryo from each group was selected for transfer.</p><p><strong>Results: </strong>Fertilization rates and blastocyst quality were comparable between the two groups. Although the Felix ™ group exhibited a higher proportion of high-quality blastocysts than the DGC group, this difference was not statistically significant (P=0.220). The number of embryo transfers per couple varied depending on the availability of transferable embryos. In total, 16 embryo transfers were performed in the Felix™ group, resulting in a 37% clinical pregnancy rate, whereas 11 transfers were performed in the DGC group, resulting in a 36% clinical pregnancy rate.</p><p><strong>Conclusion: </strong>This pilot study demonstrated that the Felix™ system provides assisted reproductive technology (ART) outcomes comparable to those of DGC, while requiring less semen and time and avoiding centrifugal stress. However, larger studies and additional functional and long-term evaluations are needed to confirm its efficacy, safety, and impact on offspring health (registration number: IRCT20110804007223N11).</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 Suppl 1","pages":"39-47"},"PeriodicalIF":2.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Intramuscular Human Chorionic Gonadotropin on Endometrial Preparation in Frozen-Thawed Embryo Transfer: A Randomized Clinical Trial.","authors":"Mahdieh Moridi, Azar Yahyaei, Samira Vesali, Mehri Mashayekhi","doi":"10.22074/ijfs.2025.2054284.1828","DOIUrl":"10.22074/ijfs.2025.2054284.1828","url":null,"abstract":"<p><strong>Objective: </strong>Experimental evidence suggests that the human endometrium expresses receptors for human chorionic gonadotropin (hCG), and activation of these receptors may enhance embryo implantation. Numerous studies have explored the effects of intrauterine hCG injection on embryo transfer (ET) outcomes; however, the impact of systemic hCG administration has been investigated in comparatively fewer studies. This study aimed to evaluate the effects of intramuscular administration of 5000 IU hCG on the outcomes of frozen-thawed ET in hormonal replacement cycles using a gonadotropin-releasing hormone (GnRH)-agonist protocol.</p><p><strong>Materials and methods: </strong>This randomized controlled trial (RCT, registered April 22, 2021) was conducted at the ROYAN Institute, a tertiary referral center in Tehran, Iran, between July 2020 and August 2022. A total of 200 infertile women undergoing cleavage-stage frozen-thawed ET were enrolled. Inclusion criteria were age <40 years, body mass index <30 kg/m², and the availability of at least three frozen embryos of good or excellent quality. Participants were randomly assigned to either an intervention group receiving intramuscular hCG (5000 IU administered three times: 72 hours before ET, on the day of ET, and 72 hours after ET) or a control group without hCG.</p><p><strong>Results: </strong>A total of 188 participants completed the trial (93 in the intervention group and 95 in the control group). No significant differences were observed in implantation rate (P=0.903), chemical pregnancy (P=0.912), clinical pregnancy (P=0.999), pregnancy complications (P=0.480), preterm labor (P=0.853), or live birth rate (P=0.233). However, the miscarriage rate was lower in the intervention group. This reduction approached significance per cycle (P=0.059) and reached statistical significance per pregnancy (P=0.011).</p><p><strong>Conclusion: </strong>Intramuscular hCG administration in hormonal replacement cycles with a GnRH-agonist does not significantly affect overall frozen-thawed ET outcomes at the cleavage stage but may be associated with a lower miscarriage rate among those who achieve pregnancy (registration number: NCT04855383).</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 Suppl 1","pages":"17-23"},"PeriodicalIF":2.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for Evaluating The Effect of Pelvic Physiotherapy on Uterine Blood Flow: A Single-Center, Two-Arm, Parallel, Randomized, Clinical Trial.","authors":"Zahra Chakeri, Kobra Hamdi, Elham Eghbali, Hakimeh Adigozali, Bahram Amirshakeri, Fariba Ghaderi","doi":"10.22074/ijfs.2025.2054039.1836","DOIUrl":"10.22074/ijfs.2025.2054039.1836","url":null,"abstract":"<p><strong>Objective: </strong>Repeated implantation failure (RIF) is a major challenge in <i>in vitro</i> fertilization (IVF). Insufficient uterine blood flow and reduced endometrial thickness are important factors contributing to implantation failure. Pelvic physiotherapy, including electrotherapy, manual therapy, and exercise therapy, has shown potential to enhance endometrial thickness and improve local blood flow through pelvic floor exercises. Transfer of Energy Capacitive and Resistive (TECAR) therapy, a novel physiotherapy modality, promotes vasodilation, tissue oxygenation, and blood circulation. This study presents a clinical trial protocol designed to evaluate the effect of pelvic physiotherapy, comprising electrotherapy, exercise therapy, and TECAR therapy, on uterine blood supply in infertile women with RIF.</p><p><strong>Materials and methods: </strong>Eligibility criteria include women with a history of at least two RIF events and inadequate uterine blood flow (pulsatility index (PI)> 1.95). The primary aim of this protocol is to evaluate uterine blood flow, endometrial thickness, and endometrial pattern, while secondary outcomes will include sexual function, depression, quality of life, pregnancy and implantation rates, fetal growth up to 12 weeks of gestation, ectopic pregnancy, and miscarriage. Following approval from the relevant ethics committee, this protocol will initially be implemented in a pilot phase involving 22 participants at Al-Zahra Hospital, Tabriz University of Medical Sciences.</p><p><strong>Results: </strong>As of the protocol submission date, the pilot phase is planned but not yet completed. No participant data have been analyzed. Therefore, no results on uterine blood flow, endometrial thickness, implantation rates, or secondary outcomes are available at this stage. Upon completion of the pilot phase and subsequent full-scale trial, the findings will be reported separately.</p><p><strong>Conclusion: </strong>The findings of the forthcoming trial are expected to contribute to establishing evidence-based physiotherapy approaches for improving uterine perfusion and implantation outcomes in infertile women with RIF (registration number: IRCT20230206057338N1).</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 Suppl 1","pages":"24-31"},"PeriodicalIF":2.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Curcumin on Angiogenic and Proliferative Factors inHuman Endometriotic Cells.","authors":"Sedigheh Kamrani, Reyhaneh Sadat Hayaei Tehrani, Fereshteh Esfandiari, Firouzeh Ghaffari, Elham Amirchaghmaghi, Kamran Ghaedi, Maryam Shahhoseini","doi":"10.22074/ijfs.2025.2029019.1684","DOIUrl":"10.22074/ijfs.2025.2029019.1684","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a benign gynaecological disorder characterised by the presence of endometrial-like tissue outside the uterus. Proliferation of endometrial tissue and neoangiogenesis are essential factors in the development of endometriosis. Vascular endothelial growth factor (<i>VEGF</i>) and insulin-like growth factors (<i>IGF1</i>, <i>IGF2</i>) can be effective in neoangiogenesis and cell proliferation. Imprinted long non-coding RNA (lncRNA) H19 is involved in endometriosis pathogenesis through the regulation of cellular proliferation and differentiation. Curcumin has antiangiogenic, anti-proliferative, and anti-invasive properties for various diseases, and it is hypothesised that it may have therapeutic effects on endometriosis. This study aimed to evaluate the effects of curcumin on the expression of <i>VEGF</i>, <i>IGF1</i>, <i>IGF2</i>, and <i>H19</i> lncRNA, as well as on cell migration and proliferation in endometrial stromal cells isolated from women with endometriosis.</p><p><strong>Materials and methods: </strong>In this experimental study, human normal endometrial stromal cells (N-ESCs) from healthy endometrial tissue and human eutopic endometrial stromal cells (EU-ESCs) from endometriosis patients were cultured and treated with different concentrations of curcumin (0-100 mM) for 72 hours. Then, the effects of curcumin on cell viability, proliferation, and migration were assessed using methylthiazole tetrazolium (MTT) and the scratch test, respectively. Expressions of genes involved in angiogenesis (<i>VEGF</i>), proliferation (<i>IGF1</i>, <i>IGF2</i>), and the H19 lncRNA gene were evaluated using real-time polymerase chain reaction (PCR).</p><p><strong>Results: </strong>Curcumin decreased cell migration and proliferation of endometriotic stromal cells in a time- and concentration- dependent manner. It also reduced <i>VEGF</i> expression and increased the expressions of <i>H19</i>, <i>IGF1</i>, and <i>IGF2</i>.</p><p><strong>Conclusion: </strong>The anti-migration effect of curcumin on EU-ESCs and its impact on the expression of proliferative and angiogenic genes indicate that curcumin can be a promising treatment for endometriosis.</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 2","pages":"130-136"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Ovulation Outcomes of Letrozole-Tamoxifen-Estradiolwith and without Vitamin E in Infertile Women with PolycysticOvary Syndrome: A Double-Blind, Randomized Clinical Trial.","authors":"Athar Rasekh Jahromi, Nader Sharifi, Mohamad Karimi Javad, Vahid Rahmanian","doi":"10.22074/ijfs.2025.2055868.1841","DOIUrl":"10.22074/ijfs.2025.2055868.1841","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is a common endocrine disorder and a leading cause of anovulatory infertility. This study evaluated whether adding vitamin E to a regimen of letrozole, tamoxifen, and estradiol improves ovulation outcomes in infertile women with PCOS.</p><p><strong>Materials and methods: </strong>In a double-blind, randomized clinical trial conducted in Jahrom, Iran (December 2023-August 2024), 90 infertile women with PCOS were randomly assigned to two groups. Group A (n=45) received letrozole, tamoxifen, estradiol, and vitamin E, while group B (n=45) received the same regimen without vitamin E. The primary outcome was pregnancy rate; secondary outcomes included follicle size, count, and endometrial thickness, measured on cycle days 3, 7, and 12. Data were analyzed using Chi-square, Fisher's exact, and t tests (Stata 14).</p><p><strong>Results: </strong>Baseline characteristics including age (mean: 31.21 ± 6.31 Y), BMI (24.96 ± 3.45 kg/m²), and infertility duration (3.48 ± 2.70 Y) were similar between groups (P>0.05). On day 7, the vitamin E group showed significantly larger follicles (14.15 ± 0.36 mm vs. 10.90 ± 0.68 mm), more follicles (5.16 ± 0.36 vs. 3.73 ± 0.83), and thicker endometrium (7.16 ± 0.36 mm vs. 5.16 ± 0.36 mm). These advantages persisted on day 12, including improved follicular maturity and endometrial thickness. Although the pregnancy rate was higher in the vitamin E group (11.1% vs. 6.7%), the difference was not statistically significant (P=0.457). Adverse effects, including ovarian hyperstimulation syndrome (OHSS) and irregular bleeding, did not differ significantly (P=0.553).</p><p><strong>Conclusion: </strong>The results indicate that the addition of vitamin E to the letrozole-tamoxifen-estradiol protocol might be associated with improved ovulatory outcomes in women with PCOS. Nevertheless, no significant effect on pregnancy rates was observed. These findings highlight the potential adjunctive role of vitamin E in ovulation induction among women with PCOS, although further large-scale randomized trials are needed to confirm its clinical relevance (number registration: IRCT20150407021653N20).</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 2","pages":"115-123"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Compound Heterozygous Missense Variant in The <i>DNAH5</i> Gene Could Be A Significant Factor in Unexplained Male Infertility: A Case Study.","authors":"Maryam Afkari, Najmeh Salehi, Hesamoddin Sajadi, Marjan Sabbaghian, Seyed Abolhassan Shahzadeh-Fazeli, Amir Amiri-Yekta","doi":"10.22074/ijfs.2025.2051131.1811","DOIUrl":"10.22074/ijfs.2025.2051131.1811","url":null,"abstract":"<p><strong>Background: </strong>Infertility affects approximately 50 million couples worldwide, with both men and women being equally affected. Male infertility is a complex issue with genetic factors playing a significant role. Conditions such as Klinefelter syndrome (XXY), Y chromosome microdeletions (YCMDs), and monogenic mutations can contribute to male infertility. Currently, hereditary factors account for 4% of male infertility cases, while the causes of 60-70% of cases remain unknown. Ongoing research aims to identify new genes and variants related to male fertility to improve diagnostic methods. More than 2000 genes are believed to be involved in preserving germ cells and ensuring normal meiosis, with more than 100 genes already identified for male infertility.</p><p><strong>Materials and methods: </strong>In this case series study, we assessed a patient with unexplained male infertility, who also had a brother with a similar issue. We used whole exome sequencing (WES) technology, segregation analysis and analyzed the data through bioinformatics tools.</p><p><strong>Results: </strong>Bioinformatics analysis and Sanger sequencing revealed that two infertile brothers had a compound heterozygous (CH) mutation with missense variants in dynein axonemal heavy chain 5 (DNAH5) gene: one variant in exon 9, (c.1121T>C: p.Ile374Thr), and another in exon 66, (c.11437C>T: p.Arg3813Trp). The protein structure analysis showed that the Ile374Thr variant is located near the outer dynein arm-docking subunit 1 (ODA-D1) and ODA-D3. Additionally, the Arg3813Trp variant replaces the positively charged arginine with a hydrophobic tryptophan residue, which may lead to local instability in the protein structure, particularly in the ATP-binding site.</p><p><strong>Conclusion: </strong>Our study reports a CH presence of a missense variant in DNAH5 within a family experiencing male infertility. In silico structural predictions suggest a potential role of these DNAH5 variants in causing fertility issues.</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 2","pages":"159-168"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding Challenges and Determinants among Mothers withGestational Diabetes: A Systematic Review.","authors":"Soltan Asghari, Nahid Jahani Shoorab, Samira Shahbazzadegan, Talat Khadivzadeh","doi":"10.22074/ijfs.2025.2029123.1686","DOIUrl":"10.22074/ijfs.2025.2029123.1686","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of gestational diabetes has increased in parallel with risk factors such as obesity, a family history of diabetes, and advanced maternal age. Studies suggest that gestational diabetes may negatively affect breastfeeding outcomes. This systematic review aimed to investigate the relationship between gestational diabetes and breastfeeding, as well as the contributing factors influencing breastfeeding among affected women.</p><p><strong>Materials and methods: </strong>Articles published up to January 2023, with an update through 2025, were included. A comprehensive search was conducted across databases including Medline, PubMed, Scopus, and others, using relevant keywords such as gestational diabetes, breastfeeding, blood sugar, misconception, cultural factors, and predisposing factors. Quantitative studies were assessed using the STROBE checklist, and qualitative studies were evaluated using the CASP tool. Key challenges identified include delayed onset of lactogenesis, misconceptions regarding diabetes transmission, and insufficient support.</p><p><strong>Results: </strong>A total of 19 studies (16 quantitative and 3 qualitative) were included. Analysis revealed several trends: ten quantitative studies reported a reduction in exclusive breastfeeding duration; three indicated lower breastfeeding rates at hospital discharge; and three studies identified difficulties in breastfeeding initiation and continuation. Notably, three studies found similar breastfeeding continuation rates between mothers with gestational diabetes and healthy controls. Factors associated with reduced breastfeeding included maternal obesity, cesarean delivery, prematurity, advanced maternal age, racial disparities, insulin treatment, limited knowledge about complementary feeding, misconceptions about exclusive breastfeeding, and concerns over diabetes transmission through breast milk.</p><p><strong>Conclusion: </strong>Addressing breastfeeding barriers among mothers with gestational diabetes requires targeted education, social support, and attention to professional challenges. Additional barriers included insufficient organizational resources, lack of hospital policies supporting breastfeeding, inadequate post-discharge support, and poor coordination with other healthcare facilities. Strengthening post-discharge support and inter-facility collaboration is essential. Future longitudinal and qualitative research should integrate cultural and psychosocial dimensions into evidence-based practices.</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 2","pages":"96-114"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Depression and Anxiety Symptoms between Husbandsof Women with High-Risk and Low-Risk Pregnancies: A Case-Control Study.","authors":"Azita Ghanbarpour, Hossein Soltani, Zahra Geraili, Seyyedeh Mahboubeh Mirtabar, Hajar Adib-Rad, Mahbobeh Faramarzi","doi":"10.22074/ijfs.2025.2047264.1790","DOIUrl":"10.22074/ijfs.2025.2047264.1790","url":null,"abstract":"<p><strong>Background: </strong>High-risk pregnancies, due to the need for special care and medical risks, can lead to increased stress, anxiety, and even depression in the spouses of pregnant women. This study aimed to compare symptoms of depression and anxiety in the spouses of women with high-risk and low-risk pregnancies.</p><p><strong>Materials and methods: </strong>This case-control study was conducted using a case-control design. The study population included the spouses of women with high-risk and low-risk pregnancies who entered in the Babol Pregnancy Mental Health Registry. A purposeful sampling method was used, with 160 participants (80 in each group) selected for the study. Two groups were matched for age, education, job, and history of having psychiatric disorders. Data were collected using a demographic questionnaire and the Brief Symptom Index (BSI-18), and data analysis was performed using independent t tests and multivariate logistic regression.</p><p><strong>Results: </strong>The frequency of depression (66.3 vs. 51.2%), anxiety (65.0 vs. 33.8%), and psychological distress (48.8 vs. 31.3%) was significantly higher in the spouses of women with high-risk pregnancies compared to those with low-risk pregnancies. Logistic regression analysis revealed that the factors of high-risk pregnancy (B=0.195, 95% confidence interval (Cl)=[0.300-3.142], P=0.018) and a history of previous high-risk pregnancies (B=0.214, 95% Cl=[0.559-4.107], P=0.010) were significant predictors of depression in the spouses of women with high-risk pregnancies. Additionally, educational level (B=-0.185, 95% Cl=[0.258-3.278], P=0.022) and high-risk pregnancy status (B=0.293, 95% Cl=[1.295-4.240], P<0.001) were identified as predictors of anxiety in the spouses.</p><p><strong>Conclusion: </strong>High-risk pregnancy may be an important factor in the increased prevalence of depression and anxiety in spouses of pregnant women. These findings emphasize the importance of providing supportive interventions and psychological counseling for spouses alongside pregnant women with high-risk pregnancies.</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 2","pages":"147-153"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lean Polycystic Ovarian Syndrome Has Better Responses toRecombinant Follicle-Stimulating Hormone Compared to ObesePCOS during Ovarian Stimulation for <i>In Vitro</i> Fertilization:A Cross-Sectional Study.","authors":"Radan Muharam, Yuannita Ika Putri, Muhammad Ikhsan, Edward Christopher Yo, Alisha Nurdya Irzanti, Achmad Kemal Harzif, Mila Maidarti, Budi Wiweko, Andon Hestiantoro, Eva Suarthana, Togas Tulandi","doi":"10.22074/ijfs.2025.2023851.1632","DOIUrl":"10.22074/ijfs.2025.2023851.1632","url":null,"abstract":"<p><strong>Background: </strong>Obese or lean patients with polycystic ovarian syndrome (PCOS) may respond differently to <i>in vitro</i> fertilization (IVF) treatment. The purpose of our study was to compare ovarian response as well as IVF outcomes in lean and obese PCOS patients. The evaluation specifically focused on the utilization of recombinant follicle-stimulating hormone (rFSH) for ovarian stimulation.</p><p><strong>Materials and methods: </strong>This cross-sectional study recruited patients diagnosed with PCOS (according to Rotterdam criteria) undergoing IVF utilizing the gonadotropin-releasing hormone (GnRH) antagonist combined with rFSH protocol. The PCOS patients were grouped into lean PCOS [body mass index (BMI) < 23 kg/m²] and obese PCOS (BMI > 25 kg/m²). Data were obtained from our comprehensive database. This study included a total of 226 women diagnosed with PCOS, who underwent IVF between 2013 and 2023 at our fertility clinics. Women with alternative reproductive endocrinology disorders, frozen embryo cycles, canceled cycles, or those who failed to follow-up were excluded. Each of the lean and obese PCOS groups had 113 patients.</p><p><strong>Results: </strong>The mean age of the subjects was 32.7 ± 3.6 years. We found significant differences between the two groups in terms of the anti-müllerian hormone (AMH) levels (P=0.005), the initial dosage of rFSH (P<0.001), and cumulative doses of rFSH administered (P<0.001). However, the number of retrieved oocytes, endometrial thickness, cleavage rate, and pregnancy rates were comparable. Compared to the obese PCOS patients, the lean patients had higher AMH levels (8.80 vs. 6.85 ng/mL) and lower total dosages of rFSH (2128 ± 586 vs. 2752 ± 1136 IU).</p><p><strong>Conclusion: </strong>Individuals within the lean PCOS group exhibited elevated AMH levels and demonstrated a more favorable response to rFSH stimulation. Consequently, the lean PCOS group yielded more retrieved oocytes, while necessitating lower doses of rFSH stimulation compared to the obese PCOS group.</p>","PeriodicalId":14080,"journal":{"name":"International Journal of Fertility & Sterility","volume":"20 2","pages":"124-129"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}