Journal of Assisted Reproduction and Genetics最新文献

{"title":"Fertility care in the age of algorithms: opportunities and risks of AI and social media integration in reproductive medicine.","authors":"Tommy Wondrasek, Elizabeth Boucher, Jennifer Dundee, Jessica Ryniec, Navid Esfandiari","doi":"10.1007/s10815-026-03883-5","DOIUrl":"https://doi.org/10.1007/s10815-026-03883-5","url":null,"abstract":"<p><p>Media representations have long influenced public understandings of infertility and assisted reproductive technologies (ART), with traditional media frequently relying on moralized or sensational narratives that reinforce stigma and oversimplification. The rise of social media and artificial intelligence (AI) has reshaped reproductive health communication, allowing patients to share lived experiences, build community, and access information outside clinical settings, while also increasing exposure to misinformation. This review synthesizes peer-reviewed research, clinical commentary, and digital media analyses to examine infertility narratives, online patient engagement, and AI-driven information dissemination. Findings indicate that social media has expanded patient agency and reduced isolation, but AI-generated content and influencer marketing contribute to the rapid spread of inaccurate or misleading fertility information. Despite these risks, digital platforms offer significant opportunities for evidence-based education and empathetic engagement. Clinicians who thoughtfully engage with social media and AI can counter misinformation, direct patients to trustworthy resources, and strengthen patient-physician relationships. When used responsibly, these tools can enhance communication and promote more informed, compassionate infertility care.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current state of the art in the transmission of mitochondrial DNA pathogenic variants: reviewing preventive-therapeutic alternatives.","authors":"Marta Reguera-Cabezas, Felipe Martínez-Pastor, Cristina Soriano-Úbeda","doi":"10.1007/s10815-026-03888-0","DOIUrl":"https://doi.org/10.1007/s10815-026-03888-0","url":null,"abstract":"<p><p>This review analyzes strategies to prevent or reduce the transmission of diseases caused by pathogenic variants in mitochondrial DNA (mtDNA). Among these, we will focus on prenatal screening, preimplantation genetic testing, gene-editing techniques, other molecular tools, and selected heterologous mitochondrial replacement techniques (MRTs), explaining their status and the uncertainties surrounding their clinical application. After this analysis and review, we recognise the limitations of the efficacy of prenatal and preimplantation genetic testing for mitochondrial DNA pathogenic variants, the legal constraints on gene editing, and the status of mitochondrial replacement techniques. MRTs are a safe and possibly more effective alternative for preventing diseases caused by mitochondrial DNA pathogenic variants.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating preconception carrier screening into public health: lessons learned from a pilot implementation study.","authors":"Aina Marsal-Olivan, Clara Serra-Juhe, Alicia Artigas-Baleri, Sara Bernal, Ivon Cusco, Anna Abulí, Carlos Brotons, Benjamín Rodríguez-Santiago, Jordi Surralles","doi":"10.1007/s10815-026-03871-9","DOIUrl":"https://doi.org/10.1007/s10815-026-03871-9","url":null,"abstract":"<p><strong>Purpose: </strong>Carrier screening identifies individuals at risk of transmitting autosomal recessive or X-linked recessive conditions, supporting informed reproductive decisions. Despite international recommendations for universal carrier screening, integration into public healthcare systems remains limited. This study evaluated the feasibility of implementing a carrier screening program in Spain's public health system.</p><p><strong>Methods: </strong>Non-pregnant women aged 18 to 38 with reproductive intent were recruited through text messages sent from a primary care center, along with their partners. A sequential screening approach was used: women underwent a 351-gene massively parallel sequencing panel and complementary tests, while male partners were tested only if their partner carried autosomal recessive variants. Specific genetic counselling was provided, and emotional responses were assessed through pre- and post-test questionnaires.</p><p><strong>Results: </strong>Of 518 candidates contacted, 400 (77%) responded positively and 152 couples (50.8% of those eligible) enrolled. Among 218 individuals screened, 62% (135) carried at least one pathogenic variant. Six carrier couples (4%) were identified as being at reproductive risk of non-syndromic hearing loss (GJB2, 2 couples), cystic fibrosis (CFTR), Stargardt disease and retinitis pigmentosa (ABCA4), Smith-Lemli-Opitz syndrome (DHCR7), and Fabry disease (GLA). Of four couples followed post-disclosure, 75% opted for in vitro fertilization with preimplantation genetic testing or prenatal diagnosis. Prevention of severe genetic conditions was the most frequently reported motivation for participation.</p><p><strong>Conclusions: </strong>This study proves the feasibility and clinical utility of carrier screening within a public healthcare system. Our findings demonstrate high participation rates, clinical relevance through the identification of 4% of carrier couples, and strong motivation among participants to prevent the transmission of severe genetic conditions.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letrozole administration during ovarian stimulation: intrafollicular concentrations, effects on steroidogenesis and pregnancy outcome-a secondary analysis.","authors":"Elisabeth Minke Elfrink, Malene Louise Johannsen, Kenneth Munk Pedersen, Liv la Cour Poulsen, Mengxue Zheng, Marie Louise Grøndahl, Anders Hay-Schmidt, Bjarne Styrishave, Claus Yding Andersen","doi":"10.1007/s10815-026-03890-6","DOIUrl":"https://doi.org/10.1007/s10815-026-03890-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine intrafollicular concentrations of letrozole (LTZ) and key steroids in women undergoing ovarian stimulation (OS) with or without LTZ co-treatment, and to explore associated clinical outcomes.</p><p><strong>Methods: </strong>Follicular fluid (FF) collected at oocyte pickup from 30 women participating in the RIOT-B study, a randomized controlled trial comparing OS with recombinant FSH (150 IU/day) combined with either LTZ (5 mg/day; n = 15) or placebo (n = 15). Concentrations of LTZ and steroid were quantified by LC-MS/MS. Associations between FF composition and clinical outcomes were evaluated.</p><p><strong>Results: </strong>At oocyte pickup, mean FF LTZ concentration was 144 ± 12 nmol/L (nM) (range 51-270). FF 17β-estradiol (E₂) concentrations were similar between groups (≈900 nM), whereas testosterone, androstenedione, DHEA, and 17OH-progesterone (17OH-P₄) were markedly elevated in the LTZ group (p < 0.001-0.0001). In contrast, P₄ levels remained unchanged. Among LTZ-treated women, higher FF concentrations of LTZ and testosterone were significantly associated with failure to conceive. No relationship was observed between FF LTZ levels and BMI or gonadotropin dose.</p><p><strong>Conclusions: </strong>Intrafollicular estrogen levels remain preserved during LTZ administration, accompanied by pronounced androgen accumulation and elevated 17OH-P₄. These findings suggest complex, cell-specific effects of aromatase inhibition on follicular steroidogenesis and raise questions regarding the optimal dosing and mechanistic rationale for LTZ co-treatment in assisted reproduction.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of adolescents and young adults (AYA) attending for fertility counselling and oocyte cryopreservation prior to gonadotoxic treatment.","authors":"Niamh Fee, Niamh Joyce, Maebh Horan, Louise Glover, David Crosby","doi":"10.1007/s10815-026-03889-z","DOIUrl":"https://doi.org/10.1007/s10815-026-03889-z","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescents and young adults (AYA) who receive gonadotoxic treatment are at risk of future infertility. Fertility preservation is recommended to improve long-term quality of life, but outcomes are less well characterised in AYA than in adults. This study sought to analyse oocyte cryopreservation procedures, outcomes and ethical considerations, to improve counselling for AYA patients and their families.</p><p><strong>Methods: </strong>Single-centre, retrospective observational cohort study of AYA patients (14-25 years) referred for fertility counselling and oocyte vitrification prior to gonadotoxic treatment between July 2018 and July 2025.</p><p><strong>Results: </strong>Of 47 referrals received, 37 patients initiated ovarian stimulation, and 36 underwent oocyte cryopreservation. Oncological indications included haematological malignancy (43%), sarcoma (30%) and neurological (9%); benign conditions included aplastic anaemia (6%), neurofibromatosis (2%) and desmoid tumour (2%). The median age of patients who underwent ovarian stimulation was 16 years (range 13-24), with median AMH of 15 pmol/L (range 5.1-81.7 pmol/L). Ultrasound follicle tracking was performed transvaginally in 8/37 (21.6%) and transabdominally in 29/37 (78.4%); transvaginal oocyte collection was performed in 34/36 (94.4%) and laparoscopic in 2/36 (5.63%). Median number of oocytes cryopreserved was 11 (range 0-31), with oocyte maturity rate of 80.5% (range 50-100%).</p><p><strong>Conclusions: </strong>Fertility preservation in post-pubertal AYA patients is feasible, and transabdominal ultrasound monitoring can be used successfully where transvaginal monitoring is not appropriate. Multidisciplinary input is important to ensure fertility preservation can be performed safely, particularly for those with haematological malignancies. To enable clinicians to appropriately counsel young patients, follow-up studies of livebirth outcomes will be important in the long term.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective experimental randomized controlled trial to investigate the effect of virtual reality (VR) technology on improving clinical pregnancy rates and lowering anxiety for IVF patients undergoing frozen embryo transfer (FET).","authors":"Jak Ozsarfati, Samantha Yee, Michal Dviri, Lilach Marom Haham, Andie Blankenstein, Ayesha Noman, Avishai Gasner, Shruti Pathak, Shivani Dhanani, Lianet Lopez, Carly Keshen, Karen Glass, Prati Sharma, Ari Baratz, Andree Gauthier-Fisher, Clifford Librach","doi":"10.1007/s10815-026-03881-7","DOIUrl":"https://doi.org/10.1007/s10815-026-03881-7","url":null,"abstract":"<p><strong>Purpose: </strong>The objective was to study the effect of exposure to virtual reality (VR) on clinical pregnancy rate (CPR) and anxiety levels in patients undergoing frozen embryo transfer (FET), one of the most stressful stages of the in vitro fertilization (IVF) treatment journey.</p><p><strong>Methods: </strong>A single-site prospective experimental randomized controlled trial was conducted between 05/2019 and 05/2023. Three hundred fifty FET patients using their own oocytes, or donated oocytes/embryos (oocyte provider's aged 21-45) were enrolled and randomized in a 1:1 ratio to the VR and control groups. Clinical pregnancy rates (CPR) were assessed at 2, 6, and 12 weeks. Stress physiological parameters (heart rate, saliva samples, and systolic/diastolic blood pressure) and anxiety (STAI-State questionnaire) were assessed at baseline (T1), pre-FET (T2) and post-FET (T3). Patients were blinded to their group assignment at T1 and T2 measurements.</p><p><strong>Results: </strong>Pregnancy rates at 2 weeks were higher in the VR group than in the control group (52.6% vs. 44.6%, p = 0.134). The CPR increased significantly at 6 weeks (45.7% vs. 34.9%, p = 0.038) and 12 weeks (42.9% vs. 28.6%, p = 0.005) in the VR compared to the control group. In the multivariate logistic regression analyses, the total number of previous ovum pick-up, quality of the transferred embryo, and receiving VR exposure were the three significant predictors of increased CPR at 2, 6, and 12 weeks. Differences in the physiological stress parameters of all participants at three timepoints were found (p < 0.05) but did not differ between the two groups (p > 0.05). STAI-State anxiety scores among the VR group dropped much more substantially from T2 to T3 than in the control group (mean difference of 5.2 vs. 2.7, p = 0.026).</p><p><strong>Conclusion: </strong>The findings of this large-scale RCT suggest that one-time VR exposure before FET, along with other clinical factors such as the quality of transferred embryos, significantly increased CPR and decreased participants' stress and anxiety levels associated with the FET procedure.</p><p><strong>Trial registration: </strong>Clinical Trial Registry: Clinical Trials.gov.</p><p><strong>Trial registration number: </strong>NTC04394962 https://clinicaltrials.gov/study/NCT04394962 Registration Date: 2020-05-06. Date of Initial Enrollment: 2019-05-31.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking cytomegalovirus screening in gamete donation: a critical appraisal of practices and risks.","authors":"Louis-Philippe Coutu-Nadeau, Naomi Chevrier, Camille Sylvestre, Laurence Bissonnette, Christian Renaud, Elias M Dahdouh, Isabelle Boucoiran","doi":"10.1007/s10815-026-03878-2","DOIUrl":"https://doi.org/10.1007/s10815-026-03878-2","url":null,"abstract":"<p><p>In the context of gamete donation, cytomegalovirus (CMV) serological screening was originally implemented to mitigate concerns about viral transmission, particularly following the HIV epidemic. Although emerging evidence questions the reliability of serological markers in accurately reflecting the presence of the virus in genital secretions, current North American practices still heavily rely on CMV serological testing to identify sperm donors at risk of transmitting CMV during fertility treatments. This review explores the complexities of CMV transmission in assisted reproductive technologies (ART), underscoring the unpredictable nature of viral shedding in semen and the inherent limitations of relying solely on serostatus for risk assessment. Additionally, the available data suggest that the risk of congenital CMV (cCMV) following ART appears low, although significant gaps in the literature highlight the need for more comprehensive studies to better evaluate transmission risks. Finally, this review advocates for the revision of CMV screening societies' guidelines, emphasizing the need for broader, evidence-based preventive strategies. Preventing CMV risk in fertility treatments may include more significant action such as patient education on simple hygiene measures to prevent infection during pregnancy-instead of current, potentially unnecessary measures such as CMV serostatus matching.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining safety standards: a large-scale comparative analysis of bovine versus murine models for medical device embryotoxicity testing.","authors":"Raquel Romar, Jon Romero-Aguirregomezcorta, Maria Maroto, Alfonso Gutiérrez-Adán, Pilar Coy","doi":"10.1007/s10815-026-03891-5","DOIUrl":"https://doi.org/10.1007/s10815-026-03891-5","url":null,"abstract":"<p><strong>Purpose: </strong>To overcome the limited sensitivity of the standard mouse embryo assay (MEA) for embryotoxicity screening of assisted reproduction devices and to assess the bovine embryo assay (BEA) as a suitable alternative.</p><p><strong>Methods: </strong>In a large comparative laboratory study, sperm selection, fertilization, and embryo culture media from two suppliers (Vitrolife and Genea Biomedx, respectively) were used to generate bovine blastocysts from cumulus-oocyte complexes obtained from slaughterhouse ovaries and inseminated with frozen semen from the same bull (BEA). Bovine culture media were used for the control group. BEA assessed the following in the three groups: cleavage; blastocyst development and kinetics; post-warming re-expansion/hatching; total cell number; inner cell mass (ICM) and trophectoderm (TE) allocation; and ICM/TE ratio. In parallel, the culture media from both suppliers were tested using mouse cumulus-oocyte complexes that had been inseminated with epididymal sperm (IVF-MEA) and in vivo-derived one-cell embryos (standard MEA).</p><p><strong>Results: </strong>BEA detected differences consistent with reduced developmental competence and embryo quality across 4118 bovine oocytes (≥ 4 independent cycles; ≥ 50 oocytes/group). Sperm selection media performed similarly. Regarding fertilization media, the bovine control yielded higher day 8 blastocyst rates than Vitrolife (P < 0.005), while Genea Biomedx exhibited superior blastocyst quality indicators than Vitrolife (P < 0.05). For embryo culture media, the bovine control outperformed Genea Biomedx, with Vitrolife performing intermediately (P < 0.05). Multiple kinetic, hatching, first lineage allocation and survival endpoints were reduced for Genea Biomedx (P < 0.05). Standard MEA found no significant differences, whereas IVF-MEA (1028 oocytes) detected a difference in day 4 blastocyst yield only.</p><p><strong>Conclusion: </strong>BEA revealed functional and quality differences between media not detected by mouse assays, supporting BEA to strengthen safety assessment while reducing animal sacrifice.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An injection-lite approach to ovarian stimulation in poor responder patients using corifollitropin alfa and nasal GnRH agonist.","authors":"K Arulpragasam, D Lieberman, M O'Neil, P Sweeten, S Dalati, J E Shin, J Tan, S Choi, N Briggs, I Barcelos, W Ledger","doi":"10.1007/s10815-026-03872-8","DOIUrl":"https://doi.org/10.1007/s10815-026-03872-8","url":null,"abstract":"<p><strong>Objective: </strong>Can the unique pharmacokinetic and pharmacodynamic profiles of corifollitropin alfa (CFA) in combination with an intra-nasal GnRH agonist (CFA flare) provide adequate ovarian stimulation for poor-responder patients while minimising the burden of injections?</p><p><strong>Methods: </strong>Twenty women aged between 31 and 41 years of age who were identified as potential poor responders to ovarian stimulation according to the POSEIDON criteria and who were attending the Fertility and Research Centre, Royal Hospital for Women and City Fertility, Sydney for IVF treatment were randomised to receive either the flare or the antagonist cycle. Serum FSH, LH, and E2 concentrations were measured daily for 5 days post-initiation of CFA during the early follicular phase.</p><p><strong>Results: </strong>The number of injections given to women in the CFA flare arm (4) was significantly less than those in the CFA antagonist arm (11), (p = 0.001). Two days after the initiation of CFA, serum FSH concentrations were 27 versus 11 IU/L (flare versus antagonist) (p = 0.022), and mean serum E2 concentrations were 349 versus 157 pmol/L (p = 0.039), and on day 7, were 3000 versus 1850 pmol/L. The CFA flare stimulation protocol resulted in higher concentrations of FSH in the early period of follicular stimulation. There was an equivalent rise in serum E2 in both groups. The CFA flare protocol was non-inferior to the CFA antagonist protocol and may have been less burdensome to patients as fewer injections were needed.</p><p><strong>Conclusion: </strong>The CFA flare protocol is a novel alternative to conventional ovarian stimulation regimens that are used for 'poor responder' patients. It significantly reduces the patient burden, with less injections of FSH and no injections of GnRH antagonist. The ovarian response is similar to that achieved with a conventional GnRH antagonist cycle, but this requires further evaluation in a larger study.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shortened warming protocols preserve spindle integrity and mitochondrial mass less effectively than standard warming in autologous oocytes cryopreserved via standard vitrification.","authors":"Alessandro Bartolacci, Valentina Pavone, Teresa Vergara, Sofia de Girolamo, Elisa Giacomini, Stefania Esposito, Lucia De Santis, Giulia D'Alessandro, Manuela Ludovisi, Carla Tatone, Luca Pagliardini, Giovanna Di Emidio","doi":"10.1007/s10815-026-03884-4","DOIUrl":"https://doi.org/10.1007/s10815-026-03884-4","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the clinical applicability of shortened (SW) and ultra-shortened (USW) warming protocols for oocytes cryopreserved using standard vitrification (STD-V).</p><p><strong>Methods: </strong>This prospective sibling study included 436 mature human oocytes from 47 patients, all vitrified using a single standard vitrification (STD-V) protocol. Experiment 1 compared the standard warming (STD-W) with the SW protocols (2 min), and Experiment 2 compared the SW protocol with USW protocol (1 min). Oocyte survival rates were assessed 1.5 h post-warming, and oocytes were immediately fixed. The analysis of meiotic spindle organization and chromosome alignment was assessed by detailed examination of individual optical sections and corresponding full Z-stack projections encompassing the entire spindle. Mitochondrial mass was quantified from Z-stack-based projections integrating fluorescence across all optical sections. We also performed a pooled analysis to directly compare STD-W, SW, and USW groups.</p><p><strong>Results: </strong>Survival rates were comparable across protocols. Both SW and USW protocols were associated with significantly lower odds of normal chromosomal distribution, spindle organization, and normal MII apparatus compared with the STD-W protocol, with no significant differences between SW and USW. Spindle length and pole width were increased in SW and USW versus STD-W. Mitochondrial mass was significantly reduced in SW compared with STD-W.</p><p><strong>Conclusions: </strong>Although survival rates were comparable, our data indicate that SW and USW protocols are associated with a higher incidence of spindle and chromosomal abnormalities than the traditional approach. This may affect oocyte developmental competence, highlighting the need for further investigation regarding the clinical use of SW/USW protocols for STD-V-cryopreserved oocytes.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}