Journal of Assisted Reproduction and Genetics最新文献

{"title":"Platelet-rich plasma hydrogel supports long-term germ cell maintenance in rat testicular organotypic culture.","authors":"Nilgün Öksel, Merve Bulut Özer, İlayda Yücel, Muzaffer Katar","doi":"10.1007/s10815-026-03936-9","DOIUrl":"10.1007/s10815-026-03936-9","url":null,"abstract":"<p><strong>Purpose: </strong>Fertility preservation has become an important clinical concern for prepubertal boys undergoing gonadotoxic cancer treatments. Preservation of germ cells within immature testicular tissue is therefore considered a promising strategy for future fertility restoration. The purpose of this study was to evaluate the effects of platelet-rich plasma (PRP), used as a culture medium supplement and/or as a hydrogel scaffold, on germ cell survival and spermatogenic progression in a three-dimensional rat testicular organotypic culture system and to explore its potential relevance for fertility preservation approaches.</p><p><strong>Methods: </strong>Testicular tissue fragments obtained from postnatal day 7-9 Wistar albino rats were cultured using an air-liquid interface organotypic culture system on agarose blocks. PRP was incorporated either as a hydrogel scaffold supporting the tissue fragments or as a soluble supplement in the culture medium. Cultures were maintained for 8 weeks, and samples were collected at weeks 1, 3, 4, 6, and 8. Spermatogenic progression was evaluated using histomorphometric and immunohistochemical analyses.</p><p><strong>Results: </strong>SCP3( +) spermatocytes were better preserved in PRP hydrogel-supported cultures, with persistence observed up to week 8 only in this group. In addition, PLZF( +) undifferentiated spermatogonia remained detectable at week 8 in PRP hydrogel cultures, indicating improved preservation of the spermatogonial population. In vitro spermatogenesis progressed up to the spermatocyte stage in all experimental conditions, whereas differentiation into round spermatids was not observed.</p><p><strong>Conclusions: </strong>This organotypic culture approach may support germ cell maintenance during long-term culture and may contribute to the development of future fertility preservation strategies.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2593-2604"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Extended ovarian stimulation\": a prolonged ovarian exposure to gonadotrophins leads to an increase in the oocyte yield-evidence from the DuoStim experience.","authors":"Antonio La Marca, Martina Capuzzo","doi":"10.1007/s10815-026-03922-1","DOIUrl":"10.1007/s10815-026-03922-1","url":null,"abstract":"<p><p>The recent better understanding of folliculogenesis throughout the ovarian cycle (the \"continuous/waves\" theory), as well as the improvement of embryo survival rates after vitrification (which permits untangling the timing of embryo transfer from ovarian stimulation and oocyte yield) has permitted to elevate ovarian stimulation from the old classic single stimulation starting in the early follicular phase to novel strategies of ovarian stimulation, such as random start, luteal phase, and double ovarian stimulation. The role of FSH in follicular recruitment and growth is well known and is the cornerstone of ovarian stimulation. Prolonged exposure to FSH, as it happens in the double stimulation protocol, may lead to a potential increase in the number of oocytes obtainable after the second stimulation. A very high number of studies on DuoStim showed a greater number of oocytes retrieved, expressed as cumulus-oocyte complexes (COCs) or mature oocytes (MIIs), in the second ovarian stimulation rather than the first ovarian stimulation. This was particularly significant when a GnRH agonist was used to trigger the ovulation. Different hypotheses can be formulated to explain this eventuality including increased synchronization of antral follicles at the time of the second stimulation, enhanced granulosa cell sensitivity to FSH, the flare-up effect of the GnRH agonist at the time of the first triggering, and an increased rate of progression of small follicles to the antral recruitable stage as a consequence of the prolonged exposure to gonadotropins. The evidence that repeated back-to-back ovarian stimulations could lead to a progressive increase in the number of oocytes retrieved reported in our review opens the way to the consideration of innovative stimulation protocols based on this new concept of \"Extended ovarian stimulation.\" If future prospective studies designed on purpose will confirm our thesis that the prolonged FSH stimulation would involve a clear gain in the number of oocytes retrieved, this strategy could become the first therapeutic choice when the goal is to maximize the oocyte yield.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2341-2349"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of prior hormonal intrauterine device (IUD) use on endometrial lining thickness in the fertility clinic setting: a retrospective cohort study.","authors":"Esther Chung, Fiona Wang, Jiaqi Zhang, Michael Strug, Lusine Aghajanova, Ruth Lathi","doi":"10.1007/s10815-026-03950-x","DOIUrl":"10.1007/s10815-026-03950-x","url":null,"abstract":"<p><strong>Purpose: </strong>Despite wide-spread use of intrauterine devices (IUDs), research on an IUD's long-term impact on endometrial growth and function is limited. Endometrial atrophy is a known mechanistic action of hormonal IUDs, and characterizing its reversibility is critical. Our study compared endometrial lining thickness (EMT) in patients undergoing fertility treatment with and without prior hormonal IUD use.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 163 patients aged 18-45, each with at least 1 treatment cycle with ultrasound monitoring at a single academic institution between 2018 and 2023. Patients with prior hormonal IUD use (n = 72) were compared with patients without prior IUD exposure (n = 91). Primary outcomes included mid-cycle endometrial thickness (EMT) in the first monitored cycle, thin lining (< 7 mm), and persistently thin lining (< 7 mm in ≥ 2 cycles). Secondary outcomes included trilaminar endometrial pattern. Multivariable regression models adjusted for age, BMI, parity, infertility diagnosis, uterine pathology, history of uterine procedures, miscarriage history, and treatment protocol type. Exploratory analyses evaluated duration of hormonal IUD exposure.</p><p><strong>Results: </strong>Median EMT in the first monitored cycle was significantly lower among patients with prior hormonal IUD exposure compared with patients without prior IUD exposure (6.70 mm vs 8.60 mm, p < 0.001). Thin endometrium in the first cycle occurred in 63% of HORMONAL IUD users versus 16% of controls (RR 3.79, 95% CI 2.31-6.23, p < 0.001). Among patients with multiple cycles, persistently thin lining occurred in 64% of hormonal IUD users versus 10% of controls (RR 6.32, 95% CI 3.05-13.13, p < 0.001). In multivariable analyses, prior hormonal IUD exposure remained associated with thinner EMT in the first cycle (adjusted mean difference - 1.9 mm, 95% CI - 2.6 to - 1.2, p < 0.01) and increased risk of thin lining (adjusted RR 4.09, p < 0.01). Cycle-level analyses similarly demonstrated thinner endometrium and higher rates of thin lining among hormonal IUD users after adjustment for treatment protocol type. Longer duration of hormonal IUD use was not significantly associated with greater risk of thin lining.</p><p><strong>Conclusions: </strong>Prior hormonal IUD use was significantly associated with thinner EMT in patients undergoing fertility treatment. While thinner lining after IUD use is concerning in this specific population, future prospective studies are needed to evaluate the clinically relevant outcomes of live birth.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2473-2483"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embryonic mosaicism in severe male factor infertility is unrelated to sperm retrieval technique.","authors":"Tamar Alkon, Carlos Hernandez-Nieto, Joseph Lee, Morgan Baird, Natan Bar-Chama, Martha Luna, Alan Copperman, Erkan Buyuk","doi":"10.1007/s10815-026-03968-1","DOIUrl":"10.1007/s10815-026-03968-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association between the method of sperm retrieval (ejaculated versus testicular sperm) and embryonic mosaicism in infertile couples with severe male factor infertility undergoing in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A).</p><p><strong>Methods: </strong>This retrospective study analyzed 298 patients with severe male factor infertility undergoing IVF with PGT-A from 2019 to 2025. Patients were divided into two groups based on sperm source: ejaculated sperm (n = 229) and testicular sperm obtained via testicular sperm extraction (TESE) (n = 69). All cycles used fresh sperm collected on the day of oocyte retrieval. The primary outcome was the rate of embryonic mosaicism among biopsied blastocysts. Secondary outcomes included euploidy, aneuploidy, mosaicism level, inconclusive embryo count, clinical pregnancy and live birth rates.</p><p><strong>Results: </strong>A total of 1124 embryos were biopsied (250 from testicular sperm extraction; 874 from ejaculate). Mosaicism rates were similar between testicular and ejaculated sperm groups (9.6% vs. 9.4%, p = 0.62). Sperm retrieval method was not associated with mosaicism (OR 0.98, CI 0.61-1.58), euploidy (OR 0.90, CI 0.70-1.08), or aneuploidy (OR 0.89, CI 0.60-1.06). High- and low-level mosaicism were also comparable between groups (OR 0.96, CI 0.75-1.18 and OR 0.99, CI 0.81-1.22). No differences were observed in clinical pregnancy and live birth rates among cohorts.</p><p><strong>Conclusions: </strong>Sperm retrieval technique does not influence embryonic mosaicism rates in patients with severe male factor infertility. These findings support patient counseling by indicating that invasive procedures should not be pursued solely for the purpose of reducing mosaicism rates.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2515-2523"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural and functional characterization of DNAH5 variants in a Portuguese family with primary ciliary dyskinesia.","authors":"Leonor Roseta, Maria João Oliveira, Eduarda Tinoco, Edite Ferreira, Inês Sanches, Regina Monteiro, Ivone Pascoal, Joana Saranago, Telma Oliveira, Rute Pereira, Jorge Oliveira, Luís Gales, João Freixo, Rosália Sá, Mário Sousa","doi":"10.1007/s10815-026-03930-1","DOIUrl":"10.1007/s10815-026-03930-1","url":null,"abstract":"<p><strong>Purpose: </strong>Primary ciliary dyskinesia (PCD) is a rare genetic heterogeneous disorder mainly characterized by impaired mucociliar clearance and chronic respiratory symptoms. Although DNAH5 is commonly implicated in PCD, several DNAH5 variants remain unclassified.</p><p><strong>Methods: </strong>The proband was studied by high-speed videomicroscopy, transmission electron microscopy, whole exome sequencing and immunofluorescence. Protein structural analysis was performed through structural models obtained by X-ray crystallography and cryo-electron microscopy. The family was studied by Sanger sequencing of the variants, high-speed videomicroscopy and immunofluorescence.</p><p><strong>Results: </strong>The patient carry, in heterozygosity, the DNAH5 c.5290 T > C p.(Ser1764Pro) missense variant of uncertain significance and the pathogenic truncated variant DNAH5 c.4237C > T p.(Gln1413*). He was clinically diagnosed in adulthood with PCD, confirmed following nasal nitric oxide measurement, high-speed videomicroscopy and transmission electron microscopy, all of which revealed hallmark PCD defects, with decreased nasal nitric oxide levels (30 nl/min) and ciliary beating frequency (0.66 Hz), a dyskinetic ciliary beating pattern (62.5% total immotility) and a class-1 ultrastructure. Immunofluorescence analysis demonstrated reduced DNAH5 expression, and protein structural models predicted that the variant of uncertain significance causes an unstable protein. Family analyses confirmed a trans-inheritance and uncovered a brother with a similar PCD phenotype, the same two variants and similar reduced DNAH5 expression.</p><p><strong>Conclusions: </strong>Results support a pathogenic role for the c.5290 T > C p.(Ser1764Pro) variant and elucidate the effects of the other variant. These results underscore the importance of integrating clinical, ultrastructural, molecular and protein expression analyses to clarify and contribute to PCD diagnosis, besides now serving as potential markers for diagnostics and targeted therapies.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2641-2657"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should posthumously retrieved mammalian spermatozoa be evaluated via interspecific ICSI?","authors":"Kristyna Vackova, Jana Rychtarova, Helena Fulka, Josef Fulka","doi":"10.1007/s10815-026-03970-7","DOIUrl":"10.1007/s10815-026-03970-7","url":null,"abstract":"<p><p>There are circumstances in which mammalian spermatozoa are collected and/or long-term stored under suboptimal conditions, such as during posthumous sperm retrieval. As a consequence, the sperm can exhibit lower motility, be completely immotile, or have membranes that are more or less severely damaged. With the advent of ICSI (intracytoplasmic sperm injection), either the entire sperm or only the sperm head (e.g., in the mouse) can be directly injected into a mature oocyte, thereby making motility a less critical parameter. However, if sperm were collected and stored under suboptimal conditions, blind sperm injection into oocytes seems risky, especially when oocytes are also scarce, as in the case of endangered animals. The same applies to humans, where safety and ethical considerations are primary concerns. If such sperm are intended for reproductive purposes, DNA quality and integrity should be routinely evaluated, as they are among the most important factors for embryo viability. Although there are several standard tests to assess sperm quality, they may not be sufficient when working with to a certain extent compromised samples. Here, we discuss whether, in these specialized cases, interspecific ICSI could help expand the range of tests available to assess sperm normality.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2525-2529"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel mutations in NLRP2 and NLRP7 cause early embryonic arrest and female infertility.","authors":"Ruyi Liu, Shuwen Qiu, Menghui Li, Jian Mu, Qing Sang, Yong Fan, Mingru Yin, Tiantian Wang, Meng Ma, Jie Zhang, Ling Wu","doi":"10.1007/s10815-026-03959-2","DOIUrl":"10.1007/s10815-026-03959-2","url":null,"abstract":"<p><strong>Purpose: </strong>Early embryonic arrest is one of the reasons for the recurrent IVF/ICSI failures. We aimed to identify pathogenic mutations in female infertility patients with early embryonic arrest.</p><p><strong>Methods: </strong>Whole-exome sequencing was performed in the affected patients. Sanger sequencing was used on patients and their families to confirm the identified mutations. Wild-type and mutant plasmids were constructed and transfected into HeLa cells to investigate the functional effect of the identified mutations.</p><p><strong>Results: </strong>We identified three novel homozygous mutations of NLRP2 (p.Arg81*, p.Lys312del, and p.Val316Ala) and compound heterozygous mutations with a novel frameshift mutation and a novel missense mutation of NLRP7 (p.Gln315Arg fs*5 and p.Ile830Thr) in the affected individuals with early embryonic arrest. Western blot in HeLa cells showed the mutations caused a significant decrease in NLRP2 and NLRP7 to a varying degree, which impaired the stability of the proteins. Immunofluorescent staining showed some mutations altered the localization of NLRP2 and NLRP7.</p><p><strong>Conclusion: </strong>This study identified novel mutations in NLRP2 and NLRP7, expanding the mutational and phenotypic spectrum of NLRP2 and NLRP7. Our findings also establish the foundation for genetic diagnosis in recurrent IVF/ICSI failure patients with early embryonic arrest.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2679-2688"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond obstructive azoospermia: emerging insights into reproductive health in men with cystic fibrosis.","authors":"Andrea Crafa, Aldo E Calogero, Sarah C Vij, Rossella Cannarella","doi":"10.1007/s10815-026-03896-0","DOIUrl":"10.1007/s10815-026-03896-0","url":null,"abstract":"<p><p>Cystic fibrosis (CF) is a genetic disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene and is classically associated with male infertility due to obstructive azoospermia secondary to congenital bilateral absence of the vas deferens. Increasing evidence suggests that CFTR dysfunction may also contribute to nonobstructive forms of male infertility. Accordingly, CFTR is widely expressed throughout the male reproductive tract, including Sertoli cells, germ cells, and mature spermatozoa. This review summarizes current evidence linking CFTR mutations and variants to hypogonadism, impaired spermatogenesis, altered sperm function, and reduced reproductive outcomes. Clinical studies indicate a high prevalence of testosterone deficiency in men with CF or CBAVD, often occurring in the presence of normal gonadotropin levels. Genetic and meta-analytic data support an association between CFTR variants, particularly the IVS8-5 T polymorphism, and nonobstructive azoospermia. Experimental studies further demonstrate that CFTR plays a critical role in spermatogenesis via regulation of the cAMP-CREB signaling pathway in Sertoli cells and through modulation of microRNA expression affecting germ cell proliferation. CFTR expression in spermatozoa is also implicated in capacitation, motility, and fertilizing capacity through coordinated chloride and bicarbonate transport and interactions with SLC26 family members. Emerging evidence additionally suggests a role for CFTR in early embryonic development, with potential implications for assisted reproductive technology outcomes. Collectively, these findings challenge the traditional view of CF-related male infertility as purely obstructive and highlight CFTR mutations as a potential contributor to nonobstructive infertility. Further studies are required to clarify pathogenic mechanisms and explore targeted therapeutic strategies.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2307-2314"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking supply chain disruption: a practical resilience framework for IVF laboratory quality management.","authors":"Fadi Choucair, Abdulla Almohammadi, Rawan Alhamarneh, Johnny A Awwad, Johnny T Awwad","doi":"10.1007/s10815-026-03955-6","DOIUrl":"10.1007/s10815-026-03955-6","url":null,"abstract":"","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2469-2471"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Another round, another chance: oocyte developmental competence and outcomes in second IVF attempts-the earlier, the better.","authors":"Alessandro Ruffa, Danilo Cimadomo, Marilena Taggi, Federica Innocenti, Erika Pittana, Federica Battista, Gemma Fabozzi, Michele Morelli, Maurizio Guido, Laura Albricci, Giulia Fiorentino, Laura Rienzi, Filippo Maria Ubaldi, Alberto Vaiarelli","doi":"10.1007/s10815-026-03961-8","DOIUrl":"10.1007/s10815-026-03961-8","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether the outcomes and characteristics of a first IVF/ICSI cycle are associated with embryological and clinical outcomes in a subsequent cycle performed within 2 years.</p><p><strong>Methods: </strong>This retrospective single-center observational study included 1190 couples undergoing two stimulated ICSI cycles with planned blastocyst culture between 2015 and 2020. Associations between first- and second-cycle outcomes were analyzed, including oocyte yield, blastocyst development, and live birth. The effect of the inter-cycle interval was assessed using multivariate models.</p><p><strong>Results: </strong>The mean maternal age was 38.7 years, and the mean AMH level was 1.7 ng/ml. Second cycles showed improved embryological outcomes, including higher numbers of retrieved cumulus-oocyte complexes (COCs), increased blastocyst yield, and higher blastocyst rate per COC. Overall, 50% of patients retrieved more COCs in the second cycle, and 87% of those with no COCs in the first cycle obtained ≥ 1 in the second. A longer inter-cycle interval was negatively associated with outcomes, reducing the likelihood of retrieving more COCs (OR 0.96 per month, 95% CI 0.93-0.98), obtaining more blastocysts (OR 0.95, 95% CI 0.93-0.98), and improving blastocyst rate (OR 0.96, 95% CI 0.94-0.99). First-cycle outcomes were not associated with live birth probability in the second cycle, which was instead associated with maternal age and the number of COCs previously retrieved.</p><p><strong>Conclusions: </strong>First-cycle outcomes should not discourage further attempts, as subsequent cycles may yield improved embryological results. A shorter interval between cycles represents a modifiable factor associated with better outcomes. These findings support early re-treatment and a multicycle counseling approach to optimize cumulative live birth rates, especially as maternal age and ovarian reserve remain the most important predictors of success even in second attempts.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"2443-2455"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}