Journal of Ovarian Research最新文献

{"title":"Exploring the role of the NLRP3 Inflammasome in polycystic ovary syndrome: therapeutic potential of herbal medicines.","authors":"Shayan Vafaei, Reyhane Naghibzade, Ghazaleh Moshkdanian, Hossein Nikzad, Golnaz Shafiei, Mahna Mansoori","doi":"10.1186/s13048-026-02187-7","DOIUrl":"10.1186/s13048-026-02187-7","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine disorders in women during their reproductive years and is associated with a wide range of reproductive, metabolic, and psychological complications. This review aims to synthesize current knowledge regarding the complex pathophysiology of PCOS, focusing on the NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome's role in mediating inflammation and metabolic dysfunction. Additionally, we explore the therapeutic potential of herbal medicines in modulating the NLRP3 pathway, highlighting their multi-targeted mechanisms of action. The bioactive compounds derived from various medicinal plants may effectively regulate NLRP3 inflammasome activation, thereby alleviating the symptoms associated with PCOS. As PCOS continues to pose significant health challenges for women worldwide, this review emphasizes the necessity for innovative therapeutic strategies that integrate traditional knowledge with modern scientific approaches.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368744","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":"An organoid-guided platform for ovarian cancer: enabling prediction of patients' chemotherapy response.","authors":"Ling Wang, Misi He, Xueping Zhu, Lifang Ma, Lin Zhong, Qingxiu Jiang, Qiaoling Li, Hongji Wu, Haixia Wang, Dongling Zou","doi":"10.1186/s13048-026-02178-8","DOIUrl":"10.1186/s13048-026-02178-8","url":null,"abstract":"<p><strong>Background: </strong>Organoids represent a new platform for drug screening and personalized medicine. However, the difficulty of organoid construction limits their wide application.</p><p><strong>Methods: </strong>We collected 153 tumour samples from patients with epithelial ovarian tumours. The associations between patient characteristics and organoid generation were analysed via chi-square tests and Fisher's exact tests. Univariate and multivariate logistic regression analyses were performed to identify independent factors influencing organoid development. We conducted a drug screen on 20 organoids to predict the drug response of clinical patients retrospectively and prospectively.</p><p><strong>Results: </strong>One hundred fifty-three organoids were developed from 153 ovarian tumour patients, with a 57.52% success rate. Preoperative low CA153 levels (OR (95% CI): 3.44 (1.39, 9.00), P = 0.009) and high CA199 levels in patients (OR (95% CI): 0.20 (0.06, 0.57), P = 0.004) correlated with successful organoid generation, whereas other clinical features were not significantly correlated with ovarian tumour organoid generation. The subgroup analyses further showed that CA153 and CA199 were two independent factors influencing organoid construction. Ovarian cancer organoids can retain the pathological and genetic characteristics of the original tumour tissues. The PDOs were able to predict the prior clinical responses of these patients with an efficiency rate of 100%. The prospective prediction efficiency of PDOs was 80%.</p><p><strong>Conclusions: </strong>Preoperative CA153 and CA199 levels were found to be independent factors influencing ovarian tumour organoid generation. The drug responses of most PDOs to paclitaxel and carboplatin were consistent with the clinical treatment outcomes.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361075","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":"Bisphenol S fetal exposure in ewes exhibiting contrasted metabolic status impaired the ovarian follicular development of fetuses and lambs.","authors":"Ophélie Téteau, Marie-Emilie Lebachelier de la Riviere, Hans Adriaensen, Olivier Lasserre, Marlène Lacroix, Laetitia Corset, Peggy Jarrier-Gaillard, Pascal Papillier, Alice Desmarchais, Sandrine Freret, Virginie Maillard, Véronique Gayrard, Nicole Picard-Hagen, Sebastien Elis","doi":"10.1186/s13048-026-02182-y","DOIUrl":"10.1186/s13048-026-02182-y","url":null,"abstract":"<p><p>The size of the ovarian reserve, defined by the pool of primordial follicles, is established during fetal life in women and sheep. The prenatal period is a critical window of sensitivity, especially for ovarian development. Maternal metabolic status and nutrition during gestation can influence fetal programming, and affect the establishment of ovarian reserve. In addition, the developing fetus is particularly sensitive to endocrine disruptors. Bisphenol A (BPA), a plasticizer widely used in food packaging, has deleterious effects on fetal folliculogenesis. BPA has been banned from the food industry and has been replaced mainly by bisphenol S (BPS), whose effects on ovarian development remain poorly characterized.The objective of this study was to determine the effects of in utero exposure to BPS (50 µg/kg/day) on ovarian development in female fetuses, and lambs, using histology and/or magnetic resonance imaging (MRI). In addition, pregnant ewes exhibited contrasted metabolic status (lean versus fat), allowing assessment of the interaction between maternal nutrition and BPS exposure. This study was divided into two experiments. In the first, pregnant ewes received daily subcutaneous injection of BPS for 3 months, and fetal ovarian development was analyzed at 130 days of gestation. In the second, pregnant ewes were exposed daily to BPS through food for 3 months and female lambs were then monitored up to 4-month-old (pre-puberty). In offspring of fat mothers, the body weight of the fetuses increased but this increase was not observed anymore in lambs. Plasma anti-Mullerian hormone (AMH) concentrations decreased in 1-month-old lambs and the antral follicle number increased in both fetuses and 4-month-old lambs from well-fed mothers. In addition, a significant interaction between maternal metabolic status and gestational BPS exposure was reported for the numbers of primordial, intermediate and total follicles of fetuses, with a similar trend for pre-antral follicles. Such significant interaction was also reported for the number of intermediate follicles in 4-month-old lambs, with a similar tendency being reported for AMH concentration.In conclusion, maternal nutrition and gestational exposure to BPS had deleterious consequences on the body growth and ovarian follicular development in the offspring. In addition, BPS effects differ according to the maternal metabolic status. Thus, the maternal environment affected folliculogenesis in both fetuses and lambs. Further research is needed to determine whether these alterations have long-term deleterious effects on their reproductive function in adulthood.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352179","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":"Temporal deep learning for 28-day mortality prediction in critically ill ovarian cancer patients: a multicenter development and validation study using hourly vital signs.","authors":"Chengling Wang, Li Liu, Jianguo Hu, Xingshu Li, Xingchuan Li, Qikun Zhu, Liang Yang, Ke Pu, Renlan Li","doi":"10.1186/s13048-026-02174-y","DOIUrl":"10.1186/s13048-026-02174-y","url":null,"abstract":"<p><strong>Background: </strong>Ovarian cancer patients requiring intensive care unit (ICU) admission face particularly grave prognosis, yet current prognostic models rely on static baseline characteristics and generic severity scores, neglecting the rich temporal dynamics of vital signs that may better capture physiological deterioration patterns.</p><p><strong>Objectives: </strong>To develop and validate an interpretable Long Short-Term Memory (LSTM) neural network integrating hourly vital signs and static features for predicting 28-day mortality in ICU-admitted ovarian cancer patients.</p><p><strong>Methods: </strong>This retrospective multicenter study utilized MIMIC-IV (2008-2022) and SICdb (2013-2021) databases. Adult ovarian cancer patients with first ICU admission, length of stay ≥ 24 h, and complete hourly measurements of six vital signs (blood pressures, heart rate, respiratory rate, oxygen saturation) were included. MIMIC-IV was split into training (n = 269) and internal validation (n = 115) sets, while SICdb (n = 154) served as external validation. A dual-pathway LSTM network integrated temporal and static features (age, BMI, SOFA score). Model performance was assessed using AUROC, calibration metrics, and compared against traditional ICU scores and five static-only machine learning baselines. Five-fold cross-validation and 100 repeated temporal ablation trials assessed robustness. SHapley Additive exPlanations (SHAP) analysis quantified feature importance and temporal dynamics.</p><p><strong>Results: </strong>The LSTM model achieved AUROC of 0.845 (95%CI: 0.789-0.901) in training, 0.785 (95%CI: 0.655-0.915) in internal validation, and 0.767 (95%CI: 0.617-0.917) in external validation, significantly outperforming SOFA (AUC: 0.683-0.733), SAPS II (AUC: 0.743), SAPS 3 (AUC: 0.678), and OASIS (AUC: 0.659 - 0.569). Five-fold cross-validation confirmed stability (mean AUROC: 0.785 ± 0.018). Negative predictive values exceeded 94% across all cohorts. The LSTM achieved AUC improvements of 0.10-0.17 over static baselines, with repeated permutation trials confirming significant temporal contributions (all P < 0.001). Temporal ablation identified the 12-24 h window as most critical (ΔAUC = 0.062). SHAP analysis revealed static features dominated prediction, while respiratory rate and diastolic blood pressure were leading temporal contributors.</p><p><strong>Conclusions: </strong>This interpretable LSTM model accurately predicts mortality in ICU-admitted ovarian cancer patients by capturing temporal vital sign dynamics, significantly outperforming traditional severity scores and enabling personalized risk stratification for clinical decision-making.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352274","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":"Epigenetic safety of in vitro maturation in PCOS: genome-wide DNA methylation profiling of cord blood from a randomized controlled trial.","authors":"Wei Guo, Yi Yang, Meng Qin, Siming Kong, Linlin Wang, Xiaoying Zheng, Rui Yang, Shuo Yang, Xiumei Zhen, Xiaohui Zhu, Rong Li, Liying Yan, Jie Qiao, Zhiqiang Yan","doi":"10.1186/s13048-026-02179-7","DOIUrl":"10.1186/s13048-026-02179-7","url":null,"abstract":"<p><strong>Background: </strong>In vitro maturation (IVM) provides a safer alternative to conventional in vitro fertilization (IVF) for women with polycystic ovary syndrome (PCOS) by mitigating the risk of ovarian hyperstimulation. However, concerns persist regarding whether IVM perturbs epigenetic reprogramming in the offspring. Current evidence is constrained by candidate-gene approaches or a lack of parental controls. This study aimed to evaluate the genome-wide DNA methylation safety of IVM compared with conventional IVF using a rigorous trio-based design.</p><p><strong>Methods: </strong>This secondary epigenetic analysis was nested within a randomized controlled trial (RCT) (ClinicalTrials.gov: NCT03463772). We included 10 nuclear families (trios), comprising five IVM-conceived and five IVF-conceived singleton offspring alongside their biological parents. Both groups utilized a uniform freeze-only single-blastocyst transfer strategy to minimize hormonal confounding. Genomic DNA from umbilical cord blood (UCB) and parental peripheral blood was analyzed using reduced representation bisulfite sequencing (RRBS). Genome-wide methylation patterns and differentially methylated regions (DMRs) were subsequently compared between the groups.</p><p><strong>Results: </strong>Clinical characteristics were comparable between the IVM and IVF groups. Genome-wide analyses demonstrated high concordance in UCB methylation patterns, revealing no significant differences in global CpG methylation levels or distributions across key genomic features (promoters, CpG islands, and gene bodies). Only three rare DMRs were identified in UCB (representing ~ 0.0001% of the genome), none of which mapped to imprinted or developmentally critical loci. Furthermore, methylation variability remained consistent between the groups.</p><p><strong>Conclusions: </strong>Our findings provide robust mechanistic evidence supporting the epigenetic safety of IVM. The remarkable stability of the neonatal methylome confirms that specific IVM conditions do not compromise early developmental programming, thereby endorsing IVM as a safe and viable alternative for women with PCOS.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov registry, NCT03463772. Registered on March 13, 2018.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338969","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":"Revisiting ESR in PCOS: an easily obtainable link to immune and metabolic dysregulation.","authors":"Congcong Jin, Yue Xu, Licong Xu, Namin Zhang, Congcong Zhou, Yun Shen, Jiexue Pan","doi":"10.1186/s13048-026-02185-9","DOIUrl":"10.1186/s13048-026-02185-9","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is closely associated with systemic low-grade inflammation, yet evidence regarding erythrocyte sedimentation rate (ESR), a cost-effective and stable inflammatory marker, in reproductive-aged women without comorbidities remains limited, particularly its relationships with metabolic-endocrine parameters. This study aimed to characterize ESR dynamics in reproductive-aged women with PCOS who have no systemic comorbidities versus normo-ovulatory controls, and to evaluate its associations with endocrine and metabolic disturbances while controlling for systemic confounders.</p><p><strong>Methods: </strong>In this retrospective analysis, we enrolled a total of 2,006 women diagnosed with PCOS and 10,038 normo-ovulatory women as controls. ESR was measured using an automated ESR analyzer, and metabolic-endocrine parameters (lipid profile, hepatic/renal function, and reproductive hormones) were quantified using automated immunoassays. The alterations in ESR levels and their associations with endocrine and metabolic conditions were assessed.</p><p><strong>Results: </strong>PCOS women exhibited significantly elevated ESR levels across all age/BMI strata, with a higher hyper-ESR (ESR > 20 mm/h) prevalence. ESR was positively correlated with atherogenic lipids and renal/hepatic function. LH/FSH ratio, TT, and atherogenic lipids contributd to hyper-ESR in both PCOS and control groups, indicating neuroendocrine/metabolism-inflammation crosstalk. Despite associations, ESR demonstrated low discriminative performance for incident PCOS and suboptimal predictive value for dyslipidemia/hyperandrogenemia across distinct populations.</p><p><strong>Conclusions: </strong>This large-scale study suggests ESR may serve as an accessible biomarker of chronic inflammation associated with PCOS, which is linked to metabolic-endocrine dysregulation. The findings offer new insights into the pathophysiology of PCOS and may support the clinical utility of ESR in monitoring disease severity and guiding anti-inflammatory interventions in PCOS women.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352226","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":"Making themselves scarce: immune cells in the ovary.","authors":"Bettina Toth, Elisabeth Reiser, Samuel M Vorbach, Monika Frank, Lea Huber, Thomas Seppi, Elisabeth Pechriggl, Bettina Böttcher, Katharina Feil, Marko Konschake, Ute Ganswindt, Michael Niederwanger","doi":"10.1186/s13048-026-02177-9","DOIUrl":"10.1186/s13048-026-02177-9","url":null,"abstract":"<p><strong>Research question: </strong>In human and animal reproduction, the majority of the ovary's reproductive potential is lost before puberty. In order to survive, oocytes must interact with stromal cells. However, the specific distribution and role of ovarian immune cells compared to lymphatic organs is still indistinct.</p><p><strong>Design: </strong>Immune cell composition in the ovary, spleen, and lymph nodes was analyzed in six-week-old female C57BL/6 mice using flow cytometry. The following populations were examined: macrophages, dendritic cells, natural killer cells, NKT cells, B cells, T cells, CD4 + T cells and CD8 + T cells.</p><p><strong>Results: </strong>Only 3% of the cells that make up the ovary are immune cells. Ovarian immune cells consisted of natural killer cells (24%), T cells including CD4+- and CD8 + T cells (21%), macrophages (17%), dendritic cells (7%), NKT- and B cells (each 11%). In contrast, spleen and lymph nodes were dominated by B and T cells (spleen: 56% and 32%; lymph nodes: 33% and 62%).</p><p><strong>Conclusions: </strong>Ovarian immune cells are scarce in healthy young mice. Apart from a relatively large T-cell population, the ovarian immune compartment is dominated by innate immune cells, particularly macrophages and natural killer cells, which is in line with the multifarious role of macrophages in multiple aspects of ovarian physiology. In contrast, adaptive immune cells such as B and T lymphocytes are primarily enriched in secondary lymphoid organs, including the spleen and lymph nodes.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338897","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":"BTN3A1 regulate the function of Vγ9Vδ2 T cells through TCR signaling pathway in ovarian cancer.","authors":"Jian Liu, Yuqin Wang, Min Wu, Hui Wang","doi":"10.1186/s13048-026-02180-0","DOIUrl":"10.1186/s13048-026-02180-0","url":null,"abstract":"<p><strong>Background: </strong>Adoptive cell transfer (ACT) therapy shows great promise in ovarian cancer. In addition to the classic αβ T cells, γδ T cells have become a very important anti-tumor weapon in tumor immunotherapy, especially in hematological tumors, due to their high in vitro expansion efficiency and high tumor killing activity. However, in solid tumors, especially cold tumors such as ovarian cancer, the anti-tumor effect of γδ T cells and the key factors affecting and regulating the anti-tumor ability of γδ T cells are still unclear.</p><p><strong>Method: </strong>The functional characteristics of Vγ9Vδ2 T cells in ovarian cancer, along with the molecules and pathways mediating their interaction with tumor cells, were preliminarily explored. This was done using databases such as The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO), in addition to RNA sequencing (RNA-seq). Furthermore, Vγ9Vδ2 T cells were co-cultured with ovarian cancer tumor cell lines to validate the molecules and pathways affecting Vγ9Vδ2 T cell function through flow cytometry.</p><p><strong>Results: </strong>Vγ9Vδ2 T cells in ovarian cancer have strong anti-tumor properties. High expression of BTN3A1 in tumor cells reduces the activation of expanded Vγ9Vδ2 T cells, increases expression of exhaustion related molecules, and raises apoptosis levels in these cells. Blocking the T cell receptor (TCR) can eliminate the effect of BTN3A1 on exhaustion of Vγ9Vδ2 T cells.</p><p><strong>Conclusion: </strong>BTN3A1 activates Vγ9Vδ2 T cells but also induces their exhaustion through the TCR signaling pathway. BTN3A1 may serve as a regulator of activation-induced exhaustion in γδ T cells. Targeting downstream related molecules of BTN3A1 is of great significance for enhancing adoptive Vγ9Vδ2 T cells transfer therapy.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338981","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":"Comparing the clinical pregnancy outcomes of fresh embryo transfer in young patients with poor prognosis using different ovarian stimulation protocols.","authors":"Nan Jia, Ruolei Wang, Qiuyuan Li, Haoying Hao, Siyue Xu, Lei Jin, Yundong Mao, Juanzi Shi, Cuilian Zhang, Xiaoyan Liang, Shaodi Zhang","doi":"10.1186/s13048-026-02181-z","DOIUrl":"10.1186/s13048-026-02181-z","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical pregnancy outcomes of fresh embryo transfer at the cleavage stage utilizing gonadotropin-releasing hormone agonist (GnRH-a) and the antagonist protocols in young patients with poor prognosis.</p><p><strong>Methods: </strong>A retrospective cohort study was carried out on patients who underwent in vitro fertilization-embryo transfer (IVF-ET) between January 2016 and July 2024. Women under 35 years old with anti-Müllerian hormone (AMH) levels < 1.2 ng/ml in fresh cycles were included. A total of 1,732 cycles using the GnRH-a protocol and 3,168 cycles utilizing the antagonist protocol were investigated. The two groups were compared based on their baseline characteristics, clinical and embryological laboratory parameters, and outcome indicators. To compare the clinical results of the two stimulation protocols, we employed propensity score matching (PSM, 1:1) and multivariate logistic regression.</p><p><strong>Results: </strong>After PSM (1:1) with a tolerance of 0.01, the number of cycles in the two groups was 1422 each.The GnRH-a group had a higher clinical pregnancy rate (55.01%, P = 0.003) and live birth rate (41.66%, P < 0.001) than the antagonist group (clinical pregnancy rate: 47.67%; live birth rate: 31.74%). Ectopic pregnancy, early miscarriage, preterm birth, and the number of live births did not differ significantly (P > 0.05). Multivariate logistic regression analysis revealed that the clinical pregnancy rate in the GnRH-a group (OR = 1.25,95%CI:1.02, 1.52) was 1.25 times higher than that in the antagonist group (P = 0.0297), and the live birth rate(OR = 1.38,95%CI:1.12, 1.71) was 1.38 times higher (P = 0.0025). Additionally, compared to the antagonist group (transfer cancellation rate: 45.71%; total embryo freezing: 31.58%), the GnRH-a group exhibited reduced rates of fresh cycle transfer cancellation (34.67%; P < 0.001) and total embryo freezing (22.01%; P < 0.001). The rates of oocyte retrieval cancellation, oocyte retrieval failure, and the lack of usable embryos did not differ significantly between the two groups (P > 0.05).</p><p><strong>Conclusion: </strong>In young patients with poor prognosis, the GnRH-a protocol for controlled ovarian stimulation in fresh embryo transfer cycles produces higher clinical pregnancy and live birth rates, as well as a lower fresh transfer cancellation rate, as compared to the antagonist protocol.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338945","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 optimal SVM model from multi-model comparison outperforms conventional criteria in preoperative prediction of ovarian cancer residual disease.","authors":"Dongdong Ye, Shaodan Lin, Zhuyan Shao, Yunyun Liu, Bin Wu, Chuying Huo, Dongdong Xu, Suen Wai Pang, Chunxian Huang, Jingyan Li, Jiachen Liu, Lijuan Wang, Tao Zhu, Huaiwu Lu","doi":"10.1186/s13048-026-02176-w","DOIUrl":"10.1186/s13048-026-02176-w","url":null,"abstract":"<p><strong>Objective: </strong>To develop an interpretable artificial intelligence (AI)-based machine learning model integrating ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) radiomics, metabolic parameters, and clinical biomarkers for predicting residual disease after primary debulking surgery of ovarian cancer.</p><p><strong>Methods: </strong>This multicenter retrospective study included 203 epithelial ovarian cancer patients (2017-2024), including 153 in the training cohort and 50 in the validation cohort. Radiomic features and metabolic parameters were extracted from preoperative PET/CT, and clinical variables were from medical records. After Synthetic Minority Over-sampling Technique (SMOTE) balancing and minimum Redundancy Maximum Relevance (mRMR)-based feature selection, seven models were trained using nested 5 × 10 cross-validation. Performance was assessed by Area Under the Curve (AUC), Brier score, and decision curve analysis (DCA), with comparison to the conventional criteria such as the Suidan criteria or Fagotti criteria. Survival outcomes were analyzed using Kaplan-Meier and Cox regression.</p><p><strong>Results: </strong>The SVM model (constructed using the support vector machine method) achieved superior discrimination (AUC 0.896 [95% CI 0.842-0.937] for training; 0.872 [0.792-0.932] for validation), significantly outperforming the Suidan criteria (AUC 0.696, P < 0.001; DeLong's test). Key predictors included tumor spatial heterogeneity (Elongation, Least Axis Length) and metabolic activity (SUVmax), alongside CA-125 and albumin. The model demonstrated excellent calibration (Brier score 0.119) and clinical net benefit across thresholds (4-85%). Moreover, high-risk patients had increased mortality risk (P < 0.001).</p><p><strong>Conclusion: </strong>The PET/CT-based model improves preoperative prediction of residual disease in ovarian cancer, potentially reducing nontherapeutic surgeries. Automated lesion segmentation and multicenter validation are needed for clinical translation.</p><p><strong>Trial registration: </strong>NCT06533709 (ClinicalTrials.gov, Registration Date: 2024-08-01).</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148330473","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}