Minerva obstetrics and gynecology最新文献

{"title":"Pelvic floor function in women undergoing isolated pelvic organ prolapse surgery or combined with urinary incontinence correction: a prospective cohort study.","authors":"Cazuy Guerra, Edson Silva-Filho, M Letícia de Carvalho, Heloíse T Oliveira, Gustavo Mafaldo, M Thereza Albuquerque Barbosa Cabral Micussi","doi":"10.23736/S2724-606X.25.05794-X","DOIUrl":"10.23736/S2724-606X.25.05794-X","url":null,"abstract":"<p><strong>Background: </strong>Pelvic floor dysfunctions are highly prevalent among women, yet many remain unaware of their condition. While conservative treatment is the first-line approach for urinary incontinence, surgical intervention is often necessary in severe cases. However, its effectiveness becomes less predictable when incontinence is associated with pelvic organ prolapse (POP). This cohort study aimed to evaluate pelvic floor muscle function in women undergoing surgical correction of POP, either alone or in combination with urinary incontinence repair.</p><p><strong>Methods: </strong>Women aged 18 to 65 years with no prior history of POP or urinary incontinence surgery were enrolled and divided into two groups: an isolated POP group (POPg, N.=47) and a group with urinary incontinence associated with POP (UI+POPg, N.=53). A blinded researcher evaluated participants at three time points: before surgery, three months postoperatively, and twelve months postoperatively. Assessments included manometry, the Urogenital Distress Inventory, the Pelvic Organ Prolapse Distress Inventory, and the Colorectal-Anal Distress Inventor.</p><p><strong>Results: </strong>The results demonstrated improvements in pelvic floor muscle function across both groups, emphasizing the positive impact of surgical intervention on pelvic floor performance in women with POP, regardless of the presence of urinary incontinence.</p><p><strong>Conclusions: </strong>Pelvic floor muscle performance and symptoms in women treated surgically for pelvic organ prolapse whether isolated or accompanied by urinary incontinence correction showed comparable improvement throughout the 12-month follow-up.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"241-249"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blastocyst implantation assay: towards the development of a new in vitro model for studying woman-specific blastocyst implantation.","authors":"Serena De Carlini, Francesca Liuzzi, Chiara Selmi, Antonio La Marca","doi":"10.23736/S2724-606X.26.05823-9","DOIUrl":"10.23736/S2724-606X.26.05823-9","url":null,"abstract":"<p><strong>Background: </strong>Despite the large number of studies on embryo invasion, in vitro models investigating early-implantation phase are limited. The aim of this study was to investigate woman-specific blastocyst implantation through the development of a new in vitro model.</p><p><strong>Methods: </strong>Human endometrial epithelial cells were purified from endometrial tissue biopsies of women in reproductive age. BeWo cells were used to develop blastocyst surrogate spheroids and Ishikawa cells were used to develop an in vitro spheroids adhesion assay. BeWo-spheroids were co-cultured with endometrial epithelial cells monolayer to assess the endometrial receptivity.</p><p><strong>Results: </strong>Our BeWo spheroids culture protocol provided us with 3D embryo surrogates that were homogeneous in shape and their dimensions were comparable to blastocysts size after 48h of spheroids culture. Spheroids adhesion rate on Ishikawa cells after three hours co-incubation was 96.3% and there were no significant differences when compared to later time points. This allowed to assess three hours as the optimal time to run the test on primary endometrial epithelial cells. The average adhesion rate on human endometrial epithelial cells was 70.8%.</p><p><strong>Conclusions: </strong>In this study we developed an in vitro model to mimic the endometrial exposure to the blastocyst in vitro and to evaluate the maternal tissue response in terms of the amount of trophoblastic spheroids able to adhere to endometrial cultures. Our results underline the high variability existing among healthy patients in their endometrial ability to retain the embryo, pointing out the necessity of developing a test aimed at the customization of in vitro fertilization treatments.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"225-232"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is known from the existing literature about the physiological and pathological plateaus of labor?","authors":"Mara Tormen, Barbara Toniolo, Stefano Salvioli, Arianna Sabattini, Irene Piccolotti, Cristina Taliento, Pantaleo Greco","doi":"10.23736/S2724-606X.25.05811-7","DOIUrl":"10.23736/S2724-606X.25.05811-7","url":null,"abstract":"<p><strong>Introduction: </strong>Labor progression is traditionally considered linear; however, recent evidence highlights natural variations, including pauses or plateaus in contraction intensity or cervical dilation. Recognizing these variations is crucial, as a lack of clear distinction between physiological and pathological plateaus often leads to unnecessary interventions with potential short- and long-term consequences. This scoping review aims to map and summarize the characteristics, differences and management strategies of physiological and pathological labor plateaus in low-risk women.</p><p><strong>Evidence acquisition: </strong>This scoping review was conducted following the Joanna Briggs Institute (JBI) methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and its extension for scoping reviews (PRISMA-ScR). Eligibility criteria included studies on physiological term pregnancies detailing labor plateau characteristics or management strategies. We searched five databases (MEDLINE, CINAHL, Embase, Scopus, CENTRAL), relevant gray literature, and reference lists of included studies, without restrictions on time, geography, or setting. Two reviewers independently screened abstracts and full-text articles for inclusion. Data were synthesized narratively and summarized in tables.</p><p><strong>Evidence synthesis: </strong>We included 35 studies. Definitions of labor plateaus varied widely. Factors contributing to labor plateaus were categorized into modifiable and non-modifiable factors. Management strategies ranged from non-invasive approaches such as emotional support and hydration to invasive interventions like amniotomy and oxytocin administration.</p><p><strong>Conclusions: </strong>Current literature does not clearly distinguish between physiological and pathological labor plateaus. Standardized definitions and management protocols are needed to improve clinical outcomes. Recognizing the potential for physiological progression during plateaus may help balance timely interventions with the benefits of supporting natural labor processes.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"284-294"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology-based interventions that support adolescent pregnancy prevention: a systematic review.","authors":"Annie D Smith, Ketan Tamirisa, Asari Offiong, Sofia Osio Smith, Shelby Rohlff, Arik V Marcell, Kathleen P Tebb","doi":"10.23736/S2724-606X.26.05846-X","DOIUrl":"10.23736/S2724-606X.26.05846-X","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent inequities in unintended pregnancy among adolescents across the globe combined with their increased use of technology warrants an increased understanding of technology-based pregnancy prevention interventions designed specifically for this population. The objective of this systematic review was to identify \"standalone\" (i.e., able to be implemented without facilitation by people) technology-based interventions designed to support pregnancy prevention among adolescents and young adults.</p><p><strong>Evidence acquisition: </strong>We included peer-reviewed articles available on the PubMed database that were published between 2010-2025 if they evaluated a standalone technology-based adolescent pregnancy prevention intervention. Articles went through a title and abstract review and subsequently a full-text review. Intervention characteristics and reported impacts were extracted and summarized from included articles.</p><p><strong>Evidence synthesis: </strong>From 247 articles identified, 16 articles representing 13 interventions were included. Among the interventions, three were text message-based, four were web-based, and six were smartphone applications. Most of the interventions were developed in the USA for female adolescents and young adults. Five interventions used randomized control trials and demonstrated improvements in behaviors that can reduce the risk of unintended pregnancies.</p><p><strong>Conclusions: </strong>Several technology-based interventions have been shown to improve adolescent pregnancy prevention behaviors; however, more attention to intervention implementation efforts, mechanisms of action that lead to behavior change, and the impact youth engagement has on the development and implementation has on outcomes is needed. In addition, greater investments and attention to pregnancy prevention efforts that target youth from different cultural backgrounds, countries and contexts are also needed to reach those who have less access to information and care. Future research and practice should also address how engaging males, gender-expansive and sexual minorities in pregnancy prevention efforts can contribute to improved outcomes. There is also a need to standardize behavioral measures to facilitate meta-analysis.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"295-303"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myofascial pelvic floor dysfunction as a hidden contributor to urinary symptoms.","authors":"Anne Lenore Ackerman, Andrea Wise-Fuchs","doi":"10.23736/S2724-606X.26.05858-6","DOIUrl":"10.23736/S2724-606X.26.05858-6","url":null,"abstract":"<p><p>Lower urinary tract symptoms (LUTS) such as frequency, urgency, and sensation of incomplete emptying are frequently attributed to bladder or urothelial disorders, but pelvic floor myofascial dysfunction is underrecognized as an etiologic factor. To present a conceptual framework for myofascial pelvic floor dysfunction (MPFD) as a contributor to urinary symptoms, review its urologic manifestations, discuss, and explore occult contributing factors, and propose integrated diagnostic and interventional therapeutic strategies. This is a narrative review and conceptual synthesis anchored on recent observational studies and existing literature on myofascial pelvic floor dysfunction. MPFD involves failure of appropriate muscle relaxation (or paradoxical contraction), often resistant to standard rehabilitation if underlying drivers remain untreated. The pelvic floor should be conceptualized as a biomechanical \"cuboid\" interacting with the diaphragm, spine, and abdominal wall. Patients may present with a spectrum of urinary, bowel, sexual, neurogenic, and pain symptoms. Success in rehabilitation demands identification and targeting occult contributors (anatomic, biomechanical, inflammatory, neurologic, behavioral, and central nervous system). Recognizing and addressing myofascial dysfunction as part of the multidimensional pathophysiology of LUTS may improve outcomes in patients' refractory to bladder-centric therapies. Prospective trials are needed to validate integrative treatment strategies.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"250-260"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic-guided antihypertensive therapy reduces low-birth-weight incidence.","authors":"Serena Lecis, Gloria Guariglia, Valeria Pedrini, Jessica Bugiolacchi, Beatrice Melis, Lucia Lisotti, Letizia Ramovecchi, Anna L Tramontano, Isabella Neri, Riccardo Cuoghi Costantini, Fabio Facchinetti, Antonio La Marca, Francesca Monari","doi":"10.23736/S2724-606X.26.05860-4","DOIUrl":"10.23736/S2724-606X.26.05860-4","url":null,"abstract":"<p><strong>Background: </strong>Chronic hypertensive disorders in pregnancy are associated with adverse maternal and perinatal outcomes. Hemodynamic-guided management has been proposed to optimize antihypertensive therapy. This study evaluates outcomes before and after the introduction of the USCOM^® device - a non-invasive hemodynamic monitor - into clinical practice for tailoring antihypertensive treatment.</p><p><strong>Methods: </strong>A retrospective, monocentric descriptive study was conducted at the AOU Policlinic of Modena. USCOM^® was implemented in March 2022. The control group included 22 pregnant individuals with chronic hypertensive disorder (HD) from 2021, while the USCOM group included 46 individuals from 2023 who received USCOM^® hemodynamic monitoring to tailor antihypertensive therapy. Patients with missing delivery data or gestational hypertension were excluded. Maternal and neonatal outcomes were collected retrospectively from electronic medical records and analyzed using SPSS v.28. Continuous variables were presented as means with standard deviations, and categorical variables as counts and percentages.</p><p><strong>Results: </strong>No significant differences in maternal characteristics were observed between groups. The USCOM group showed a significantly lower incidence of low-birthweight (<2500 g) newborns (6.5% vs. 36.4%; P=0.004) and longer gestational age (38.9 vs. 37.4 weeks; P=0.049). Although not statistically significant, trends indicated fewer extremely preterm births (<34 weeks; P=0.096) and lower Neonatal Intensive Care Unit (NICU) admissions (P=0.096). Multivariate analysis confirmed USCOM^® evaluation as the only significant factor reducing the risk of low birth weight (adjusted odds ratio [aOR] 0.118, P=0.004), adjusted for parity, ethnicity, and prepregnancy Body Mass Index (BMI).</p><p><strong>Conclusions: </strong>While larger studies are needed to confirm these findings, the implementation of USCOM^® in routine clinical practice may contribute to improved neonatal outcomes in pregnancies complicated by chronic hypertensive disorders.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"198-204"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal growth restriction and preeclampsia as endpoints of a spectrum from the viewpoint of placental histopathology.","authors":"István Dankó, András Tankó, Edit Kelemen, Gábor Cserni","doi":"10.23736/S2724-606X.25.05779-3","DOIUrl":"10.23736/S2724-606X.25.05779-3","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the common histopathological characteristics of preeclampsia (PE) and fetal growth restriction (FGR), and demonstrated the major differences of the three groups of 1/PE with FGR, 2/PE without FGR and 3/FGR without PE.</p><p><strong>Methods: </strong>Placental slides were studied retrospectively. Predominantly FGR- and PE-associated lesions were identified. Gestational age at the time of delivery (GATD) and diagnosis-to-delivery time (DTDT) were also examined.</p><p><strong>Results: </strong>Decidual arteriopathies, maternal hypertension and obesity were more common in PE, and villous capillarization was significantly lower in FGR. We found that only villous infarction and chorangiosis had a connection with GATD. Villous infarction and chorangiosis were associated with DTDT >80 days, while placental changes leading to decreased villous capillarization was associated with DTDT <30 days.</p><p><strong>Conclusions: </strong>Despite several common histopathological characteristics, placental histopathological profile of PE with FGR, PE without FGR and FGR without PE have remarkable differences, indicating histological background of their distinguished prognosis. Inadequate vascular development and decidual vasculopathies are characteristic in PE, while the undercapillarization of placental villous tree and villitis of unknown etiology leading to placental damage are characteristic of FGR. The dynamic equilibrium of different entities determines global placental function, and manifestation of FGR and/or PE.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"205-214"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of minimal stimulation versus conventional GnRH antagonist protocols in controlled ovarian hyperstimulation: a retrospective analysis of 10769 IVF/ICSI cycles.","authors":"Shashank V Sanagoudar, Vipin Chandra, Kshitiz Murdia, Nitiz Murdia, Shipra Nigam, Ritu Punhani, Gaurav Sharma, Nihar Bhoi, Walmik Mistari, Isha Suwalka","doi":"10.23736/S2724-606X.25.05790-2","DOIUrl":"10.23736/S2724-606X.25.05790-2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to find the efficacy of minimal stimulation protocol over antagonist protocol in infertile couples.</p><p><strong>Methods: </strong>A total of 10769 patients who visited between January 2018 and January 2022 were included in this retrospective study. To reduce potential bias and baseline heterogeneity between the two groups, Propensity Score Matching was employed, so the data after propensity matching was N.=978. Group 1 - minimal stimulation group (N.=347) - received clomiphene citrate 100 mg along with gonadotropin (≤150 IU), either recombinant follicle-stimulating hormone (r-FSH) or human menopausal gonadotropin (hMG). Group 2, the conventional dose antagonist group (N.=631), received a conventional dosage of r-FSH (≥225 IU) as per institutional practice.</p><p><strong>Results: </strong>The minimal stimulation group had a considerably higher live birth rate (58.20%) than the antagonist group (51.20%), with a P value of 0.035, demonstrating a statistically significant benefit for the minimal stimulation procedure. For live birth rate, endometrial thickness (odds ratio [OR] = 1.22, 95% confidence interval [CI]: 1.09-1.36, P<0.001), number of embryos transferred (OR=1.95, 95% CI: 1.37-2.78, P<0.001), and sperm count (OR=1.01, 95% CI: 1.00-1.05, P=0.044) were significant predictors. In the subgroup anti-Müllerian hormone (AMH; 1.5-2.5 ng/mL), the antagonist protocol yielded a significantly higher number of oocytes retrieved and mature oocytes; however, the minimal protocol demonstrated superior blastulation rates, good blastocyst quality, and a notably higher live birth rate.</p><p><strong>Conclusions: </strong>Compared to the standard treatment, the minimal stimulation group's live birth rate was much higher, indicating that some patient populations might benefit from fewer drugs and less stimulation.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"215-224"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited knowledge of preventive measures for cytomegalovirus among pregnant women: an Italian study.","authors":"Elisabetta Colciago, Federica Fernicola, Giulia Capitoli, Elisa Merelli, Francesca Arienti, Valeria Poletti DE Chaurand, Maria V Vasarri, Anna Carli, Sara Ornaghi","doi":"10.23736/S2724-606X.25.05651-9","DOIUrl":"10.23736/S2724-606X.25.05651-9","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus (CMV) is the leading cause of congenital infection in pregnancy and non-genetic infant hearing loss. Evidence showed that antenatal education about hygiene practices might decrease infection acquisition. We aimed to assess pregnant women's awareness of CMV infection and knowledge of preventive behaviors and to identify associated factors.</p><p><strong>Methods: </strong>A prospective cross-sectional survey study was conducted at a single academic maternity center between May and November 2023. Data were gathered via a self-administered paper questionnaire from pregnant women aged 18 or older.</p><p><strong>Results: </strong>Out of 384 participants, 65.4% were aware that CMV infection could pose risks during pregnancy. CMV awareness was significantly linked to university education (OR 7.18, 95% CI 2.79-18.44), preconceptional provision of information (OR 1.98, 95% CI 1.17-3.36), folic acid intake (OR 2.75; 95% CI 1.53-4.95, P=0.0007), and pregnancy vaccination uptake (OR 1.64; 95% CI 1.06-2.52, P=0.0249). Women starting folic acid when already pregnant and smoking during pregnancy, were 55% and 72% less aware of CMV, respectively (OR 0.45, 95% CI 0.23-0.86; OR 0.28, 95% CI 0.14-0.59). Only 28.1% of women had adequate CMV preventive behaviors knowledge, rising to just 33.1% among those aware of CMV and its risks in pregnancy. Mass-media use positively influenced awareness of CMV (OR 2.57, 95% CI 1.44-4.60).</p><p><strong>Conclusions: </strong>Although we identified a moderately high rate of CMV infection awareness, appropriate knowledge of its specific preventive measures was low. Mass-media use to inform before conception and the adoption of effective communication methods early in pregnancy might represent feasible ameliorating interventions.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"188-197"},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of heparin on in-vitro fertilization outcomes: a systematic review and SWOT analysis.","authors":"Erika Pittana, Giosuè Giordano Incognito, Danilo Cimadomo, Alessandro Conforti, Alessandro Ruffa, Pasquale Petrone, Gemma Fabozzi, Laura Albricci, Ilenia Mappa, Marco Palumbo, Giuseppe Rizzo, Antonio Pellicer, Laura Rienzi, Filippo M Ubaldi, Alberto Vaiarelli","doi":"10.23736/S2724-606X.25.05716-1","DOIUrl":"10.23736/S2724-606X.25.05716-1","url":null,"abstract":"<p><strong>Introduction: </strong>Embryo implantation is a crucial step in pregnancy that requires interaction between the embryo and the endometrial lining, facilitated by cytokines, growth factors, and adhesion molecules. Failures in this process are a leading cause of implantation failure and miscarriage in in-vitro fertilization (IVF) treatments. Heparin has shown potential to improve outcomes by enhancing endometrial receptivity, promoting angiogenesis, and modulating inflammatory responses. This study aims to provide an overview of the main characteristics of existing research on the role of heparin adjuvant therapy in IVF cycles.</p><p><strong>Evidence acquisition: </strong>A comprehensive bibliographic search was systematically conducted from inception to 2024, focusing on studies that evaluated the impact of heparin adjuvant therapy in IVF cycles and compared clinical outcomes between case and control groups.</p><p><strong>Evidence synthesis: </strong>A total of 31 studies were included. Most of the studies have focused on patients with recurrent implantation failure, defined using highly heterogeneous criteria across studies, as well as patients with both congenital and acquired thrombophilic disorders. Additionally, most of the studies involved small sample sizes.</p><p><strong>Conclusions: </strong>Current evidence does not adequately support the routine use of heparin in IVF cycles. To date, the research is plagued by methodological inconsistencies, which undermine both the reliability and the applicability of the findings.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"275-283"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}