Liu XueXia, Gong BenJiao, Zhang XueYing, Zhu Peng, Liu FuJun
{"title":"Expression Patterns and Functional Implications of CMTM2 in Human Testis and Sperm.","authors":"Liu XueXia, Gong BenJiao, Zhang XueYing, Zhu Peng, Liu FuJun","doi":"10.1007/s43032-025-01852-4","DOIUrl":"https://doi.org/10.1007/s43032-025-01852-4","url":null,"abstract":"<p><p>The CMTM family plays pivotal roles in various physiological and pathological processes, including those associated with the male reproductive system. Among them, CMTM2 exhibits specific expression in testicular tissue; however, its relationship with spermatogenesis, sperm function, and the underlying molecular mechanisms remains unclear. This study systematically investigated the localization of CMTM2 in human testis and sperm, as well as its correlation with spermatogenesis and sperm quality. The results revealed that CMTM2 expression was specifically localized in human testis, predominantly in germ cells, with significantly lower levels observed in sperm from patients with asthenozoospermia and teratozoospermia compared to normospermic individuals. Immunofluorescence analysis revealed that CMTM2 was predominantly localized in the middle piece of sperm, with significant reductions in infertile samples. Western blot analysis confirmed decreased CMTM2 levels in sperm from asthenozoospermia, oligozoospermia, and teratozoospermia patients, indicating a strong correlation between CMTM2 expression and sperm quality. Furthermore, CMTM2 expression positively correlated with sperm progressive motility, but not with sperm concentration, suggesting its potential role in regulating sperm motility in both normal and asthenozoospermia patients. The findings suggested a significant correlation between the CMTM2 expression and spermatogenesis as well as sperm quality, thereby providing valuable insights for further investigations into the molecular mechanisms involved. These results lay a foundational basis for exploring the potential roles of other members within the CMTM family in male reproduction.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754368","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}
Bei Liu, Keya Tong, Yang Gao, Yi Chen, Yifan Wang, Jiaqiang Wang, Jingyu Li, Liwei Sun
{"title":"Identification of the novel homozygous whole exon deletion in MEI1 underlying azoospermia and embryonic arrest in one consanguineous family.","authors":"Bei Liu, Keya Tong, Yang Gao, Yi Chen, Yifan Wang, Jiaqiang Wang, Jingyu Li, Liwei Sun","doi":"10.1007/s43032-025-01851-5","DOIUrl":"https://doi.org/10.1007/s43032-025-01851-5","url":null,"abstract":"<p><p>This study characterized a male infertile patient suffering from azoospermia and a female infertile patient with embryonic arrest from one consanguineous family. We aimed to elucidate the novel pathogenic mechanism and provide support for the genetic diagnosis of infertility. Mutations were detected by whole-exome sequencing (WES) and confirmed by Sanger sequencing. Effect of the mutations on mRNA level was investigated by sequencing the cDNA amplification product. Functional characterization of the mutations was investigated through transfection in HEK293T cells in vitro, and the subcellular localization and protein levels were evaluated by immunofluorescence and western blot. Preimplantation genetic testing was performed to analyze chromosomal anomalies of the arrested embryos. The novel homozygous whole exon deletion of exon 19 in MEI1 was detected by WES. Amplification and sequencing of the cDNA verified the deletion of whole exon of MEI1. Quantitative expression revealed that the deletion result in almost no detectable expression of MEI1 Exon 19 in patients, and their mother is a heterozygous carrier of this whole exon deletion. Western blotting revealed that the whole exon deletion in MEI1 result in production of truncated MEI1 protein, corresponding to the predicted premature termination at Exon 20 of MEI1. Highly chromosomal anomalies were revealed in arrested embryos with MEI1 mutation. Overall, this study reported the first exon rearrangement of MEI1, thus broadening the mutational pattern and spectrum of MEI1-associated infertility, and also revealed the aneuploidies of embryos with MEI1 mutation as a potential reason for declined developmental potency and embryonic arrest.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754370","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}
Khalid Khadawardi, Mohammed Abuzaid, Saeed Baradwan, Saud Owaimer Alsehaimi, Hedaya Albelwi, Seham Adel Arishi, Mooza M Alzayed, Osama Alomar, Ahmed Abu-Zaid
{"title":"High Maternal Serum Uric Acid Levels and Risk of Low-Birth-Weight and Small for Gestational Age Infant: A Systematic Review and Meta-Analysis.","authors":"Khalid Khadawardi, Mohammed Abuzaid, Saeed Baradwan, Saud Owaimer Alsehaimi, Hedaya Albelwi, Seham Adel Arishi, Mooza M Alzayed, Osama Alomar, Ahmed Abu-Zaid","doi":"10.1007/s43032-025-01853-3","DOIUrl":"https://doi.org/10.1007/s43032-025-01853-3","url":null,"abstract":"<p><p>Although the association between high uric acid levels and adverse pregnancy outcomes has been explored, the effects of elevated uric acid levels on the risk of low-birth-weight (LBW) and small for gestational age (SGA) remain unclear. Therefore, this systematic review and meta-analysis aimed to investigate the relationship between uric acid levels during pregnancy and the risk of LBW. PubMed, Scopus, Cochrane central and Web of Science databases were searched up to September 2024 for relevant observational studies. A random effects model was used to estimate pooled odds ratios (OR) and 95% confidence intervals (95% CI). To assess the heterogeneity of included studies, the I<sup>2</sup> index was used. Finally, 29 observational studies were eligible for inclusion in this meta-analysis. Pooled analysis showed that higher uric acid levels significantly increased the risk of LBW (OR = 2.28, 95% CI: 1.62-3.22, P < 0.001; I<sup>2</sup> = 93.14%, n = 21 studies) and SGA (OR = 1.77, 95% CI 1.38-2.27, P < 0.001, I<sup>2</sup> = 91.67%, n = 14 studies). However, there was no significant effect of high uric acid levels and macrosomia (OR = 1.29, 95% CI 0.52-3.18, P = 0.59, I<sup>2</sup> = 71.86%, n = 3 studies). This study demonstrated a positive association between uric acid levels and the risk of LBW and SGA. It appears that elevated uric acid can significantly impact neonatal health, highlighting the critical importance of uric acid monitoring during pregnancy.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736199","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":"The Association Between Annexin A5 c.-302G > T Variant and the Risk of Recurrent Pregnancy Loss: Systematic Review and Meta-analysis.","authors":"Jintuo Zhou, Yanting Zhu, Ying Liu, Hairong Zhan, Peiguang Niu, Huajiao Chen, Jinhua Zhang","doi":"10.1007/s43032-025-01848-0","DOIUrl":"https://doi.org/10.1007/s43032-025-01848-0","url":null,"abstract":"<p><p>This study aimed to conduct a comprehensive meta-analysis of the relationship between Annexin A5 (ANXA5) c.-302G > T variant and susceptibility to recurrent pregnancy loss (RPL). We conducted a comprehensive systematic search of the literature published before June 17, 2023 using PubMed, Embase, Web of Science, and Cochrane Library. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included studies. The odds ratio was used to estimate the correlation of the ANXA5 c.-302 T > G genetic alteration with RPL susceptibility. The I squared (I<sup>2</sup>) statistic and Q statistic were used to assess the heterogeneity among the included studies. And Begg's test and Egger's regression were then conducted to evaluate publication bias. In this meta-analysis, we included seven studies comprising 1535 RPL cases and 1328 healthy pregnant women to investigate the relationship between ANXA5 c.-302G > T variants and the susceptibility of RPL. No significant publication bias was detected across different comparison models. In the overall population analysis, the ANXA5 c.-302G > T variant was positively associated with the risk of RPL under the dominant, allelic, heterozygote and homozygous models. Meta-regression analysis was performed to identify the potential source of heterogeneity, revealing that neither publication year nor country contributed to heterogeneity. Our findings provided robust evidence that the ANXA5 c.-302G > T variant was significantly associated with an increased risk of RPL, highlighting its potential as a genetic marker for identifying women at high risk of developing RPL. These results emphasized the importance of genetic screening in improving the understanding and clinical management of RPL.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736200","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}
Gokul Sudhakaran, Sanjay Gopi, Snega Priya, Raman Pachaiappan, Ilavenil Soundharrajan, Bader O Almutairi, Jesu Arockiaraj
{"title":"Apigenin Regulates Bisphenol-A Induced Polycystic Ovarian Syndrome (PCOS) Symptoms In-Vivo Zebrafish.","authors":"Gokul Sudhakaran, Sanjay Gopi, Snega Priya, Raman Pachaiappan, Ilavenil Soundharrajan, Bader O Almutairi, Jesu Arockiaraj","doi":"10.1007/s43032-025-01845-3","DOIUrl":"https://doi.org/10.1007/s43032-025-01845-3","url":null,"abstract":"<p><p>Bisphenol A (BPA) is an environmental pollutant known to induce oxidative stress and reproductive toxicity, symptoms that are commonly associated with Polycystic Ovary Syndrome (PCOS). This study investigates the potential protective effects of Apigenin (AGN), a bioactive flavonoid, against BPA-induced PCOS-like symptoms in adult zebrafish. The research aims to explore the therapeutic potential of natural compounds in mitigating the effects of environmental endocrine disruptors. Zebrafish were exposed to BPA at a concentration of 10 µg/L, a level known to adversely affect aquatic organisms. The non-toxicity and efficacy of AGN were assessed through a dose-response study involving concentrations of 5, 10, 15, and 20 µM. The experimental design was informed by computational molecular dynamics, including docking and simulations targeting the human androgen receptor. The study involved histological staining of ovarian tissues, biochemical assays for antioxidant enzyme activities, high-performance liquid chromatography (HPLC) for BPA accumulation, and gene expression analysis targeting PCOS-susceptible genes. AGN treatment significantly modulated antioxidant defenses in zebrafish, restoring activities of enzymes such as superoxide dismutase (SOD) and catalase (CAT), and reducing lactate dehydrogenase (LDH) levels. Histologically, AGN mitigated follicular damage and prevented excessive collagen deposition and ovarian hypertrophy, with the gonadosomatic index (GSI) approaching control levels. HPLC analysis confirmed lower BPA accumulation in tissues of AGN-treated groups. Additionally, gene expression studies showed downregulation of PCOS-related genes and TNF-α. AGN exerts a protective role against BPA-induced reproductive toxicity and offers potential as a natural intervention for both ecological and reproductive health challenges.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731498","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":"Is a Large Neck Circumference a Predictive Factor for Poor Semen Quality in the Turkish Population?","authors":"Duygu Dursunoglu","doi":"10.1007/s43032-025-01850-6","DOIUrl":"https://doi.org/10.1007/s43032-025-01850-6","url":null,"abstract":"<p><p>Currently, the potential role of obesity on semen quality remains unclear. In recent years, alternative anthropometric indices to body mass index (BMI), which can precisely distinguish body fat distribution, have been described to estimate central adiposity. However, the role of neck circumference (NC), a novel index of central adiposity, on semen quality is unknown. This study aims to reveal the potentials of adiposity indices, including NC, in predicting poor semen quality. A total of 4739 male participants between the ages of 17-55 were included in this cross-sectional study. Semen parameters, including sperm concentration, total count, total, progressive and rapid progressive motility and vitality, were divided into two categories according to the WHO classification for male infertility. As anthropometric measurements of obesity, BMI and central obesity indices including waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR) and NC were examined. The predictive potentials of obesity indices for low semen parameters were evaluated by Receiver Operating Characteristics (ROC) curve analysis. The associations of obesity indices with semen parameters were analyzed by binary logistic regression analyze after adjusting potential confounding factors. Patients with lower semen parameters had higher obesity indices than those with normal parameters. All obesity indices have the predictive potentials for low semen parameters. After adjustment for confounders, the strongest associations were found between HC with sperm count parameters, WC and WHtR with sperm vitality and motility parameters and WHpR and NC with rapid progressive motility. Obesity plays an important role in male infertility. Body fat distribution appears to have specific roles on sperm functionality, which may influence different infertility markers. NC is a strong predictor for sperm rapid progressive motility, suggesting a role for male infertility.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721245","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}
Julia J M Deneer, Saskia Le Cessie, Evert J P van Santbrink, Lucette A J van der Westerlaken, Eileen E L O Lashley
{"title":"Higher Pregnancy Success Rates in Patients with Diminished Ovarian Reserve < 40 Years When Initially Treated by Intrauterine Insemination with Mild Ovarian Stimulation Compared to In Vitro Fertilization Alone: A Pilot Study.","authors":"Julia J M Deneer, Saskia Le Cessie, Evert J P van Santbrink, Lucette A J van der Westerlaken, Eileen E L O Lashley","doi":"10.1007/s43032-025-01830-w","DOIUrl":"https://doi.org/10.1007/s43032-025-01830-w","url":null,"abstract":"<p><p>For women with idiopathic diminished ovarian reserve (DOR), direct start with IVF has been suggested to potentially shorten the time to pregnancy. Others however prefer intra-uterine insemination with ovarian stimulation (IUI + OS) due to the expected low response in IVF. In this pilot study, we determined the effect of these two strategies in women with DOR < 40 years. From a retrospective cohort, we included 135 women that met the diagnostic criteria of DOR. Patients were randomly referred to two different outpatient clinics in the Netherlands between 2012-2018 because of subfertility. Primary outcome was clinical pregnancy; secondary outcomes included ongoing pregnancies, live births, time to pregnancy and pregnancy-related complications. An instrumental variable analysis was used to assess the average effect of treatment with IUI + OS followed by IVF (protocol A) compared to IVF alone (protocol B) and correct for (unknown) confounders. Treatment protocol A was performed in 72.6% patients in Centre 1 and 30.6% in Centre 2. In Centre 1 61.6% (45/73) women had a clinical pregnancy compared to 41.9% (26/62) in Centre 2 (difference 19.7% (95% CI 3.1%-36.3%), p = 0.02). Early miscarriage occurred in 24% of the women in Centre 1 in comparison to 45% of the women in Centre 2. There were no significant differences in pregnancy-related complications. This pilot study suggests that women < 40 with DOR, if treated with IUI + OS followed by IVF, have higher estimated cumulative clinical pregnancy success, with a trend towards higher ongoing pregnancies and live births, in comparison to women treated with IVF alone.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711008","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":"SCM-198 Inhibits EMS Development by Reversing Decreased Proportions of IFN-γ<sup>+</sup>T Cells and CCR5<sup>+</sup>T Cells.","authors":"Yewei Lu, Yunyun Li, Yue Li, Yikong Lin, Xiaolin Wang, Yizhun Zhu, Beihua Wang, Meirong Du","doi":"10.1007/s43032-025-01823-9","DOIUrl":"https://doi.org/10.1007/s43032-025-01823-9","url":null,"abstract":"<p><p>Endometriosis is a common gynecological disease that causes severe pain and infertility. However, the available treatments for EMS are limited. SCM-198, a synthetic form of leonurine, possesses various abilities, including anti-inflammatory, immunomodulatory, antioxidant, anti-fibrotic, and anti-proliferative effects. Previous studies have shown that SCM-198 can inhibit the growth of ectopic lesions, but the specific mechanism remains unknown. The results of our studies indicate that SCM-198 significantly suppresses the endometriotic growth of EMS mice. Enrichment analysis of RNA-seq indicates that SCM-198 is involved in T cell differentiation, activation, cytokine production, stimulation of chemotaxis, and migration. Flow cytometry reveals that SCM-198 reverses the decreased proportions of IFN-γ + T cells and CCR5 + T cells in ectopic lesions. RNA-seq analysis shows that SCM-198 enhances the expression of CCL5 in the ectopic lesions, and western blot is conducted to verify this conclusion both in vivo and in vitro. These findings demonstrate that SCM-198 reverses the decreased proportions of IFN-γ + T cells and CCR5 + T cells, alleviating the growth of mouse ectopic lesions, and the changes in CCR5 + T cells are likely due to the reduced expression of CCL5.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670913","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":"Disruption of the Wnt/β-Catenin and PI3K-AKT-mTOR Crosstalk in Endometrial Stromal Cells: A Case Report of Impaired Decidualization Leading to Recurrent Implantation Failure and Potential Pathway-Specific Therapeutic Interventions.","authors":"Zeyad Hossam Atta Khalil, Omar Altayfa","doi":"10.1007/s43032-025-01832-8","DOIUrl":"https://doi.org/10.1007/s43032-025-01832-8","url":null,"abstract":"<p><p>A 34-year-old woman with a long-standing history of recurrent implantation failure (RIF) and unexplained infertility presented for further evaluation. Molecular analysis revealed a significant disruption in the crosstalk between the Wnt/β-catenin and PI3K-AKT-mTOR signaling pathways, both essential for regulating endometrial receptivity and successful embryo implantation. Immunohistochemical testing showed a marked reduction in β-catenin nuclear translocation and a 65% decrease in AKT phosphorylation, leading to impaired cellular processes such as proliferation and differentiation. This disruption contributed to incomplete decidualization of the endometrium, which played a central role in her repeated implantation failures. Conventional fertility treatments, including hormone therapy and in vitro fertilization (IVF), were ineffective. Consequently, we explored targeted molecular therapies aimed at restoring functionality within these signaling pathways to enhance endometrial receptivity. This case underscores the critical role of the Wnt/β-catenin and PI3K-AKT-mTOR pathways in endometrial function and highlights the potential for novel therapeutic strategies in treating RIF by addressing specific molecular defects.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664466","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}
Li Yan, Yang Wang, Huiyu Zhang, Bangchun Lu, Jinglan Liu, Yamei Li, Juan Li, Jian Zhang
{"title":"Deeper Trophoblastic Invasion and More-Promotive Vascular Remodeling in Tubal Isthmic Pregnancy Compared with Ampullary Pregnancy: A Retrospective Clinicopathological Study.","authors":"Li Yan, Yang Wang, Huiyu Zhang, Bangchun Lu, Jinglan Liu, Yamei Li, Juan Li, Jian Zhang","doi":"10.1007/s43032-025-01841-7","DOIUrl":"https://doi.org/10.1007/s43032-025-01841-7","url":null,"abstract":"<p><p>To explore clinical and pathological characteristics of tubal isthmic pregnancy. A single-center, retrospective clinicopathological cohort study was conducted in women diagnosed with tubal pregnancy that underwent salpingectomy in International Peace Maternal and Child Health Care Hospital from January 2018 to April 2023. A total of 598 eligible women with tubal pregnancy were included in the analysis, including 75 women with isthmic pregnancy and 523 women with ampullary pregnancy. Among women with isthmic pregnancy, 29 (38.67%) had trophoblastic infiltration into the muscular layer, while 46 (61.33%) had infiltration into the serosal layer. Meanwhile 66 (12.62%) women, 258 (49.33%) women, and 199 (38.05%) women had trophoblastic infiltration into the mucosal layer, muscular layer, and serosal layer of the ampullary pregnancy, respectively. The study found that women with isthmic pregnancy had enhanced trophoblastic activity, deeper vascular remodeling, increased trophoblastic infiltration into the deep wall of the tube, higher serum beta subunit of human chorionic gonadotropin (β-hCG) levels, and a higher probability of clinical manifestations. Additionally compared with ampullary pregnancy, the occurrence of isthmic pregnancy was positively correlated with salpingitis isthmica nodosa (AOR = 3.62, 95% CI 1.45-9.00, P < 0.01), and negatively correlated with the presence of chronic tubal inflammation (AOR = 0.24, 95% CI 0.09-0.64, P < 0.01). Salpingitis isthmica nodosa, not chronic inflammation of the fallopian tubes, may be a risk factor for isthmic pregnancy. Compared to ampullary pregnancy, isthmic pregnancy exhibits a more profound trophoblastic vascular remodeling of the fallopian tube and a greater tendency to infiltrate the deep layers of the tubal wall. These characteristics render it more concealed and perilous, underscoring the importance of early recognition and diagnosis.</p>","PeriodicalId":20920,"journal":{"name":"Reproductive Sciences","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650100","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}