Reproductive biomedicine online最新文献

{"title":"Reproductive biomedicine in space: implications for gametogenesis, fertility and ethical considerations in the era of commercial spaceflight","authors":"Giles Anthony Palmer ,&nbsp;Begum Aydogan Mathyk ,&nbsp;Jeffrey Jones ,&nbsp;Blair T. Stocks ,&nbsp;Paul Root Wolpe ,&nbsp;Virginia Wotring ,&nbsp;Christopher E. Mason ,&nbsp;Jacques Cohen ,&nbsp;Fathi Karouia","doi":"10.1016/j.rbmo.2025.105431","DOIUrl":"10.1016/j.rbmo.2025.105431","url":null,"abstract":"<div><div>As the era of commercial and frequent spaceflight advances, the question of human fertility in space is no longer theoretical but urgently practical. Despite over 65 years of human spaceflight activities, little is known of the impact of the space environment on the human reproductive systems during long-duration missions. Extended time in space poses potential hazards to the reproductive function of female and male astronauts, including exposure to cosmic radiation, altered gravity, psychological and physical stress, and disruption to circadian rhythm. This review encapsulates current understanding of the effects of spaceflight on reproductive physiology, incorporating findings from animal studies, a recent experiment on sperm motility, and omics-based insights from astronaut physiology. Female reproductive systems appear to be especially vulnerable, with implications for oogenesis and embryonic development in microgravity. Male reproductive function reveals compromised DNA integrity, even when motility appears to be preserved. This review examines the limited embryogenesis studies in space, which show frequent abnormal cell division and impaired development in rodents. Alongside physiological findings, this review explores ethical issues of space work, particularly with increasing spaceflights involving non-professional astronauts and individuals of all ages. This convergence of space medicine, reproductive biology and bioethics represents a novel and critical intersection that warrants attention. Drawing from multidisciplinary fields, a collaborative framework is proposed for future research, aiming to catalyse cross-disciplinary dialogue and guide the next generation of reproductive biomedical research in space.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105431"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal occupational exposure to endocrine-disrupting chemicals during pregnancy and adult male reproductive hormones","authors":"Pauline Blanc-Petitjean ,&nbsp;Rita Rahban ,&nbsp;Brigitte Dananché ,&nbsp;Alfred Senn ,&nbsp;Fanny Zufferey ,&nbsp;Eric Stettler ,&nbsp;Luc Multigner ,&nbsp;Serge Nef ,&nbsp;Ronan Garlantézec","doi":"10.1016/j.rbmo.2025.105236","DOIUrl":"10.1016/j.rbmo.2025.105236","url":null,"abstract":"<div><div><strong>Research question</strong>: Does maternal occupational exposure to endocrine-disrupting chemicals (EDC) during pregnancy affect reproductive hormone concentrations in adult sons?</div><div><strong>Design</strong>: Data from a cross-sectional study of 2326 Swiss conscripts collected between 2005 and 2017 were analysed. On inclusion, the conscripts’ mothers completed a detailed questionnaire about their pregnancy. A job-exposure matrix was used to assess exposure to 10 categories of potential EDC. Reproductive hormones – FSH, LH, total and free testosterone, oestradiol and sex hormone-binding globulin (SHBG) – were determined in serum samples from all conscripts whose mothers were exposed to EDC during pregnancy (<em>n</em> = 138) and a random sample of non-exposed conscripts (<em>n</em> = 276). Multiple linear regression analyses were adjusted for potential confounders.</div><div><strong>Results</strong>: Prenatal exposure to phthalates or alkyl phenolic compounds was significantly associated with higher FSH concentrations (aβ = 0.26, 95% CI 0.03–0.49, and aβ = 0.22, 95% CI 0.02–0.42, respectively) and prenatal exposure to pesticides was significantly associated with higher SHBG concentrations (aβ = 0.22, 95% CI 0.05–0.38). No statistically significant associations were found between other EDC categories and reproductive hormones.</div><div><strong>Conclusions</strong>: Maternal occupational exposure to certain types of EDC during pregnancy was associated with the concentrations of reproductive hormones in adult sons. These findings require replication in larger, prospective population studies.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105236"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The endometrium: is thickness all that counts?","authors":"Paul Pirtea ,&nbsp;Baris Ata","doi":"10.1016/j.rbmo.2025.105277","DOIUrl":"10.1016/j.rbmo.2025.105277","url":null,"abstract":"<div><div>The commonly used 7 mm threshold for endometrial thickness in assisted reproductive technology lacks strong evidence and stems from outdated data. Recent studies show that live birth outcomes are comparable even with linings of less than 7 mm, particularly when using euploid embryos. Measurement variability, confounding factors and differing clinical practices limit the reliability of endometrial thickness as a standalone predictor. While extremely thin linings may warrant further evaluation, rigid cut-off values are unjustified. Endometrial thickness should be integrated into a broader, individualized assessment rather than drive clinical decisions in isolation.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105277"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to endocrine-disrupting chemicals in follicular fluid: implications for assisted reproductive technology outcomes","authors":"Yuxin Jiang ,&nbsp;Xiaoyu Long ,&nbsp;Yongxiu Hao ,&nbsp;Lixue Chen ,&nbsp;Tian Tian ,&nbsp;Yue Zhao","doi":"10.1016/j.rbmo.2025.105341","DOIUrl":"10.1016/j.rbmo.2025.105341","url":null,"abstract":"<div><h3>Research question</h3><div>Are endocrine-disrupting chemicals (EDC) in follicular fluid associated with assisted reproductive technology (ART) outcomes among women undergoing ART treatment?</div></div><div><h3>Design</h3><div>This prospective cohort study involved 176 women who underwent ART treatment in China. The concentrations of 76 EDC, across five categories, in follicular fluid were quantified. Generalized linear models (with and without restricted cubic splines to account for non-linear relationships) and Bayesian kernel machine regression (BKMR) models were utilized.</div></div><div><h3>Results</h3><div>Fifteen EDC exhibited significant negative associations with at least one conventional IVF/intracytoplasmic sperm injection (ICSI) outcome. Notably, mono (2-ethyl-5-carboxypentyl) phthalate (MECPP) was consistently associated with reductions in all conventional IVF/ICSI outcomes, including the numbers of retrieved oocytes, mature oocytes, two pronuclear zygotes, blastocysts and high-quality embryos. Similarly, 3,5-di-tert-butyl-4-hydroxybenzoic acid (BHT-COOH) was negatively associated with all conventional IVF/ICSI outcomes except the number of blastocysts. No significant negative associations were observed between individual EDC and pregnancy outcomes, including the live birth rate. BKMR model analyses revealed that combinations of EDC were significantly associated with reductions in the numbers of retrieved oocytes and mature oocytes, and the probability of biochemical pregnancy. Among EDC combinations, phthalates (PAE) and bisphenol S (BPS) were identified as dominant contributors to adverse conventional IVF/ICSI outcomes and the biochemical pregnancy rate, respectively. Stratified and interaction analyses further indicated that stronger associations with conventional IVF/ICSI outcomes were observed among women aged ≤33 years.</div></div><div><h3>Conclusions</h3><div>Elevated concentrations of EDC in follicular fluid were associated with adverse ART outcomes, both as individual compounds and in combination. MECPP, BHT-COOH, PAE and BPS were identified as key EDC. Moreover, the associations were modified by age, with stronger adverse effects observed in younger women.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105341"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the performance of generative AI chatbots in preimplantation genetic testing: a comparative study of expert evaluations","authors":"Belén Lledo ,&nbsp;Paola Carbone ,&nbsp;Jose A. Ortiz ,&nbsp;Ruth Morales ,&nbsp;Adoración Rodríguez-Arnedo ,&nbsp;Leyre Herrero ,&nbsp;Elisa Alvarez ,&nbsp;Jorge Ten ,&nbsp;Lydia Luque ,&nbsp;Juan C. Castillo ,&nbsp;Jordi Suñol ,&nbsp;Anna Lissa Racca ,&nbsp;Andrea Bernabeu","doi":"10.1016/j.rbmo.2025.105275","DOIUrl":"10.1016/j.rbmo.2025.105275","url":null,"abstract":"<div><h3>Research question</h3><div>How reliable are generative artificial intelligence (AI) chatbots in responding to patient-relevant questions about preimplantation genetic testing (PGT), as evaluated by reproductive medicine specialists?</div></div><div><h3>Design</h3><div>A prospective evaluation was conducted comparing three publicly available generative AI models: ChatGPT-3.5, Gemini-1.5 and Llama-2. Twelve reproductive medicine specialists from different clinics assessed the chatbot-generated responses to 13 PGT-related questions, divided into simple and controversial categories. Each response was scored from 0 to 5 using predefined criteria. Assuming all answers were excellent, the maximum score was 25 points for simple questions and 40 points for controversial questions.</div></div><div><h3>Results</h3><div>In total, 156 evaluations were completed for each chatbot. Among the simple questions, ‘What are the types and techniques used for PGT?’ scored lowest (mean ± SD 2.83 ± 0.94). For the controversial questions, ‘What is the percentage of aneuploidy that allows an embryo to be defined as mosaic?’ scored lowest (mean ± SD 2.67 ± 1.22). ChatGPT performed best across both categories (simple 16.83 ± 1.80; controversial 27.75 ± 4.49), followed by Gemini (simple 14.92 ± 2.02; controversial 26.08 ± 3.99) and Llama (simple 13.58 ± 3.60; controversial 16.92 ± 4.96). Significant differences were observed, particularly between ChatGPT and Llama for both simple and controversial questions (<em>P</em> = 0.027 for simple, <em>P</em> &lt; 0.001 for controversial), and between Gemini and Llama for controversial questions (<em>P</em> &lt; 0.001). No significant performance differences were noted between participating specialists.</div></div><div><h3>Conclusions</h3><div>Generative AI shows moderate reliability in addressing PGT-related enquiries, with ChatGPT and Gemini outperforming Llama. While performance was higher for simple questions than for controversial questions, the variability underscores the need for clinical oversight. Further refinement and validation are essential before widespread integration of AI tools in reproductive medicine.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105275"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inside Front Cover - Affiliations and First page of TOC","authors":"","doi":"10.1016/S1472-6483(26)00186-0","DOIUrl":"10.1016/S1472-6483(26)00186-0","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105645"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low risk of endometrioma infection after oocyte retrieval","authors":"Guillaume Parpex ,&nbsp;Mathilde Bourdon ,&nbsp;Louis Marcellin ,&nbsp;Manon Sorel ,&nbsp;Chloé Maignien ,&nbsp;Corinne Bordonné ,&nbsp;Caroline Charlier ,&nbsp;Catherine Patrat ,&nbsp;Pietro Santulli ,&nbsp;Charles Chapron","doi":"10.1016/j.rbmo.2025.105344","DOIUrl":"10.1016/j.rbmo.2025.105344","url":null,"abstract":"<div><h3>Research Question</h3><div>What is the incidence of endometrioma infections requiring surgical drainage following oocyte retrieval in women with ovarian endometrioma?</div></div><div><h3>Design</h3><div>This retrospective observational cohort study included women aged 18–43 years with a confirmed radiological diagnosis of ovarian endometrioma who underwent ovarian stimulation and oocyte retrieval for IVF/intracytoplasmic sperm injection (ICSI) or fertility preservation between January 2018 and December 2023 at a single tertiary academic centre. All procedures were performed under standardized aseptic conditions with antibiotic prophylaxis. Transcystic puncture was performed when deemed necessary. The primary outcome was the incidence of endometrioma infections requiring surgical drainage within 30 days after oocyte retrieval.</div></div><div><h3>Results</h3><div>Oocyte retrievals were performed in 1102 out of 1668 cycles (66.1%) for IVF/ICSI and in 566 cycles (33.9%) for fertility preservation. Bilateral endometriomas were present in 322 of 880 patients (36.6%), with a mean cyst (SD) diameter of 31.5 ± 22.7 mm. Endometriomas larger than 30 mm accounted for 295 of 649 cases (45.5%). Intentional transcystic puncture was performed in 76 of 1148 applicable procedures (6.6%), and endometrioma drainage during oocyte retrieval occurred in 52 cases (4.5%). Endometrioma infections requiring surgical drainage occurred in 6 of 1668 procedures (0.36%). Only one infection was reported following transcystic puncture (1.3%). No cases of sepsis or septic shock occurred. Five infections were managed with ultrasound-guided transvaginal drainage; one required laparoscopic surgery.</div></div><div><h3>Conclusions</h3><div>The incidence of endometrioma infection requiring surgical intervention after oocyte retrieval, including after transcystic puncture, is low. These findings support the safety of assisted reproductive techniques in women with endometriomas.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105344"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum magnesium is linked with sperm concentration, motile sperm count and serum anti-Müllerian hormone in infertile men","authors":"Sam Kafai Yahyavi ,&nbsp;Benedicte Probst-Drejer ,&nbsp;Nadia Nicholine Poulsen ,&nbsp;Mads Joon Jorsal ,&nbsp;Anders Juul ,&nbsp;Niels Jørgensen ,&nbsp;Martin Blomberg Jensen","doi":"10.1016/j.rbmo.2025.105232","DOIUrl":"10.1016/j.rbmo.2025.105232","url":null,"abstract":"<div><h3>Research question</h3><div>What is the relationship between serum magnesium, semen quality and reproductive hormones in infertile men?</div></div><div><h3>Design</h3><div>This study was a secondary analysis of data from a randomized controlled trial involving 330 infertile men treated with cholecalciferol + calcium or placebo for 150 days. Each participant underwent a physical examination and had blood and semen parameters assessed. Thirty-one men were excluded due to missing serum magnesium, leaving 299 men stratified by serum magnesium tertile.</div></div><div><h3>Results</h3><div>Sperm concentration and total sperm count were higher in men in the highest serum magnesium tertile compared with men in the lowest serum magnesium tertile (20.9 million/ml versus 8.6 million/ml, <em>P</em> = 0.007; 72 million versus 37 million, <em>P</em> = 0.009, respectively). Total numbers of motile and progressively motile spermatozoa were also higher in men in the highest serum magnesium tertile (34 million versus 23 million, <em>P</em> = 0.023; 23 million versus 11 million, <em>P</em> = 0.033, respectively). Serum anti-Müllerian hormone (AMH) was higher in the highest serum magnesium tertile compared with the lowest serum magnesium tertile (40 pmol/l versus 28 pmol/l, <em>P</em> = 0.002), while FSH, LH and inhibin B showed no difference between serum magnesium tertiles. Vitamin D supplementation did not influence serum magnesium.</div></div><div><h3>Conclusions</h3><div>Serum magnesium is positively associated with serum AMH, and total numbers of motile and progressively motile spermatozoa. This study suggests that magnesium, along with other minerals, may influence male fertility. More evidence is needed for full validation of these findings.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105232"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Never a lost cause: can artificial intelligence help embryologists when only poor-quality embryos are available?","authors":"Nina Gidel-Dissler ,&nbsp;Guillaume Canat ,&nbsp;Pierre Boyer ,&nbsp;Daniela Nogueira ,&nbsp;Alexandra Boussommier-Calleja","doi":"10.1016/j.rbmo.2025.105439","DOIUrl":"10.1016/j.rbmo.2025.105439","url":null,"abstract":"<div><h3>Research question</h3><div>Can EMBRYOLY, an objectively trained artificial intelligence (AI) system, assist embryologists in embryo assessment when only poor-quality embryos are available for transfer?</div></div><div><h3>Design</h3><div>Data from 15,767 embryos were collected via EMBRYOLY from 3214 egg retrievals (2019–2024) across 15 clinics (four countries) using three time-lapse systems, including data from seven independent clinics (not used in the original training of the algorithm). EMBRYOLY was used to automatically detect poor-quality embryos. Subsequently, EMBRYOLY’s transformer-based model was applied on poor-quality embryos to evaluate agreement with embryologists, ranking performances against clinical pregnancy and live birth outcomes, effect on time to pregnancy and first cycle pregnancy rate. Finally, clinical pregnancy rate was compared between poor versus non-poor embryos recommended for transfer by EMBRYOLY’s hybrid model.</div></div><div><h3>Results</h3><div>For 29% of embryo cohorts, embryologists were faced with only poor-quality embryos available for transfer. EMBRYOLY’s first choice of poor-quality embryo was concordant with the embryologists’ first choice in 66% of embryo cohorts. EMBRYOLY’s score was significantly associated (<em>P</em> &lt; 0.001) with clinical pregnancies and live births on poor-quality embryos. For multiple transfers of poor-quality embryos, the adjunct use of EMBRYOLY could have reduced cycles to pregnancy by 19% and increased first cycle pregnancy rate by 65%. When EMBRYOLY recommended a poor-quality embryo for transfer, it had comparable chances of leading to a clinical pregnancy compared with higher quality embryos.</div></div><div><h3>Conclusions</h3><div>Objectively trained AI can help embryologists to select poor-quality embryos that can lead to pregnancy, which is crucial when good or fair embryos are unavailable.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105439"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient motivations and barriers in the donation of surplus embryos: a systematic review","authors":"Pilar Jiménez Fernández ,&nbsp;Adrian Villalba ,&nbsp;Gabriela Llanos ,&nbsp;Salvador Mut ,&nbsp;Leda Pedelini","doi":"10.1016/j.rbmo.2025.105218","DOIUrl":"10.1016/j.rbmo.2025.105218","url":null,"abstract":"<div><div>Cryopreservation of surplus embryos in assisted reproductive technology has led to their substantial accumulation in fertility clinics worldwide, raising ethical, legal and logistical challenges. This systematic review examines the factors influencing patients’ decisions regarding surplus embryo disposition, including donation, continued storage or disposal. Following PRISMA guidelines, 24 studies from 15 countries were analysed, incorporating qualitative, quantitative and mixed-methods research. Findings reveal that patients’ choices are shaped by the moral status attributed to embryos (e.g. ‘cell cluster’ versus ‘potential child’), religious beliefs, educational level, gamete origin and storage duration. While many patients prefer donating embryos to research or other couples, emotional attachment and ethical concerns often lead to indecision or prolonged storage. Additionally, inadequate counselling and legal restrictions further complicate decision making, with many patients reporting insufficient information and support. The review highlights the need for improved patient-centred counselling, culturally sensitive policies and standardized ethical guidelines to address embryo accumulation while respecting patient autonomy. Future research should explore cross-cultural perspectives and develop interventions to facilitate informed, ethically sound decisions.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 3","pages":"Article 105218"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}