Reproductive biomedicine online最新文献

{"title":"Legal framework and IVF outcomes: a comparative analysis of fresh and frozen embryo transfers in Switzerland","authors":"Janna Pape ,&nbsp;Jérémy Levy ,&nbsp;Sofia Makieva ,&nbsp;Michael von Wolff","doi":"10.1016/j.rbmo.2024.104483","DOIUrl":"10.1016/j.rbmo.2024.104483","url":null,"abstract":"<div><h3>Research question</h3><div>To what extent do legislative measures impact standard reproductive outcome parameters?</div></div><div><h3>Design</h3><div>Retrospective cohort study using data from the Swiss national IVF registry analysing the outcomes of 13,908 women undergoing embryo transfers resulting from their first lifetime oocyte retrieval before (2014–2016) or after (2020–2022) revision of the legislation, allowing extended culture for 12 zygotes. Live birth rates (LBR) and cumulative LBR (cLBR) were compared in fresh and frozen embryo transfer strategies in both periods. Adjusted multivariable mixed model analyses were performed to determine OR and incidence rate ratios (IRR).</div></div><div><h3>Results</h3><div>Before revision of the legislation, LBR was higher for fresh embryo transfers compared with frozen embryo transfers (27.2% versus 22.7%; <em>P</em> = 0.006). After revision of the legislation, LBR was lower for fresh embryo transfers (29.3% versus 36.3%; <em>P</em> &lt; 0.001), and cLBR was higher for the freeze-all embryo transfer strategy (59.0% versus 39.8%; <em>P</em> &lt; 0.001). However, in a multivariable analysis, no difference in the odds of live birth was found between fresh and frozen embryo transfers (OR = 1.08, 95% CI 0.95–1.22), and the freeze-all embryo transfer strategy was not found to be more effective than the fresh embryo transfer strategy (IRR = 1.12, 95% CI 0.98–1.27). In a subgroup analysis, fresh blastocyst embryo transfers showed higher LBR than cleavage stage embryo transfers (OR = 2.01, 95% CI 1.62–2.49).</div></div><div><h3>Conclusion</h3><div>The change in national legislation provided the unique opportunity to evaluate the legal impact on reproductive outcomes. Besides a reduction in the number of multiple births, LBR in frozen embryo transfers improved, resulting in comparable success of fresh and frozen embryo transfer strategies. In addition to technological improvement, the legal framework influences the evolution of clinical practice, thereby contributing to enhanced reproductive outcomes.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 2","pages":"Article 104483"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outside Back Cover - Editorial Board","authors":"","doi":"10.1016/S1472-6483(25)00028-8","DOIUrl":"10.1016/S1472-6483(25)00028-8","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 2","pages":"Article 104821"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429112","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":"A biomimetic sperm selection device for routine sperm selection","authors":"Steven A. Vasilescu ,&nbsp;Dale M. Goss ,&nbsp;Kathryn H. Gurner ,&nbsp;Rebecca L. Kelley ,&nbsp;Maria Mazi ,&nbsp;Fabrice K. De Bond ,&nbsp;Jennifer Lorimer ,&nbsp;Fabrizzio Horta ,&nbsp;Farin Y. Parast ,&nbsp;David K. Gardner ,&nbsp;Reza Nosrati ,&nbsp;Majid E. Warkiani","doi":"10.1016/j.rbmo.2024.104433","DOIUrl":"10.1016/j.rbmo.2024.104433","url":null,"abstract":"<div><h3>Research question</h3><div>Can a biomimetic microfluidic sperm sorter isolate motile sperm while minimizing DNA damage in comparison with density gradient centrifugation (DGC)?</div></div><div><h3>Design</h3><div>This was a two-phase study of 61 men, consisting of a proof-of-concept study with 21 donated semen samples in a university research laboratory, followed by a diagnostic andrology study with 40 consenting patients who presented at a fertility clinic for semen diagnostics. Each sample was split to perform DGC and microfluidic sperm selection (one-step sperm selection with 15 min of incubation) side-by-side. Outcomes evaluated included concentration, progressive motility, and DNA fragmentation index (DFI) of raw semen, and sperm isolated using DGC and the microfluidic device. Results were analysed using Friedman's test for non-parametric data (significant when <em>P</em> &lt; 0.05). DFI values were assessed by sperm chromatin dispersion assay.</div></div><div><h3>Results</h3><div>Sperm isolated using DGC and the microfluidic device showed improved DFI values and motility compared with the raw semen sample in both cohorts. However, the microfluidic device was significantly better than DGC at reducing DFI values in both the proof-of-concept study (<em>P</em> = 0.012) and the diagnostic andrology study (<em>P</em> &lt; 0.001). Progressive motility was significantly higher for sperm isolated using the microfluidic device in the proof-of-concept study (<em>P</em> = 0.0061) but not the diagnostic andrology study. Sperm concentration was significantly lower for samples isolated using the microfluidic device compared with DGC for both cohorts (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Channel-based biomimetic sperm selection can passively select motile sperm with low DNA fragmentation. When compared with DGC, this method isolates fewer sperm but with a higher proportion of progressively motile cells and greater DNA integrity.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 2","pages":"Article 104433"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transrectal oocyte retrieval for fertility preservation in virginal women","authors":"Michael Fakih ,&nbsp;Ahmad Fakih ,&nbsp;Mouna Fawaz ,&nbsp;Yasmin Sajjad ,&nbsp;Muhammad Ahsan Akhtar ,&nbsp;Fady Sharara","doi":"10.1016/j.rbmo.2024.104475","DOIUrl":"10.1016/j.rbmo.2024.104475","url":null,"abstract":"<div><h3>Research question</h3><div>How safe and effective is transrectal oocyte retrieval (TROR) for fertility preservation in nulliparous virginal women?</div></div><div><h3>Design</h3><div>This was a retrospective single-centre study of 105 nulliparous women from five satellite centres of Fakih IVF, UAE, who underwent TROR for oocyte cryopreservation. Extensive bowel preparation and rectal cleansing was performed prior to oocyte retrieval. Patient characteristics, stimulation protocol, and procedure outcome and safety data were collected. Correlation analyses of the number of follicles and oocyte yield in relation to age and anti-Müllerian hormone (AMH) concentration, and the number of follicles in relation to oocyte yield were performed.</div></div><div><h3>Results</h3><div>This study evaluated 105 patients who underwent 152 cycles of ovarian stimulation and TROR. The most common indication was social fertility preservation. A significant positive correlation was found between the AMH concentration and number of oocytes (<em>r</em> = 0.83, <em>P</em> &lt; 0.003). No intra-operative or postoperative complications were observed.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that TROR is an alternative and clinically effective oocyte harvesting procedure in assisted reproductive technology, producing good results in terms of oocyte yield, with no complications and a good safety profile. Although transvaginal oocyte retrieval remains the gold-standard treatment, TROR is safe and effective for virginal women in whom transvaginal oocyte retrieval is not an option.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 2","pages":"Article 104475"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assisted reproductive technologies in Latin America: the Latin American Registry, 2021","authors":"Fernando Zegers-Hochschild ,&nbsp;Javier A. Crosby ,&nbsp;Carolina Musri ,&nbsp;Fanny Petermann-Rocha ,&nbsp;Gustavo Martinez ,&nbsp;Hitomi Nakagawa ,&nbsp;Carlos Morente ,&nbsp;Armando Roque ,&nbsp;Ana Palma-Govea ,&nbsp;Latin American Network of Assisted Reproduction","doi":"10.1016/j.rbmo.2024.104413","DOIUrl":"10.1016/j.rbmo.2024.104413","url":null,"abstract":"<div><h3>Research question</h3><div>What are the trends and impact of new technologies on the effectiveness and safety of assisted reproductive technology (ART) performed in Latin America during 2021?</div></div><div><h3>Design</h3><div>This was a retrospective collection of cycle-based multinational data obtained from ART procedures performed by 204 accredited institutions in 16 countries.</div></div><div><h3>Results</h3><div>In total 127,351initiated cycles resulted in 20,032 deliveries and 22,708 births. ART utilization showed great variability, from 623.5 cycles/million inhabitants in Uruguay to fewer than 35 in Guatemala and El Salvador. The proportion of women aged ≥40 years increased to 35.8%, while that of women ≤34 years dropped to 23.9%. Nonetheless, the proportion of single-embryo transfers (SET) increased from 11.9% in the previous decade to 42.4% in 2021. Of 22,708 babies born, 76.8% were singletons, 22.3% twins and 1.0% triplets or more. Intracytoplasmic sperm injection represented 84.5% of fertilization techniques, and blastocyst transfer increased from 49.6% in 2016 to 79.3% in 2021. The delivery rate after fresh blastocyst elective SET was significantly higher than after the transfer of one frozen embryo from a freeze-all cycle (<em>P</em> &lt; 0.0001). The number of aspirations leading to preimplantation genetic testing has increased 2.8 times in 5 years and significantly increased delivery rates/transfer at all ages, including in oocyte donation (<em>P</em> ≤ 0.002), and reduced miscarriage in women ≥35 years old. In oocyte donation, delivery rates after the fresh transfer of embryos from vitrified-warmed oocyte cycles generated similar outcomes to frozen embryo transfer. Perinatal mortality increased from 7.7‰ in singletons to 21.3‰ in twins.</div></div><div><h3>Conclusion</h3><div>The systematic collection of cycle-based multinational data contributes to cooperative sustained development and helps implement evidence-based reproductive decisions.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 2","pages":"Article 104413"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626947","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":"Front Matter - Continued TOC","authors":"","doi":"10.1016/S1472-6483(24)00961-1","DOIUrl":"10.1016/S1472-6483(24)00961-1","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 1","pages":"Article 104772"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099947","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":"Preconception carrier screening in couples seeking IVF: exploring the patient perspective","authors":"Celine Frank ,&nbsp;Claire H.C. Laeven ,&nbsp;Deidre Meulenbroeks ,&nbsp;Edith Coonen ,&nbsp;Christine E.M. de Die-Smulders ,&nbsp;Ronald J.T. van Golde ,&nbsp;Lonne M. Mallens ,&nbsp;Aimée D.C. Paulussen ,&nbsp;Juliette Schuurmans ,&nbsp;Liesbeth A.D.M. van Osch","doi":"10.1016/j.rbmo.2024.104452","DOIUrl":"10.1016/j.rbmo.2024.104452","url":null,"abstract":"<div><h3>Research question</h3><div>What is the level of understanding, and what are the attitudes and considerations regarding preconception carrier screening (PCS) among couples seeking IVF or intracytoplasmic sperm injection (ICSI)?</div></div><div><h3>Design</h3><div>A mixed-methods design was used. Nine interviews were conducted with couples or individual partners (<em>n</em> = 16) who had an initial consultation for IVF/ICSI in the 2 years preceding this study. A questionnaire was completed by 115 participants. No actual PCS was offered.</div></div><div><h3>Results</h3><div>All interviewed couples expressed a positive attitude towards PCS, and over half of the respondents stated that they would pursue or seriously consider pursuing PCS if possible. Some couples falsely believed that PCS could identify a cause for their fertility problems and increase their chance of conceiving. The desire to make an informed reproductive decision was the most important argument in favour of PCS. The primary argument against PCS was the apprehension of being confronted with reproductive dilemmas. The longer the delay to IVF/ICSI treatment required to perform PCS, the more couples would be inclined to decline screening. Participants indicated that they would prefer to receive information about PCS from a medical specialist at an early stage in their IVF/ICSI treatment.</div></div><div><h3>Conclusion</h3><div>Although attitudes towards PCS were generally positive, some concerns were raised about treatment delays and potential reproductive dilemmas, and some couples had misconceptions about the purpose of screening within the context of their IVF/ICSI treatment. These findings highlight the importance of tailoring information and counselling to the specific needs of couples seeking IVF/ICSI.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 1","pages":"Article 104452"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of vitrified-warmed autologous oocyte cycles with 15-year follow-up at a single UK centre: consistent and predictable results","authors":"Jemma Garratt ,&nbsp;Trina Shah ,&nbsp;Anna Mclaughlin,&nbsp;Balsam Al-Hashimi,&nbsp;Nick Macklon,&nbsp;Elena Linara-Demakakou,&nbsp;Kamal K. Ahuja","doi":"10.1016/j.rbmo.2024.104376","DOIUrl":"10.1016/j.rbmo.2024.104376","url":null,"abstract":"<div><h3>Research question</h3><div>What were the clinical outcomes from 332 autologous vitrified- warmed oocyte cycles derived from 3182 elective autologous oocyte freeze cycles carried out between 2008 and 2022 in a single-centre series?</div></div><div><h3>Design</h3><div>In this retrospective observational study, outcomes in 299 patients returning to use their frozen oocytes between 2015 and 2023 were analysed.</div></div><div><h3>Results</h3><div>A total of 3328 elective oocyte vitrification cycles were performed in 2280 patients. The return rate to use oocytes was 14% (299/2171). Mean ages were 37.6 years at storage and 40 at warming. Ninety-three clinical pregnancies and 77 healthy live births were recorded. The live birth rate (LBR) was 24% (39/163) per fresh transfer and 17% (39/227) per embryo transferred. Stratified by age at freezing, the LBR per embryo transferred was 26% (12/47) in participants under 35 years, 20% (24/118) in those 35–39 years and 5% (3/62) in those 40+ years. Frozen embryo transfers (FET) achieved a 30% (24/80) LBR per embryo transfer and a 27% (24/90) LBR per embryo transferred. PGT-A for embryo selection doubled the LBR compared with FET from an untested embryo after one attempt (40% versus 21%). In patients aged over 40 years, the cumulative LBR reached 42% per patient in euploid FET.</div></div><div><h3>Conclusion</h3><div>The proportion of patients who returned to use their stored oocytes and the clinical outcomes were consistent with other recent reports and challenges the prevalent critical narrative regarding elective oocyte freezing for fertility preservation. The results are now comparable to routine IVF. Not everyone who returns to use their oocytes will conceive, but for those choosing to preserve their fertility, oocyte freezing can provide reproducible and reassuring results.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 1","pages":"Article 104376"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polar body-based PGT-A: not dead yet? A step forward back to the roots of PGT-A","authors":"Anna Oberle,&nbsp;Michael Feichtinger","doi":"10.1016/j.rbmo.2024.104430","DOIUrl":"10.1016/j.rbmo.2024.104430","url":null,"abstract":"<div><div>Trophectoderm-based preimplantation genetic testing for aneuploidies (PGT-A) is used worldwide as a means of selecting embryos with high potential for achieving a live birth. However, trophectoderm analysis may be impaired through embryonic mosaicism, leading to genetically healthy embryos being falsely discarded, and thus even reducing cumulative live birth rates. Polar body biopsy, a technique applied since the early days of preimplantation testing, has been abandoned by most IVF centres. In comparison to trophectoderm analysis, however, polar body biopsy might even have certain advantages over trophectoderm PGT-A. This Countercurrent contribution discusses the newest clinical evidence, as well as ethical and cost-efficiency considerations, and argue that polar body analysis should be reconsidered.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 1","pages":"Article 104430"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506936","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":"Looking into the future: a machine learning powered prediction model for oocyte return rates after cryopreservation","authors":"Yuval Fouks ,&nbsp;Pietro Bortoletto ,&nbsp;Jeffrey Chang ,&nbsp;Alan Penzias ,&nbsp;Denis Vaughan ,&nbsp;Denny Sakkas","doi":"10.1016/j.rbmo.2024.104432","DOIUrl":"10.1016/j.rbmo.2024.104432","url":null,"abstract":"<div><h3>Research question</h3><div>Could a predictive model, using data from all US fertility clinics reporting to the Society for Assisted Reproductive Technology, estimate the likelihood of patients using their stored oocytes?</div></div><div><h3>Design</h3><div>Multiple learner algorithms, including penalized regressions, random forests, gradient boosting machine, linear discriminant analysis and bootstrap aggregating decision trees were used. Data were split into training and test datasets. Patient demographics, medical and fertility diagnoses, partner information and geographic locations were analysed.</div></div><div><h3>Results</h3><div>A total of 77,631 oocyte–cryopreservation cycles (2014–2020) were analysed. Patient age averaged 34.5 years. Treatment indications varied: planned (35.6%), gender-related (0.1%), medically indicated (15.5%), oncologic (5.7%) and unknown (42.3%). Infertility diagnoses were less common: unexplained infertility (1.8%), age-related infertility (3.2%), diminished ovarian reserve (9.9%) and endometriosis (1.6%). An ensemble model combining bootstrap aggregation classification and regression trees, stochastic gradient boosting and linear discriminant analysis yielded the highest predictive accuracy on test set (balanced accuracy: 0.83, sensitivity: 0.76, specificity: 0.91), with a receiver operating characteristic curve of 0.90 and precision-recall curve and area under the curve of 0.57. Key factors influencing the likelihood of returning for oocyte use included patient age, presence of a partner, race or ethnicity, the clinic's geographic region and oocyte cryopreservation indication.</div></div><div><h3>Conclusions</h3><div>This model demonstrated significant predictive accuracy, and is a valuable tool for patient counselling on oocyte cryopreservation. It helps to identify patients more likely to use stored oocytes, enhancing healthcare decision-making and the efficiency of gamete storage programmes. The model can be applied to self-financed and insurance-funded cycles.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 1","pages":"Article 104432"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792307","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}