Reproductive biomedicine online最新文献

{"title":"The importance of being critical","authors":"Guido Pennings","doi":"10.1016/j.rbmo.2024.104793","DOIUrl":"10.1016/j.rbmo.2024.104793","url":null,"abstract":"<div><div>A critical attitude towards applications and arguments in the field of medically assisted reproduction is needed to make progress in the area. By challenging the accepted positions on practices such as elective egg freezing and gamete donation, it has become evident that the arguments are flawed. First, elective egg freezing does not promote or hinder women's emancipation. It could even be argued that elective egg freezing is a consequence of the successful emancipation of the group of highly educated women who, as a result, can inadvertently no longer find the right partner. Second, openness and donor identifiability are presented as progress in gamete donation. This places undue emphasis on a bionormative ideology that runs counter to the core principles of gamete donation. It attributes great value to genetic relationships rather than focusing on social relationships. However, given the importance that Western societies attach to this ideology, some donor-conceived persons are harmed and their well-being is negatively affected. This, in turn, generates a moral obligation for would-be parents to try to have genetically related children.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 4","pages":"Article 104793"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863678","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":"Does IVF make people happy?","authors":"Mariana Sousa-Leite,&nbsp;Jacky Boivin","doi":"10.1016/j.rbmo.2025.104834","DOIUrl":"10.1016/j.rbmo.2025.104834","url":null,"abstract":"<div><div>Research has been focused on exploring the negative side of IVF. However, a comprehensive picture of the overall impact of IVF needs to acknowledge its positive side. Prospective and cross-sectional research have shown that happiness can be experienced before, during and after IVF, irrespective of whether or not a live birth is achieved. Psychosocial models within positive psychology support the intrinsic benefit and adaptative effect of the action of undergoing IVF on well-being and mental health through the opportunity it affords people to achieve, accept and make meaning of their (un)realized parenthood goals. The PERMA model was used to explore the concept of happiness, with evidence showing that happiness can be achieved in IVF via positive emotions (most investigated), a sense of being engaged, positive relationships, and a sense of meaning and accomplishment. The positive lived experience of IVF can be moderated by individual patient characteristics, and enhanced by positive-focused approaches to care. High-quality research and patient-centred models of care are needed to evaluate and promote the holistic positive value of IVF in all dimensions of happiness.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 4","pages":"Article 104834"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863679","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":"Bridging ideal studies and real-world practice: the potential role of real-world evidence in reproductive medicine","authors":"Georg Griesinger","doi":"10.1016/j.rbmo.2025.104807","DOIUrl":"10.1016/j.rbmo.2025.104807","url":null,"abstract":"<div><div>Evidence-based medicine is central to reproductive health care, guiding interventions such as ovarian stimulation protocols and fertility preservation strategies. While randomized controlled trials (RCT) remain the gold standard for providing evidence and for establishing causality, their limitations, including restricted generalizability and high costs, highlight the need for complementary methodologies. Real-world evidence (RWE), derived from real-world data (RWD) such as electronic health records and assisted reproductive technology (ART) registries, has the potential to bridge the gap between controlled research settings and routine clinical practice, particularly for evaluating long-term and rare outcomes. However, RWE faces considerable challenges, including bias, variability in data quality, and difficulties in establishing causality. This paper explores the role of RWE in ART. Despite its promise, RWE cannot replace RCT, particularly in scenarios where the signal-to-noise ratio is low, such as detecting small effect differences in ovarian stimulation protocols or treatment add-ons. Instead, in most instances, RWE is positioned to complement RCT, supported by emerging regulatory frameworks such as the guidelines of the European Medicine Agency and the European Union's tissue directives, which emphasize the generation of RWE from ART practice to strengthen patient follow-up and safety monitoring. For ART stakeholders, a comprehensive understanding of the strengths and limitations of RWE is essential, as is the target trial emulation framework on RWD, for advancing the field and improving patient outcomes.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 4","pages":"Article 104807"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863682","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(25)00116-6","DOIUrl":"10.1016/S1472-6483(25)00116-6","url":null,"abstract":"","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 4","pages":"Article 104909"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863685","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":"Human fertility at a crossroad","authors":"Bart CJM Fauser ,&nbsp;Luca Gianaroli ,&nbsp;Edgar Mocanu","doi":"10.1016/j.rbmo.2024.104787","DOIUrl":"10.1016/j.rbmo.2024.104787","url":null,"abstract":"<div><div>Since the early 1970s, family planning policies aiming to reduce global population growth have been successful. Currently, more than 50% of all countries are (way) below the replacement level of 2.1 child per woman. Underpopulation causes distinct society challenges in many countries. More focus on family-building strategies (including decreasing barriers for people who would like to establish a family) is urgently needed.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 4","pages":"Article 104787"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863727","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":"Oocyte development: it's all about quality","authors":"Richard A. Anderson ,&nbsp;Adele L. Marston ,&nbsp;Evelyn E. Telfer","doi":"10.1016/j.rbmo.2025.104804","DOIUrl":"10.1016/j.rbmo.2025.104804","url":null,"abstract":"<div><div>Mammalian fertility depends on the production of an oocyte capable of fertilization and supporting early embryo development. This requires both cytoplasmic and nuclear, i.e. chromosomal, competence, processes that were initiated decades prior to ovulation. Current demographic changes with delayed motherhood are increasingly in conflict with these biological processes. This brief review highlights the key stages in oocyte development, as well as recent findings that continue to inform on how the oocyte is able to maintain function over such a prolonged period. These include minimizing oocyte damage caused by the production of reactive oxygen species, the importance of intercellular communication with the surrounding somatic cells, and the molecular mechanisms that underpin the fidelity of chromosome cohesion and then separation at the resumption of meiosis. Some of these are already approaching clinical testing and interventions, with new approaches in the coming years potentially being able to ‘put back the clock’ to improve oocyte quality.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 4","pages":"Article 104804"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863674","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":"Shaping the future of the IVF laboratory: standardization for more predictable outcomes","authors":"Mina Alikani ,&nbsp;Alison Campbell","doi":"10.1016/j.rbmo.2025.104854","DOIUrl":"10.1016/j.rbmo.2025.104854","url":null,"abstract":"<div><div>IVF is the foundational technology in the broader field of assisted reproductive technology (ART). The IVF laboratory is at the heart of ART, both as a major source of innovation and advancement and as a key to the success of the treatments. However, substantial variability in laboratory practices persists, despite longstanding efforts to establish uniform standards for improved reliability, reproducibility, and comparability. This commentary highlights the core factors contributing to disparity in outcomes and illustrates how emerging technologies, particularly artificial intelligence and robotics, offer new opportunities to propel standardization forwards. By integrating data-driven benchmarks and automated processes, including in quality management, the future IVF laboratory can achieve better and more predictable outcomes and advance the global standard of care.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 4","pages":"Article 104854"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863692","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 evolution of preimplantation genetic testing: where is the limit?","authors":"Antonio Capalbo ,&nbsp;Dagan Wells","doi":"10.1016/j.rbmo.2025.104845","DOIUrl":"10.1016/j.rbmo.2025.104845","url":null,"abstract":"<div><div>Preimplantation genetic testing (PGT) has revolutionized reproductive medicine over the past 30 years, providing a reliable method for reducing the risk of transmitting severe inherited conditions and offering the possibility of improved IVF outcomes. Today, PGT is widely accepted and integrated into fertility care in many countries around the world. Its history, however, has not been without controversy, with debate around its application to the diagnosis of late-onset disorders, conditions with incomplete penetrance and its use for embryo selection based upon human leukocyte antigen status. Nonetheless, PGT has progressively broadened its scope, and the number of embryos undergoing genetic testing continues to grow each year. Preimplantation genetic testing is most often used for the detection of chromosomal abnormalities, assisting in the identification of embryos affected by lethal aneuploidy. This application has generated the greatest debate of all, owing, in part, to difficulties delivering effective embryo testing using earlier methods. In recent years, advances in technology and rigorous validation studies have helped to improve accuracy, although variability among methods underscores the need for greater standardization and transparency. Emerging technologies, such as whole genome sequencing (WGS) and genome editing, hold promise for further advancements but introduce complex ethical, privacy and consent challenges that demand careful consideration, public engagement and thorough clinical research before implementation. Given its current trajectory, it seems likely that the use of PGT will continue to grow, offering reduced reproductive risks and the possibility of enhanced fertility treatment outcomes for ever greater numbers of patients, ultimately becoming an accepted cornerstone of reproductive care.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 4","pages":"Article 104845"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863693","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":"Twenty-five years of research in endometriosis","authors":"Juan A. Garcia-Velasco ,&nbsp;Paola Viganò ,&nbsp;Edgardo Somigliana","doi":"10.1016/j.rbmo.2025.104830","DOIUrl":"10.1016/j.rbmo.2025.104830","url":null,"abstract":"<div><div>Research rarely progresses in a straight line. It is more like an unpredictable front, marked by bursts of brilliance that fade after a few years, sudden breakthroughs, periods of stagnation, rediscoveries of forgotten ideas and occasional setbacks. Endometriosis research is no exception to these dynamics. In this opinion piece, three Generation X researchers who have been dedicated to endometriosis since the early days of their careers reflect on the field's progress over the past 25 years. Their verdict? Not disappointing. In fact, some pivotal strides have been made. The understanding of endometriosis has undergone a dramatic transformation. Hormonal therapies and assisted reproductive technology have emerged as first-line treatments, dethroning the once-central role of surgery. Non-invasive diagnosis of the disease has spread. This shift marks a notable evolution in how the disease is managed. However, high-throughput technologies have failed to deliver transformative insights, and the root causes of the disease remain as elusive as ever. Despite the setbacks, the progress made offers hope and direction.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 4","pages":"Article 104830"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863676","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":"Influence of trophectoderm biopsy for preimplantation genetic testing in the serum level of first trimester biomarkers","authors":"Pilar Prats ,&nbsp;María Gabriela Palacios-Verdú ,&nbsp;Alberto Rodríguez-Melcón ,&nbsp;Ignacio Rodríguez ,&nbsp;Bernat Serra ,&nbsp;Mónica Parriego ,&nbsp;Valeria Donno ,&nbsp;Nikolaos P. Polyzos","doi":"10.1016/j.rbmo.2024.104490","DOIUrl":"10.1016/j.rbmo.2024.104490","url":null,"abstract":"<div><h3>Research question</h3><div>Does trophectoderm biopsy for preimplantation genetic testing for aneuploidies (PGT-A) affect maternal serum first-trimester pregnancy biomarkers (pregnancy-associated plasma protein A [PAPP-A], free β-HCG and placental growth factor [PIGF])?</div></div><div><h3>Design</h3><div>Retrospective cohort study of all singleton pregnancies (<em>n</em> = 9794) after naturally conceived (<em>n</em> = 8005) IVF and fresh embryo transfers (<em>n</em> = 478), frozen embryo transfer of non PGT-A (FET) (<em>n</em> = 963) or PGT-A tested embryos (FET + PGT-A) (<em>n</em> = 348). Serum levels of free β-HCG and PAPP-A were measured in all women with a viable pregnancy at 8–13.6 weeks of pregnancy; PIGF was measured in 3784 women. Biomarkers were converted to a multiple of the expected normal median (MOM) for a pregnancy of the same gestational day. The medians for the multiple of the median were calculated and compared.</div></div><div><h3>Results</h3><div>Free β-HCG did not differ according to mode of conception. The PAPP-A concentrations were significantly lower in IVF and fresh embryo transfers (–0.1 Log10 MOM raw PAPP-A) compared with FET + PGT-A (–0.04 Log 10 MOM raw PAPP-A, <em>P</em> = 0.009) and natural conceptions (–0.0187 Log 10 MOM raw PAPP-A) (<em>P</em> &lt; 0.001). The PIGF levels were significantly lower in the FET + PGTA group versus natural conception (<em>P</em> = 0.001). Difference in means adjusted by crown rump length was 4.6 pg/ml (95% CI 2.7 to 6.6) for natural conceptions, 3.5 pg/ml (95% CI 0.34 to 6.6) for IVF and 2.2 pg/ml (95% CI 0.06 to 4.4) for FET.</div></div><div><h3>Conclusion</h3><div>Trophectoderm biopsy for PGT-A has a significant effect on first-trimester maternal serum PAPP-A and PIGF. This needs to be further validated, as it may mislead the estimation of the first-trimester risk of aneuploidies and pre-eclampsia.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 3","pages":"Article 104490"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371009","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}