FS Reports最新文献

{"title":"Time to pregnancy in young women with high response to controlled ovarian stimulation undergoing fresh transfer vs. a freeze-all strategy after in vitro fertilization treatment—a nationwide register-based cohort study","authors":"Emily Jacobs M.D., Karen Summers M.P.H., C.H.E.S., Amy Sparks Ph.D., Brad Van Voorhis M.D., Abey Eapen M.B.B.S., Ph.D.","doi":"10.1016/j.xfre.2025.07.002","DOIUrl":"10.1016/j.xfre.2025.07.002","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the time to pregnancy in women ≤37 years of age with high response to controlled ovarian stimulation and undergoing an initial fresh transfer vs. those women proceeding with a freeze-all strategy.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Subjects</h3><div>The study included 56,614 women, aged ≤37 years and those with ≥15 oocytes retrieved after their first oocyte retrieval for in vitro fertilization (IVF) between January 2014 and December 2019, with data entered in the Society of Assisted Reproductive Technology Clinical Outcomes Reporting System.</div></div><div><h3>Exposure</h3><div>Initial fresh autologous IVF and fresh embryo transfer cycles compared with a freeze-all strategy of embryos</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was time to pregnancy resulting in live birth, defined as the start of controlled ovarian stimulation through 10 days after embryo transfer. Secondary end points included clinical pregnancy rate (CPR), miscarriage rate, live birth rate (LBR) per embryo transfer, rates of ovarian hyperstimulation syndrome, singleton birthweights, and preterm birth rate. The outcomes were assessed with proportional hazard regression analysis and adjusted for body mass index, protocol type, insemination method, days of ovarian stimulation, number of embryos transferred in the initial cycle, and reporting year of retrieval cycle. Further, a subgroup analysis was performed based on the number of oocytes retrieved (cohort A: 15–19, cohort B: 20–24, cohort C: 25–29, cohort D: 30–34, cohort E: 35–39, and cohort F: ≥40).</div></div><div><h3>Results</h3><div>A total of 56,614 patients were included in the analysis. A total of 35,058 women (mean [SD] age, 31 [3.28] and mean [SD] body mass index, 26.4 [6.23]) underwent fresh embryo transfers and 21,556 women (mean [SD] age, 31 [3.32] and mean [SD] body mass index, 26.3 [6.19]) underwent a freeze-all strategy. The time to pregnancy in weeks, mean (SD) in women who had a fresh embryo transfer was 12.6 (20.6) and 20.8 (21.9) in women who used the freeze-all strategy. After adjusting for multiple treatment variables there was a statistically significant shorter time to pregnancy in those who had a fresh embryo transfer than those who used a freeze-all strategy (adjusted hazard ratio, 1.66 [95% confidence interval {CI}, 1.62–1.69], adjusted mean difference, −8.1 [95% CI, −8.64 to −7.55] weeks). In the adjusted subgroup analyses, the significant reduction in time to pregnancy between groups was compromised by a statistically significant reduction in LBR and CPR in the initial transfer cycle, but not the cumulative outcomes. The adjusted relative risk, 95% CI for LBR between groups in cohort A was 0.94 (0.92–0.97) and cohort F was 0.79 (0.72–0.87). The adjusted relative risk, 95% CI for CPR between groups in cohort A was 0.91 (0.89–0.94) and cohort F was 0.80 (0.74–0.87).</div></div><div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 309-318"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps and opportunities in polycystic ovary syndrome care—a qualitative study","authors":"Alexander Z. Zhang B.S. ,&nbsp;Madeleine Sehrt M.P.H. ,&nbsp;Sara A. Ley M.S., R.D. ,&nbsp;Kaitlin V. Ross Ph.D. ,&nbsp;Phoutdavone Phimphasone-Brady Ph.D. ,&nbsp;Kathryn M. McKenney M.D., M.P.H.","doi":"10.1016/j.xfre.2025.05.011","DOIUrl":"10.1016/j.xfre.2025.05.011","url":null,"abstract":"<div><h3>Objective</h3><div>To understand perceived shortcomings in polycystic ovary syndrome (PCOS) diagnosis and care among individuals living with PCOS.</div></div><div><h3>Design</h3><div>Qualitative study conducted at a university hospital Obstetrics and Gynecology clinic.</div></div><div><h3>Subjects</h3><div>Individuals diagnosed with or suspected to have PCOS.</div></div><div><h3>Exposure</h3><div>Virtual focus groups with semistructured questions.</div></div><div><h3>Main Outcome Measures</h3><div>Participants’ diagnosis with, management of, and ideal care approach for PCOS.</div></div><div><h3>Results</h3><div>Among 24 participants, 3 primary themes emerged: (1) symptom dismissal before diagnosis of PCOS negatively contributes to wellbeing, (2) goals of care between providers and participants were perceived as misaligned, often focusing exclusively on weight management and fertility, and (3) participants found self-advocacy as a necessary means to seek answers, resulting in use of social media as their main source of information.</div></div><div><h3>Conclusion</h3><div>PCOS is a complex condition in which symptoms are often dismissed by providers, leading to frustration and delay in care for individuals. These study results emphasize a need for greater educational resources and a revised approach toward more comprehensive management of PCOS.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 357-365"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of endometrial hyperplasia and carcinoma in women with polycystic ovarian syndrome","authors":"Ravi Agarwal M.D.,&nbsp;Frank Z. Stanczyk Ph.D.,&nbsp;Rachel Mandelbaum M.D.,&nbsp;Richard J. Paulson M.D.,&nbsp;Lynda K. McGinnis Ph.D.,&nbsp;Sharon A. Winer M.D.","doi":"10.1016/j.xfre.2025.06.007","DOIUrl":"10.1016/j.xfre.2025.06.007","url":null,"abstract":"<div><h3>Objective</h3><div>To measure the prevalence of EH and EC in women with PCOS.</div></div><div><h3>Design</h3><div>Prospective, cross-sectional study.</div></div><div><h3>Subjects</h3><div>208 women diagnosed with PCOS according to the Rotterdam criteria. Patients were excluded if all study variables were not measured/collected, or if they were on hormone treatment within 3 months of diagnosis.</div></div><div><h3>Intervention</h3><div>All women diagnosed with PCOS underwent an endometrial biopsy in the outpatient setting.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the prevalence of a normal endometrium, nonatypical EH (NAEH), atypical EH (endometrial intraepithelial neoplasia (EIN)), or EC on endometrial biopsy.</div></div><div><h3>Results</h3><div>146 PCOS women (70%) had a normal endometrium, 19 (9%) had NAEH, 31 (15%) had EIN, and 12 (6%) had EC. Compared with women with a normal endometrial biopsy, patients with EC were significantly older (32.1 vs. 28.8 years) and had lower levels of free and total testosterone (5.2 vs. 9.3 pg/mL and 33.9 vs. 60.9 ng/dL, respectively).</div></div><div><h3>Conclusion</h3><div>There is a high prevalence of EH and EC in PCOS women. The high risk of EIN and EC in an unselected population with PCOS strongly suggests that endometrial biopsy should be a part of the routine evaluation of women &gt;20 years old diagnosed with PCOS.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 394-398"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of ovulation induction in obese women with infertility after bariatric surgery","authors":"Miranda Blanco-Breindel M.D. ,&nbsp;Angela Hui-Chia Liu M.D. ,&nbsp;Andrew Rezk M.D. ,&nbsp;Esther Wu M.D. ,&nbsp;Harry J. Lieman M.D.","doi":"10.1016/j.xfre.2025.06.003","DOIUrl":"10.1016/j.xfre.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>To compare pregnancy rate (PR) and clinical pregnancy rates between obese women with a history of bariatric surgery and nonoperated controls undergoing ovulation induction (OI).</div></div><div><h3>Design</h3><div>Retrospective case-control study.</div></div><div><h3>Subjects</h3><div>Twenty-seven women with surgical weight loss in the case group (group 1), 2 nonoperated age-matched control groups consisting of 27 women with body mass index (BMI) similar to the preoperative BMI of case group (group 2), and 28 women matched by postoperative BMI of the case group (group 3).</div></div><div><h3>Exposure</h3><div>Bariatric surgery before OIs.</div></div><div><h3>Main Outcome Measures</h3><div>Cumulative PR and clinical pregnancy rates (CPRs).</div></div><div><h3>Results</h3><div>Group 1 cases and the 2 nonoperated obese control groups had pretreatment BMIs of 34.67, 41.51, and 35.83 kg/m², respectively. Each underwent 64 (group 1), 80 (group 2), and 68 (group 3) OI cycles. No significant differences were found in the mean follicular phase lengths (11.13, 13.39, and 12.14 days) and peak estradiol levels (166.17, 278.36, and 246.43 pg/mL). The outcomes of cumulative pregnancy rate were 12.50%, 10.00%, and 20.59% across the 3 groups. The cumulative CPR showed a trend toward improvement in group 3 (9.38%, 6.25%, and 19.12%).</div></div><div><h3>Conclusion</h3><div>Among women with infertility undergoing OIs, surgical weight loss may improve CPR despite a persistent obese postoperative BMI.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 245-250"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unscientific nature of the arguments of “Restorative Reproductive Medicine” and why we need to understand them","authors":"Richard J. Paulson M.D., M.S.","doi":"10.1016/j.xfre.2025.07.006","DOIUrl":"10.1016/j.xfre.2025.07.006","url":null,"abstract":"","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 235-236"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “Real-world use of an artificial intelligence–powered clinical decision support tool for ovarian stimulation”","authors":"Rishita Ojha B.Tech","doi":"10.1016/j.xfre.2025.07.004","DOIUrl":"10.1016/j.xfre.2025.07.004","url":null,"abstract":"","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Page 406"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AMY109, an interleukin-8 antibody, as a potential target for endometriosis treatment: a commentary","authors":"Taylor R. Wilson Ph.D.,&nbsp;Katherine A. Burns Ph.D.","doi":"10.1016/j.xfre.2025.08.003","DOIUrl":"10.1016/j.xfre.2025.08.003","url":null,"abstract":"","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 241-242"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “Utero-placental (vascular) development throughout pregnancy in women with polycystic ovary syndrome: the Rotterdam Periconceptional Cohort”: a call to clarify mechanisms and clinical implications","authors":"Shashank Dokania B.H.M.S.,&nbsp;Parth Aphale Ph.D.,&nbsp;Himanshu Shekhar B.H.M.S","doi":"10.1016/j.xfre.2025.05.010","DOIUrl":"10.1016/j.xfre.2025.05.010","url":null,"abstract":"","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 399-400"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of gonadotropin selection on risk of ovarian hyperstimulation syndrome in predicted high responders: a Menopur in Gonadotropin-releasing hormone Antagonist Single Embryo Transfer–High Responder trial analysis","authors":"Russell Foulk M.D. ,&nbsp;Cristin C. Slater M.D. ,&nbsp;Vishvanath Karande M.D. ,&nbsp;Lindsay K. Kelly Ph.D. ,&nbsp;Eric D. Foster Ph.D. ,&nbsp;Patrick W. Heiser Ph.D. ,&nbsp;Gaurang S. Daftary M.D., M.B.A. ,&nbsp;Sasmira Lalwani M.D","doi":"10.1016/j.xfre.2025.07.003","DOIUrl":"10.1016/j.xfre.2025.07.003","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the risk of ovarian hyperstimulation syndrome (OHSS) with highly purified human menopausal gonadotropin (HP-hMG) or recombinant follicle-stimulating hormone (rFSH) for controlled ovarian stimulation in patients predicted to be high responders.</div></div><div><h3>Design</h3><div>Post hoc analysis of a randomized, open-label, assessor-blind, parallel-group, noninferiority trial conducted at 31 US fertility centers.</div></div><div><h3>Subjects</h3><div>620 women with serum anti-Müllerian hormone (AMH) ≥5 ng/mL.</div></div><div><h3>Intervention</h3><div>Controlled ovarian stimulation with HP-hMG or rFSH in a gonadotropin-releasing hormone antagonist assisted reproductive technology cycle. Human chorionic gonadotropin trigger and fresh transfer of a single blastocyst was performed unless ovarian response was excessive; in this case, subjects received gonadotropin-releasing hormone agonist trigger and all embryos were cryopreserved. Subjects could undergo frozen blastocyst transfers within 6 months of randomization.</div></div><div><h3>Main Outcome Measures</h3><div>Demographic differences between subjects who developed OHSS and those who did not; incidence of OHSS based on trigger type; interaction between baseline AMH and oocyte yield by treatment group; and OHSS incidence based on number of oocytes retrieved by treatment group.</div></div><div><h3>Results</h3><div>Subjects who developed early OHSS were significantly younger, with lower weight and body mass index, shorter duration of infertility, and lower baseline estradiol than those who did not develop early OHSS. Among subjects who developed early OHSS, those treated with rFSH had a lower weight than those treated with HP-hMG; all other baseline demographics were similar between treatment groups. The rate of early OHSS was not significantly different based on trigger type. A statistically significant interaction was observed between baseline AMH and treatment group on the number of oocytes retrieved. Odds of early OHSS increased by 1.06 times (95% confidence interval [CI]: 1.04, 1.08) for each additional oocyte retrieved, independent of treatment group. Subjects with high oocyte yields (&gt;25) had lower early OHSS rates when treated with HP-hMG compared with rFSH (difference: 24%, 95% CI: 8.3, 36.2). Holding the number of oocytes constant, the odds of early OHSS in HP-hMG–treated subjects was 0.46 times (95% CI: 0.26, 0.82) that in rFSH-treated subjects.</div></div><div><h3>Conclusion</h3><div>In predicted high-responder patients, HP-hMG stimulation was associated with significantly diminished OHSS rates compared with rFSH, adjusted for oocyte yield.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 251-260"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro fertilization with preimplantation genetic testing compared with donor sperm and natural conception among male Robertsonian translocation carriers: a cost-effectiveness analysis","authors":"Samuel J.F. Melville M.D.,&nbsp;Ava Mandelbaum B.S.,&nbsp;Jeanne Shi M.D.,&nbsp;Molly Kornfield M.D.,&nbsp;Aaron B. Caughey M.D., Ph.D.,&nbsp;Sacha A. Krieg M.D. Ph.D.","doi":"10.1016/j.xfre.2025.06.005","DOIUrl":"10.1016/j.xfre.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the cost-effectiveness of reproductive strategies for male carriers of Robertsonian translocations.</div></div><div><h3>Design</h3><div>We designed a model to compare the outcomes and costs of three strategies: in vitro fertilization with preimplantation genetic testing for structural rearrangements (IVF PGT-SR), frozen donor sperm intrauterine insemination, and natural conception. The model was built using a Markov process to simulate one year of clinical care (up to 3 cycles of IVF, 6 intrauterine inseminations, or 12 attempts at natural conception), incorporating delays between cycles for adverse outcomes.</div></div><div><h3>Subjects</h3><div>Theoretical cohort of 2,751, an estimate of men aged 15–49 diagnosed with subfertility or nonsurgical sterility that are carriers of the most common Robertsonian translocation (13;14), within couples with fertility intention in one year.</div></div><div><h3>Exposure</h3><div>Reproductive strategy selection (IVF PGT-SR, donor sperm, natural conception).</div></div><div><h3>Main Outcome Measures</h3><div>Outcomes included cost and quality-adjusted life years (QALYs) for the parents in addition to secondary outcomes of live births and decreased miscarriages, stillbirths, Trisomy 13 diagnoses, terminations, and neonatal deaths. A willingness-to-pay threshold was set at $100,000/QALY.</div></div><div><h3>Results</h3><div>Compared with natural conception, donor sperm and IVF PGT-SR increased overall live births and decreased miscarriages, stillbirths, Trisomy 13 diagnoses, terminations, and neonatal deaths, albeit at a higher cost. Using donor sperm vs. IVF PGT-SR resulted in cost savings with modest reductions in poor outcomes. Both alternative strategies to natural conception were cost-effective. Donor sperm and IVF PGT-SR yielded incremental cost-effectiveness ratios of $2,019 per QALY and $8,469 per QALY compared with natural conception, respectively. Utilizing IVF PGT-SR vs. donor sperm was not cost-effective with an incremental cost-effectiveness ratio of $722,138 per QALY. However, in sensitivity analysis, IVF PGT-SR became cost-effective over donor sperm when the utility of non-biological progeny was less than 0.99.</div></div><div><h3>Conclusion</h3><div>For male rob(13;14) carriers, mother and offspring outcomes are improved with donor sperm and IVF PGT-SR. Utilizing donor sperm is a cost-effective conception strategy compared with both natural conception and IVF PGT-SR. For individuals strongly preferring biological progeny, IVF PGT-SR is cost-effective over donor sperm.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"6 3","pages":"Pages 280-288"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}