European Journal of Obstetrics and Gynecology and Reproductive Biology: X最新文献

{"title":"The benefits of testosterone therapy for menopausal symptoms","authors":"Jillian Chan ,&nbsp;Julia Cunningham ,&nbsp;Colin Cunningham ,&nbsp;John Cunningham ,&nbsp;Catherine Cunningham","doi":"10.1016/j.eurox.2025.100440","DOIUrl":"10.1016/j.eurox.2025.100440","url":null,"abstract":"<div><h3>Objectives</h3><div>This study will address the effects of testosterone pellet therapy in menopausal women treated over a ten-year period.</div></div><div><h3>Study design</h3><div>A retrospective review of a single gynecologic practice was performed to evaluate patients treated with subcutaneous testosterone pellet therapy for androgen deficiency. Consent was obtained from all patients before pellet placement. Women completed a menopause rating scale (MRS) questionnaire prior to starting therapy and before the third pellet placement. Patients were treated every 3 months. Blood work was obtained prior to treatment, before the third pellet insertion and then yearly. Non-parametric analysis was performed using the Wilcoxon signed-rank test and the Bonferroni test was used to correct for comparisons across multiple domains. A p value of less than 0.05 was considered significant.</div></div><div><h3>Main outcome measures</h3><div>Scores on the MRS were calculated as medians and compared from the initial MRS to the subsequent MRS questionnaire. Patient’s age and peak testosterone levels were used to evaluate the effect of therapy on menopausal symptoms. Side effects from therapy were noted at follow-up visits.</div></div><div><h3>Results</h3><div>There were 78 patients who completed both MRS questionnaires. A comparison of results from the initial and subsequent MRS questionnaire showed that median scores were significantly reduced in all eleven categories of symptoms. Scores improved in all categories of patient age and peak testosterone levels. The most common side effects were acne and facial hair. These were treated with dose reduction and or spironolactone therapy.</div></div><div><h3>Conclusions</h3><div>The use of testosterone pellet therapy in women with androgen deficiency results in rapid and sustained relief of menopausal symptoms in all age groups and at all testosterone levels. Further studies are needed to optimize the use of testosterone in women with menopausal symptoms.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100440"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926457","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":"Evaluation of pregnancy outcomes using a novel hysterosalpingography scoring system for tubal patency","authors":"Huijun Yang ,&nbsp;Yali Xu ,&nbsp;Saiming Cheng ,&nbsp;Haixia Zhang ,&nbsp;Jiejun Cheng ,&nbsp;Feng Gao","doi":"10.1016/j.eurox.2025.100437","DOIUrl":"10.1016/j.eurox.2025.100437","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate pregnancy rates using a novel classification system based on hysterosalpingography (HSG) findings, categorizing tubal patency as either patent or functionally deficient. Furthermore, the study assesses the predictive value of this scoring system for fertility outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted involving 4461 patients who underwent HSG at an academic radiology center between January 2020 and December 2022. HSG findings and subsequent pregnancy outcomes were systematically analyzed.</div></div><div><h3>Results</h3><div>Of the 2461 patients initially followed up, 301 were excluded due to incomplete data, resulting in a final cohort of 2160 patients. Within two years post-HSG, 970 patients (44.9 %) achieved natural pregnancy, 808 (83.2 %) of whom resulted in live births. In vitro fertilization (IVF) pregnancies accounted for 35.8 % (n = 775). Ectopic pregnancies occurred in 1.8 % of patients, with a higher incidence in those with unilateral tubal occlusion. Using the novel scoring system—where Score 0 indicates bilateral patency, Score 1 indicates unilateral functional deficiency, and Score 2 indicates bilateral functional deficiency—the Score 0 group exhibited the highest natural pregnancy rate (51.1 %), which was significantly higher than that of the Score 1 and Score 2 groups. Natural pregnancy rates were 20.8 % for unilateral hydrosalpinx and 36.7 % for unilateral occlusion. Only 5 % of patients with bilateral hydrosalpinx conceived naturally. Age was a significant factor; women under 35 years had a natural pregnancy rate of 46.8 %, compared to 10.2 % in those over 40 years.</div></div><div><h3>Conclusion</h3><div>Tubal patency status is significantly associated with pregnancy outcomes, and functional deficiencies appear to reduce fertility. The proposed HSG-based scoring system serves as a valuable predictive tool for pregnancy potential. Additionally, the presence of hydrosalpinx is associated with adverse pregnancy rates.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100437"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665556","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":"Transvaginal radiofrequency ablation for uterine myomas: A preliminary ecuadorian study","authors":"Hernan Sabay ,&nbsp;Maritza Freire ,&nbsp;Belen Tite ,&nbsp;Eduardo Pilatuna ,&nbsp;Paola Solis- Pazmino","doi":"10.1016/j.eurox.2025.100443","DOIUrl":"10.1016/j.eurox.2025.100443","url":null,"abstract":"<div><h3>Background</h3><div>Transvaginal radiofrequency ablation (TVRFA) is a minimally invasive, incisionless, outpatient procedure. This study evaluates the feasibility, outcomes, and complications of TVRFA in women with symptomatic uterine myomas (UMs).</div></div><div><h3>Methods</h3><div>This preliminary single-center, retrospective study included 79 women treated with TVRFA between December 2021 and April 2024 in Quito, Ecuador. Women with 1–4 UMs of any size or type were eligible. Preoperative and follow-up assessments included transvaginal ultrasound (TVUS) for both uterine and myoma volume. Outcomes (uterine and myoma volume + complications) were assessed at 45 days and 6 months. Complications were classified by Clavien–Dindo. Statistical analyses used paired tests for baseline vs. follow-up comparisons, with missing data excluded from each analysis.</div></div><div><h3>Results</h3><div>The median baseline uterine volume was 160.0 mL. At 6 months, this decreased to 91.0 mL (−43.1 %, p &lt; 0.001). The median baseline myoma volume was 22.5 mL, which decreased to 7.7 mL at 45 days (−55.1 %) and 3.7 mL at 6 months (−81.5 %, p &lt; 0.001). Follow-up was completed by 68/79 patients (86.1 %) at 45 days and 59/79 (74.7 %) at 6 months. Minor complications occurred in 12.7 %, most commonly skin burns at the electrode site. Two patients (2.5 %) experienced intestinal perforation requiring surgery.</div></div><div><h3>Conclusion</h3><div>TVRFA significantly reduced both uterine and myoma volumes, supporting its role as a minimally invasive alternative for fibroid management. However, the observed complication rate, particularly intestinal perforation, requires critical attention to operator training and procedural refinements. Prospective studies with standardized symptom measures are warranted.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100443"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977307","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 obesity on perioperative outcomes in robot-assisted surgery for endometrial cancer: A single-center study of 119 cases","authors":"Yasushi Iida ,&nbsp;Miwako Shimazaki ,&nbsp;Ayane Kosuge ,&nbsp;Takahiro Matsunami ,&nbsp;Kosuke Kato ,&nbsp;Teppei Ichikawa ,&nbsp;Taichi Irie ,&nbsp;Makoto Iizuka ,&nbsp;Daishi Hirano ,&nbsp;Satoshi Takakura","doi":"10.1016/j.eurox.2026.100446","DOIUrl":"10.1016/j.eurox.2026.100446","url":null,"abstract":"<div><h3>Introduction</h3><div>Whether obesity (body mass index [BMI] ≥30 kg/m²) independently affects perioperative outcomes in robot-assisted surgery for endometrial cancer remains uncertain.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective single-center cohort including 119 consecutive patients who underwent a uniform robotic procedure—total hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy using the da Vinci Xi system—between November 2018 and June 2025. Patients were grouped by BMI ≥ 30 (n = 32) versus &lt; 30 (n = 87). Outcomes were estimated blood loss (EBL), operative time, lymph-node yield, and length of stay (LOS). Multivariable linear regression adjusted for age, prior abdominal/pelvic surgery, comorbidity history (diabetes, hypertension, dyslipidemia), operating surgeon, and surgical year (2018–2020 vs 2021–2025).</div></div><div><h3>Results</h3><div>BMI ≥ 30 was independently associated with higher EBL and longer operative time, and prior surgery also prolonged operative time. Surgeon effects were pronounced for efficiency and nodal retrieval; BMI was not associated with lymph-node yield. LOS was not associated with BMI; however, LOS was higher in later surgical years and varied by surgeon.</div></div><div><h3>Conclusion</h3><div>In standardized robot-assisted endometrial cancer surgery, obesity increased intraoperative workload (blood loss and operative time) without reducing lymph-node yield. LOS reflected surgeon- and time-related factors rather than BMI. These findings support the feasibility of robotic surgery in patients with obesity and underscore the importance of surgeon experience, pathway fidelity, and ongoing quality improvement.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100446"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182729","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":"Targeted metabolomics and fatty acid profiling in lean and obese polycystic ovarian syndrome patients: A pilot study","authors":"Emilin Zacharias ,&nbsp;Rukmini Mysore Srikantiah ,&nbsp;Sindhu H ,&nbsp;Shraddha Shetty K ,&nbsp;Aparna Rajesh Bhat ,&nbsp;Shrinath Pratap Shetty ,&nbsp;Sonali Ullal ,&nbsp;Himani Kotian ,&nbsp;Varashree B.S ,&nbsp;YS Phaneendra Mallimoggala","doi":"10.1016/j.eurox.2026.100445","DOIUrl":"10.1016/j.eurox.2026.100445","url":null,"abstract":"<div><h3>Introduction</h3><div>Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting approximately 10 % of women globally, with variations in prevalence across geographic regions. It is strongly associated with metabolic disturbances causing dyslipidaemia, increased risk for diabetes and cardiovascular diseases. This study investigates the metabolic implications of body mass index (BMI) in PCOS, focusing on targeted metabolomics and fatty acid profiling.</div></div><div><h3>Methodology</h3><div>23 PCOS patients and 12 normal healthy female participants in the age group 17–35 years were recruited. PCOS was diagnosed based on revised Rotterdam criteria and classified into respective phenotypes. PCOS patients were further categorized into lean (n = 15) and obese (n = 8) groups based on BMI. Absolute quantification of fatty acids was done by Gas Chromatography (GC)-mass spectrometry (MS). ANOVA was used to compare between the PCOS subgroups. Metabolic enrichment pathway analysis was used for the identified fatty acids.</div></div><div><h3>Results</h3><div>Significantly different fatty acid profiles were observed between the PCOS and control groups. Elevated level of hexadecenoic acid (8.819 ± 2.63 µg/mL) was found in PCOS subjects compared to controls. Cis-10-heptadecenoic acid levels were highest in control (59.8 ± 3.17 µg/mL) and lean PCOS (59.0 ± 3.35 µg/mL) subjects. The phenotype B demonstrated significantly higher levels of 9-hexadecenoic acid (13.576 ± 0.132 µg/mL) than other phenotypes. Functional enrichment analysis and Variable Importance in Projection (VIP) score calculation revealed dysregulated very long-chain fatty acid oxidation, fatty acid biosynthesis, and arachidonic acid metabolism in PCOS.</div></div><div><h3>Conclusion</h3><div>Fatty acid profiling and metabolic analysis showed dysregulation between PCOS subjects based on BMI. The lean PCOS could be more involved with hormonal regulation than the adipocyte dysfunction.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100445"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143786","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":"Association of umbilical cord venoarterial differences, ΔpH, to morbidity and mortality up to 20 years of follow-up: A cohort study","authors":"Tiia-Marie Sundberg ,&nbsp;Karin Källén ,&nbsp;Mehreen Zaigham","doi":"10.1016/j.eurox.2026.100447","DOIUrl":"10.1016/j.eurox.2026.100447","url":null,"abstract":"<div><h3>Introduction</h3><div>Umbilical cord blood measurement is the gold standard of evaluating neonatal metabolic status at birth. Dual sampling of cord blood vessels is clinical routine, yet the long-term value of venoarterial differences (ΔpH) is undetermined. The objective was to investigate the association of ΔpH, to long-term mortality and morbidity up to 20 years.</div></div><div><h3>Material and methods</h3><div>This was a retrospective cohort study with singleton births 1997–2012 at Skåne University hospital, Malmö, Sweden. Validated umbilical cord blood records were crosslinked to data from high quality national registers. Hazard ratios (HR) for diagnosis according to International Classification of Disease version 10 (00−99) during the follow-up period were calculated for the ≤ 10th/10th–90th/≥ 90th percentiles of ΔpH, adjusted for maternal age, smoking, body mass index, parity and gestational age.</div></div><div><h3>Results</h3><div>The study population was comprised of 35 171 births meeting the inclusion criteria after validation. Of the included births 4 956/14.1% had a small ΔpH (≤0.040), 26 690/75.9% normal ΔpH (0.041–0.150) and 3 525/10.0% large ΔpH (≥0.151). HR were statistically significant for small ΔpH for diseases of the eye and adnexa, crude HR:1.095 (95%CI:1.021–1.175), adjusted HR:1.081 (95%CI 1.007–1.160). No other organ system diseases were associated with small/large ΔpH.</div></div><div><h3>Conclusion</h3><div>ΔpH showed no strong long-term association of increased risk of organ-system related morbidity or mortality with twenty years of follow-up time. Multiple comparison may explain statistically significant finding of HR diseases of the eye and adnexa. Dual umbilical cord blood sampling remains vital clinically, ensuring correct sampling.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100447"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327548","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":"Results of relugolix/estradiol/norethisterone acetate combination therapy in real-world clinical practice: Effectiveness, tolerability, and factors influencing discontinuation","authors":"A. Santalla-Hernández,&nbsp;M. Naveiro-Fuentes,&nbsp;N. Esquinas-Orellana,&nbsp;LM Benítez-Cejas,&nbsp;M. García-Rivera,&nbsp;J. Fernández-Parra","doi":"10.1016/j.eurox.2025.100442","DOIUrl":"10.1016/j.eurox.2025.100442","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the real-world effectiveness, safety, and tolerability of relugolix/estradiol/norethisterone acetate combination therapy (relugolix CT) for managing symptomatic uterine fibroids in routine gynaecological practice.</div></div><div><h3>Methods</h3><div>A retrospective, observational study was conducted at a tertiary hospital in Spain between June 2023 and January 2025. Adult women with symptomatic uterine fibroids treated with relugolix CT were included, either as a long-term treatment or preoperative management. Clinical outcomes were assessed at baseline, 6 months, and in a subset of patients, at 12 months. Primary endpoints included changes in total bleeding days, heavy menstrual bleeding (HMB) days, and UFS-QoL symptom severity scores (SSS), as well as treatment adherence and adverse events.</div></div><div><h3>Results</h3><div>Among the 142 women who initiated treatment, Relugolix CT significantly reduced total bleeding days (from 12 to 2.2), HMB days (from 7.1 to 0.4), and UFS-QoL SSS (from 27.9 to 15.1) at 6 months (p &lt; 0.05). Amenorrhea was achieved in 52.7 % at 6 months and 66 % at 12 months. Better clinical outcomes were linked to continued treatment. Adverse events were reported in 34.5 % of patients, primarily abdominal pain and vasomotor symptoms. Bone densitometry at 12 months showed no osteoporosis and mild osteopenia in a few patients. Discontinuation was most commonly due to planned surgery or perceived lack of efficacy.</div></div><div><h3>Conclusion</h3><div>Relugolix CT demonstrates strong real-world effectiveness and tolerability for managing symptomatic uterine fibroids, with marked improvements in bleeding and quality of life, and a favourable safety profile.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100442"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926455","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":"Ultrasound-guided quadratus lumboum block versus transversus abdominis plane block for post-operative analgesia in patients undergoing total abdominal hysterectomy: A systematic review and meta-analysis","authors":"Hossein Jalilzadeh ,&nbsp;Amirali Farshid ,&nbsp;Mahla Esmaeili ,&nbsp;Yasaman Tamaddon ,&nbsp;Sanam Faizabadi ,&nbsp;Neda Hashemi ,&nbsp;Kimia Mohammadi ,&nbsp;Arash Saberian ,&nbsp;Soroush Yousefi ,&nbsp;Elahe Ahsan ,&nbsp;Rasoul Hossein Zadeh ,&nbsp;Reza Hossein Zadeh ,&nbsp;Mahdyieh Naziri ,&nbsp;Niloofar Deravi","doi":"10.1016/j.eurox.2025.100441","DOIUrl":"10.1016/j.eurox.2025.100441","url":null,"abstract":"<div><h3>Purpose</h3><div>Total abdominal hysterectomy is associated with moderate to severe postoperative pain, often requiring multimodal analgesic strategies. This meta-analysis compares the efficacy of ultrasound-guided quadratus lumborum block (QLB) versus transversus abdominis plane (TAP) block for pain control in this setting.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in January 2025 across PubMed, Scopus, and Web of Science, restricted to English-language publications. Study selection and data extraction followed standard protocols and PRISMA guidelines, with screening performed in two phases and study quality rigorously assessed. Outcomes were synthesized using random-effects meta-analysis, and risk of bias was evaluated.</div></div><div><h3>Results</h3><div>Eight randomized controlled trials (RCTs), encompassing 623 patients, met eligibility criteria and were included in the analysis. QLB was associated with significantly lower postoperative pain scores compared to TAP at 12 h (Hedges’ g = −4.48; 95 % CI: −8.04 to −0.92; p = 0.01) and 24 h (Hedges’ g = −4.16; 95 % CI: −7.56 to −0.77; p = 0.02). No significant differences were observed in duration of analgesia (Hedges’ g = 0.64; p = 0.65) or surgery time (Hedges’ g = 0.02; p = 0.86). Notable, persistent heterogeneity was present across most outcomes. Subgroup and sensitivity analyses did not identify determinants for this variation, and publication bias assessment by trim-and-fill indicated robust primary findings. However, the review was limited by restriction to selected databases, exclusion of gray literature, and inclusion of English-language studies only.</div></div><div><h3>Conclusion</h3><div>Ultrasound-guided QLB may provide superior analgesia to TAP block following total abdominal hysterectomy. Nonetheless, substantial between-study heterogeneity and database/language restrictions limit the generalizability of these findings. Future large-scale, high-quality trials—incorporating standardized endpoints, broader database searching, non-English studies, and gray literature—are warranted to further clarify the optimal regional analgesic approach post-TAH.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100441"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926456","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":"Trimester-specific reference intervals for serum N-acetyl-β-D-glucosaminidase in healthy pregnant women in Hainan, China","authors":"Fen Zhou,&nbsp;Yichuan Wang,&nbsp;Ying Zheng,&nbsp;Desheng Wang,&nbsp;Meng Chang,&nbsp;Shichuan Wang","doi":"10.1016/j.eurox.2026.100444","DOIUrl":"10.1016/j.eurox.2026.100444","url":null,"abstract":"<div><div>The absence of gestational age-specific reference intervals for serum N-acetyl-β-<span>D</span>-glucosaminidase (NAG) in pregnant women may lead to clinical misinterpretation. This study aimed to establish trimester-specific reference intervals for serum NAG in healthy pregnant women from Hainan, China, and to characterize its dynamic changes throughout gestation. In this cross-sectional study, 2416 healthy women with singleton pregnancies were stratified by gestational age into three groups: first trimester (1–12 +6 weeks; <em>n</em> = 1295), second trimester (13–27 +6 weeks; <em>n</em> = 670), and third trimester (28–40 weeks; <em>n</em> = 451). Serum NAG levels were measured, and trimester-specific reference intervals were established using the 2.5th to 97.5th percentiles. Serum NAG concentrations increased significantly with advancing gestation (<em>P</em> &lt; 0.0001). The established reference intervals were 12.0–40.0 U/L for the first trimester, 16.0–63.2 U/L for the second trimester, and 29.3–107.0 U/L for the third trimester—all substantially higher than those of the non-pregnant control group (8.0–23.4 U/L). The median NAG level in the third trimester (56.2 U/L) represented a 143 % increase compared to the first trimester (22.5 U/L). This study provides the first gestational age-specific reference intervals for serum NAG in pregnant women in a tropical region of China. The findings confirm that physiological NAG levels increase progressively with gestational age. The use of non-pregnant reference intervals in clinical practice may lead to misclassification of renal function during pregnancy, underscoring the necessity of adopting trimester-specific reference standards in prenatal laboratory settings.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100444"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077968","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 effect of laser-assisted hatching on clinical outcomes of frozen-thawed embryo transfer at different embryo ages","authors":"Min-Min Ou ,&nbsp;Bi-Yun Liao ,&nbsp;Xing-Hong Chen ,&nbsp;Lin-Lin Hu ,&nbsp;Yu-Lan Lu ,&nbsp;Hai-Mei Qin ,&nbsp;Jun-Li Wang ,&nbsp;Yu-Xia Wei","doi":"10.1016/j.eurox.2026.100448","DOIUrl":"10.1016/j.eurox.2026.100448","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the impact of laser-assisted hatching (LAH) on clinical outcomes in patients undergoing frozen-thawed embryo transfer (FET) cycles with embryos at different developmental stages.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 2208 patients who underwent vitrification-thawed FET at our reproductive center between October 2018 and June 2024, with some patients contributing multiple cycles. Patients were stratified by embryonic developmental stage into cleavage-stage FET (n = 793) and blastocyst-stage FET (n = 1415) groups. Each group was further subdivided based on post-thawing LAH implementation: Non-LAH and LAH subgroups (cleavage-stage: Non-LAH (n = 363) vs. LAH (n = 430); blastocyst-stage: Non-LAH (n = 532) vs. LAH (n = 883)). Embryological parameters and clinical outcomes were compared across subgroups. Binary logistic regression analysis was performed to assess the impact of LAH on live birth rates after adjusting for confounding factors.</div></div><div><h3>Results</h3><div>In cleavage-stage FET, LAH group had higher clinical pregnancy rate (39.3% vs 27.5%), implantation rate (25.2% vs 17.7%) and live birth rate (25.8% vs 19.8%) than Non-LAH group (P &lt; 0.05), but lower multiple pregnancy rate (5.9% vs 15.0%, P &lt; 0.05). In blastocyst-stage FET, the LAH group had a higher clinical pregnancy rate (67.6% vs 58.5%) and implantation rate (65.0% vs 52.3%) than the Non-LAH group (P &lt; 0.001). There were no statistically significant differences in the miscarriage rate, birth defect rate, and singleton birth weight between the LAH group and the Non-LAH group of different embryo ages (P &gt; 0.05). Binary logistic regression analysis showed that after adjusting for confounding factors, LAH could increase the live birth rate of patients with cleavage FET (OR=1.529, 95% CI=1.081–2.162, P = 0.016). However, it had no effect on the live birth rate of FET patients at the blastocyst stage (OR=0.988, 95% CI=0.794–1.230, P = 0.914).</div></div><div><h3>Conclusion</h3><div>In the FET cycles, LAH can improve the live birth rate of patients undergoing cleavage-stage FET, especially for women aged ≥ 35 years or those with ≤ 2 previous transfers, but has no significant effect on the live birth rate of patients undergoing blastocyst-stage FET. LAH did not increase the risk of perinatal outcomes in either the cleavage-stage or blastocyst-stage embryo transfer.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100448"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147395503","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}