Bjog-An International Journal of Obstetrics and Gynaecology最新文献

{"title":"Effect of Comprehensive Individualised Interventions on the Clinical Outcomes of Patients With Recurrent Implantation Failure: A Single-Centre Retrospective Cohort Study","authors":"Yuan Li, Qi Zhao, Xiangxiu Fan, Shujuan Ma, Ge Lin, Fei Gong","doi":"10.1111/1471-0528.18093","DOIUrl":"10.1111/1471-0528.18093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to evaluate the impact of comprehensive individualised interventions on the clinical outcomes of patients with recurrent implantation failure (RIF), as few studies have evaluated their effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Tertiary hospital, from June 2016 to December 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Overall, 1546 patients with RIF underwent endometrial biopsy during implantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The comprehensive individualised interventions were conducted on the basis of the endometrial histological dating, endometrial CD138 count, endometrial immune-cell proportion and endometrial microbiota testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Cumulative ongoing pregnancy rate (cOPR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median number of failed transfer cycles was 3 (range, 2–12), and the cOPR was 58.0%. The rates of window of implantation (WOI) displacement, CD138 positivity, imbalanced endometrial immune-cell proportion, endometrial microbiota testing, multiple factors and unexplained RIF were 34.0%, 9.3%, 7.5%, 4.1%, 32.4% and 12.7%, respectively. The cOPRs of the individualised frozen embryo transfers in patients having RIF with WOI displacement, WOI CD138 positivity, imbalanced endometrial immune-cell proportion, endometrial microbiota testing, multiple factors and unexplained RIF were 64.1%, 57.6%, 55.1%, 38%, 64.2% and 34.5%, respectively. After adjusting for basic characteristics through logistic regression analysis, the cOPRs of the WOI displacement group, WOI CD138 positive group and immune-cell proportion imbalanced group remained higher than that of the unexplained RIF group. However, the cOPR was comparable between the endometrial microbiota testing and unexplained RIF groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Comprehensive individualised interventions may improve clinical outcomes for patients with RIF, warranting further investigation.</p>\u0000 </section>\u0000 ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S2","pages":"83-91"},"PeriodicalIF":4.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal and Neonatal Outcomes Following In Vitro Fertilisation in Poor Ovarian Responders: A Prospective Single-Centre Observational Study","authors":"Cuiping Hu,&nbsp;Tianxiang Ni,&nbsp;Zhangwei Jia,&nbsp;Jianye Deng,&nbsp;Jing Li,&nbsp;Qian Zhang,&nbsp;Mingdi Xia,&nbsp;Juanjuan Lu,&nbsp;Junhao Yan","doi":"10.1111/1471-0528.18046","DOIUrl":"10.1111/1471-0528.18046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the risk of adverse perinatal and neonatal outcomes between individuals with poor ovarian response (POR) and those with normal ovarian response (NOR) following in vitro fertilisation (IVF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A prospective single-centre observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>University hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Overall, 1663 patients who underwent embryo transfer cycles between June 2017 and August 2019 were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The patients were divided into the POR and NOR groups based on the Bologna diagnostic criteria. The risk of perinatal and neonatal complications was then compared between groups with adjustment made for confounding factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The risk of perinatal and neonatal complications between the POR and NOR groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with the NOR group, the POR group had poor pregnancy outcomes but comparable overall risks of poor perinatal and neonatal outcomes. The overall incidence rate of complications was 25.42% and 25.30% in the POR and NOR groups respectively [risk ratio (RR): 1.01; 95% confidence interval (CI): 0.63–1.59]. In subgroup analysis of singleton live births, the overall risk of total complications was higher in the POR group than in the NOR group (24.07% vs. 15.21%; RR: 1.77; 95% CI: 1.04–3.00); however, the risks became comparable between them after logistic regression adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The overall risk of perinatal and neonatal complications among singleton live births was higher in patients with POR than in those with NOR; however, the risks became similar after logistic regression adjustment. Our findings provide overall comforting evidence for POR patients with IVF treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S2","pages":"36-43"},"PeriodicalIF":4.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caesarean Scar Endometrial Defects Contribute to Post-Caesarean Abnormal Uterine Bleeding and Chronic Endometritis: A Retrospective Case–Control Study","authors":"Yanpeng Wang,&nbsp;Yongshu Han,&nbsp;Xiaoyan Guo,&nbsp;Qianqian Wei,&nbsp;Yan Xia,&nbsp;Leilei Gao,&nbsp;Huihua Wang,&nbsp;Xue Lu,&nbsp;Jing Shu","doi":"10.1111/1471-0528.18089","DOIUrl":"10.1111/1471-0528.18089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the role of endometrial defects in the pathogenesis of abnormal uterine bleeding (AUB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective case–control study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Two tertiary centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population or Sample</h3>\u0000 \u0000 <p>We included 155 patients with caesarean scar defects (CSDs) who underwent hysteroscopy (69 AUB, 86 non-AUB). Thirty patients with AUB were successfully matched with 30 patients without AUB after propensity score matching (PSM) based on CSD size and number of previous caesarean sections, which indicate myometrial defect severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Hysteroscopic features of CSD before and after PSM were compared between two groups. Pathological features of 13 patients in each group with biopsies of the CSD surface and uterine endometrium were compared, including endometrial thickness determined by haematoxylin–eosin staining, vascular density identified by CD31 staining and chronic endometritis assessed by plasma cells stained with CD138.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Incidence of hysteroscopic and pathological features of CSD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before PSM, the AUB group exhibited larger diverticulum sizes and more severe myometrial CSD defects than the non-AUB group. After PSM, five features of endometrial defects demonstrated statistically significant differences: in situ haemorrhage, bloody mucus, epithelial deficiency, exposed blood vessels and hyperplastic vessels. Pathological assessments also revealed significant differences in endometrial thickness of CSD, local vascularization and plasma cell count at CSD between the AUB and non-AUB groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endometrial defects at caesarean scars contribute more to AUB than myometrial defects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S2","pages":"132-139"},"PeriodicalIF":4.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive Implications and Management of Congenital Uterine Anomalies (2024 Second Edition)","authors":"M. A. Akhtar,&nbsp;S. H. Saravelos,&nbsp;T. C. Li,&nbsp;K. Jayaprakasan,&nbsp;the Royal College of Obstetricians and Gynaecologists","doi":"10.1111/1471-0528.18054","DOIUrl":"10.1111/1471-0528.18054","url":null,"abstract":"<p>Congenital uterine anomalies (CUAs) are malformations of the uterus (womb) that develop during fetal life. When a female baby is in her mother's uterus, her uterus develops as two separate halves from two tubular structures called Müllerian ducts, which fuse together before she is born. Anomalies that occur during the baby's development can be variable, from complete absence of the uterus through to more subtle anomalies, which are classified into specific categories. While conventional ultrasound is good at detecting CUAs, 3D ultrasound is used to confirm a diagnosis. If a complex uterine anomaly is suspected, additional investigations may be used, including MRI scanning, laparoscopy (where a camera is inserted into the cavity of the abdomen) and/or hysteroscopy (where a camera is placed in the uterine cavity). As there can be a link between CUAs and anomalies of the kidney and bladder, scans of these organs are also usually requested.</p><p>Although CUAs are present at birth, adult women typically do not have any symptoms, although some may experience painful periods. Most cases of CUA do not cause difficulties in becoming pregnant, and the outcome of pregnancy, in most cases, is good. However, these uterine anomalies are often discovered during investigations for infertility or miscarriage. Moreover, depending upon the type and severity of CUA, there may be increased risk of first and second trimester miscarriages, preterm birth, fetal growth restriction (smaller and lighter babies for the stage of pregnancy), pre-eclampsia (development of high blood pressure and protein in urine after the 20th week of pregnancy) and fetal malpresentation (baby not facing head-first down the birth canal) at birth. Surgical treatment may be considered for those who have had recurrent miscarriages and have a septate uterus, i.e. the uterine cavity is divided by a partition. In this case, surgery may reduce the chances of miscarriage. However, women should be informed that there is inconclusive and conflicting evidence regarding the improved likelihood of live births in this context. Further evidence from large randomised controlled trials are required to provide conclusive evidence-based recommendations for surgical treatment for septate uterus. Surgical treatment for other types of CUAs is not usually recommended as the risks outweigh potential benefits, and evidence for any benefits is lacking. Women with CUAs may be at an increased risk of preterm birth even after surgical treatment for a septate uterus. These people, if suspected to be at an increased risk of preterm birth based on the severity of CUA, should be followed up using an appropriate protocol for preterm birth as outlined in UK Preterm Birth Clinical Network Guidance.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"e86-e97"},"PeriodicalIF":4.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bringing Endometriosis to the Road of Contemporary Pain Science","authors":"Marcelo de França Moreira,&nbsp;Marco Aurelio Pinho Oliveira","doi":"10.1111/1471-0528.18096","DOIUrl":"10.1111/1471-0528.18096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endometriosis pain is mainly understood based on peripheral lesion characteristics and an outdated perspective equating nociception with pain. This limited view may divert understanding of interventions beyond peripheral logic, leading clinicians to see approaches targeting other processes as supplementary, limiting the effective addressing of treatment failure. Integrating critical advancements in pain and endometriosis can promote more comprehensive knowledge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This article provides a conceptual framework focusing on overlooked or less clearly linked areas concerning the interplay between nociception and factors influencing endometriosis pain. It explores the complexity of nociceptive processing, the association between neuromerically connected structures, and the role of the brain in pain perception. Further, it emphasizes adopting mechanism-based understanding of pain that integrates neurobiological aspects of the nociceptive apparatus and related systems, shaped by psychosocial factors contributing to a possible negative spiral in those living with endometriosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Aware of such a broader perspective can incentivize a balanced effort to inquire into peripheral lesion-related mechanisms and other domains potentially impacting endometriosis pain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"685-693"},"PeriodicalIF":4.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Screening for CMV Primary Infection: A Cost-Utility Model","authors":"Gebrael El Hachem,&nbsp;Thomas G. Poder,&nbsp;Catherine Mc Carey,&nbsp;Soren Gantt,&nbsp;Fatima Kakkar,&nbsp;Marc Sab,&nbsp;Christian Renaud,&nbsp;Isabelle Boucoiran","doi":"10.1111/1471-0528.18080","DOIUrl":"10.1111/1471-0528.18080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Congenital cytomegalovirus (CMV) infection is a major cause of deafness and neurodevelopmental disability in children. Our objective was to assess the cost utility of first-trimester serological CMV screening, compared to screening of high-risk pregnancies and no serological screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A decision-analytic model was created to compare the cost utility of three strategies from a healthcare sector perspective: universal first-trimester serological screening, screening only of high-risk pregnant women (both including antiviral prophylaxis in cases of primary infection) and serological testing triggered by foetal morphological ultrasound (no CMV serological screening).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Canada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Hypothetical population of 80 000 pregnant women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Probability, expected values and cost estimates were derived from published literature and local hospital and national insurance data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure</h3>\u0000 \u0000 <p>Cost per maternal and infant quality-adjusted life year (QALY) lost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Universal serological screening was superior to both screening of high-risk women and no screening (utility of −0.42, −0.63 and − 0.87 QALY lost, respectively). Sensitivity analysis demonstrated that universal screening was the most cost-effective strategy regardless of the incidence of primary infection, the acceptability of amniocentesis and the efficacy of antiviral prophylaxis. In the Monte Carlo analyses, universal serological screening was the most cost-effective option in 96.36% of simulations. Universal serological screening would allow detection of 152 cases of primary maternal CMV infection and would prevent 29 cases of congenital CMV infection annually.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings support the adoption of a population-based prenatal screening programme for the prevention of congenital CMV infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"805-815"},"PeriodicalIF":4.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal Physical Activity Interventions and Pregnancy Outcomes: A Systematic Review and Meta-Analysis With a Focus on Trial Quality","authors":"Amanda J. Poprzeczny,&nbsp;Andrea R. Deussen,&nbsp;Megan Mitchell,&nbsp;Laura Slade,&nbsp;Jennie Louise,&nbsp;Jodie M. Dodd","doi":"10.1111/1471-0528.18084","DOIUrl":"10.1111/1471-0528.18084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Guidelines recommending regular physical activity in pregnancy for improving pregnancy outcomes are informed by published meta-analyses. Inclusion of randomised trials of poor methodological quality may bias effect estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the validity of these recommendations by focusing on trial quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>Systematic search of PubMed, PubMed Central, Ovid Medline, Embase, Cochrane Central Register of Controlled Trials, and CINAHL from inception to 14 December 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Randomised trials evaluating an antenatal physical activity intervention alone, compared with no such intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Trial quality was assessed using the Cochrane Risk of Bias tool. Independent of this, studies were grouped based on degree of deviation from the intention to treat principle. Sequential meta-analysis was performed in which greater degrees of potential bias were allowed. Between intervention group comparisons used, relative risks or mean differences with 95% confidence intervals for dichotomous outcomes and continuous outcomes, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>Overall, the quality of trial reporting was low. Only 5 trials (12.5%) were performed and analysed in keeping with the intention to treat principle. When considering only those trials performed rigorously, there was no evidence that antenatal physical activity improves pregnancy outcomes or limits gestational weight gain (WMD −0.60 kg; 95% CI −2.17, 0.98 WMD −0.60 kg; 95% CI −2.17, 0.98).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>When considering only trials at no/negligible risk of bias, antenatal physical activity interventions were not associated with improved pregnancy outcomes. Most trials were not methodologically rigorous. Incorporation of such meta-analyses into pregnancy care guidelines may result in inaccurate recommendations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"709-723"},"PeriodicalIF":4.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effectiveness of Assisted Oocyte Activation in ICSI: Pairwise Meta-Analyses and Systematic Evidence Evaluation","authors":"Mohamed Fawzy,&nbsp;Mohamad AlaaEldein Elsuity,&nbsp;Yasmin Magdi,&nbsp;Mosab Mahmod Rashwan,&nbsp;Mostafa Ali Gad,&nbsp;Nehal Adel,&nbsp;Mai Emad,&nbsp;Dina Ibrahem,&nbsp;Sara El-Gezeiry,&nbsp;Ahmed Etman,&nbsp;Niveen Shaker Ahmed,&nbsp;Tamer Abdelhamed,&nbsp;Ahmed El-Damen,&nbsp;Ali Mahran,&nbsp;Gamal I. Serour,&nbsp;Mohamed Y. Soliman","doi":"10.1111/1471-0528.18085","DOIUrl":"10.1111/1471-0528.18085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Artificial oocyte activation (AOA) is used to improve fertilisation rates in intracytoplasmic sperm injection (ICSI) cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the effectiveness of AOA on fertilisation, embryo development, and clinical outcomes, including live birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>We searched PubMed, Cochrane, and Scopus from January 1990 to March 2024 using terms related to ‘artificial oocyte activation’ and ‘ICSI.’</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Study designs included randomised trials (RCTs), quasi-experimental, cohort, and case–control studies that evaluated AOA's effects on ICSI outcomes, provided quantitative data and were published in English.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Reviewers independently performed data extraction using a standardised form. Study quality was appraised using Joanna Briggs Institute (JBI) Checklists. Meta-analyses employed a random-effects model, and evidence was classified using a comprehensive numerical framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>We included 45 studies covering 56 787 mature oocytes, 7463 women for clinical pregnancies, and 7063 women for live births. AOA showed potential in increasing fertilisation rates in patients with a history of low or absent fertilisation but did not enhance embryo development or clinical outcomes. This effect diminished when excluding low-quality studies or focusing solely on RCTs. In other patient groups, AOA showed limited or nonsignificant benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Applying comprehensive evidence assessment, AOA showed potential in improving fertilisation rates in patients with fertilisation problems but no benefits for embryo development or live birth rates. This underscores the critical importance of rigorous evidence credibility in informing clinical practice in assisted conception.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"724-741"},"PeriodicalIF":4.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Pregnant Women's Participation in Randomised Clinical Trials in India: A Qualitative Study","authors":"Mridula Shankar,&nbsp;Umesh Charantimath,&nbsp;Ashwini Dandappanavar,&nbsp;Alya Hazfiarini,&nbsp;Yeshita V. Pujar,&nbsp;Manjunath S. Somannavar,&nbsp;Sara Rushwan,&nbsp;Joshua P. Vogel,&nbsp;A. Metin Gülmezoglu,&nbsp;Shivaprasad S. Goudar,&nbsp;Meghan A. Bohren","doi":"10.1111/1471-0528.18074","DOIUrl":"10.1111/1471-0528.18074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore factors affecting participation of pregnant women in randomised clinical trials in Belagavi, Karnataka, India.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative study using semi-structured in-depth interviews and focus group discussions as data collection methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Primary, secondary and tertiary health facilities and their community catchment areas in Belagavi district.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Sample</h3>\u0000 \u0000 <p>Thirty-three in-depth interviews with health workers and previous participants of a pregnancy-focused trial, and 12 focus group discussions with currently pregnant women who had not previously participated in a clinical trial, family and community members, and accredited social health activists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Inductive thematic analysis with a team-based approach to interpretation in the study context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pregnant women were often unable to distinguish between maternal health programmes and trial interventions. Among previous trial participants, expectations of higher quality care were a key motivation for trial participation. Household gendered power relations and trust in the health workforce influenced decisional dynamics regarding participation. Health workers vouched for trial safety, once they assessed the intervention as acceptable. Trial Implementation by the health workforce required understanding and navigating pregnancy-related beliefs and practices in communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anticipated health benefits, improved healthcare access, and trust in health workers are facilitators of trial participation. Engaging primary decision-makers is essential due to household gender dynamics. Trials must integrate strategies that clarify the distinct goals of research versus clinical care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"772-781"},"PeriodicalIF":4.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Laser-Assisted Hatching on Cognitive and Metabolic Development of Singletons Conceived Through Frozen–Thawed Embryo Transfer: A Matched Cohort Study","authors":"Xin-Yi Liu,&nbsp;Chun-Xi Zhang,&nbsp;Jian-Peng Chen,&nbsp;Qi Liang,&nbsp;Yi-Qing Wu,&nbsp;Jing-Lei Xue,&nbsp;Ling-Hui Li,&nbsp;Qi-Qi Xu,&nbsp;Fang-Hong Zhang,&nbsp;Ying-Zhi Yang,&nbsp;Yue-Mei Wang,&nbsp;Yi-Feng Liu,&nbsp;Dan Zhang","doi":"10.1111/1471-0528.18047","DOIUrl":"10.1111/1471-0528.18047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to examine the impact of laser-assisted hatching (LAH) on the physical, metabolic, cognitive and behavioural profiles of singletons conceived through frozen–thawed embryo transfer (FET) at the preschool age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A matched cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The reproductive centre of Women's Hospital, Zhejiang University School of Medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Singletons born to couples with infertility who underwent FET cycles with or without LAH treatment from 2016 to 2019 and were followed up till age 4–6 years in 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cognitive and behavioural development was evaluated at the preschool age using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) and the Adaptive Behavior Assessment System, Second Edition (ABAS-II). Statistical analysis was performed using moderated multiple linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The full-scale intelligence quotient (FSIQ) and general adaptive composite (GAI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 120 pairs of mother and child were included in the analysis. No significant differences in age, sex, height, weight, body mass index, blood pressure, thyroid function and metabolic indicators were observed between the two groups. After adjusting for demographics and socioeconomic status, LAH singletons showed FSIQ and GAI scores similar to those of non-LAH singletons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>At 4–6 years of age, the cognitive, metabolic and physical developmental outcomes of preschool children born after LAH treatment were comparable with those of the non-LAH group, indicating that LAH may be considered a safe assisted reproductive technology method. However, further longer and regular follow-ups are needed to validate the findings of this study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S2","pages":"18-25"},"PeriodicalIF":4.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}