JBRA assisted reproduction最新文献

{"title":"Egg freezing in transgender men.","authors":"Caiane Gabrielle Souza de Paula, Paula Bruno Monteiro, Raissa de Vasconcelos Cavalcanti","doi":"10.5935/1518-0557.20260009","DOIUrl":"10.5935/1518-0557.20260009","url":null,"abstract":"<p><p>Transgender men are people who were biologically assigned female at birth but identify as men. It is important to consider the impacts of testosterone and reassignment surgery on fertility. Hormone therapy can compromise ovarian function, and surgery can result in the irreversible loss of reproductive capacity. Fertility preservation has emerged as a viable option for those who wish to have biological children. This study aimed to evaluate the effectiveness of this method in trans men, analyze the ovarian response to hormonal stimulation, and investigate the impact of the duration of therapy on the quality and quantity of oocytes. PubMed, SciELO, and LILACS databases were consulted, with articles from 2015 to 2025 in English, Portuguese, and Spanish, following the PRISMA guide. The data was organized in Microsoft Excel tables. Case, cohort, cross-sectional, prospective, and retrospective studies were included, excluding articles out of scope, unavailable, used animals, and reviews. Initially, 404 articles were identified, with four duplicates excluded. After screening, 25 articles remained for full reading, of which 13 were analyzed. The duration of hormone therapy varied between 2 and 12 years among the patients in the studies analyzed, and only one patient did not have sufficient data due to the absence of embryo transfer. The studies showed promising results for egg cryopreservation, even with prolonged use of testosterone, but there are still no definitive conclusions about the long-term effect on fertility. This review contributes to the understanding of fertility in trans men and their reproductive alternatives.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"602-608"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian hyperstimulation syndrome: severity predictors.","authors":"Magdalena Piróg, Olga Kacalska-Janssen, Alicja Ogiegło, Robert Jach","doi":"10.5935/1518-0557.20260034","DOIUrl":"10.5935/1518-0557.20260034","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate clinical and laboratory parameters associated with the severity of ovarian hyperstimulation syndrome (OHSS) and to assess pregnancy outcomes in women hospitalized with moderate or severe OHSS. Several risk factors, including elevated antral follicle count (AFC), anti-Mullerian hormone (AMH), and serum estradiol (E2) levels, increase the risk of OHSS.</p><p><strong>Methods: </strong>We studied 71 women with a median age of 32.7 years and a body mass index (BMI) of 22.8 kg/m2 with moderate (n=38) and severe (n=31) OHSS. We measured E2, hemoglobin (Hb), hematocrit (Hct), creatinine, albumin (Alb), total protein (TP), D-dimer (DD), and alanine aminotransferase (ALT) levels on the day of hospitalization and every second day until discharge. Data on the length of hospitalization, along with pregnancy outcomes, were recorded.</p><p><strong>Results: </strong>There were no intergroup differences between women with moderate and severe OHSS in terms of age and BMI. The total pregnancy rate in both moderate (18/38) and severe (9/31) OHSS was 27/69; however, in women with severe OHSS, the positive pregnancy outcome was approximately half that observed in the moderate OHSS group and was accompanied by longer hospitalization (2.9-fold). All women with OHSS had elevated initial E2 levels (>6910pg/mL). Women with severe OHSS had higher initial E2 (p=0.001) and Hct (p=0.006) levels, together with lower Alb and TP concentrations (both p<0.001), compared with those with moderate OHSS.</p><p><strong>Conclusion: </strong>Elevated estradiol concentration is an associated factor for OHSS in women undergoing COH. Basal serum albumin concentration, together with total protein level and hematocrit, are predictive factors for OHSS severity.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"481-489"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Experiences and Motivations of Oocyte Donors in Spain.","authors":"Marta Guerri Pons, Natalia Romera Agulló","doi":"10.5935/1518-0557.20260051","DOIUrl":"10.5935/1518-0557.20260051","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the psychological and emotional experiences of women who donated oocytes in Spain.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted between June 2024 and February 2025 at Instituto Bernabéu (Alicante) and Clínica Fertty (Barcelona). The sample consisted of women who met the inclusion criteria for oocyte donation programs. Participation was voluntary and anonymous, with informed consent obtained. The study was approved by the internal research committee of Instituto Bernabéu and registered under protocol MR48, in accordance with the Declaration of Helsinki. Data were collected using the EMODON questionnaire, developed ad hoc for this study, which assessed motivations, concerns, perceived professional support, and emotional state. Quantitative data were analyzed descriptively, and qualitative responses underwent thematic analysis.</p><p><strong>Results: </strong>The mean age was 25 years (SD=3.88). Most donors reported altruistic motivations (95%), while 61% cited financial compensation. Concerns before treatment were expressed by 55%, primarily regarding future fertility (70%), hormonal side effects (50%), and surgical risks (45%). During stimulation, 54% felt emotionally stable, 24% more irritable, and 13% reported a negative emotional impact overall. After donation, 92% felt calm and satisfied. Foreign donors reported higher irritability (34%) than Spanish donors (19%). Nearly all participants (99%) valued the professional support received. Regarding anonymity, 71.3% stated it would not affect them or had never considered it, while a minority reported concern or refusal to donate again.</p><p><strong>Conclusions: </strong>Oocyte donation was generally well tolerated emotionally, with high satisfaction regarding clinical support. Nonetheless, a vulnerable subgroup highlighted the need for targeted psychological assistance.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"540-547"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world evidence shows no consensus on PGT-A effectiveness depending on outcome denominator.","authors":"Jose G Franco, Claudia Petersen, Laura D Vagnini, Fabiana C Massaro, Bruna Petersen, Andreia Nicoletti, Juliana Ricci, Camila Zamara, Isabela M Pasotti, Renata A Pouza, Bianca C Matuella, Elisange-la V Espirito Santo, Joao B Meziara, Antonio H Oliani, Joao Batista A Oliveira","doi":"10.5935/1518-0557.20260056","DOIUrl":"10.5935/1518-0557.20260056","url":null,"abstract":"<p><strong>Objective: </strong>The routine use of preimplantation genet-ic testing for aneuploidy (PGT-A) remains controversial in assisted reproductive technology, particularly regarding its effectiveness in improving live birth rates. Evidence is derived from randomized controlled trials (RCTs), non-ran-domized studies, and real-world data (RWD). Although RCTs offer strong internal validity, they often lack exter-nal validity. Non-randomized studies may suggest associ-ations, but their lack of randomization limits causal infer-ence because of potential bias. RWD reflect routine clinical practice but are heterogeneous and prone to selection bias. A pooled evaluation restricted to RWD, supporting what is called real-world evidence (RWE), has not previ-ously been performed.</p><p><strong>Methods: </strong>A critical methodological issue is the de-nominator used to report live birth rate (LBR): per embryo transfer (ET), per oocyte retrieval (OR), or per cycle initiat-ed (CI). We performed a systematic review of RWD studies published between January 2020 and January 2026 using PubMed, Scopus, Google Scholar, and the Latin American Network Registration System. Studies were eligible if at least one arm included ≥800 cycles and reported live birth outcomes comparing PGT-A and non-PGT-A cycles.</p><p><strong>Results: </strong>Seven studies met the inclusion criteria, com-prising 70,816 live births in PGT-A cycles and 63,557 in controls. Reported LBRs ranged from 24% to 44% in non-PGT-A cycles and from 17% to 53% in PGT-A cycles. All studies reporting LBR per ET favored PGT-A. In contrast, studies reporting LBR per CI or OR favored the control group. The direction of effect was therefore fully explained by denominator choice.</p><p><strong>Conclusion: </strong>Real-world evidence does not demon-strate a consistent benefit of PGT-A, and the interpretation of effectiveness is strongly dependent on outcome denomi-nator selection. Therefore, the routine use of PGT-A should not be considered justified, and the medical literature has a duty to precisely define the subpopulations in which PGT-A might have value.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":"30 3","pages":"594-597"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural vs. artificial cycle for frozen embryo transfer: impact on clinical and obstetric outcomes.","authors":"Maria do Carmo Borges de Souza, Roberto de Azevedo Antunes, Marcelo Marinho de Souza, Ana Cristina Allemand Mancebo, Thaísa Damasceno Renovato, Verônica de Almeida Raupp, Ana Luísa Bruno Marinho de Souza, Flávia Fernandes Sequeira, Brenda Maria Loureiro de Melo, Karina Abelha Rabaço","doi":"10.5935/1518-0557.20260045","DOIUrl":"10.5935/1518-0557.20260045","url":null,"abstract":"<p><strong>Objective: </strong>To compare clinical, obstetric, and neonatal outcomes between natural and artificial endometrial preparation protocols for frozen embryo transfer (FET) in cycles involving single euploid blastocyst transfer.</p><p><strong>Methods: </strong>This retrospective observational study included only single embryo transfers of thawed day 5 or 6 good-quality blastocysts submitted to preimplantation genetic testing for aneuploidy (PGT-A) between January 2022 and May 2024. Patients were allocated to either natural or artificial endometrial preparation groups, and each group was further stratified into three subgroups according to luteal phase support: oral dydrogesterone, vaginal micronized progesterone, or combined treatment. Exclusion criteria were submucosal fibroids, endometrial polyps, intramural fibroids ≥5 cm, and hydrosalpinx detected on transvaginal ultrasound. Clinical pregnancy, live birth, miscarriage, neonatal birth weight, and gestational complications were analyzed using odds ratios (OR), confidence intervals (CI), p-values, generalized linear models, and z test, as appropriate.</p><p><strong>Results: </strong>The natural cycle group showed significantly better reproductive outcomes, with higher clinical pregnancy rates (OR=0.37; 95%CI: 0.13-1.02; p=0.047) and live birth rates (OR=0.46; 95%CI: 0.24-0.89; p=0.022), whereas the artificial cycle group had a significantly higher miscarriage rate (OR=2.96; 95%CI: 1.51-5.96; p=0.002). Analysis across the six subgroups demonstrated a significant advantage in clinical pregnancy among patients undergoing natural cycles with oral progesterone support. In contrast, miscarriage was significantly more frequent in the artificial cycle subgroup receiving oral progesterone than in the corresponding natural cycle subgroup. Neonatal birth weight was higher in artificial preparation cycles by a mean of 135.81 g, although this difference was not statistically significant (95%CI: -138.29 to 409.90; p=0.326). Among gestational complications, only gestational diabetes differed significantly between groups (z=2.156; p=0.03), while no significant differences were observed for preeclampsia or HELLP syndrome.</p><p><strong>Conclusion: </strong>True natural cycles were associated with significantly higher clinical pregnancy and live birth rates, as well as lower miscarriage rates, than artificial cycles in euploid frozen embryo transfer cycles.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"548-555"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological stress and semen quality impairment: A systematic review.","authors":"Ane Francyne Costa, Lucas Valentim Silveira, Fabiana Botelho de Miranda Onofre, Alexandre Sherlley Casimiro Onofre","doi":"10.5935/1518-0557.20260023","DOIUrl":"10.5935/1518-0557.20260023","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this review was to evaluate the extent to which psychological stress may adversely affect seminal quality parameters in men.</p><p><strong>Methods: </strong>A systematic review was conducted across databases including Embase, PubMed, Scopus, and Web of Science. Studies were subjected to data extraction, risk of bias, and narrative synthesis.</p><p><strong>Results: </strong>A total of 34 studies were included in this review. Three (8.82%) studies were judged to be at a high risk of bias. Included studies were published between 1988 and 2023 and concerned a total of 11,141 participants, ranging from 20 to 1,362 participants per study. Psychological stress negatively impacted semen volume in 12.9% of studies, sperm concentration in 52.9%, total sperm count in 56.3%, sperm motility in 63.3%, and sperm morphology in 21.4%. Sources of psychological stress such as academic stress, daily life stress, infertility-related stress, stressful life events, and work-related stress were correlated to impairment of semen parameters in 70.6% of included studies. The ability to draw robust conclusions is severely restricted by significant heterogeneity across the reviewed literature.</p><p><strong>Conclusions: </strong>This systematic review found that psychological stress is frequently associated with impaired semen parameters, particularly sperm concentration and sperm motility. Nevertheless, these findings should be interpreted with caution. Most of the reported associations are observational and do not establish a definitive causal relationship between psychological stress and semen quality impairment.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"628-640"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy-Induced Infertility: Mechanisms, Risk Factors, and Fertility Preservation Strategies in Cancer Patients.","authors":"Amirreza Talaie, Sanaz Alaee, Soudabeh Sabetian, Fatemeh Zal, Amin Tamadon","doi":"10.5935/1518-0557.20260014","DOIUrl":"10.5935/1518-0557.20260014","url":null,"abstract":"<p><p>Chemotherapy remains a cornerstone of cancer treatment, effectively targeting rapidly dividing cancer cells, yet its systemic effects often extend to healthy reproductive cells, resulting in temporary or permanent infertility. This review explores the mechanisms by which chemother-apy impairs fertility in both men and women, focusing on the damage to ovarian follicles and spermatogenesis. Key factors influencing fertility outcomes include the type and dosage of chemotherapy drugs, patient age, and pre-existing reproductive health. Alkylating agents, such as cyclophosphamide, and platinum-based drugs, like cisplatin, pose the highest risk of gonad-otoxicity, while other agents exhibit milder, often reversible effects. Fertility preservation op-tions such as oocyte and embryo freezing for women, sperm banking for men, and emerging techniques like ovarian and testicular tissue cryopreservation offer hope for maintaining re-productive potential. The psychological burden of infertility and the promising yet complex role of nanoparticles in reproductive medicine are also discussed. By synthesizing current research, this review underscores the need for personalized fertility counseling and advanced preserva-tion strategies to balance cancer treatment efficacy with reproductive goals.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"609-627"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity and weight loss differentially regulate autophagy in mouse ovarian granulosa cells.","authors":"Feng Li, Xinyan Chen, Xi Zhang, Jiajia Lu, Chenchen Xu, Huiming Ju, Tongmin Xue","doi":"10.5935/1518-0557.20260039","DOIUrl":"10.5935/1518-0557.20260039","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to elucidate the impact of obesity and weight loss on autophagic processes in ovarian granulosa cells (GCs), given the crucial roles that these cells and this process play in oogenesis.</p><p><strong>Methods: </strong>Three experimental groups were used: a control group (ND group), a high-fat diet-induced obese mouse model group (HFD group), and a swimming exercise group (SE group). Immunohistochemistry (IHC) and Western Blotting (WB) were used to detect protein expression in GCs.</p><p><strong>Results: </strong>LC3B expression was higher in the HFD and SE groups than in the ND group (p<0.01), but lower in the SE group than in the HFD group (p<0.05). p62 expression was lower in the HFD and SE groups than in the ND group (p<0.01 and p<0.05, respectively), but higher in the SE group than in the HFD group (p<0.05). The LC3B-II/I ratio was elevated in the HFD group versus the ND and SE groups (p<0.05). p62 expression was lower in the HFD group than in the SE and ND groups (p<0.05 and p<0.01, respectively), and lower in the SE group than in the ND group (p<0.01). In IHC, the p-mTOR/mTOR ratio was lower in the HFD group than in the ND group (p<0.05), but higher in the SE group than in the ND and HFD groups (p<0.01). The AMPK/AMPK ratio was higher in the HFD group than in the ND group (p<0.01), but lower in the SE group than in the HFD group (p<0.01). In WB, the p-mTOR/mTOR ratio was lower in the HFD and SE groups than in the ND group (p<0.01), but higher in the SE group than in the HFD group (p<0.05). p-RPS6/RPS6 ratio was lower in the HFD group than in the ND group (p<0.01), but higher in the SE group than in both groups (p<0.01).</p><p><strong>Conclusions: </strong>Our findings suggest that obesity activates granulosa cell autophagy via AMPK/mTOR signaling, while weight loss partially restores homeostasis.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"533-539"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Cooling Curve Type on Sperm DNA Integrity During Cryopreservation.","authors":"Letica Avi, João Paolo Bilibio, Ana Carolina Martinhago, Martina Cordini, Alfred Paul Senn, Vera Lucia Langaro Amaral","doi":"10.5935/1518-0557.20260047","DOIUrl":"10.5935/1518-0557.20260047","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether sperm DNA fragmentation is affected differently by cryopreservation techniques using different cooling curves before immersion in liquid nitrogen (LN₂).</p><p><strong>Methods: </strong>A paired case-control study was conducted with 21 semen samples from men undergoing fertility evaluation. Each sample (Fresh Group) was initially analyzed for sperm concentration, vitality, motility, and DNA fragmentation. The remaining semen was divided into two groups and subjected to different cryopreservation protocols: 1) preliminary refrigeration for 20 min at a cooling rate of -0.9°C/min, by exposure to liquid nitrogen vapor (Refrigerated Group), 2) direct exposure to liquid nitrogen vapor at a cooling rate of -20.5°C/min (Vapor Group).</p><p><strong>Results: </strong>Both cooling protocols (Refrigerated and Vapor) caused a significant reduction compared with the Fresh Group in progressive motility (49.0% vs. 30.4% and 27.4%, p<0.001) and sperm vitality (85.1% vs. 64.9% and 64.1%, p<0.001). No significant differences were observed between the Refrigerated and Vapor Groups in terms of recovery of vitality and motility (p=0.361 and p=0.718, respectively). DNA fragmentation increased from 27.4% in the Fresh Group to 39.6% in the Refrigerated Group and to 36% in the vapor Group (p<0.001). However, the Vapor Group showed a lower mean DNA fragmentation rate than the Refrigerated Group (p=0.001).</p><p><strong>Conclusion: </strong>Cryopreservation using direct exposure to liquid nitrogen vapor was associated with lower sperm DNA damage compared with the protocol involving pre-refrigeration, suggesting that faster cooling may better preserve DNA integrity during freezing.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"556-561"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 Receptor Agonists and Fertility: What Is Known So Far?","authors":"Alice Scalzilli Becker, Júlia Prauchner de Castilhos, Sophia Abur Said Shugair, Talita Colombo, Marta -Ribeiro Hentschke","doi":"10.5935/1518-0557.20260028","DOIUrl":"10.5935/1518-0557.20260028","url":null,"abstract":"<p><p>GLP-1 receptor agonists (GLP-1RAs) have gained attention as a potential adjunct in preconception care for women with polycystic ovary syndrome (PCOS) and infertility. This narrative literature review (June 2025) searched PubMed, SciELO, and LILACS using the descriptors \"weight loss medication,\" \"GLP-1 receptor agonists,\" \"liraglutide,\" \"semaglutide,\" \"fertility,\" \"PCOS,\" and \"reproductive outcomes,\" including studies published between 2014 and 2025, yielding 47 relevant articles. Overall, GLP-1RAs show consistent metabolic benefits and emerging evidence of improved reproductive outcomes in PCOS, with clinical trials reporting increased menstrual regularity, ovulation, and pregnancy rates-particularly when combined with metformin. Liraglutide (1.2-3.0 mg/day) and exenatide (10 µg twice daily) have been associated with improved follicular development and endometrial receptivity. Mechanistically, GLP-1 receptors are expressed in reproductive tissues, and these agents may exert anti-inflammatory, antifibrotic, and androgen-lowering effects; liraglutide has also been reported to restore granulosa-oocyte communication via suppression of CXCL10. In one randomized trial, pregnancy rates were higher with liraglutide plus metformin (69.2%) than with metformin alone (35.4%; p<0.05). Ovulation rates up to 86% have been described with exenatide plus metformin, exceeding those observed with monotherapy. Despite these signals of benefit, GLP-1RAs remain contraindicated during pregnancy due to limited human data and fetal risks observed in animal studies; semaglutide and tirzepatide require an 8-10 week washout period prior to conception, and tirzepatide may reduce oral contraceptive effectiveness because of delayed gastric emptying. In summary, GLP-1RAs are a promising strategy for preconception management in women with PCOS and obesity-related infertility, especially in combination with metformin, but they should be avoided during pregnancy and lactation, and individualized counseling is essential to align therapy with reproductive goals.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"649-657"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}