Current Opinion in Obstetrics & Gynecology最新文献

In-vitro fertilization laboratory safety: engineered through people, process, and planning. 体外受精实验室安全：通过人、过程和计划来设计。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-06-01 Epub Date: 2026-04-14 DOI: 10.1097/GCO.0000000000001104

Cihan Halicigil, Olga Chaplia

{"title":"In-vitro fertilization laboratory safety: engineered through people, process, and planning.","authors":"Cihan Halicigil, Olga Chaplia","doi":"10.1097/GCO.0000000000001104","DOIUrl":"10.1097/GCO.0000000000001104","url":null,"abstract":"Purpose of review: IVF laboratories operate in biologically constrained environments where strict timing and chain of custody govern patient safety. In the last decade, the field has undergone a seismic operational shift as the transition to the freeze-all model has exponentially increased specimen inventories, altering the risk profile from acute procedural errors to latent infrastructure and data management failures. This review examines the risks of relatively new field threats and outlines strategies necessary to mitigate them.Recent findings: As frozen embryo transfers increasingly dominate the assisted reproductive technology field and social freezing becomes prevalent, the risk for the embryos and gametes concentrates in a long-term perspective. While procedural error rate in IVF labs remains rare, reviews of recent disasters highlight vulnerabilities in cryostorage monitoring, proper witnessing, and data transferring.Summary: Modern IVF laboratories face tail-risk scenarios where rare equipment or data failures can affect hundreds of patients. Mitigating these threats requires a shift from relying on human alertness to preventive work resilience. Accreditation standards govern changes, while automated technologies such as weight-based cryostorage monitoring and electronic witnessing protect the identity, viability, and genetic integrity of patients' specimens.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"161-167"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of pregnancy loss following assisted reproductive treatment on outcomes of subsequent cycles. 辅助生殖治疗后流产对后续周期结果的影响。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-06-01 Epub Date: 2026-04-27 DOI: 10.1097/GCO.0000000000001102

Francesca Barrett, Emre Seli

{"title":"Impact of pregnancy loss following assisted reproductive treatment on outcomes of subsequent cycles.","authors":"Francesca Barrett, Emre Seli","doi":"10.1097/GCO.0000000000001102","DOIUrl":"10.1097/GCO.0000000000001102","url":null,"abstract":"Purpose of review: This article reviews recent literature on the impact of pregnancy loss in an embryo transfer on subsequent reproductive outcomes within assisted reproduction.Recent findings: Research supports that across fresh or frozen transfers with untested blastocysts, patients with a first biochemical or clinical pregnancy loss have a similar or decreased risk of pregnancy loss, and similar or improved pregnancy and live birth rates, compared to those with an implantation failure, in the subsequent cycle. While limited research has addressed the impact of pregnancy loss after a frozen embryo transfer with a euploid blastocyst, these patients appear to have similar odds of biochemical loss, clinical loss, and live birth in the next transfer cycle, compared to those who had a first failed transfer.Summary: Patients who experience a biochemical or clinical pregnancy loss after a first embryo transfer with an untested or euploid embryo can be reassured that they are not at increased risk of pregnancy loss or decreased risk of live birth in the subsequent cycle.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"183-191"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial intelligence in human-assisted reproduction: a paradigm shift still in search of clinical impact. 人工智能在人类辅助生殖：仍在寻求临床影响的范式转变。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-06-01 Epub Date: 2026-02-02 DOI: 10.1097/GCO.0000000000001092

Danilo Cimadomo, Giovanni Coticchio, Laura Rienzi

{"title":"Artificial intelligence in human-assisted reproduction: a paradigm shift still in search of clinical impact.","authors":"Danilo Cimadomo, Giovanni Coticchio, Laura Rienzi","doi":"10.1097/GCO.0000000000001092","DOIUrl":"10.1097/GCO.0000000000001092","url":null,"abstract":"Purpose: Artificial intelligence in human-assisted reproduction has attracted intense interest and inflated expectations, with proposed applications ranging from ovarian stimulation to gamete and embryo selection and outcome prediction. Despite the initial enthusiasm, its real-world clinical value remains uncertain. This review critically reassesses the current evidence to clarify where artificial intelligence meaningfully contributes and where expectations exceed demonstrated impact.Recent findings: Most published studies show relevant methodological weaknesses, including limited reproducibility, poor external validation, scarce explainability, and weak comparison with standard clinical practice. Research efforts have disproportionately focused on embryo selection, an area with intrinsically constrained potential to improve treatment efficacy, while other clinically relevant domains remain underexplored. As a result, reported improvements often concern surrogate or intermediate endpoints rather than robust clinical outcomes.Summary: Artificial intelligence holds greater promise in domains such as gamete assessment, automated data extraction, and personalized outcome prediction, where it may enhance treatment management, counselling, and decision-making for both clinicians and patients. Realizing this potential requires a strategic shift in research priorities and rigorous adherence to shared standards, including model transparency, uniformity, external validation, and benchmarking against established clinical workflows. Without such recalibration, artificial intelligence risks becoming a hyped technology with limited clinical relevance in assisted reproduction.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"168-176"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of serum progesterone levels in frozen embryo transfer: an update. 血清孕酮水平在冷冻胚胎移植中的作用：最新进展。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-06-01 Epub Date: 2026-03-02 DOI: 10.1097/GCO.0000000000001099

Elena Labarta, Linda C Giudice, Peter Humaidan

{"title":"Role of serum progesterone levels in frozen embryo transfer: an update.","authors":"Elena Labarta, Linda C Giudice, Peter Humaidan","doi":"10.1097/GCO.0000000000001099","DOIUrl":"10.1097/GCO.0000000000001099","url":null,"abstract":"Purpose of review: Progesterone plays a pivotal role in implantation and ongoing pregnancy. In the context of assisted reproductive technology (ART), and in particular frozen embryo transfer (FET), increasing evidence suggests that serum progesterone levels strongly influence reproductive outcomes. This review summarizes the latest findings regarding the optimal range of serum progesterone concentrations and their implications across different endometrial preparation protocols.Recent findings: Observational and interventional studies have consistently shown that suboptimal mid-luteal serum progesterone levels are associated with lower implantation and live birth rates in FET cycles. The need for exogenous supplementation varies according to the type of endometrial preparation, with hormone replacement therapy cycles being particularly sensitive to inadequate progesterone exposure. Emerging data support the concept of individualized luteal support, including serum-guided adjustments or alternative routes of administration in cases of suboptimal serum progesterone levels.Summary: Adequate serum progesterone concentrations are critical for optimizing outcomes after FET. Evidence supports a paradigm shift from empirical supplementation to precision medicine approaches based on serum thresholds and patient characteristics. Future research should aim to define universally accepted cutoff values, clarify the role of endometrial versus systemic progesterone, and refine strategies for tailoring luteal phase support in ART.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"139-146"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reproductive outcomes of mosaic embryo transfers - rethinking the clinical relevance of contemporary mosaicism reporting in preimplantation genetic testing for aneuploidy. 镶嵌胚胎移植的生殖结果——重新思考当代镶嵌现象在非整倍体植入前基因检测中的临床意义。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-06-01 Epub Date: 2026-04-27 DOI: 10.1097/GCO.0000000000001101

Christian Simon Ottolini, Silvia Caroselli, Antonio Capalbo

{"title":"Reproductive outcomes of mosaic embryo transfers - rethinking the clinical relevance of contemporary mosaicism reporting in preimplantation genetic testing for aneuploidy.","authors":"Christian Simon Ottolini, Silvia Caroselli, Antonio Capalbo","doi":"10.1097/GCO.0000000000001101","DOIUrl":"10.1097/GCO.0000000000001101","url":null,"abstract":"Purpose of review: Next-generation sequencing-based preimplantation genetic testing for aneuploidy (PGT-A) has enabled the detection of intermediate copy-number signals, leading to widespread clinical classification of embryos as chromosomally 'mosaic'. Mosaic embryo transfer (MET) is now routinely considered in assisted reproduction, yet the clinical relevance of mosaic classification remains uncertain. This review critically evaluates reproductive outcomes following MET in light of embryonic biology, technical constraints of PGT-A, and study design.Recent findings: Across the body of evidence, embryos labelled as mosaic retain substantial reproductive potential, with largely reassuring outcomes once implantation occurs. Apparent differences in reproductive efficiency, particularly among high-level mosaic categories, are better explained by study design bias, diagnostic imprecision, and classification artefact than by a clear biological intolerance to mosaicism. When selection bias and post hoc stratification are minimised, mosaic classification contributes little independent information beyond established clinical and embryological factors. The persistent signal observed in a small subset of embryos is increasingly attributable to misclassified constitutional aneuploidy rather than by adverse effects of mitotic mosaicism.Summary: These findings shift the conceptual framework away from mosaicism as a clinically actionable diagnosis and toward a model in which accurate identification of constitutional aneuploidy is the principal determinant of reproductive outcome.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"177-182"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is there a role for radiofrequency and assisted reproductive technology? 射频和辅助生殖技术有什么作用吗？

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-06-01 Epub Date: 2026-02-17 DOI: 10.1097/GCO.0000000000001097

María Cerrillo, Sergio Caballero

{"title":"Is there a role for radiofrequency and assisted reproductive technology?","authors":"María Cerrillo, Sergio Caballero","doi":"10.1097/GCO.0000000000001097","DOIUrl":"10.1097/GCO.0000000000001097","url":null,"abstract":"Purpose of review: The purpose of this study is to review the current evidence on the efficacy and safety of transvaginal radiofrequency ablation (TRFA) for the treatment of uterine fibroids and adenomyosis in infertile women, and to assess its feasibility as a fertility-preserving alternative to myomectomy.Recent findings: TRFA induces coagulative necrosis of fibroid tissue, achieving a 60-70% reduction in fibroid volume within 1 year while preserving uterine anatomy. Recent studies report pregnancy rates comparable to those of the general population, achieved through both spontaneous conception and assisted reproductive techniques. Large clinical series show no cases of uterine rupture or major obstetric complications attributable to the procedure. Initial fibroid volume appears to be a key determinant of time to conception, with larger fibroids requiring longer resorption periods.Summary: TRFA is a safe, minimally invasive technique that preserves uterine integrity and offers obstetric outcomes comparable to those of the general population. It represents an effective option to optimize the uterine environment prior to pregnancy, particularly in women with intramural fibroids.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"147-153"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evolving concepts in the world of vitrification. 玻璃化世界中不断发展的概念。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-06-01 Epub Date: 2026-04-14 DOI: 10.1097/GCO.0000000000001103

Miguel Gallardo, Ana Cobo, Laura Rienzi

{"title":"Evolving concepts in the world of vitrification.","authors":"Miguel Gallardo, Ana Cobo, Laura Rienzi","doi":"10.1097/GCO.0000000000001103","DOIUrl":"10.1097/GCO.0000000000001103","url":null,"abstract":"Purpose of review: Cryopreservation by vitrification has become a cornerstone of contemporary assisted reproductive technologies, enabling widespread use of embryo and oocyte banking and fundamentally reshaping IVF workflows. Although recent clinical practice has adopted shortened protocols for both preparation for vitrification and postwarming cryoprotectant elution, the fundamental biophysical principles governing vitrification - membrane transport, cellular dehydration, cooling and warming rates, and ice formation - occur at the same rates, neither faster nor slower, which the present review aims to clarify.Recent findings: A shortened equilibration phase can achieve intracellular glass-forming conditions comparable, but not identical, to conventional protocols for oocytes. However, certain biological characteristics hinder its application in blastocysts. One-step postwarming rehydration protocols for both blastocysts and oocytes are already being used clinically, but there may exist protocol-specific dependencies on prior cryoprotectant exposure and intracellular solute content.Summary: While emerging data suggest that fast vitrification and warming strategies can yield survival and developmental outcomes equivalent to standard protocols - and may offer logistical and physiological advantages - important knowledge gaps remain. Despite these advancements, there is still a strong need for improved permeability parameter estimation, modelling approaches, and prospective clinical studies to rationally optimize vitrification protocols to ensure robust, reproducible outcomes across diverse patient populations.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"154-160"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assisted reproductive technology for patients with medical comorbidities. 辅助生殖技术为患者的医疗合并症。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-05-08 DOI: 10.1097/GCO.0000000000001113

Lina Safi, Zain Al-Safi

{"title":"Assisted reproductive technology for patients with medical comorbidities.","authors":"Lina Safi, Zain Al-Safi","doi":"10.1097/GCO.0000000000001113","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001113","url":null,"abstract":"Purpose of review: We sought to review current principles for the management of patients with complex medical disease undergoing assisted reproductive technology (ART) and related fertility interventions, focusing on disease-specific considerations, risk mitigation during controlled ovarian stimulation and oocyte retrieval, medication management, peri-procedural anesthesia planning, and multidisciplinary care pathways.Recent findings: Increased use of ART refined the recommendations and guidelines to provide safe fertility planning and treatment in the setting of complex medical disease. Protocols continue to develop to enable safe application of ART for those individuals through a coordinated and patient-centered approach.Summary: Utilization of ART has expanded to include patients with significant medical comorbidities. These fertility treatments can shorten time to conception when pregnancy-incompatible therapies must be paused, preserve fertility while optimizing health, enable preimplantation genetic testing to prevent transmission of heritable conditions, and allow the use of gestational carriers when carrying pregnancy is unsafe. Success depends on individualized treatment plans developed and coordinated by a multidisciplinary team.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Activity restriction after minimally invasive gynecologic surgery. 微创妇科手术后活动限制。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-05-08 DOI: 10.1097/GCO.0000000000001112

Aliyah Ali, Tiffani-Amber Miller, Caitlin Waters, Sara Kim, Xun Lian

引用次数: 0

Genomic insights into endometriosis, adenomyosis, and uterine fibroids for the clinician. 子宫内膜异位症、子宫腺肌症和子宫肌瘤的临床基因组分析。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2026-05-08 DOI: 10.1097/GCO.0000000000001109

Michelle DenAdel, Caitlin Hamilton, Angela Frankel, Alan DenAdel, Marisa Dahlman

{"title":"Genomic insights into endometriosis, adenomyosis, and uterine fibroids for the clinician.","authors":"Michelle DenAdel, Caitlin Hamilton, Angela Frankel, Alan DenAdel, Marisa Dahlman","doi":"10.1097/GCO.0000000000001109","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001109","url":null,"abstract":"Purpose of review: Over the last few decades, genomics has become integral to understanding disease pathophysiology, improving diagnostics, and refining treatment strategies. Endometriosis, uterine fibroids, and adenomyosis are highly prevalent benign gynecologic disorders characterized by estrogen responsiveness, aberrant tissue growth, and overlapping clinical manifestations. The purpose of this review is to highlight the current genomic understanding of these conditions and their shared and distinct molecular features.Recent findings: Genome-wide association studies and sequencing efforts have identified multiple susceptibility risk loci and somatic mutations associated with uterine fibroids, adenomyosis, and endometriosis. These genetic variants provide insight into the pathogenesis of these conditions. Furthermore, while some genetic overlap between these conditions has been discovered, there are also important molecular distinctions between these diseases.Summary: Current genomic evidence supports a model in which these diseases share hormonally driven and genetically influenced mechanisms of abnormal tissue growth, but diverge in key somatic events and cellular contexts. Although clinical applications remain limited, continued multiomics research will enable molecular subtyping, targeted therapies, and improved risk stratification.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0