F&S reviews最新文献

{"title":"Dynamic changes of histone methylation in male germ cells during spermatogenesis","authors":"Yesim Bilmez M.Sc.,&nbsp;Saffet Ozturk Ph.D.","doi":"10.1016/j.xfnr.2023.07.001","DOIUrl":"https://doi.org/10.1016/j.xfnr.2023.07.001","url":null,"abstract":"<div><p><span>Spermatogenesis<span><span> is a strictly regulated, complex process by which sperm cells are continuously produced throughout a person’s lifespan. This process includes 3 unique events: mitotic division, meiosis, and spermiogenesis. Many genes playing key roles in these events are mainly regulated by epigenetic mechanisms<span>, especially DNA methylation and </span></span>histone modifications<span>. Histone methylation is one of the basic modifications in </span></span></span>histones<span><span> and contributes to the timely control of transcriptional activation<span> and repression of the genes implicated in cell cycle progression, </span></span>meiotic recombination<span>, DNA repair, chromosome segregation<span>, and chromatin condensation<span><span>. For this purpose, specific histone methyltransferases<span> perform methylation of the lysine and/or arginine residues of histones localized in nucleosomes. Added methyl groups can be removed by exclusive </span></span>histone demethylases<span> when necessary. Potential defects in correctly establishing histone methylation marks in H3K4, H3K9, H3K27, H3K36, H4R3, and H4K20 residues in male germline cells during spermatogenesis may result in the development of infertility. In this review, we comprehensively evaluate histone methylation dynamics in male germ cells, from spermatogonia to sperm cells. In addition, infertility development in males is discussed in terms of altered histone methylation accumulation because of altered expression of the histone methyltransferases and histone demethylases.</span></span></span></span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 3","pages":"Pages 187-205"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49882329","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":"Searching for the optimal number of oocytes to reach a live birth after in vitro fertilization: a systematic review with meta-analysis","authors":"Nathalie Sermondade M.D., Ph.D. ,&nbsp;Charlotte Sonigo M.D., Ph.D. ,&nbsp;Maud Pasquier M.D. ,&nbsp;Naouel Ahdad-Yata M.D. ,&nbsp;Eloïse Fraison M.D., M.Sc. ,&nbsp;Michaël Grynberg M.D., Ph.D.","doi":"10.1016/j.xfnr.2023.03.002","DOIUrl":"https://doi.org/10.1016/j.xfnr.2023.03.002","url":null,"abstract":"<div><h3>Objective</h3><p><span>To investigate the relationship between the number of oocytes and both the live birth rate (LBR) after fresh </span>embryo transfer and the cumulative live birth rate (CLBR).</p></div><div><h3>Evidence Review</h3><p>The optimal number of oocytes necessary to expect a live birth after in vitro fertilization remains unclear. A systematic review with meta-analysis was performed, searching for studies published between January 2004 and March 2021. Two independent reviewers performed study selection and data extraction according to Cochrane methods. The mean-weighted threshold of optimal oocyte number was estimated from documented thresholds, followed by a one-stage meta-analysis on articles with documented or estimable relative risks.</p></div><div><h3>Results</h3><p>After reviewing 1,090 records, 102 full-text articles were assessed for eligibility. A total of 45 studies were available for quantitative syntheses. Twenty-two and 21 studies were included in the meta-analyses evaluating the relationship between the number of retrieved oocytes and LBR or CLBR, respectively. For LBR, most studies reported a plateau or a peak effect, corresponding to a weighted mean of 13.5 oocytes, and the pooled dose-outcome showed a nonlinear relationship, with a plateau or even a drop beyond 15 oocytes. The meta-analysis of the relationship between the number of oocytes and CLBR found a nonlinear relationship, with a continuous increase in CLBR, including for high-oocyte yields.</p></div><div><h3>Conclusion</h3><p>Above a 15-oocyte threshold, LBR after fresh transfer plateaus, advocating for a freeze-all strategy. In contrast, the continuous increase in CLBR suggests that a strong response to controlled ovarian stimulation seems unlikely to impair oocyte quality. High numbers of oocytes could be offered to improve the chances of cumulative live births, after evaluating the benefit–risk balance.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 2","pages":"Pages 101-115"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50204243","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 emerging role of the gut-testis axis in male reproductive health and infertility","authors":"Navid Leelani D.O.,&nbsp;Petar Bajic M.D.,&nbsp;Neel Parekh M.D.,&nbsp;Sarah C. Vij M.D.,&nbsp;Scott D. Lundy M.D., Ph.D.","doi":"10.1016/j.xfnr.2023.01.001","DOIUrl":"https://doi.org/10.1016/j.xfnr.2023.01.001","url":null,"abstract":"<div><p><span><span>Male factor infertility continues to be a challenging condition with a significant proportion of men receiving no clear explanation for why they are unable to conceive. On the basis of the data presented in this review, there is now mounting evidence to support the role of the gut-testis axis in both healthy and diseased states, and at the core of this axis is the gut microbiome. Under nonpathological conditions, the gut microbiome maintains a symbiotic relationship with the testes. Disruption of the gut microbiome by diet or </span>diseases initiates a chain reaction leading to diminishing fertility. Under dysbiotic conditions, there is an increase in inflammatory markers coupled with a loss of integrity of the </span>gut epithelium<span><span> leading to translocation of bacteria and inflammatory cytokines into systemic circulation<span><span>. Ultimately, the testes along with the rest of the body are exposed to chronic inflammation because of this </span>dysbiosis through pathways that remain to be fully elucidated. Eventually, this may also lead to loss of integrity of the blood-testis barrier causing impaired </span></span>spermatogenesis<span> and depressed semen parameters. Restoration of the gut microbiome to a symbiotic state via probiotics<span>, fecal microbiota transplantation, bacteriophages, or small molecules may soon be able to decrease gut inflammation, rescue the integrity of the blood-testis barrier, and ultimately improve semen quality.</span></span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 2","pages":"Pages 131-141"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50204246","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":"Current concepts, therapies, and recommendations to assist fertility outcomes in male patients with spinal cord injury","authors":"Jeffrey Song B.A. ,&nbsp;Mohit Khera M.D., M.B.A., M.P.H.","doi":"10.1016/j.xfnr.2023.02.001","DOIUrl":"https://doi.org/10.1016/j.xfnr.2023.02.001","url":null,"abstract":"<div><p><span>Spinal cord injury<span> (SCI) is a prevalent problem, affecting nearly 288,000 people in the United States. Many men with SCI can present with erectile dysfunction<span> (ED), anejaculation, and infertility, imputing profound impacts on </span></span></span>quality of life<span> for this population. Erectile dysfunction is generally well managed pharmacologically with phosphodiesterase-5 inhibitors and intracavernous injections<span><span> or surgically with penile prosthesis<span>. Additional treatment modalities, including vacuum constrictive devices and </span></span>muscle stimulation<span><span>, can be used to supplement pharmacological treatment of ED. Anejaculation is a prevalent problem, especially for men seeking to have children, but it is managed well with penile vibratory stimulation, electroejaculation, and testicular sperm extraction<span><span>. Various sperm abnormalities are also prevalent in this population, with consensual support for the presence of </span>hypospermia<span>, asthenospermia, and necrospermia. Recent literature supports the potential use of </span></span></span>probenecid<span> and mirabegron<span> to help improve these sperm abnormalities. The literature most consensually supports a high inflammatory state as the most likely pathological driver behind these sperm abnormalities. In all, ED, anejaculation, and infertility are managed relatively well in men with SCI. More work is needed to better understand the pathophysiology of sperm abnormalities to shed more light on better methods of treatment.</span></span></span></span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 2","pages":"Pages 142-151"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50204247","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":"Effects of assisted reproductive techniques on offspring gonadal function: a systematic review and meta-analysis","authors":"Andrea Crafa M.D.,&nbsp;Rossella Cannarella M.D., Ph.D.,&nbsp;Federica Barbagallo M.D.,&nbsp;Sandro La Vignera M.D., Ph.D.,&nbsp;Rosita A. Condorelli M.D., Ph.D.,&nbsp;Aldo E. Calogero M.D.","doi":"10.1016/j.xfnr.2023.03.001","DOIUrl":"https://doi.org/10.1016/j.xfnr.2023.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate whether the use of assisted reproductive techniques (ARTs) affected the gonadal function of the offspring. Numerous concerns have emerged over the years about the use of ARTs and their effects on the health of the offspring.</p></div><div><h3>Evidence Review</h3><p>Data were extracted through extensive searches in the PubMed and Scopus databases from their establishment until August 2022. Meta-analysis was performed following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. All eligible studies were selected according to the Population, Exposure, Comparison/Comparator, Outcomes, Study design model. All studies that analyzed pubertal development and testicular and ovarian function of offspring conceived using ARTs were included. The quality of the studies was assessed using the Cambridge Quality Checklists. For the different outcomes, the standardized mean difference (SMD), the mean difference, and the odds ratio were evaluated. Cochran-Q and I² statistics were used to evaluate statistical heterogeneity. Differences in pubertal development, hormone levels, and sperm function in ART-conceived subjects compared with spontaneously conceived (SC) control subjects.</p></div><div><h3>Results</h3><p>Children conceived using ART do not appear to have impaired pubertal development or achievement of pubertal milestones. From an endocrine point of view, ART-conceived males showed lower sex hormone-binding globulin levels than the control group (SMD = −0.25 [−0.44, −0.05]; I² = 29%) and a tendency to lower testosterone levels (SMD = −0.16 [−0.32, 0.01]; I² = 0). Lower levels of inhibin B, on the other hand, were present only in intracytoplasmic sperm injection-born males compared with the control group (SMD = −0.24 [−0.44, −0.04]; I² = 0). In females, higher luteinizing hormone levels were found in the ART group than in the control group (SMD = 0.33 [0.06, 0.59]; I² = 17%). In contrast, lower levels of 17ß-estradiol were observed only in the intracytoplasmic sperm injection group compared with girls with SC (SMD = −0.39 [−0.74, −0.03]; I² = 0). However, no definitive conclusions can be drawn considering the heterogeneity of hormonal assessments in females. Finally, young adults born from ART had a reduced sperm concentration (SMD = −0.34 [−0.57, −0.11]; I² = 0), total sperm count (SMD = −0.28 [−0.51, −0.05]; I² = 0), and normal sperm morphology (SMD = −0.35 [−0.58, −0.13]; I² = 0) compared with those SC.</p></div><div><h3>Conclusion</h3><p>A slight alteration in the function of the male germinal epithelium appears to be associated with the use of ART, as shown by the reduced levels of inhibin B and the altered sperm parameters.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 2","pages":"Pages 152-173"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50204245","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":"Aberrant microribonucleic acid expression patterns in recurrent implantation failure: a review","authors":"Zahra Khosravizadeh Ph.D. ,&nbsp;Zahra Rashidi Ph.D. ,&nbsp;Maral Daneshyan B.S. ,&nbsp;Kajal Khodamoradi Ph.D. ,&nbsp;Ali Talebi Ph.D.","doi":"10.1016/j.xfnr.2022.11.003","DOIUrl":"https://doi.org/10.1016/j.xfnr.2022.11.003","url":null,"abstract":"<div><p><span><span>Implantation failure is the most common cause of pregnancy loss after in vitro fertilization and embryo transfer. Recurrent implantation failure (RIF) after in vitro fertilization has devastating consequences for some patients with infertility. Recent studies have reported that microribonucleic acids (miRNAs) can regulate </span>embryo implantation<span><span> events and may be involved in RIF. MiRNAs are small, single-stranded, noncoding ribonucleic acids that can regulate gene expression in a posttranscriptional manner through degradation or suppression of messenger ribonucleic acids. MiRNAs are generated as long primary miRNA transcripts that are processed by a nuclear </span>RNase<span> III enzyme into precursor miRNAs. After transport to the cytoplasm, the precursor miRNAs are processed into functional miRNAs. MiRNAs have a critical role in normal development and are involved in several biologic processes, including cell proliferation<span><span>, apoptosis, and differentiation, as well as embryo implantation. MiRNAs also have a role in the down-regulation of several cell cycle genes in the epithelium of the secretory-phase </span>endometrium. This review aimed to discuss the possible roles of miRNAs in RIF. According to published data, miRNAs secreted by the endometrium and embryos can contribute to regulating embryo-endometrium cross talk and impact embryo implantation </span></span></span></span>in patients<span> with RIF. An improved understanding of molecular mechanisms underlying RIF may help to advance diagnosis and treatment of this clinical condition. Although several studies have provided evidence that miRNAs play important roles in RIF, further research is essential to evaluate the function of miRNAs and their target genes and understand the mechanisms by which miRNAs control the molecular events involved in RIF.</span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 1","pages":"Pages 26-37"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49889735","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":"How does adenomyosis impact endometrial receptivity? An updated systematic review of clinical and molecular insights","authors":"Takehiro Hiraoka M.D., Ph.D.,&nbsp;Yasushi Hirota M.D., Ph.D.,&nbsp;Yutaka Osuga M.D., Ph.D.","doi":"10.1016/j.xfnr.2022.11.004","DOIUrl":"https://doi.org/10.1016/j.xfnr.2022.11.004","url":null,"abstract":"<div><h3>Objective</h3><p><span>To summarize current knowledge regarding the outcomes of assisted reproductive technology (ART) </span>in patients<span> with adenomyosis, offer insights into the defects in the regulation of endometrial receptivity, and discuss the implications for the clinical management of adenomyosis and infertility.</span></p></div><div><h3>Evidence Review</h3><p>We conducted a comprehensive literature search of PubMed for original and review articles published in English up to June 2022 in the following areas: adenomyosis and infertility; ART; endometrial receptivity; and embryo implantation.</p></div><div><h3>Results</h3><p><span><span>Adenomyosis may have a negative impact on endometrial receptivity, reducing the probability of conception by ART. The severity of adenomyosis seems to be associated with the severity of the impairment in receptivity, and before treatment with a gonadotropin-releasing hormone agonist before frozen-thawed </span>embryo transfer<span> may restore endometrial receptivity. Molecular analyses demonstrated that genes associated with endometrial receptivity are aberrantly expressed in the eutopic endometria of women with infertility with adenomyosis. Hyperproliferation of the endometrial epithelium, impaired </span></span>decidualization<span>, progesterone<span> resistance, altered expression of adhesion molecules<span><span>, a hyperinflammatory microenvironment, chronic </span>endometritis<span>, and abnormal uterine contractility seem to be involved in the impairment of endometrial receptivity.</span></span></span></span></p></div><div><h3>Conclusion</h3><p>Uterine adenomyosis reduces endometrial receptivity via several mechanisms. In addition, data suggest that the etiologic mechanism of adenomyosis is responsible for impaired endometrial receptivity. Before treatment with a gonadotropin-releasing hormone agonist before frozen-thawed embryo transfer may ameliorate the defects in the uterine environment, probably by restoring the expression of genes that are essential for embryo implantation. Further research using animal models should aim to additionally clarify the relationship between adenomyosis and infertility to refine the treatment strategies for women with infertility with adenomyosis.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 1","pages":"Pages 15-25"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49889734","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":"Modifiable socioeconomic and lifestyle risk factors for female infertility in Asia: a systematic review from the population health perspective","authors":"Ling-Jun Li Ph.D. ,&nbsp;Ashley Chow B.Sc. ,&nbsp;Audrey J. Gaskins Ph.D. ,&nbsp;Jie Ning Jovin Lee B.Sc. ,&nbsp;Mahesh Choolani Ph.D. ,&nbsp;Brian K. Kennedy Ph.D. ,&nbsp;Zhongwei Huang Ph.D. ,&nbsp;Yap Seng Chong M.D. ,&nbsp;Cuilin Zhang Ph.D.","doi":"10.1016/j.xfnr.2022.09.001","DOIUrl":"https://doi.org/10.1016/j.xfnr.2022.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>To pinpoint the knowledge gaps and systematically identify modifiable infertility-related socioeconomic and lifestyle risk factors in Asian women, since most studies on female infertility-related risk factors were conducted in the Western populations. This review pinpointed the knowledge gaps and aimed to systematically identify modifiable infertility-related socioeconomic and lifestyle risk factors in Asian women.</p></div><div><h3>Evidence Review</h3><p>We performed a systematic literature search according to the Preferred Reporting Items for Systematic Reviews<span> and Meta-Analyses checklist from January 1, 1990, to October 31, 2021, in PubMed, the Web of Science, Embase, and Scopus, using a set of keywords related to our schemes, such as socioeconomics, lifestyle, infertility, and time to pregnancy. We shortlisted a combination of available full texts, English publications, original research articles, human subjects, and nonpregnant women of childbearing age with the intent of conceiving without medical assistance as the population of interest for further screening.</span></p></div><div><h3>Results</h3><p>We included 43 Asian studies that reported modifiable socioeconomic and lifestyle risk factors with the following outcomes: time to pregnancy; pregnancy rate; or infertility rate. Similar to the Western populations, female infertility in Asian women was associated with advanced age at marriage, sexual dysfunction, elevated stress levels, and greater adiposity. Interestingly, a higher socioeconomic status in Asian women was positively associated with female infertility, whereas a higher socioeconomic status in their male partners was inversely associated with couple infertility. Regrettably, few publications reported lifestyle risk factors, such as physical activity, dietary food groups, sleep disorders, and substance use.</p></div><div><h3>Conclusion</h3><p>Asian women may have more infertility-related cultural and dietary diversity, and it is worthy of future research efforts. It is also critical and more effective to tackle the infertility problem in both women and men. Hence, we discussed the imperative need for research efforts in Asian couples.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 1","pages":"Pages 78-99"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49906533","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 impact of obesity and subsequent weight loss through bariatric surgery on male fertility","authors":"Sally F. Vitez M.D. ,&nbsp;Bestoun H. Ahmed M.D., F.A.C.S. ,&nbsp;Miguel Brieño-Enríquez M.D., Ph.D. ,&nbsp;Kathleen Hwang M.D.","doi":"10.1016/j.xfnr.2022.11.002","DOIUrl":"https://doi.org/10.1016/j.xfnr.2022.11.002","url":null,"abstract":"<div><p><span>This is a comprehensive review evaluating current literature published on the impact of obesity and subsequent weight loss on male factor infertility. The prevalence of obesity is increasing worldwide, and it is projected that by 2030, &gt;50% of all adults in the United States will be obese. Obesity, with excess adipose tissue<span>, leads to a proinflammatory state with higher reactive oxygen species<span> production, dysfunction of the hypothalamic-pituitary-gonadal axis, and subsequent alterations in spermatogenesis. There is growing evidence to support the negative impact of obesity on male </span></span></span>factor fertility<span><span><span>, specifically manifesting as reduced semen parameters. However, the male contribution to fertility goes beyond the standard semen analysis<span>. As a result, in-depth molecular studies through metabolomics<span>, proteomics, and </span></span></span>epigenomics have been described to better understand male factor infertility and the impact of obesity on subfecundity. Given the obesity epidemic, there has been an increase in medically supervised weight loss programs and surgical intervention for weight loss. </span>Bariatric surgery<span><span> has become the mainstay of treatment for obesity. Early case reports documented a harmful impact of bariatric surgery on semen parameters; however, more recent </span>prospective cohort studies identify no change in standard semen parameters after significant weight loss after bariatric surgery. Nonetheless, the clinical impact of bariatric surgery on fertility and ongoing clinical pregnancy when performed for obese male partners remains undetermined and an area for further study.</span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 1","pages":"Pages 38-49"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49906540","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":"Current options to lower the cost of in vitro fertilization: a comprehensive review","authors":"Austin Gardner M.D. ,&nbsp;Kristen L. Smith M.D. ,&nbsp;Elizabeth Huuki B.S. ,&nbsp;Jacqueline Luizzi M.L.I.S., A.H.I.P. ,&nbsp;Deidre D. Gunn M.D. ,&nbsp;Sukhkamal B. Campbell M.D. ,&nbsp;Bruce D. Pier M.D.","doi":"10.1016/j.xfnr.2022.10.001","DOIUrl":"https://doi.org/10.1016/j.xfnr.2022.10.001","url":null,"abstract":"<div><p><span>Although the first successful in vitro fertilization (IVF) cycle occurred over 40 years ago, the financial cost of IVF remains steep and prevents several patients from pursuing this option for infertility treatment. Institutional coverage for IVF varies widely depending on state or country, and some individuals may ultimately encounter no financial support. In some cases, surgical intervention (instead of or before IVF) could provide a less costly option or optimize IVF success to decrease the number of cycles needed for a successful pregnancy. Alterations in the individual components of the IVF process may cumulatively drive down overall costs. Changing stimulation protocols, medication regimens, or the medications themselves used during IVF could lead to similar pregnancy rates at lower costs. The addition of adjuncts to traditional IVF stimulation may further elevate the success rate. Monitoring of the patient’s response to stimulation medications and the genetic testing of embryos can be applied more judiciously in certain patient populations. Automation in established practices, such as </span>intracytoplasmic sperm injection, may lead to decreased costs if broadly implemented. Patient-specific approaches using demographic and clinical factors to stratify patients on the basis of likelihood of success may enable providers to efficiently counsel patients to better financially plan for an IVF cycle.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"4 1","pages":"Pages 66-77"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49906534","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}