Frontiers in reproductive health最新文献

{"title":"Role of platelet-rich plasma in unexplained recurrent implantation failure: an umbrella review.","authors":"Harpreet Kaur, Anil Chauhan, Muhammed Shabil, Mishu Mangla","doi":"10.3389/frph.2026.1856964","DOIUrl":"10.3389/frph.2026.1856964","url":null,"abstract":"<p><strong>Background/objective: </strong>The role of platelet-rich plasma (PRP) in assisted reproductive technology is being explored, particularly in cases of recurrent implantation failure (RIF). The objective of our study is to thoroughly synthesise and critically assess the available evidence from systematic reviews and meta-analyses regarding the use of PRP in women with unexplained RIF.</p><p><strong>Methods: </strong>A thorough web search was performed on Medline, PubMed, EMBASE, Web of Science, OVID, JBI Evidence Synthesis, the Cochrane Database of Systematic Reviews, DARE, and the PROSPERO register to identify systematic reviews addressing the research question. Systematic reviews were assessed based on their \"explicit, reproducible methodology,\" comprehensive search strategy, acceptable methods for assessing the validity of included studies, evaluation of the risk of bias, and assessment of the certainty of the evidence. The methodological quality was assessed with the AMSTAR tool comprising 11 items. Before compiling the results, a corrected covered area (CCA) metric was used to evaluate the degree of overlap. Data extraction included descriptive variables and details about the intervention and outcomes.</p><p><strong>Results: </strong>A total of 15 systematic reviews of randomised controlled trials are included. The CCA matrix revealed very high overlap (42%). Although our study showed an improvement in implantation rate, clinical pregnancy rate, and live birth rate, the certainty of evidence was either low or not reported. Therefore, it is difficult to make recommendations based on these findings as the quality of evidence was low.</p><p><strong>Discussion: </strong>Although the qualitative review of these reviews has shown a beneficial effect of PRP in RIF, this result cannot be recommended with certainty, as Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) analysis was performed in only five of the 15 studies. Meta-analysis of the individual outcomes after extracting data from all studies also revealed an overall beneficial effect of PRP in terms of various outcomes, i.e., live birth rate, clinical pregnancy rate, and implantation. However, this may be an overestimation of the true effect due to the low quality of evidence or the quality of evidence not being assessed.</p><p><strong>Conclusion: </strong>Intrauterine infusion of PRP appears to be a promising adjunct therapy for women with unexplained recurrent implantation failure; however, the overall quality of evidence remains low.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024504453, PROSPERO CRD42024504453.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1856964"},"PeriodicalIF":3.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563985","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":"Positive but insufficient: ghana's attempt at eradicating period-related school absenteeism through sanitary pads provision for schoolgirls.","authors":"Godfred Bonnah Nkansah, Carlos Vega, Esther Amofa-Adade","doi":"10.3389/frph.2026.1869076","DOIUrl":"10.3389/frph.2026.1869076","url":null,"abstract":"<p><strong>Objectives: </strong>This study reassesses the dominant \"pad deficit\" explanation for period-related school absenteeism in Ghana by identifying the key factors driving girls' absence during menstruation and assessing perceptions of parents and teachers on the national free sanitary pad policy.</p><p><strong>Methods: </strong>A mixed-methods approach was employed, combining survey data from over 1,300 adolescent school girls with focus group discussions involving teachers and parents. Descriptive statistics and a supplementary ordered logistic regression model were used to analyze the relative importance and independent effects of reported constraints, while thematic analysis was used to assess the views of stakeholders on period-related school absenteeism.</p><p><strong>Results: </strong>Among school girls, menstrual discomfort emerged as the most frequently cited reason for absenteeism, followed by inadequate sanitation conditions and limited access to sanitary products, while teachers and parents most frequently attributed absenteeism to sanitary pad deficit. Supplementary regression results confirm that menstrual discomfort outweighs the effects of pad access, WASH infrastructure, and social factors. Stakeholder perceptions suggest that the free pad initiative addresses only part of the problem.</p><p><strong>Conclusion: </strong>Findings challenge the dominant sanitary pad deficit explanations of period-related absenteeism among school girls in low-income settings, and highlight the need for an integrated, ecosystem-based response that prioritizes biological, material, infrastructural, and socio-cultural constraints to addressing period-related absenteeism among school girls. The study accordingly reconceptualizes period-related absenteeism by positioning menstrual discomfort, rather than material access, as the central predictor of school absence.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1869076"},"PeriodicalIF":3.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563958","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":"Understanding practices of lactation and infant feeding together with women with HIV: the UPLIFT observational study protocol.","authors":"Christiana Smith, Emily Anne Barr, Karen Hampanda, Mark Trumbull, Hulin Wu, Jennifer McKinney, Sarah Buisson, Carly Hoffmann, Ciarra Brown, Angela B Hutchinson, K Rivet Amico, Ifeyinwa V Asiodu, Elizabeth J McFarland, Margaret A Lampe, Preetam A Cholli, Olga Varechtchouk, Allahna Esber, Athena P Kourtis, Lisa Abuogi","doi":"10.3389/frph.2026.1856899","DOIUrl":"10.3389/frph.2026.1856899","url":null,"abstract":"<p><strong>Introduction: </strong>There is a limited understanding of infant feeding decisions, practices, and outcomes for women living with HIV (WLHIV) and their infants since U.S. guidelines were updated in 2023 to support breastfeeding for virally suppressed women on antiretroviral treatment.</p><p><strong>Methods and analysis: </strong>The Understanding Practices of Lactation and Infant Feeding Together with women with HIV (UPLIFT) study is a convergent mixed-methods, multisite, observational study designed to address key knowledge gaps. Twelve US sites will begin enrollment in early 2026 to accomplish three core activities (CA). In CA1, we explore infant feeding decision-making and experiences via in-depth interviews with pregnant/postpartum WLHIV (<i>n</i> = 50), their partners and other influential individuals (<i>n</i> = 25), and a diverse sample of healthcare professionals (<i>n</i> = 45). Site-level surveys assess infant feeding practices and estimate the prevalence of breastfeeding among WLHIV. In CA2, we establish an observational longitudinal cohort of 450 WLHIV-infant dyads to examine infant feeding practices and outcomes. WLHIV will be enrolled during pregnancy and early postpartum, with half intending to breastfeed, and will be followed for ≥48 weeks. Clinical and laboratory data will be collected. Comprehensive surveys collect data on demographics, social determinants of health, mental health, antiretroviral therapy adherence, and infant feeding intentions and experiences. We measure HIV RNA and DNA in breast milk to determine factors associated with detectable HIV. Finally, we estimate the costs and benefits associated with breastfeeding compared to replacement feeding. In CA3, we develop and pilot a voluntary registry of U.S. WLHIV who are breastfeeding and their infants (<i>n</i> = 50-200). Pilot registry testers (<i>n</i> = 30) will provide feedback on the usability, acceptability, appropriateness, and feasibility of the registry.</p><p><strong>Discussion: </strong>The UPLIFT study will generate critical insights to inform patient-centered care, guide practice and policy, and empower WLHIV in the US to make informed infant feeding decisions.</p><p><strong>Ethics and dissemination: </strong>The UPLIFT study received approval from Advarra, the institutional review board of record for all UPLIFT sites. Results will be disseminated through conference presentations, peer-reviewed journals, and lay summaries.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT07293559, NCT07293559.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1856899"},"PeriodicalIF":3.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564002","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":"Non-linear multivariate decomposition modelling of the predictors of menstrual product use among reproductive-aged women: evidence from the 2022 Ghanaian demographic and health survey.","authors":"Benjamin Ansah Dortey, Yula Salifu, Emefa Judith Modey Amoah, Emmanuel Anongeba Anaba, Joseph Lasong, Amidu Alhassan, Adom Manu","doi":"10.3389/frph.2026.1874033","DOIUrl":"10.3389/frph.2026.1874033","url":null,"abstract":"<p><strong>Background: </strong>Menstrual health is a critical yet under-prioritized component of women's sexual and reproductive health, with persistent inequities in access to menstrual products across socioeconomic and geographic contexts. In Ghana, these disparities are influenced by a combination of individual, household, and community-level factors. This study examined the determinants of menstrual product use and quantified the relative contributions of compositional and structural factors to residence-related disparities using nationally representative data.</p><p><strong>Methods: </strong>Data were derived from the 2022 Ghana Demographic and Health Survey among a weighted sample of 12,497 women aged 15-49 years. Single-and multilevel logistic and ordered logistic regression models were fitted to identify determinants of menstrual product use, adjusting for intra-cluster correlations and complex survey design. Predictive performance and model fit were evaluated using AIC/BIC, McFadden's pseudo-R², C-index, and ROC AUC. Non-linear multivariate decomposition analysis was conducted to disentangle the contributions of compositional differences (endowments) and differential effects (coefficients) to disparities by urban-rural residence.</p><p><strong>Results: </strong>Use of modern menstrual products was strongly associated with higher individual educational attainment, household wealth, urban residence, younger age, self-reported good health, and greater media exposure. At the community level, higher average education and media exposure within clusters were also positively associated with uptake. Multilevel modelling revealed that 13%-15% of the variance in product use was attributable to between-cluster differences, highlighting the influence of contextual factors. Predictive models exhibited excellent discrimination (C-index ≥ 0.82; ROC AUC = 0.87). Decomposition analyses indicated that compositional factors, particularly household wealth and education, accounted for the majority of rural-urban (63%) inequalities, while differences in the effects of these determinants further contributed to disparities.</p><p><strong>Conclusions: </strong>Structural inequities in wealth, education, and community resources are major determinants of menstrual product use in Ghana. Policy interventions that subsidize menstrual products, expand school-and community-based distribution programs, enhance mass media outreach, and improve rural WASH infrastructure are critical to reducing disparities. Integrating menstrual health into national health and gender equity strategies is essential to advancing Sustainable Development Goals related to health, education, and gender equality.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1874033"},"PeriodicalIF":3.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551693","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":"American Medical Women's Association's commitment to advancing menopausal health equity and awareness.","authors":"Meghan Etsey, Rhea Manohar, Aida Mansour, Leah Liszak, Chelsea Oppong, Sarv Raafati, Kiana Wells, Vashti Price, Vaishnavi J Patel, Teresa Lazar, Ariela L Marshall, Rosy Thachil, Brianna Clark, Roberta Gebhard","doi":"10.3389/frph.2026.1867746","DOIUrl":"10.3389/frph.2026.1867746","url":null,"abstract":"<p><p>Menopause is a universal yet underrecognized phase of health, with significant implications for physical, mental, and social well-being. Persistent gaps in menopause care, education, and awareness perpetuate gender and socioeconomic inequities, particularly affecting those individuals with comorbid conditions. Menopause-related hormonal fluctuations increase vulnerability to mood instability, exacerbate chronic health conditions, and complicate clinical management. However, insufficient clinician training, lack of standardized screening, limited insurance coverage, and cultural stigma continue to hinder comprehensive and unbiased care. The American Medical Women's Association (AMWA) advocates for menopause equity through systemic strategies, including integrating menopause education into medical training, expanding insurance coverage for menopause-related services, increasing research funding, normalizing menopause in the workplace, launching public health campaigns, and promoting culturally competent care. We believe that advancing menopause equity is essential to improving quality of life, preventing health complications, and ensuring gender-responsive, holistic healthcare throughout the lifespan.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1867746"},"PeriodicalIF":3.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581003","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":"Trends and inequalities in health facility deliveries among women of reproductive age in Ghana, 1993-2022.","authors":"Patience Fakornam Doe, Frank Offei Odonkor, Yvonne Dorothy Mintah, Joseph Lasong, Yula Salifu, Amidu Alhassan","doi":"10.3389/frph.2026.1874042","DOIUrl":"10.3389/frph.2026.1874042","url":null,"abstract":"<p><strong>Background: </strong>Health facility delivery is a critical intervention to reduce maternal and neonatal mortality. Ghana has achieved substantial gains in facility deliveries over the past three decades, yet disparities persist across socioeconomic and demographic dimensions. This study describes trends and inequalities in health facility deliveries among women of reproductive age in Ghana from 1993 to 2022 across wealth, education, place of residence, age, and region.</p><p><strong>Methods: </strong>Data were extracted from the WHO Health Equity Assessment Toolkit (HEAT), which provides weighted, age-standardised estimates from Ghana Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) for the years 1993, 1998, 2003, 2006, 2008, 2011, 2014, 2017, and 2022. The outcome was the percentage of live births occurring in a health facility (WHO HEAT indicator code: MNCH7). Inequality was measured using the absolute difference (D), ratio (R), population attributable fraction (PAF), and population attributable risk (PAR) for each dimension, with 95% confidence intervals.</p><p><strong>Results: </strong>National health facility delivery prevalence increased from 42.3% (95% CI: 39.5-45.1) in 1993 to 85.4% (95% CI: 84.1-86.7) in 2022. In 2022, marked disparities remained: richest vs. poorest quintile (97.1% vs. 71.1%; D = 25.7 percentage points); higher education vs. no education (98.0% vs. 72.3%; D = 25.7 percentage points); urban vs. rural (93.7% vs. 77.9%; D = 15.8 percentage points); and Upper East vs. Northern region (97.7% vs. 69.0%; D = 28.7 percentage points). Absolute economic inequality (D) declined from 60.6 percentage points in 1993 to 25.7 in 2022; educational inequality fell from 53.6 to 17.8; and rural-urban inequality declined from 35.8 to 9.7. Age-related inequality was negligible throughout.</p><p><strong>Conclusion: </strong>While Ghana has achieved substantial gains in health facility deliveries, marked inequalities by wealth, education, place of residence, and region persist. These patterns coincide temporally with policy reforms including the Free Maternal Health Policy and the National Health Insurance Scheme; however, this descriptive analysis cannot establish causality. Targeted interventions for women in poorer, less educated, and rural settings are needed to achieve equitable maternal healthcare.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1874042"},"PeriodicalIF":3.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581274","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":"Informed consent in medically assisted procreation in Italy: medico-legal and ethical challenges shaping physician responsibility.","authors":"Costanza Raimondi, Pia Ferrari, Pietro Refolo, Antonio Oliva, Antonio G Spagnolo","doi":"10.3389/frph.2026.1850431","DOIUrl":"10.3389/frph.2026.1850431","url":null,"abstract":"<p><strong>Background: </strong>Informed consent represents a fundamental requirement in healthcare and is a key expression of patient autonomy. In the Italian context, its application in the field of medically assisted procreation (MAP) raises specific medico-legal and ethical questions. Recent developments, including updated MAP guidelines and evolving case law, further underscore the need to reflect on the specificities of informed consent in this setting.</p><p><strong>Objectives: </strong>This study aims 1) to trace the differences between informed consent in MAP and standard healthcare consent in Italy, and 2) to examine the medico-legal and ethical implications of these differences for physicians, whose obligations have come to extend beyond clinical information to encompass ethical, legal, psychological, and relational dimensions, particularly with regard to duties of information and professional liability.</p><p><strong>Materials and methods: </strong>This study adopts a qualitative, interdisciplinary approach based on a critical review of Italian legislation, case law, and bioethical and medico-legal literature. Sources were selected for relevance to MAP, with particular attention to complex scenarios such as embryo management after partner separation, post-mortem embryo transfer, and cryopreservation.</p><p><strong>Results: </strong>In Italy, informed consent in MAP differs substantially from standard healthcare consent because of its joint nature, its function beyond the therapeutic sphere, its temporal extension, and its partial irrevocability after fertilization. These features transform consent into a complex, processual act with long-term legal, ethical, and relational implications. As a result, the physician's role is not limited to the provision of technical information, but requires enhanced professional responsibility in ensuring adequate, comprehensible, and context-sensitive communication.</p><p><strong>Discussion: </strong>In this perspective, structured counselling, repeated informational processes, and careful documentation become essential not only to support autonomous decision-making, but also to prevent or mitigate medico-legal risks. These considerations highlight the need for specific professional training in communication and counselling within MAP settings, to adequately address the complexity of consent in this field.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1850431"},"PeriodicalIF":3.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474559","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":"Immunotherapy does not impair ovarian function in a mouse model of breast cancer.","authors":"Payton De La Cruz, Morgan F Woodman-Sousa, Julia N McAdams, Ellia Sweeney, Lola Hakim, Melanie Morales Aquino, Kathryn J Grive","doi":"10.3389/frph.2026.1837989","DOIUrl":"10.3389/frph.2026.1837989","url":null,"abstract":"<p><strong>Background: </strong>Representing 15%-20% of all breast cancer cases, triple negative breast cancer (TNBC) is diagnosed more frequently in reproductive-age women and exhibits higher rates of disease metastasis and recurrence when compared with other subtypes. Few targeted treatments exist for TNBC, and many patients experience infertility and endocrine disruption as a result of frontline chemotherapy treatment. While they are a promising option for less toxic therapeutic approaches, little is known about the effects of immune checkpoint inhibitors on reproductive and endocrine function.</p><p><strong>Results: </strong>Our findings in a syngeneic TNBC mouse model revealed that therapeutically relevant immunotherapies targeting PD-1, LAG-3, and TIM-3 had no effect on the quality and abundance of ovarian follicles, estrus cyclicity, or hormonal homeostasis. Similarly, in a tumor-free mouse model, we found that ovarian architecture, follicle abundance, estrus cyclicity, and ovulatory efficiency remain unchanged by PD-1 blockade.</p><p><strong>Conclusions: </strong>Taken together, our results suggest that immunotherapy may be a promising component of fertility-sparing therapeutic regimens for patients that wish to retain ovarian and endocrine function after cancer treatment.</p><p><strong>Lay summary: </strong>Triple negative breast cancer (TNBC) represents 15%-20% of all breast cancer cases, and is more likely to affect reproductive-age women than other sub-types. Unfortunately, this disease is aggressive, and has historically been treated with chemotherapy which is known to be quite toxic to the ovary. Today, novel immunotherapies - antibody treatments, which harness a patient's own immune system - are showing promise in the treatment of TNBC, and have even become standard-of-care, though reproductive effects are currently unknown. This study uses a TNBC mouse model to elucidate ways in which immunotherapy may affect the health of the ovary, finding that standard-of-care therapy not only does not negatively impact ovarian architecture or function, but hormone levels in these treated animals are also unchanged. Taken together, our results suggest that immunotherapy may be a promising component of fertility-sparing therapeutic regimens for patients that wish to retain ovarian and endocrine function after cancer treatment.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1837989"},"PeriodicalIF":3.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474539","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":"Non-invasive biomarkers in assisted reproductive technologies, current evidence, clinical utility and future perspectives.","authors":"Athanasios Zikopoulos, Athanasia Sesse, Periklis Katopodis, Ariadni Theodora Katopodi, Vasilis Sebastian Paraschos, Maria Filiponi, Ioanna Bouba, Charilaos Kostoulas, Athanasios Zachariou, Ioannis Georgiou","doi":"10.3389/frph.2026.1875776","DOIUrl":"10.3389/frph.2026.1875776","url":null,"abstract":"<p><p>Although assisted reproductive technologies have significantly advanced the treatment of infertility, overall success rates remain limited by the lack of accurate and safe tools for assessing reproductive potential. Conventional embryo selection and endometrial evaluation rely largely on morphological and non-functional criteria, which provide only indirect insight into the underlying biological competence of the embryo oocyte and uterine environment. In this context the development of non-invasive biomarkers has emerged as a critical objective in modern reproductive medicine. This review discusses current evidence on non-invasive biomarkers in <i>in vitro</i> fertilization and assisted reproductive technologies with emphasis on embryo derived follicular fluid and endometrial indicators. Advances in time lapse imaging analysis of spent embryo culture media follicular fluid profiling and uterine fluid assessment are discussed in relation to their biological significance and association with clinical outcomes. The role of metabolomic proteomic transcriptomic and genetic signals is examined alongside emerging applications of artificial intelligence for data integration and outcome prediction. While numerous non-invasive biomarkers demonstrate promising associations with embryo viability implantation potential and surrogate pregnancy outcomes, with limited evidence in live birth rates, their clinical translation is constrained by methodological heterogeneity, limited validation, and challenges in standardization. Integrative multi parameter approaches rather than single biomarker strategies appear most likely to enhance predictive accuracy. Continued efforts toward data harmonization, large scale validation, and clinically oriented model development are essential for the successful incorporation of non-invasive biomarkers into routine IVF practice. Curated databases and relevant AI applications may facilitate and help progress non-invasive biomarkers in ART.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1875776"},"PeriodicalIF":3.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474618","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":"Orchestrating the gut microbiota-mitochondrial-immune axis in gynecological diseases: mechanisms and dual-targeting therapeutic strategies.","authors":"Haixia Tang, Yiting Zhang, Yanting Wang, Ze Zhou, Rong Sun, Rong Chen, Lijuan Yang, Mengqiu Shao, Jiabao Liao","doi":"10.3389/frph.2026.1845581","DOIUrl":"10.3389/frph.2026.1845581","url":null,"abstract":"<p><p>The \"gut microbiota-mitochondria axis\" has become the core hub connecting the metabolism, immunity, and endocrine regulation of gynecological diseases. In this review, the hierarchical regulation mechanism of this axis is systematically combed: at the upstream level, intestinal short-chain fatty acids (SCFAs), bile acids (BAs), tryptophan derivatives, and other metabolites can activate AMPK/PGC-1α, FXR/TGR5, and AhR-mediated energy sensing and receptor signaling pathways; On the functional level, bacterial lipopolysaccharide-TLR4 signal and cGAS-STING/NLRP3 inflammasome pathway activated by cytoplasmic mitochondrial DNA (mtDNA) can amplify innate immune response; At the effect level, mitochondrial reactive oxygen species (ROS), mitochondrial dynamics, and PINK1/Parkin-mediated mitophagy are the common key nodes to regulate mitochondrial quality and inflammatory response. Combined with the two-way relationship between the estrobolome and steroid production, the above processes together form a self-reinforcing closed loop of \"metabolic input-immune amplification-oxidative stress/autophagy-endocrine regulation\". Based on this theoretical framework, this paper analyzes the disease-specific correlations among polycystic ovary syndrome, endometriosis, premature ovarian insufficiency, and gynecological malignancies, and puts forward a dual-targeted treatment idea with research value. The intervention plan with microbiota as the core aims to adjust the metabolite spectrum and endotoxin level; Mitochondria-centered interventions focus on restoring cell energy metabolism and apoptosis sensitivity. In addition, this review constructs a hierarchical research framework of \"microbiota-metabolomics-mitochondria\" to clarify the targeted phenotypes in the pathway, and provide guidance for subsequent clinical trial design and long-term monitoring. With the deep integration of multi-omics technology and targeted interventions, the gut microbiota-mitochondria axis is expected to become an important breakthrough in precision medical treatment of gynecological diseases and build a brand-new bridge between basic mechanism research and clinical transformation.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1845581"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457984","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}