Frontiers in reproductive health最新文献

{"title":"Influencing factors of three pronuclei incidence and their impact on pregnancy outcomes in women with good prognosis undergoing conventional <i>in vitro</i> fertilization with donor sperm: a retrospective cohort study.","authors":"Jianhua Sun, Xiang Liu, Shengjia Shi, Mingzhao Li","doi":"10.3389/frph.2025.1509710","DOIUrl":"10.3389/frph.2025.1509710","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the influencing factors of three pronuclei (3PN) zygote incidence and their impact on pregnancy outcomes in women with good prognosis undergoing conventional <i>in vitro</i> fertilization with donor sperm (C-IVFD).</p><p><strong>Methods: </strong>This retrospective study included women aged 35 years or younger who underwent the long/ultra-long follicular phase agonist protocol between January 2014 and January 2021. C-IVFD cycles were divided into the 3PN = 0% group (no 3PN zygotes) and the 3PN > 0% group (with 3PN zygotes). Multivariate logistic regression analysis was performed to identify factors influencing 3PN zygote incidence. The primary outcomes were clinical pregnancy, ongoing pregnancy, abortion and live birth rates. The secondary outcomes were cleavage, high-quality embryo, available embryo, implantation and ectopic pregnancy rates.</p><p><strong>Results: </strong>1,250 embryo transfer cycles were included in this study. The peak estradiol (E₂) level on the day of human chorionic gonadotrophin (hCG) administration (OR: 1.16, 95% CI 1.12-1.19, <i>p</i> < 0.001) and the number of retrieved oocytes (OR: 1.08, 95% CI 1.05-1.11, <i>p</i> < 0.001) were independently associated with 3PN incidence. Compared to the 3PN > 0% group, the 3PN = 0% group exhibited significantly higher ongoing pregnancy rates (<i>p</i> = 0.033) and live birth rates (<i>p</i> = 0.009), as well as lower abortion rate (<i>p</i> = 0.026). No significant differences were found between the 3PN = 0% and 3PN > 0% groups in cleavage, high-quality embryo, available embryo, implantation and ectopic pregnancy rates (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>The peak E₂ level on hCG administration day and the number of retrieved oocytes were independently associated with 3PN incidence. The incidence of 3PN zygotes has a negative impact on pregnancy outcomes in women with good prognosis undergoing C-IVFD.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1509710"},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782165","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":"First clinical pregnancy and delivery achieved after using a new 3D imaging technology for sperm selection: a case report.","authors":"Yulia Michailov, Shevach Friedler, Bozhena Saar-Ryss","doi":"10.3389/frph.2025.1559684","DOIUrl":"10.3389/frph.2025.1559684","url":null,"abstract":"<p><strong>Objective: </strong>To report a case of a patient who, after experiencing recurrent failed implantations, underwent a novel technological intervention-using the Q300 device-which successfully led to a pregnancy and delivery of a healthy baby.</p><p><strong>Design: </strong>Case report.</p><p><strong>Setting: </strong>Barzilai University Medical Center.</p><p><strong>Patient s: </strong>A 33-year-old woman with primary infertility experienced recurrent implantation failure (RIF), while her 32-year-old male partner was diagnosed with severe oligo-astheno-teratozoospermia (OTA) syndrome.</p><p><strong>Intervention: </strong>Using Q300 device for selection of the morphologically compliant sperm cells for intracytoplasmic sperm injection (ICSI).</p><p><strong>Main outcome measures: </strong>Successful pregnancy and delivery.</p><p><strong>Results: </strong>A unique case of clinical pregnancy and delivery involving a couple facing RIF and severe OTA. In this case, a new technology for sperm selection was used. The semen sample was examined using the Q300 device to choose WHO2021-morphologically compliant sperm cells for micro-injection. The resulting embryos were developed and then frozen. Later, a frozen-thawed embryo transfer was performed during the following natural menstrual cycle, leading to successful pregnancy and delivery.</p><p><strong>Conclusion: </strong>The utilization of this new 3D imaging technology underscores the evolving landscape of reproductive medicine and the potential it holds for transforming outcomes in challenging cases. By documenting such cases, we contribute to the ongoing dialogue to refine assisted reproductive technology (ART) protocols and improve reproductive outcomes for individuals facing similar challenges.</p><p><strong>Trial registration: </strong>NCT06232720 https://clinicaltrials.gov/study/NCT06232720. Date of registration: 15 Feb 2023. Date of enrollment of the first subject: 20 August 2023.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1559684"},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694430","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":"Increasing access to self-managed abortion through pharmacies: programmatic results and lessons from a pilot program in Oromia, Ethiopia.","authors":"Bekalu Mossie Chekol, Abiyot Belai Mehari, Blain Rezene, Samuel Muluye, Yadeta Ayana, Elsabet Sisay, Sally Dijkerman, Genene Assefa","doi":"10.3389/frph.2025.1472696","DOIUrl":"10.3389/frph.2025.1472696","url":null,"abstract":"<p><p>Despite increased availability of safe abortion following legal reform in Ethiopia, one-half of public sector abortion services are treatment of postabortion complications, indicating challenges meeting women's needs. Self-managed abortion (SMA)-the ability of pregnant people to manage their unwanted pregnancies with or without the support of a health care provider-is a safe, feasible, and acceptable option for women at gestational ages up to 12 weeks. Seeing the potential of SMA to vastly expand access to safe abortion and reduce postabortion complications, a pilot initiative targeting private pharmacies was implemented by the Ethiopian Ministry of Health, the Oromia Regional Health Bureau, and a non-profit organization. From December 2021 to March 2023, implementers trained and supported 41 pharmacies to provide SMA counseling and medical abortion drugs, with and without prescriptions, which was considered to contradict the legal framework at the time. Pharmacy clients' SMA experiences were documented in logbooks and via 21-day follow-up phone surveys. Thirty-two pharmacies (78%) supported 1,457 self-managed abortions during the pilot. Among clients with complete follow-up surveys (<i>n</i> = 1,233), 98.3% had a complete abortion without needing additional treatment. Only four clients (0.3%) reported a complication. The pilot demonstrated high demand for and feasibility of increasing access to quality SMA through private pharmacies in Ethiopia, but challenges remain due to the lack of a legal framework. We recommend providing multi-sector support on SMA to private pharmacies so they can in turn improve safe abortion accessibility by bringing safe, acceptable services closer to the people that need them.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1472696"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659981","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":"Comparison of bacterial vaginosis symptoms reported in social media vs. those reported by patients.","authors":"Andriana H Velmahos, Briah Cooley Demidkina, Caroline M Mitchell","doi":"10.3389/frph.2025.1549331","DOIUrl":"https://doi.org/10.3389/frph.2025.1549331","url":null,"abstract":"<p><strong>Introduction: </strong>There is an increasing tendency to seek health information online rather than through medical professionals. However, the easy accessibility of information online allows for an increased risk of encountering medical misinformation.</p><p><strong>Methods: </strong>We compared descriptions of symptomatology of bacterial vaginosis (BV) on four social media platforms: Instagram, Facebook, YouTube and X (Twitter). We then compared the frequency of discussion of symptoms with patients' report of symptoms in clinically diagnosed BV, vulvovaginal candidiasis and vulvodynia.</p><p><strong>Results: </strong>Social media was more likely to report burning (45% of posts), itching (45%) or pain (23%) as symptoms of BV than patients (moderate-severe itching 30%, burning 21% or pain 21%). Although pain was reported more often by people with vulvodynia, other symptoms were not different across diagnoses.</p><p><strong>Discussion: </strong>Social media overemphasizes the ability of symptoms to allow self-diagnosis of vaginitis, which can lead to delayed treatment, highlighting the need to promote accurate health information online.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1549331"},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652378","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":"Introducing artificial intelligence and sperm epigenetics in the fertility clinic: a novel foundation for diagnostics and prediction modelling.","authors":"Adelheid Soubry","doi":"10.3389/frph.2025.1506312","DOIUrl":"10.3389/frph.2025.1506312","url":null,"abstract":"<p><p>Worldwide, infertility is a rising problem. A couple's lifestyle, age and environmental exposures can interfere with reproductive health. The scientific field tries to understand the various processes how male and female factors may affect fertility, but translation to the clinic is limited. I here emphasize potential reasons for failure in optimal treatment planning and especially why current prediction modelling falls short. First, Assisted Reproductive Technology (ART) has become a mainstream solution for couples experiencing infertility, while potential causes of infertility remain unexplored or undetermined. For instance, the role of men is generally left out of preconceptional testing and care. Second, regularly used statistical or computational methods to estimate pregnancy outcomes miss important biological and environmental factors, including features from the male side (e.g., age, smoking, obesity status, alcohol use and occupation), as well as genetic and epigenetic characteristics. I suggest using an integrated approach of biostatistics and machine learning methods to improve diagnostics and prediction modelling in the fertility clinic. The novelty of this concept includes the use of empirically collected information on the sperm epigenome combined with readily available data from medical records from both partners and lifestyle factors. As the reproductive field needs well-designed models at different levels, derivatives are needed. The objectives of patients, clinicians, and embryologists differ slightly, and mathematical models need to be adapted accordingly. A multidisciplinary approach where patients are seen by both, clinicians and biomedically skilled counsellors, could help provide evidence-based assistance to improve pregnancy success. Next, when it concerns factors that may change the ability to produce optimal embryos in ART, the embryologist would benefit from a personalized prediction model, including medical history of the patient as well as genetic and epigenetic data from easily accessible germ cells, such as sperm.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1506312"},"PeriodicalIF":2.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627013","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":"Integrating HIV prevention with family planning services for adolescent girls and young women in Uganda: perspectives of adolescent girls and young women, health care providers, and policymakers.","authors":"Justine K Tumusiime, Davina Canagasabey, Peter Mudiope, Sabrina Kitaka, Allen Namagembe, Fiona Walugembe, Bridget Nakankaka, Josephine Nabuuma, Jesca Nasunku, Jane Cover, Betty Mirembe, Ashley Jackson, Kimberly Green","doi":"10.3389/frph.2025.1441829","DOIUrl":"10.3389/frph.2025.1441829","url":null,"abstract":"<p><strong>Introduction: </strong>Persistently high HIV incidence among women, especially adolescent girls and young women (AGYW), have drawn the attention of national policymakers, donors, and implementers in Sub-Saharan Africa to the integration of HIV and family planning (FP) programs. According to several research studies, FP services could offer a holistic strategy to address the HIV and FP needs of this demographic by including HIV prevention approaches, particularly HIV pre-exposure prophylaxis. Our study set out to explore the obstacles and opportunities that AGYW faced in accessing, using, and continuing HIV prevention and contraceptive services; to develop ideas for novel service models that would allow AGYW to receive integrated, HIV prevention and contraception services; and to evaluate the viability, scalability, and acceptability of these models through dialogues with stakeholders using a human-centered design approach.</p><p><strong>Methods: </strong>We conducted 128 in-depth interviews with 60 AGYW, 24 public and private health care providers, 10 community leaders, and 10 policymakers). We also conducted two co-creation workshops with 50 AGYW and 10 health care providers in Masaka and Nakasongola districts to generate service delivery models.</p><p><strong>Results: </strong>Our findings reveal various enablers and barriers to the successful integration of HIV prevention into FP services in the areas of policy, human resources and infrastructure, resource management, service delivery, community involvement, supply chain management, and monitoring and reporting.</p><p><strong>Discussion: </strong>Successful integration will require addressing key concerns raised by participants in human resource and infrastructure, resource management, service delivery, demand creation, male involvement, supply chain management and monitoring and reporting.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1441829"},"PeriodicalIF":2.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598413","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":"Menstrual hygiene practice and associated factors among adolescent primary school females in Dale Woreda, Sidama, Ethiopia: a cross sectional study.","authors":"Amanuel Ayele, Meskerem G/Mariam, Hunachew Beyene, Alemu Tolcha, Dansamo Tediso, Teshale Shalamo, Teshale Belayneh","doi":"10.3389/frph.2025.1458132","DOIUrl":"10.3389/frph.2025.1458132","url":null,"abstract":"<p><strong>Background: </strong>Despite poor menstrual hygiene practices exposing adolescent females to reproductive health problems, it has not been adequately studied in low-income countries. Due to a lack of proper information, the majority of teenage girls enter puberty without having prepared themselves. The aim of this study was to assess menstrual hygiene practice and associated factors among adolescent female students.</p><p><strong>Methods: </strong>An institution-based cross-sectional study design was employed from March 10 to April 20, 2022. A random sample of 608 adolescent female students was included in the study. A multistage sampling was applied to employee study participants. Data were collected using a structured questionnaire administered through an interview technique. A logistic regression model was used to analyze the data using version 26 SPSS statistical software. Descriptive statistics were used to summarize the data. An adjusted odds ratio with a 95% confidence interval and a corresponding <i>p</i>-value <0.05 was used to measure the strength of association.</p><p><strong>Result: </strong>The prevalence of poor menstrual hygiene practices among adolescent girls was 28.4%. Poor knowledge of adolescent girls [AOR = 2.64, 95% CI: 1.74, 4.02], mothers' educational level [AOR = 0.86, 95% CI: 0.79, 0.94], fathers' occupation of private employers and daily laborers [AOR = 3.1, 95% CI: 1.46, 6.69] and [AOR = 1.98, 95% CI: 1.03, 3.8], and having hand washing facilities [AOR = 0.51, 95% CI: 0.34, 0.77] were significantly associated with poor menstrual hygiene management practices among adolescent schoolgirls.</p><p><strong>Conclusion: </strong>In this study, we determined the level of poor menstrual hygiene practice. We identified factors significantly associated with menstrual hygiene practices. Interventions should focus on creating awareness among adolescent girls, providing menstrual hygiene management facilities, and improving the educational and occupational levels of parents.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1458132"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574960","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":"The correlation between sperm DNA methylation and DNA damage: a comparison of comet and TUNEL.","authors":"Hailey Zimmerman, Tim Jenkins","doi":"10.3389/frph.2025.1523386","DOIUrl":"10.3389/frph.2025.1523386","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship between sperm DNA methylation and DNA damage as determined by the comet or TUNEL assays.</p><p><strong>Design: </strong>Retrospective research study.</p><p><strong>Setting: </strong>University-based andrology and <i>in vitro</i> fertilization (IVF) laboratory.</p><p><strong>Patients: </strong>Data came from 1,470 male partners (ages 18 and older) recruited from heterosexual couples (ages 18-45 years) seeking fertility treatments. These data were analyzed retrospectively from the Folic Acid and Zinc Supplementation Trial (FAZST) study.</p><p><strong>Main outcome measures: </strong>Comet and TUNEL measures and associations with DNA methylation patterns.</p><p><strong>Results: </strong>Comet and TUNEL values were correlated with one another across all samples (<i>R</i> ² = 0.34, <i>P</i> < 0.001); however, when assessing the highest and lowest scores reported from each assay, there was little overlap between patients. This suggests that Comet and TUNEL are identifying key differences that may be meaningful and correlated with other sperm metrics. We compared both comet and TUNEL to methylation array data using a sliding window analysis, which identified far more significantly differentially methylated sites as a function of comet than TUNEL (3,387 vs. 23). Interestingly, sites associated with comet were associated with biological pathways related to DNA methylation involved in germline development, as determined by a GO term analysis. The TUNEL assay, by comparison, produced no relevant biological pathways.</p><p><strong>Conclusions: </strong>Because the comet and TUNEL assays are both used to indicate levels of DNA damage, and outputs of both are correlated to each other, it would seem to follow that both are equally predictive of deviations in DNA methylation patterns. The findings of this study suggest that this is not the case. The comet assay shows a significantly higher association with DNA methylation disruption, and we therefore believe it to be a better indicator of sperm epigenetic health.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1523386"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574961","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":"Assessing vitamin D's impact on pregnancy success: a predictive model for assisted reproductive technology outcomes.","authors":"Songwei Jiang, Zushun Chen, Liuming Li","doi":"10.3389/frph.2025.1510484","DOIUrl":"10.3389/frph.2025.1510484","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between vitamin D levels and clinical pregnancy rates in infertile women undergoing <i>in vitro</i> fertilization (IVF)/intracytoplasmic sperm injection (ICSI) procedures and to assess the utility of vitamin D levels in developing a predictive model for assisted reproductive technology (ART) outcomes.</p><p><strong>Methods: </strong>A total of 188 infertile patients receiving their initial IVF or ICSI treatment at our reproductive center between June 2020 and July 2021 were selected for data collection. Vitamin D levels and other relevant ART-related factors were used to construct a predictive model.</p><p><strong>Result: </strong>The multivariate regression analysis revealed that several independent variables significantly impacted ART pregnancy outcomes, including infertility age, vitamin D level, reproductive anti-Müllerian hormone, antral follicle count, Gn dose, daily endometrial thickness after human chorionic gonadotropin (HCG) administration, and number of retrieved eggs. The area under the receiver operating characteristic curve for this comprehensive model was 75.34%, with a standard error of 0.045 and <i>p</i>-value of 0.003 (95% confidence interval 0.712-0965). Furthermore, the multivariate regression analysis identified specific independent variables that might influence vitamin D levels, such as the number of embryos obtained, daily endometrial thickness after HCG administration, and clinical pregnancy.</p><p><strong>Conclusion: </strong>The developed predictive model integrating serum 25-Hydroxyvitamin D level and ART-related factors holds significant clinical value in forecasting pregnancy outcomes.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1510484"},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560146","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":"Health care experiences of individuals accessing or undergoing <i>in vitro</i> fertilization (IVF) in the U.S.: a narrative review of qualitative studies.","authors":"Summer K Peterson, Larissa Jennings Mayo-Wilson, Lauren Spigel, Isabel Morgan, Adriana Parker","doi":"10.3389/frph.2025.1490917","DOIUrl":"10.3389/frph.2025.1490917","url":null,"abstract":"<p><strong>Background: </strong><i>In vitro</i> fertilization (IVF) is an increasingly common method of assisted reproduction given the high rates of infertility in the United States (U.S.). However, despite growing utilization of IVF technologies, there is little known about the experiences of those accessing or undergoing IVF, particularly among adults in the U.S. The aims of this review are to (1) explore how economic, emotional and physical health, and interpersonal relationships impact and are impacted by accessing or undergoing IVF, and (2) understand the role of healthcare providers and the healthcare system.</p><p><strong>Methods: </strong>A narrative review was conducted to summarize the current literature and provide insight into potential channels for care improvement. Eligible studies were published in English from 2013 to 2024 which qualitatively evaluated experiences of individuals and couples accessing or undergoing IVF. Peer-reviewed publications were identified from three electronic bibliographic databases. Methodologic rigor was assessed by two reviewers who also abstracted data on the study's characteristics as they pertained to four domains: health systems, economic, interpersonal, and physical and emotional health. Among the 32 papers retrieved for review, 22 met inclusion criteria and were retained for analysis.</p><p><strong>Results: </strong>The available literature suggests accessing and undergoing IVF can be positively and negatively influenced by health systems, economic, interpersonal, and physical and emotional health factors. Often an individual or couple experiences multiple factors that compound to create a complex situation. Health systems-related factors included physician interaction and challenges with information volume and processing. Economic challenges primarily pertained to financing IVF and navigating insurance coverage. Interpersonal factors related to changes in relationships with partners, family members, and friends due to IVF. Physical health concerns (e.g., pain) and emotional health concerns (e.g., sadness, stress) were also noted by all included papers.</p><p><strong>Conclusions: </strong>Efforts to improve care experiences of adults accessing or undergoing IVF are urgently needed. The evidence base points to a need for provider sensitivity trainings, clinic-based intervention, and community education in both physical and virtual spaces.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"7 ","pages":"1490917"},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525467","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}