Frontiers in reproductive health最新文献

{"title":"Is age a critical indicator for determining the optimal abstinence duration in patients undergoing sperm acquisition?","authors":"Yifu Wang, Shenghui Zhu, Houbin Zheng, Hai Lin, Zhiyong Zhu, Huang Liu, Yu Zhou","doi":"10.3389/frph.2026.1921505","DOIUrl":"10.3389/frph.2026.1921505","url":null,"abstract":"<p><strong>Introduction: </strong>Sperm cryopreservation is increasingly recognized as a key strategy for fertility preservation, particularly for male infertility patients who may benefit from assisted reproductive technology (ART). However, the optimal abstinence period for maximizing semen quality prior to cryopreservation remains unclear, and whether this optimum varies with patient age has not been systematically investigated.</p><p><strong>Methods: </strong>We retrospectively analyzed semen parameters from male patients who underwent sperm cryopreservation for fertility preservation at Guangdong Provincial Reproductive Hospital. Patients were stratified by age (<40 years vs. ≥40 years). Semen samples were collected after different abstinence durations (0-2, 3-5, 6-7 and ≥7 days). Sperm quality indicators-including volume, concentration, motility, and progressive motility-were compared across abstinence groups within each age stratum.</p><p><strong>Results: </strong>Results showed that among patients aged over 40 years, sperm quality was optimal after 0-2 days of abstinence despite reductions in semen volume and concentration. By contrast, in younger patients (under 40 years), the highest semen quality was observed following 3-5 days of abstinence. Additionally, prolonged abstinence periods were linked to unstable semen quality in the older patient group, making them less ideal candidates for sperm cryopreservation.</p><p><strong>Discussion: </strong>This study is the first to demonstrate that the relationship between abstinence duration and sperm quality is strongly modified by patient age. Our findings indicate that older patients achieve better and more consistent outcomes with shorter abstinence. The findings offer new perspectives for guiding sperm cryopreservation and determining the optimal timing for sperm retrieval in patients of different age groups to improve sperm quality and increase success rates in assisted reproductive outcomes.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1921505"},"PeriodicalIF":3.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875977","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":"Fertility counseling experiences and perceived gaps in provider support among people living with HIV: a qualitative study from an antiretroviral therapy clinic in Ghana.","authors":"Victor Luckyboy Dzramado, Priscilla Asantewaa Boadi","doi":"10.3389/frph.2026.1914832","DOIUrl":"10.3389/frph.2026.1914832","url":null,"abstract":"<p><strong>Introduction: </strong>Antiretroviral therapy (ART) has made safer childbearing achievable for people living with HIV (PLHIV), and the reproductive health counseling PLHIV receive within HIV care shapes whether they can act safely on their fertility intentions. This study explored, from the perspective of PLHIV themselves, how the reproductive counseling they reported receiving shaped their fertility decision making, and which aspects of counseling support they perceived to be missing.</p><p><strong>Methods: </strong>A qualitative descriptive design with inductive reflexive thematic analysis was used. Twelve PLHIV (nine women, three men) distributed across the 26-50 year age bands and receiving ART at St. Michael's Hospital ART clinic, Pramso, Ashanti Region, were recruited through maximum variation purposive sampling within criterion based eligibility. In depth semi structured interviews were conducted between August and October 2024, audio recorded, transcribed verbatim, and coded by both authors, with differences resolved by consensus. Reporting followed the Consolidated Criteria for Reporting Qualitative Research.</p><p><strong>Results: </strong>Three themes were developed. First, participants reported clear and reassuring education on prevention of vertical (mother to child) transmission, while describing little guidance on conceiving safely with a partner of a different HIV status. Second, participants described providers as warm and accessible, yet experienced the counseling itself as general rather than matched to their own circumstances. Third, participants reported reliable treatment access and routine reproductive education, but described few services beyond education and basic counseling.</p><p><strong>Discussion: </strong>Participants perceived gaps in counseling support, particularly beyond prevention of vertical transmission. These are reported experiences and do not measure counseling quality or provider knowledge, and they may equally reflect consultation time, service organization, referral availability, and the faith based institutional context. The findings indicate areas that participants themselves identified for strengthening, including safer conception counseling, individualized fertility planning, and clearer referral pathways.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1914832"},"PeriodicalIF":3.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875974","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":"Metals and metal mixtures associated with the odds of uterine fibroid prevalence among African Caribbean women in the Tobago Health Study.","authors":"Alexis Kiyanda, Hoimonty Mazumder, Iva Miljkovic, Ryan Cvejkus, Janet Catov, Victor Wheeler, Patrick J Parsons, Elizabeth J Mullin, Austin A Roberts, Aaron Barchowsky, Natalie Price, Alison P Sanders","doi":"10.3389/frph.2026.1917571","DOIUrl":"10.3389/frph.2026.1917571","url":null,"abstract":"<p><p>Uterine fibroids are the most common benign smooth muscle neoplasm of the uterine wall and are a major indication for hysterectomy. Although common risk factors include African Ancestry, family history, obesity, and early menarche, exposure to non-essential metals is an emerging risk factor that has not been previously examined in Caribbean populations. In this cross-sectional study, a sample of the prospective Tobago Health Study, we assessed associations between individual urinary concentrations of metals and metal mixtures with self-reported uterine fibroid prevalence among 441 women (40-87 years old). We used logistic regression to estimate associations between concentrations of six metals (non-essential metals-arsenic, cadmium, and lead; essential metals-copper, manganese, and zinc) individually and as a mixture with the odds of uterine fibroids. Models were adjusted for urinary creatinine, age, body mass index, education, and number of live childbirths. We assessed the effects of metal mixtures using weighted quantile sum regression. The rate of prevalence of uterine fibroids was 48.3%. In adjusted models, each 10-fold increase in µg/L urinary concentrations of total arsenic, dimethylarsinic acid, and arsenobetaine was associated with 61%, 84%, and 38% higher odds of uterine fibroids, respectively (<i>β</i>: 1.61; 95% CI: 1.04, 2.53); (<i>β</i>: 1.84; 95% CI: 1.11, 3.09); and (<i>β</i>: 1.38; 95% CI: 1.05, 1.82). Other metals were not associated with the odds of uterine fibroids. We observed no significant associations between metal mixtures and the odds of uterine fibroids. Urinary arsenic and arsenical metabolites were associated with higher odds of uterine fibroids in a cohort of African Caribbean women. Raising awareness about arsenic and metal exposure is prudent, and further research in longitudinal studies is needed to replicate the findings of this study and inform policies for public health protection of women's health.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1917571"},"PeriodicalIF":3.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868116","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":"Exploring engagement patterns in a reproductive health app using the Technology Acceptance Model.","authors":"Alissa Kazakoff, Patricia K Doyle-Baker","doi":"10.3389/frph.2026.1904798","DOIUrl":"10.3389/frph.2026.1904798","url":null,"abstract":"<p><strong>Background: </strong>Menstrual tracking apps are widely used, yet research on what drives sustained engagement remains limited. Most studies rely on self-reported use, with few incorporating real-time behavioural data or validated theoretical frameworks such as the Technology Acceptance Model (TAM).</p><p><strong>Objective: </strong>This study examined associations between engagement with a reproductive health app offering menstrual tracking functionality and TAM constructs over a 90-day period using both survey and direct app usage data. Changes in menstrual literacy were also assessed to evaluate the app's educational impact.</p><p><strong>Methods: </strong>Participants (n = 293) were recruited via social media and completed baseline and follow-up surveys including TAM measures of perceived usefulness (PU), perceived ease of use (PEOU), trust, and menstrual literacy indicators (confidence and information sufficiency). Real-time app engagement data were collected continuously, and participants were categorized into high- and low-engaged groups based on actual use. Paired t-tests and multivariate regression analyses were used to assess changes over time and differences between groups.</p><p><strong>Results: </strong>At baseline, no differences were observed in TAM constructs between high- and low-engaged users. By follow-up, PEOU declined significantly in low-engaged users while high-engaged users maintained higher perceived ease of use (p < 0.05). Confidence in menstrual knowledge increased in both groups whereas information sufficiency did not change significantly. Feature usage showed that 98% tracked menstrual cycles, 73% tracked symptoms, and 42% tracked exercise. The app was rated as moderate quality (uMARS mean=3.1).</p><p><strong>Conclusion: </strong>Integrating TAM constructs with real-time usage data provides new insight into engagement with a reproductive health app used for menstrual tracking. Findings underscore the importance of PEOU for sustained engagement and point to gains in users' confidence in their menstrual knowledge. Future work should include more diverse participants.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1904798"},"PeriodicalIF":3.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868130","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":"Reframing endometriosis care in low-resource settings: a pragmatic 5R framework for recognition, rule-out, relief, referral and review.","authors":"Sebastian Ken-Amoah, Evans Kofi Agbeno, Samuel Agyeman, Eric Peter Yao Mensah, Betty Anane-Fenin, Godfred O Boateng","doi":"10.3389/frph.2026.1901655","DOIUrl":"10.3389/frph.2026.1901655","url":null,"abstract":"<p><p>Endometriosis is a chronic inflammatory gynecological condition associated with severe dysmenorrhea, chronic pelvic pain, deep dyspareunia, cyclic bowel or urinary symptoms and infertility. It is also linked to psychological morbidity, reduced quality of life and lost economic productivity. In low-resource settings, diagnostic and therapeutic delays often reflect pathway failure rather than specialist scarcity alone: symptoms are commonly normalized, first-contact recognition remains weak, differential diagnosis is inconsistent, referral pathways are poorly governed and structured follow-up is frequently absent. This article proposes a pragmatic 5R Framework (Recognition, Rule-Out, Relief, Referral and Review) tailored for symptom-led endometriosis care in low-resource settings. The framework draws on international guidelines, clinical review evidence, African and low- and middle-income country (LMIC) evidence on access barriers, global scoping reviews of policy and service-delivery gaps, imaging guidance, and health-systems evidence on task redistribution. Its central proposition is that endometriosis-compatible symptoms should trigger structured first-contact recognition, safety-oriented rule-out, fertility-sensitive first-line relief, need-based referral and planned review before definitive specialist confirmation is available. The framework is not a validated clinical decision rule; rather, it isa testable pathway model for local adaptation, consensus refinement, facility-level audit and prospective implementation research. Its utility lies in translating established evidence-based principles into an accountable care sequence that permits earlier action without compromising diagnostic caution, reproductive goals or referral responsibilities.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1901655"},"PeriodicalIF":3.1,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868109","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":"Women's autonomy and discrimination relevant to cervical cancer screening.","authors":"Adja Maguette Diaw, Fatoumata Binetou Diongue, Ibrahima Ndiaye, Omar Gassama, Ndeye Mbombe Dieng, Saria Awadalla, Fatou Bintou Seck, Ndèye Marème Sougou, Sarah Abboud, Assane Sall, Hilaire Sarr, Aida Fall, Aliath Salami, Alexis Claire Klima, Aida Barro, Elle Martell, Ahmadou Babana El Alaoui, J Andrew Dykens, Caryn E Peterson, Adama Faye","doi":"10.3389/frph.2026.1837034","DOIUrl":"10.3389/frph.2026.1837034","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer remains the fourth most common cancer affecting women worldwide, with large geographical variations in incidence and mortality rates. The objective of this study is to determine whether women's autonomy is predictive of the use of cervical cancer screening services in Senegal.</p><p><strong>Method: </strong>This was a descriptive and analytical cross-sectional study of a sample of 312 women. Data were analyzed using R 4.2 software. Logistic regression was used to analyze associations between indicators of women's autonomy and cervical cancer screening practices.</p><p><strong>Results: </strong>Compared with women whose partners made the decision regarding cervical cancer screening, women who reported making the decision themselves (AOR: 10.07; 95% CI: 2.72, 37.33) or jointly with their partner (AOR: 5.34; 95% CI: 1.35, 21.21) were more likely to have undergone screening. Women who were aware of the existence of a cervical cancer screening test were also more likely to have been screened than those who were not aware of it (AOR: 7.67; 95% CI: 1.41, 41.61). In contrast, women residing in Dakar were more likely to have undergone cervical cancer screening than those residing in the Kédougou region (AOR: 0.40; 95% CI: 0.17, 0.96).</p><p><strong>Conclusion: </strong>This study shows that increased autonomy among women predicts greater use of cervical cancer screening services by women. Therefore, policy interventions should focus on empowering women to make autonomous decisions about their health.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1837034"},"PeriodicalIF":3.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852001","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":"Inequitable access to risk-appropriate neonatal care: evidence from a regionalized perinatal system in Arkansas.","authors":"Md Asif Khan Sharon, Sandra D Eksioglu, Cari Anne Bogulski, Enrique Gomez Pomar","doi":"10.3389/frph.2026.1914178","DOIUrl":"10.3389/frph.2026.1914178","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate access to risk-appropriate neonatal care in Arkansas and examine relationship among geography, hospital availability, county-level maternity care access, birth triage patterns, neonatal transfers, and neonatal intensive care unit (NICU) utilization.</p><p><strong>Study design: </strong>Population-based retrospective cohort study of all live births in Arkansas from 2014 to 2023 using linked birth certificate, hospital designation, and county-level maternity care access data. Primary exposures included geographic distance to the nearest risk-appropriate facility, local hospital availability, and insurance status. Outcomes included birth triage status (over-, under-, or risk-appropriate), transfer triage patterns, NICU utilization, and the impact of obstetric unit closures.</p><p><strong>Results: </strong>Among 358,155 live births, 76.5% occurred at facilities providing a higher level of care than required, 20.1% occurred at risk-appropriate facilities, and 3.3% occurred at facilities providing a lower level of care than required. Under-triage was most common when the nearest risk-appropriate facility was geographically distant (mean distance 51.2 miles). Medicaid-covered births experienced under-triage nearly twice as often as privately insured births (4.31% vs. 2.55%; <i>p</i> < 0.001). NICU admission rates varied substantially across county access categories (6.5%-9.3%) despite similar rates of high-acuity births (3.5%-3.9%), consistent with supply-sensitive utilization. Among 6,935 neonatal transfers, 84.3% were directed to facilities providing a higher level of care than required. Of 4,703 transfers to Level IV NICUs, only 3.6% of infants met criteria for Level IV care, and a closer Level III facility was available in 96.1% of cases. Following obstetric unit closures, risk-appropriate births decreased, over-triage increased, and travel distances lengthened.</p><p><strong>Conclusion: </strong>Access to risk-appropriate neonatal care was shaped more strongly by geography, resource distribution, and referral structure than by measured clinical risk. These findings suggest that regionalized perinatal systems may simultaneously experience inequitable access and supply-sensitive utilization. Strategies including independent transfer triage coordination, preservation of lower-level maternity and nursery capacity, and standardized NICU admission practices may improve alignment between neonatal need and site of care.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1914178"},"PeriodicalIF":3.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851985","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":"Emerging peptide and neuroendocrine strategies for TRT-induced reproductive suppression and functional male hypogonadism: a narrative review.","authors":"Ana-Maria Cretu, Ahmed Adel Mansour Kamar, Alin Ciobica, Dragos Puia, Mara Doroftei, Bogdan Doroftei","doi":"10.3389/frph.2026.1914709","DOIUrl":"10.3389/frph.2026.1914709","url":null,"abstract":"<p><p>The growing burden of male hypogonadism has raised concerns regarding the potential impact of modern lifestyles and environmental exposures on male reproductive health. Testosterone replacement therapy (TRT) is widely used for the treatment of male hypogonadism. However, prolonged TRT may suppress the hypothalamic-pituitary-testicular (HPT) axis, resulting in reduced gonadotropin production, decreased intratesticular testosterone levels, impaired spermatogenesis, testicular atrophy, and compromised fertility. Current management strategies, including human chorionic gonadotropin (hCG), follicle-stimulating hormone (FSH), and selective estrogen receptor modulators (SERMs), can support recovery in some patients, but their effectiveness remains variable. This narrative review examines the emerging role of peptide and neuroendocrine strategies in TRT-induced reproductive suppression and functional male hypogonadism. A structured literature search was conducted to identify experimental, translational, and clinical studies investigating reproductive peptides and related neuroendocrine pathways. Particular attention was given to kisspeptin-based therapies, gonadotropin-releasing hormone (GnRH)-related approaches, neurokinin signaling pathways, and other developing interventions with potential relevance to male reproductive health. Current evidence suggests that peptide-based therapies may support endogenous hormonal signaling through targeted activation of the HPT axis. However, direct evidence demonstrating restoration of spermatogenesis or fertility following TRT-induced suppression remains limited, and important questions regarding long-term efficacy, safety, treatment protocols, and patient selection remain unresolved. Emerging peptide therapeutics represent a growing area of interest in reproductive endocrinology and may expand future treatment options for selected patients. Nevertheless, further well-designed clinical studies are required to establish their long-term efficacy, safety, and role in restoring reproductive function following TRT-induced suppression.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1914709"},"PeriodicalIF":3.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851995","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":"Platelet-rich plasma in reproductive medicine: from ovarian follicles to the ovarian niche and emerging stem cell mobilization-based regenerative strategies.","authors":"Manuel Muñoz-Cantero, Amparo Santamaría Ortiz","doi":"10.3389/frph.2026.1921016","DOIUrl":"10.3389/frph.2026.1921016","url":null,"abstract":"<p><p>Ovarian aging is a complex biological process traditionally attributed to the progressive depletion of the follicular reserve. However, accumulating evidence suggests that age-related reproductive decline is not solely determined by follicular loss but also by profound alterations in the ovarian microenvironment, including stromal fibrosis, vascular dysfunction, chronic low-grade inflammation, oxidative stress, and impaired intercellular communication. This evolving understanding has promoted a shift from a follicle-centered view of ovarian aging toward a broader ovarian niche-centered paradigm. Within this context, platelet-rich plasma (PRP) has emerged as one of the most extensively investigated regenerative approaches in reproductive medicine. PRP provides a concentrated source of growth factors, cytokines, and bioactive mediators capable of modulating angiogenesis, tissue remodeling, inflammation, and cellular signaling. Nevertheless, interpretation of the available clinical evidence remains challenging due to substantial heterogeneity in PRP preparation protocols, biological composition, patient selection, and outcome measures. This narrative review examines the biological basis of PRP, its potential effects on the ovarian niche, and the current clinical evidence supporting its use in women with diminished ovarian reserve, poor ovarian response, premature ovarian insufficiency, and advanced reproductive age. Particular attention is given to the emerging concept that restoration of ovarian niche functionality, rather than isolated activation of residual follicles, may represent the primary biological objective of contemporary ovarian rejuvenation strategies. The review also explores the rationale for combining local regenerative interventions with systemic regenerative approaches, including hematopoietic progenitor cell mobilization induced by granulocyte colony-stimulating factor (G-CSF). We discuss the hypothesis that mobilization-induced changes in circulating progenitor cells, chemotactic signaling pathways, and the systemic regenerative milieu may enhance the biological activity of autologous regenerative products and contribute to ovarian niche restoration. Current evidence does not yet support definitive conclusions regarding the efficacy of ovarian rejuvenation therapies. However, the integration of local and systemic regenerative signals represents a promising avenue for future investigation. Further progress will require standardized biological products, robust biomarkers, and well-designed clinical trials capable of clarifying the mechanisms, indications, and clinical value of regenerative interventions targeting the ovarian niche.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1921016"},"PeriodicalIF":3.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852049","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":"Legislating infrastructure: a state-level model to accelerate endometriosis research and women's health equity.","authors":"E T Courtois, L Roy, J Kuljancic, K Mullaj, D Lockshire, D E Luciano","doi":"10.3389/frph.2026.1918764","DOIUrl":"10.3389/frph.2026.1918764","url":null,"abstract":"<p><p>Impact statement: A legislatively mandated, statewide endometriosis biorepository integrated within a multidisciplinary endometriosis focused program demonstrates how policy-driven infrastructure can integrate education, clinical care, harmonized biobanking, and translational research to address persistent gaps in women's health in the long term. The Connecticut Endometriosis Working Group (EWG), a group of legislators, researchers, patients, health care providers, and advocates, was established in 2021. The EWG met monthly to discuss strategies to address endometriosis and propose endometriosis specific legislation which has been a turning point. Public Acts 22-33 and 23-67 directed the establishment, governance, and annual reporting of a coordinated endometriosis data and biorepository program, making Connecticut the first state in the US to pass endometriosis focused legislation, unanimously. The resulting program-EndoRISE, (Endometriosis Research, Innovation, Support and Education) is structured as a public, multi-institutional infrastructure platform linking clinical phenotyping, biospecimen banking, molecular profiling, education, public awareness, and policy engagement. On May 14, 2026, HB5514 was passed making the Endometriosis Working Group a legislatively established working group under the administration of the Committee on Women, Children, Seniors, Equity, and Opportunity. This initiative provides an opportunity to examine whether state-level policy mechanisms can meaningfully influence research capacity in women's health and particularly address disregarded and underappreciated chronic and systemic female conditions such as endometriosis.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1918764"},"PeriodicalIF":3.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841929","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}