Frontiers in reproductive health最新文献

{"title":"Editorial: Transitioning through menopause: contraceptive choices and sexual well-being.","authors":"Hannah Sebitloane, Rosie Mngqibisa","doi":"10.3389/frph.2026.1916638","DOIUrl":"10.3389/frph.2026.1916638","url":null,"abstract":"","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1916638"},"PeriodicalIF":3.1,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632719","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":"Syphilis clustering among young pregnant women (18-35 years) in Kampala and Wakiso districts, Uganda.","authors":"Rogers Nsubuga, Timothy R Muwonge, Andrew Mujugira, Barbara Castelnuvo, Edith Nakku-Joloba, Rosalind Parkes-Ratanshi, Yukari C Manabe, Agnes N Kiragga","doi":"10.3389/frph.2026.1829745","DOIUrl":"10.3389/frph.2026.1829745","url":null,"abstract":"<p><strong>Introduction: </strong>In Uganda, spatial distribution of syphilis varies by age, gender, and region. Identifying clusters (subsets of administrative subdivisions) with high syphilis prevalence could boost efforts to eliminate mother-to-child transmission of syphilis. We examined spatial variations and clustering of syphilis prevalence among pregnant young women aged 18-35 years in Central Uganda.</p><p><strong>Methods: </strong>We analysed secondary data from a randomised trial that evaluated the effectiveness of three antenatal syphilis partner notification approaches (NCT02262390). This study analysed clustering of syphilis prevalence by administrative division in Kampala and Wakiso districts, using Moran's I tests and Local Indicator of Spatial Association (LISA). We used Kulldorff Spatial-Scan Poisson model to detect syphilis clustering and classified divisions into high- or low-prevalence (HP/LP) syphilis clusters based on 95% statistical significance. We estimated prevalence ratios for sociodemographic and bio-behavioural HIV risk factors associated with residence in HP divisions using modified Poisson regression.</p><p><strong>Results: </strong>Of 422 women diagnosed with syphilis, 26 (6%) had HIV and syphilis. Median age was 26 years (IQR 24-29). Most (314, 74%) were in monogamous marriages, and half (50%) had attained secondary education. Syphilis prevalence clustering was negatively associated with residence in HP divisions among women in polygamous marriages [adjusted prevalence ratio (APR) = 0.64; 95%: 0.47-0.88], those with an unplanned pregnancy (APR = 0.78; 95% CI: 0.64-0.93), and who had HIV testing >3 months prior (APR = 0.83, 95% CI: 0.72-0.95). Syphilis prevalence was significantly higher in 3/12 clusters: Kasangati Town Council [Relative Risk (RR) = 2.79, <i>p</i> < 0.0001], Kawempe (RR = 2.52, <i>p</i> < 0.0001), and Nabweru (RR = 1.95, <i>p</i> = 0.0002), and lower in one cluster-Kyengera Town Council (RR = 0.12, <i>p</i> < 0.0001). Notably, no significant clustering was detected among women with HIV (<i>p</i> > 0.05). Random patterns of syphilis prevalence were detected across all divisions (Moran's I = 0.08, <i>p</i> = 0.19). However, some neighbouring divisions had similar prevalence: Kawempe (1.06, <i>p</i> = 0.02) and Nabweru (0.54, <i>p</i> = 0.045). LISA analysis confirmed high syphilis prevalence in northern divisions (Kawempe and Nabweru; <i>p</i> = 0.01). By contrast, Central Region had neighbouring low and high prevalence divisions (Kawempe and Central; <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Syphilis prevalence was similar within neighbouring divisions, but highest in Kasangati Town Council and Kawempe. Integrating spatial analysis in routine surveillance will enable detection of clusters where interventions can be targeted to eliminate congenital syphilis.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1829745"},"PeriodicalIF":3.1,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622937","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":"Interventional radiology in the management of vascular complications in urogynecology: a lower-extremity hematoma after transobturator sling-case report.","authors":"Leonardo Gómez Polania, Víctor S Rangel, Gustavo A Sarmiento","doi":"10.3389/frph.2026.1871761","DOIUrl":"10.3389/frph.2026.1871761","url":null,"abstract":"<p><strong>Background: </strong>Mid urethral slings are currently considered the gold standard surgical treatment for stress urinary incontinence due to their high efficacy and favorable safety profile. Although vascular complications are uncommon, they may occasionally result in clinically significant bleeding.</p><p><strong>Case report: </strong>We report the case of a 72-year-old woman with stress-predominant mixed urinary incontinence who underwent urethrocolpopexy with placement of a transobturator mid-urethral sling, combined with anterior and posterior colporrhaphy. During the procedure, friable tissue and difficult to control inguinal bleeding were observed. In the immediate postoperative period, progressive inguinal ecchymosis extending to the mons pubis raised concern for a vascular injury, although the patient remained hemodynamically stable, asymptomatic, and without a decline in hemoglobin levels. Given the clinical suspicion, the patient's risk factors, and the technical complexity of the procedure, computed tomography angiography and diagnostic arteriography were performed, both of which excluded active bleeding or vascular lesions. Conservative management and close clinical surveillance led to spontaneous resolution of the hematoma, and the patient was discharged without further complications.</p><p><strong>Conclusion: </strong>This case highlights a large lower-extremity hematoma as a rare vascular complication associated with transobturator sling surgery and emphasizes the importance of an individualized diagnostic approach. Interventional radiology may serve as a valuable diagnostic and therapeutic tool, allowing exclusion of active bleeding and avoidance of unnecessary surgical reintervention, thereby optimizing patient outcomes.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1871761"},"PeriodicalIF":3.1,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622884","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":"Astaxanthin as a potential therapeutic agent in polycystic ovary syndrome: a review of its antioxidant, anti-inflammatory, and metabolic mechanisms.","authors":"Jialai Wang, Ying Yang, Ziwei Wang, Chengdong Liu, Yanhua Han, Xiaoke Wu, Hui Chang","doi":"10.3389/frph.2026.1901207","DOIUrl":"10.3389/frph.2026.1901207","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is the most common heterogeneous disorder among women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphological changes as its core clinical features. This disease severely affects women's reproductive health and significantly increases the risk of metabolic complications. The pathogenesis of PCOS is complex, involving various pathophysiological mechanisms such as oxidative stress, chronic low-grade inflammation, and insulin resistance. Currently, lifestyle interventions and first-line pharmacological treatments are the primary clinical strategies for managing PCOS. However, existing approaches face numerous limitations in terms of efficacy, safety, and patient compliance, including incomplete therapeutic effects, drug-related side effects, poor adherence, and a lack of long-term safety data, which necessitate further optimization and breakthroughs. Natural compounds have been widely utilized as therapeutic agents worldwide, with some showing potential advantages in preclinical and pharmacological studies, positioning them as potential alternatives to modern drugs. In recent years, astaxanthin, a natural compound, has garnered attention for its auxiliary effects in the treatment of PCOS due to its potent antioxidant and anti-inflammatory properties. Astaxanthin, a strong natural antioxidant derived from Haematococcus pluvialis, exhibits significant antioxidant, anti-inflammatory, anti-proliferative, and anti-apoptotic activities. To systematically evaluate the therapeutic potential of astaxanthin for PCOS, this study conducted a systematic review in strict accordance with the PICOS principles. A comprehensive literature search was performed across PubMed, Web of Science, and Scopus for relevant studies published between January 2020 and March 2026. The retrieved records were screened based on predefined inclusion and exclusion criteria, and the finally included studies were subjected to mechanistic analysis. This review provides a comprehensive analysis of the potential mechanisms by which astaxanthin, as a dietary supplement, improves PCOS through various pathways, including enhancing insulin sensitivity, activating the Nrf2 antioxidant pathway, inhibiting the NF-κB inflammatory signaling pathway, and modulating cellular apoptosis. Furthermore, it delineates the limitations and therapeutic prospects of astaxanthin supplementation, clarifying its significant value in the adjuvant treatment of PCOS and highlighting the key issues that warrant further investigation.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1901207"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610289","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":"Global research landscape and trends of single-cell sequencing in sexually transmitted infections: a comprehensive bibliometric analysis from 2015 to 2025.","authors":"Cuixiu Wu, Yuanshuo Guo, Na Cui, Yidan Gao, Lijuan Jiang, Haoneng Tang, Qingchun Liang, Lingli Tang","doi":"10.3389/frph.2026.1817416","DOIUrl":"10.3389/frph.2026.1817416","url":null,"abstract":"<p><strong>Background: </strong>Single-cell sequencing offers new insights into sexually transmitted infections (STIs) research, but there remains a lack of systematic bibliometric overview. Here, we summarize and quantify the developmental dynamics, research hotspots, and future directions of single-cell sequencing in STIs through bibliometric analysis.</p><p><strong>Methods: </strong>Relevant publications from 2015 to 2025 were retrieved from the Web of Science Core Collection (WoSCC), and data were visualized and analyzed using CiteSpace, VOSviewer, and the Bibliometrix R package. In addition, clinical trials were obtained from ClinicalTrials.gov to assess clinical advancements in this field. It should be noted that the data for 2025 were incomplete, as only publications indexed up to the search cutoff date (May 1, 2025) were included.</p><p><strong>Results: </strong>A total of 148 relevant articles and reviews were included in this study. The United States led in terms of publication output, citation counts, international collaboration, and influence. Chiarella J, Ho YC, and Wang FS were the most active authors in this field, while Stuart T was the most frequently co-cited scholar. Analysis of co-cited references identified \"HPV-related head and neck squamous cell carcinoma\" and \"HIV-regulating factor\" as clusters with significantly increased citation activity in recent years, suggesting emerging research attention. Keyword clustering objectively outlined the current research landscape, including studies on immune responses and pathogenic mechanisms of HIV infection, research on HIV latent reservoirs and viral persistence, investigations into HPV-related cancers, as well as single-cell and spatial transcriptomics-based immune mapping. Additionally, several emerging keywords were identified, including \"spatial transcriptomics\", \"epithelial cells\", \"biomarkers\", and \"machine learning\". Clinical trial analysis indicated both the promise and the ongoing challenges of clinical translation.</p><p><strong>Conclusions: </strong>By applying bibliometric methods to comprehensively summarize the research landscape and advances of single-cell sequencing in STIs, this study enhances the understanding of research hotspots and emerging directions in the field and provides references for future research.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1817416"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610348","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 the benefits, facilitators and barriers to male involvement in sexual and reproductive health: a qualitative study of nurses' and midwives' perspectives in Ghana.","authors":"Evelyn Asamoah Ampofo, Caroline Dinam Badzi, Berit Mortensen","doi":"10.3389/frph.2026.1847732","DOIUrl":"10.3389/frph.2026.1847732","url":null,"abstract":"<p><strong>Background: </strong>Male involvement in sexual and reproductive health (SRH) though a relatively old concept in Ghana continues to evolve traditionally focusing on women's health. The World Health Organization has encouraged gender-inclusive maternal health services to leverage men's roles in supporting their partners' health.</p><p><strong>Aim: </strong>This study aims to explore the perspectives of nurses and midwives on male involvement in SRH, identifying benefits, challenges, and strategies for enhancement.</p><p><strong>Method: </strong>A qualitative exploratory design was employed in Greater Accra Region, Ghana, engaging 32 nurses and midwives through five focus group discussions. Data collection involved using a semi-structured interview guide and recorded interviews. Data analysis was based on Braun and Clark's thematic analysis framework.</p><p><strong>Results: </strong>Findings revealed three primary themes: benefits of male involvement, barriers to participation, and strategies to enhance engagement. Participants noted significant positive outcomes, including improved health outcomes for women, reduced complications due to emotional and logistical support by male partners. However, barriers such as cultural norms, societal expectations and inadequate knowledge hindered active male involvement. This notwithstanding, participants have a strong desire to promote male involvement.</p><p><strong>Discussion: </strong>Results underscore the necessity of comprehensive education and community engagement to reshape attitudes towards male involvement. The lack of formal training for healthcare providers on facilitating male participation was identified as a critical gap.</p><p><strong>Conclusion: </strong>Enhancing male involvement in SRH can significantly improve maternal health outcomes. Nurses and midwives play a pivotal role in promoting this initiative through targeted education, outreach programs, and policy advocacy, ultimately fostering healthier family dynamics in Ghanaian society.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1847732"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610299","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":"Differential immunologic response to GnRHa alone vs. dual trigger for final follicular maturation: a proof-of-concept pilot study.","authors":"Raoul Orvieto, Helly Vernitsky, Marina Safanaiev, Dolly Yuster, Dan Dominissini","doi":"10.3389/frph.2026.1890241","DOIUrl":"10.3389/frph.2026.1890241","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impact of GnRH agonist (GnRHa) vs. dual trigger (GnRHa plus hCG) for final follicular maturation on peripheral immune profiles in women undergoing oocyte cryopreservation.</p><p><strong>Design: </strong>Prospective proof-of-concept hypothesis-generating pilot study.</p><p><strong>Setting: </strong>University-affiliated single center.</p><p><strong>Patients: </strong>Five healthy women undergoing fertility preservation (<i>n</i> = 3 GnRHa trigger, <i>n</i> = 2 dual trigger).</p><p><strong>Interventions: </strong>Ovarian stimulation with either GnRHa alone or dual trigger (GnRHa + hCG). Immune profiling was performed at two time points: (1) before trigger, and (2) on the day of oocyte retrieval.</p><p><strong>Main outcome measures: </strong>Percent change (%Δ) in peripheral immune blood T, B, and NK cell populations using flow cytometry.</p><p><strong>Results: </strong>Baseline characteristics were similar. Compared with GnRHa alone, dual trigger was associated with a trend toward lower CD4/CD8 (helper/cytotoxic) T cell ratio, and an apparent increase in highly differentiated cytotoxic (CD57+) cell populations. However, given the small sample size, findings should not be interpreted as definitive but as exploratory trends. There were no cases of OHSS.</p><p><strong>Conclusions: </strong>In this small, exploratory hypothesis-generating study, the addition of hCG to GnRHa trigger was associated with a shift toward a more cytotoxic lymphocyte profile post trigger. Findings require validation in larger, randomized cohorts to better understand their implications for reproductive outcomes and OHSS risk.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1890241"},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586341","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":"Monthly trends, determinants, and forecasting of perinatal mortality in Ghana: a comparison of ARIMA, BPNN, DLNN, and GRNN models.","authors":"Agyei Helena Lartey, Denis Dekugmen Yar, Ama Asamaniwa Attua, Godfred Nyanney, Akuffo Samuel Tete Manukure, Isaac Takyi Boahen, Theophilus Oduro Kankam, Collins Mawuli Bakudie","doi":"10.3389/frph.2026.1849802","DOIUrl":"10.3389/frph.2026.1849802","url":null,"abstract":"<p><strong>Background: </strong>Perinatal mortality is a critical indicator of the quality of maternal and newborn care across sub-Saharan Africa. A recent systematic review and meta-analysis estimated Ghana's pooled perinatal mortality rate at 44.8 per 1,000 births, highlighting ongoing barriers to meeting Sustainable Development Goal targets for neonatal survival.</p><p><strong>Methods: </strong>We conducted a retrospective, hospital-based time series analysis of 192 monthly observations from January 2010 through December 2025. Perinatal mortality rate (PMR) was defined as the sum of stillbirths and early neonatal deaths per 1,000 births. Stationarity was evaluated using the Augmented Dickey Fuller (ADF) test. Forecasting performance was compared across four models-ARIMA, backpropagation neural network (BPNN), deep learning neural network (DLNN), and generalized regression neural network (GRNN)-with model validation performed on a 2025 temporal holdout.</p><p><strong>Results: </strong>The hospital recorded 46,108 live births and 1,152 perinatal deaths, giving an overall PMR of 24.98 per 1,000 births. The undifferenced monthly PMR series was borderline non-stationary (ADF statistic -2.695; <i>p</i> = 0.075), while the first-differenced series was stationary (ADF statistic -7.118; <i>p</i> < 0.001). The best-performing ARIMA model on the 2025 holdout was ARIMA (3, 0, 0). Test-set RMSE values were 11.74 for ARIMA, 14.98 for BPNN, 12.87 for DLNN, and 13.33 for GRNN. In ecological monthly models, higher ANC coverage was associated with lower PMR, whereas higher hypertension burden was associated with higher PMR.</p><p><strong>Conclusion: </strong>Perinatal mortality declined over the long term but remained unstable. Among the evaluated models, ARIMA showed the best out-of-sample accuracy, while GRNN was the strongest neural-network comparator. Forecasts should be interpreted as operational projections rather than causal predictions.What is already known on this topic?Perinatal mortality remains high in many low- and middle-income countries, and stillbirths plus early neonatal deaths continue to contribute substantially to under-5 mortality in Ghana ( 1- 6).What this study addsThis study provides a 16-year monthly hospital time series, compares classical time-series forecasting with three neural-network approaches, and demonstrates that better ANC coverage and lower hypertension burden track with lower monthly PMR in this setting.How this study might affect research, practice, or policyMonthly PMR surveillance may help maternity hospitals monitor service quality, and ARIMA-based operational forecasting may assist planning for high-risk periods while service-improvement efforts focus on ANC utilization and maternal complication control.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1849802"},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586284","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":"Prevalence of bacteriospermia and its association with semen parameters among men attending a fertility clinic in Kumasi, Ghana.","authors":"Evans Anokye Kumi, Victor Boachie Owusu, Ebenezer Kojo Addae, Peter Nyarko Coffie, Eric Darko, Rex Kwadwo Mawuli Djokoto, Kweku Bedu-Addo, John Asiedu Larbi","doi":"10.3389/frph.2026.1853404","DOIUrl":"10.3389/frph.2026.1853404","url":null,"abstract":"<p><strong>Background: </strong>Male infertility is a growing reproductive health concern in Ghana, contributing significantly to the burden of infertility among couples. Bacteriospermia, the presence of bacteria in semen, has been implicated in male infertility through its potential adverse effects on sperm quality; however, its association with semen parameters remains inconsistent across studies. This study aimed to determine the prevalence of bacteriospermia and examine its association with semen parameters among males attending a fertility clinic in Kumasi, Ghana.</p><p><strong>Materials and methods: </strong>Semen samples from 226 males attending a fertility hospital in Kumasi were collected and evaluated according to WHO guidelines. Additionally, samples were cultured for bacteria using standard bacterial culture techniques.</p><p><strong>Results: </strong>The prevalence of bacteriospermia was 46.5%, with <i>Escherichia coli</i> (41.9%), <i>Klebsiella</i> spp. (25.7%), <i>Staphylococcus</i>spp. (24.8%), <i>Streptococcus</i> spp. (2.9%), and <i>Bacillus</i> spp. (1.9%) identified. Abnormal semen parameters were observed in 47.6% of participants, predominantly teratozoospermia. No significant association was found between bacteriospermia and semen parameters (<i>p</i> > 0.05), though semen volume approached significance as a predictor of bacteriospermia (<i>p</i> = 0.057), with hypospermia associated with significantly lower odds of bacteriospermia (aOR = 0.558; <i>p</i> = 0.047) and hyperspermia showing no significant association (aOR = 0.961; <i>p</i> = 0.160).</p><p><strong>Conclusions: </strong>A high prevalence of bacteriospermia (46.5%) and abnormal semen parameters (47.6%, predominantly teratozoospermia) were observed among men seeking fertility evaluation, with <i>E. coli</i> as the most frequently isolated organism. No significant association was found between bacteriospermia and semen parameters, though hypospermia was associated with significantly lower odds of bacteriospermia. Routine screening and further research incorporating molecular techniques and larger cohorts are recommended.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1853404"},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586273","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":"Gonadotropin therapy in idiopathic hypogonadal non-obstructive azoospermia (APHRODITE Groups 3-4): a multicenter randomized controlled trial.","authors":"Vipin Chandra, Sandro C Esteves, Shashank Sanagoudar","doi":"10.3389/frph.2026.1867412","DOIUrl":"10.3389/frph.2026.1867412","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic non-obstructive azoospermia (NOA) is a severe form of male infertility with limited non-surgical treatment options. Microdissection testicular sperm extraction (micro-TESE) remains the standard approach for sperm retrieval, yet success rates vary substantially, and many patients undergo surgery without successful sperm recovery. Hormonal optimization using human chorionic gonadotropin (hCG) with or without follicle-stimulating hormone (FSH) has been proposed to improve spermatogenesis in hypogonadal men, but evidence from randomized controlled trials is lacking. This multicenter trial evaluates whether gonadotropin-based hormonal optimization improves sperm availability for intracytoplasmic sperm injection (ICSI) compared with standard-of-care (SOC) management in men with idiopathic NOA and biochemical hypogonadism.</p><p><strong>Methods and analysis: </strong>This multicenter, randomized, controlled, parallel-group superiority trial will allocate participants 1:1 to hormonal therapy or SOC. Eligible participants are men with idiopathic NOA, total testosterone <350 ng/dL on two fasting morning tests, and FSH ≥7.6 IU/L, consistent with APHRODITE Groups 3-4. Key exclusion criteria include cryptorchidism, prior chemotherapy or radiotherapy, defined genetic NOA (e.g., AZFa/complete AZFb deletions), prior micro-TESE, recent hormonal therapy use, uncontrolled endocrine disease, severe liver disease, polycythemia, active malignancy, inability to comply with the study procedures, and clinically significant varicocele. Participants assigned to the intervention arm will receive gonadotropin-based hormonal optimization using hCG and recombinant FSH, with hormonal monitoring and hCG dose titration throughout treatment. The control arm will receive standard management without hormonal therapy. The primary endpoint is a composite treatment-policy outcome defined as sperm availability suitable for ICSI at any time from randomization through Week 16, either through ejaculated sperm or through micro-TESE. Secondary outcomes include micro-TESE sperm retrieval success rate, need for surgery, embryologic outcomes, reproductive outcomes, and treatment safety. The study is designed as a pragmatic comparative effectiveness trial that intends to evaluate whether biologically informed hormonal optimization improves clinically meaningful sperm availability under routine clinical practice conditions.</p><p><strong>Ethics and dissemination: </strong>The study was approved by Institution Ethics Committee (IIVF-UA00l 00).</p><p><strong>Clinical trial registration: </strong>(https://clinicaltrials.gov/study/NCT07540611), identifier NCT07540611.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1867412"},"PeriodicalIF":3.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581332","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}