Human reproduction open最新文献

{"title":"Fertility preservation in women with benign gynaecological conditions.","authors":"Pietro Santulli,&nbsp;Christophe Blockeel,&nbsp;Mathilde Bourdon,&nbsp;Giovanni Coticchio,&nbsp;Alison Campbell,&nbsp;Michel De Vos,&nbsp;Kirsten Tryde Macklon,&nbsp;Anja Pinborg,&nbsp;Juan A Garcia-Velasco","doi":"10.1093/hropen/hoad012","DOIUrl":"https://doi.org/10.1093/hropen/hoad012","url":null,"abstract":"<p><p>Although a wealth of data has been published regarding fertility preservation (FP) in women with malignant diseases who receive gonadotoxic treatment, the role of FP in non-malignant conditions has been studied to a much lesser extent. These include benign haematological, autoimmune, and genetic disorders, as well as a multitude of benign gynaecological conditions (BGCs) that may compromise ovarian reserve and/or reproductive potential due to pathogenic mechanisms or as a result of medical or surgical treatments. Alongside accumulating data that document the reproductive potential of cryopreserved oocytes and ovarian tissue, there is potential interest in FP for women with BGCs at risk of infertility; however, there are currently insufficient data about FP in women with BGCs to develop guidelines for clinical practice. The purpose of this article is to appraise the available evidence regarding FP for BGC and discuss potential strategies for FP based on estimated ovarian impairment and on short-term and long-term reproductive goals of patients. Cost-effectiveness considerations and patients' perspectives will also be discussed.</p>","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 2","pages":"hoad012"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/f0/hoad012.PMC10130191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9392982","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 thicker the endometrium, the better the neonatal outcomes?","authors":"Jing Wu,&nbsp;Jianlei Huang,&nbsp;Jie Dong,&nbsp;Xifeng Xiao,&nbsp;Mao Li,&nbsp;Xiaohong Wang","doi":"10.1093/hropen/hoad028","DOIUrl":"https://doi.org/10.1093/hropen/hoad028","url":null,"abstract":"<p><strong>Study question: </strong>Is endometrial thickness (EMT) on the hCG trigger day related to the neonatal outcome of a single birth after fresh embryo transfer (ET)?</p><p><strong>Summary answer: </strong>An EMT ≤7.8 mm was an independent predictor for greater odds of preterm delivery (PTD) of singletons born after fresh ET.</p><p><strong>What is known already: </strong>There may be a positive association between live birth rates and EMT after fresh ET. It is still unknown whether a similar association is seen for the neonatal outcomes of singletons in fresh cycles.</p><p><strong>Study design size duration: </strong>This retrospective study involved singleton live births in women undergoing autologous IVF cycles during the period from 1 October 2016 to 31 July 2021.</p><p><strong>Participants/materials setting methods: </strong>A total of 2010 women who fulfilled the inclusion criteria were included. A multivariable regression analysis was performed to detect the relationship between EMT and neonatal outcomes after controlling for potential confounders. Smooth curve fitting and threshold effect analysis were used to evaluate the accurate cutoff value of EMT.</p><p><strong>Main results and the role of chance: </strong>The results of the multivariate regression analyses showed that the odds of PTD were reduced by 45% with an EMT of 9.00-9.90 mm (adjusted odds ratio (OR): 0.55, 95% CI: 0.13 to 0.98; <i>P</i> = 0.0451), reduced by 58% with an EMT of 10.00-10.90 mm (adjusted OR: 0.42, 95% CI: 0.06 to 0.87; <i>P</i> = 0.0211) and reduced by 75% with an EMT >11 mm (adjusted OR: 0.25, 95% CI: 0.04 to 0.66; <i>P</i> = 0.0034), compared to the group with an EMT of 6.00-8.90 mm. It could also be seen from the adjusted smooth curves that the odds of PTD decreased and gestational age (GA) increased with increasing EMT. Combined with the analysis of threshold effects, the results indicated that when the EMT was ≤7.6 mm, the incidence of PTD decreased as the EMT gradually increased (adjusted OR: 0.47, 95% CI: 0.03 to 0.99; <i>P</i> = 0.0107), and when the EMT was ≤7.8 mm, the GA increased (adjusted β: 1.94, 95% CI: 1.26 to 2.63; <i>P</i> < 0.0001) as the EMT gradually increased.</p><p><strong>Limitations reasons for caution: </strong>The main limitation of our study is its retrospective design. Although we found a significant decrease in PTD as the EMT increased, in terms of GA, the magnitude of the differences was modest, which may limit the clinical relevance of the findings.</p><p><strong>Wider implications of the findings: </strong>Our data provide new insight into the relationship between EMT and neonatal outcomes by indicating that a thin endometrium of ≤7.8 mm is associated with an increased odds of PTD of singletons after fresh ET.</p><p><strong>Study funding/competing interests: </strong>This study was supported by the National Natural Science Foundation of China (grant no. 82071717). There are no conflicts of interest.</p>","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad028"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10363027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9867592","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":"A blended preconception lifestyle programme for couples undergoing IVF: lessons learned from a multicentre randomised controlled trial","authors":"Tessy Boedt, Eline Dancet, Diane De Neubourg, Sofie Vereeck, Jan Seghers, Katleen Van der Gucht, Ben Van Calster, Carl Spiessens, Sharon Lie Fong, Christophe Matthys","doi":"10.1093/hropen/hoad036","DOIUrl":"https://doi.org/10.1093/hropen/hoad036","url":null,"abstract":"Abstract STUDY QUESTION What is the effect of a blended preconception lifestyle programme on reproductive and lifestyle outcomes of couples going through their first 12 months of IVF as compared to an attention control condition? SUMMARY ANSWER This randomized controlled trial (RCT) was stopped prematurely because of the coronavirus disease 2019 (Covid-19) pandemic but the available data did not suggest that a blended preconception lifestyle programme could meaningfully affect time to ongoing pregnancy or other reproductive and lifestyle outcomes. WHAT IS KNOWN ALREADY Increasing evidence shows associations between a healthy lifestyle and IVF success rates. Lifestyle programmes provided through a mobile phone application have yet to be evaluated by RCTs in couples undergoing IVF. STUDY DESIGN, SIZE, DURATION A multicentre RCT (1:1) was carried out. The RCT started in January 2019 and was prematurely stopped because of the Covid-19 pandemic, leading to a reduced sample size (211 couples initiating IVF) and change in primary outcome (cumulative ongoing pregnancy to time to ongoing pregnancy). PARTICIPANTS/MATERIALS, SETTING, METHODS Heterosexual couples initiating IVF in five fertility clinics were randomized between an attention control arm and an intervention arm for 12 months. The attention control arm received treatment information by mobile phone in addition to standard care. The intervention arm received the blended preconception lifestyle (PreLiFe)-programme in addition to standard care. The PreLiFe-programme included a mobile application, offering tailored advice and skills training on diet, physical activity and mindfulness, in combination with motivational interviewing over the telephone. The primary outcome was ‘time to ongoing pregnancy’. Secondary reproductive outcomes included the Core Outcome Measures for Infertility Trials and IVF discontinuation. Changes in the following secondary lifestyle outcomes over 3 and 6 months were studied in both partners: diet quality, fruit intake, vegetable intake, total moderate to vigorous physical activity, sedentary behaviour, emotional distress, quality of life, BMI, and waist circumference. Finally, in the intervention arm, acceptability of the programme was evaluated and actual use of the mobile application part of the programme was tracked. Analysis was according to intention to treat. MAIN RESULTS AND THE ROLE OF CHANCE A total of 211 couples were randomized (105 control arm, 106 intervention arm). The hazard ratio of the intervention for time to ongoing pregnancy was 0.94 (95% CI 0.63 to 1.4). Little to no effect on other reproductive or lifestyle outcomes was identified. Although acceptability of the programme was good (6/10), considerable proportions of men (38%) and 9% of women did not actively use all the modules of the mobile application (diet, physical activity, or mindfulness). LIMITATIONS, REASONS FOR CAUTION The findings of this RCT should be considered exploratory, as the Covid-19 p","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135839299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of iron in the pathogenesis of endometriosis: a systematic review.","authors":"James Wyatt,&nbsp;Sean M Fernando,&nbsp;Simon George Powell,&nbsp;Christopher J Hill,&nbsp;Ilyas Arshad,&nbsp;Chris Probert,&nbsp;Shakil Ahmed,&nbsp;Dharani K Hapangama","doi":"10.1093/hropen/hoad033","DOIUrl":"https://doi.org/10.1093/hropen/hoad033","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;What is the role of iron in the pathophysiology of endometriosis?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Iron excess is demonstrated wherever endometriotic tissues are found and is associated with oxidative stress, an inflammatory micro-environment, and cell damage; the iron-mediated oxidative stress is independently linked to subfertility, symptom severity, and malignant transformation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;Iron is found in excess in endometriotic tissues, and multiple mechanisms have been studied and posited to explain this. It is clear that iron excess plays a vital role in promoting oxidative stress and cell damage. The evidence base is large, but no comprehensive reviews exist to summarize our understanding and highlight the overarching themes to further our understanding and suggest future directions of study for the field.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;This systematic review with a thematic analysis retrieved studies from the PubMed, Embase, Web of Science, and Cochrane Library databases and searches were conducted from inception through to August 2022. Human and animal studies published in the English language were included and identified using a combination of exploded MeSH terms ('Iron' and 'Endometriosis') and free-text search terms ('Iron', 'Ferric', 'Ferrous', 'Endometriosis', 'Endometrioma').&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;This review was reported in accordance with the PRISMA guidelines. All studies reporting original data concerning the role of iron or iron complexes in the pathophysiology of endometriosis were included. Studies that did not report original data or provided a review of the field were excluded. Bias analysis was completed for each included study by using the Newcastle-Ottawa scoring system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;There were 776 records identified and these were screened down to 53 studies which met the eligibility criteria, including 6 animal and 47 human studies, with 3556 individual participants. Iron excess is demonstrated in various tissues and fluids, including ovarian endometriomas, ovarian follicles, ectopic endometriotic lesions, and peritoneal fluid. Markers of oxidative stress are strongly associated with high iron levels, and aberrant expression of iron-transport proteins has been demonstrated. Abnormal resistance to ferroptosis is likely. Iron-mediated oxidative stress is responsible for a pro-inflammatory micro-environment and is linked to subfertility, symptom severity, and, possibly, malignant transformation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations reasons for caution: &lt;/strong&gt;A minority of the included studies were of objectively low quality with a high risk of bias and may lead to misleading conclusions. Additionally, multiple studies failed to appropriately characterize the included patients by known confounding variables, such as menstrual cycle phase, which ma","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad033"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10483386","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":"Reply to: Anti-anonymity should not be taken more seriously than other positions on gamete donation.","authors":"Daniel Groll","doi":"10.1093/hropen/hoac060","DOIUrl":"https://doi.org/10.1093/hropen/hoac060","url":null,"abstract":"","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 1","pages":"hoac060"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/b3/hoac060.PMC9838311.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9100288","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":"Caution is needed when communicating analyses based on an apple to orange comparison.","authors":"Birgit Alsbjerg,&nbsp;Peter Humaidan","doi":"10.1093/hropen/hoad016","DOIUrl":"https://doi.org/10.1093/hropen/hoad016","url":null,"abstract":"It was with great interest that we read ‘The effect of frozen embryo transfer regimen on the association between serum progesterone and live birth: a multi-centre prospective cohort study (ProFET)’ by Melo et al. (2022). From their data, the authors concluded that overall serum progesterone levels (P4) &lt;7.8 ng/ml are associated with reduced odds of live birth in frozen embryo transfer (FET). Interestingly, the authors previously published a meta-analysis (Melo et al., 2021) based on several cohort studies of HRT-FET cycles using vaginal progesterone for luteal phase support and reporting a higher P4 cut-off &lt;10 ng/ml for the reproductive outcome. Thus, in that analysis, higher serum P4 levels were associated with increased ongoing pregnancy or live birth rates (LBRs). An important question to ask in relation to the newest publication by Melo et al. (2022) would be: is this suggested new cut-off of serum P4 of 7.8 ng/ml more accurate than 10 ng/ml, and is this cut-off applicable to all FET protocols? Reading the publication carefully reveals that the present study was powered to 900 FET cycles; however, only a total of 398 cycles were included in the final analysis. Furthermore, the cohort of FET protocols was very heterogeneous, including HRT-FET, true natural cycle (t-NC), and modified natural cycle (m-NC), in which ovulation is induced with a trigger bolus of hCG. In this context, we have to bear in mind that the FET protocols mentioned are very different in terms of basic endocrinology, first and foremost when considering serum P4. Thus, the natural cycle has a circadian luteal phase progesterone pattern due to the endogenous production of progesterone from the corpus luteum and importantly, in the new Melo et al. (2022) study, a huge variation in the type of ‘NC FET’ protocols was allowed. Thus, different hCG-trigger doses (5000 vs 6500 IE) were used which will definitely have an impact on circulating luteal P4; moreover, in some cycles, no hCG trigger (t-NC) was used and some cycles had vaginal progesterone support whereas others did not. Finally, different dosing and types of vaginal micronized progesterone were used (CyclogestR , UtrogestanR ). Altogether, within a cohort of 45 ‘NC FET’, there might have been as many as nine different combinations; importantly, these differences will invariably result in significant differences in luteal P4 profiles. Furthermore, in the cohort of HRT-FET cycles, we also learn that important differences were allowed in terms of different vaginal micronized progesterone products, differences in dosing regimen and differences in no use or use of a combination of subcutaneous (s.c.) progesterone (LubionR ), 25 mg once daily or twice daily. For monitoring, the authors state that blood sampling was performed 4–6 h after the last administration of exogenous progesterone. Again, the reader might ask, what does ‘approximately’ mean? One hour, two hours—or more? Timing of luteal phase blood sampling is crucial, espe","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad016"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/9c/hoad016.PMC10234700.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9570237","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":"ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma<sup />.","authors":"Alexandros Rodolakis,&nbsp;Giovanni Scambia,&nbsp;François Planchamp,&nbsp;Maribel Acien,&nbsp;Attilio Di Spiezio Sardo,&nbsp;Martin Farrugia,&nbsp;Michael Grynberg,&nbsp;Maja Pakiz,&nbsp;Kitty Pavlakis,&nbsp;Nathalie Vermeulen,&nbsp;Gianfranco Zannoni,&nbsp;Ignacio Zapardiel,&nbsp;Kirsten Louise Tryde Macklon","doi":"10.1093/hropen/hoac057","DOIUrl":"https://doi.org/10.1093/hropen/hoac057","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;How should fertility-sparing treatment of patients with endometrial carcinoma be performed?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Forty-eight recommendations were formulated on fertility-sparing treatment of patients with endometrial carcinoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;The standard surgical treatment of endometrial carcinoma consisting of total hysterectomy with bilateral salpingo-oophorectomy drastically affects the quality of life of patients and creates a challenge for clinicians. Recent evidence-based guidelines of the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy & Oncology (ESTRO) and the European Society of Pathology (ESP) provide comprehensive guidelines on all relevant issues of diagnosis and treatment in endometrial carcinoma in a multidisciplinary setting. While addressing also work-up for fertility preservation treatments and the management and follow-up for fertility preservation, it was considered relevant to further extend the guidance on fertility-sparing treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;A collaboration was set up between the ESGO, the European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE), aiming to develop clinically relevant and evidence-based guidelines focusing on key aspects of fertility-sparing treatment in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;ESGO/ESHRE/ESGE nominated an international multidisciplinary development group consisting of practising clinicians and researchers who have demonstrated leadership and expertise in the care and research of endometrial carcinoma (11 experts across Europe). To ensure that the guidelines are evidence-based, the literature published since 2016, identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgement was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 95 independent international practitioners in cancer care delivery and patient representatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;The multidisciplinary development group formulated 48 recommendations in four sections; patient selection, tumour clinicopathological characteristics, treatment and special issues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations reasons for caution: &lt;/strong&gt;Of the 48 recommendations, none could be based on level I evidence and only 16 could be based on level II evidence, implicating that 66% of the recommendations are supported only by observational data, professional experience and consensus of the development group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Wider implication","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 1","pages":"hoac057"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10681673","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":"Spermatogenesis after gonadotoxic childhood treatment: follow-up of 12 patients.","authors":"E Delgouffe,&nbsp;A Braye,&nbsp;V Vloeberghs,&nbsp;I Mateizel,&nbsp;C Ernst,&nbsp;A Ferster,&nbsp;C Devalck,&nbsp;H Tournaye,&nbsp;I Gies,&nbsp;E Goossens","doi":"10.1093/hropen/hoad029","DOIUrl":"https://doi.org/10.1093/hropen/hoad029","url":null,"abstract":"<p><strong>Study question: </strong>What is the long-term impact of presumed gonadotoxic treatment during childhood on the patient's testicular function at adulthood?</p><p><strong>Summary answer: </strong>Although most patients showed low testicular volumes and some degree of reproductive hormone disruption 12.3 (2.3-21.0) years after gonadotoxic childhood therapy, active spermatogenesis was demonstrated in the semen sample of 8 out of the 12 patients.</p><p><strong>What is known already: </strong>In recent decades, experimental testicular tissue banking programmes have been set up to safeguard the future fertility of young boys requiring chemo- and/or radiotherapy with significant gonadotoxicity. Although the risk of azoospermia following such therapies is estimated to be high, only limited long-term data are available on the reproductive potential at adulthood.</p><p><strong>Study design size duration: </strong>This single-centre prospective cohort study was conducted between September 2020 and February 2023 and involved 12 adult patients.</p><p><strong>Participants/materials setting methods: </strong>This study was carried out in a tertiary care centre and included 12 young adults (18.1-28.3 years old) who had been offered testicular tissue banking prior to gonadotoxic treatment during childhood. All patients had a consultation and physical examination with a fertility specialist, a scrotal ultrasound to measure the testicular volumes and evaluate the testicular parenchyma, a blood test for assessment of reproductive hormones, and a semen analysis.</p><p><strong>Main results and the role of chance: </strong>Testicular tissue was banked prior to the gonadotoxic treatment for 10 out of the 12 included patients. Testicular volumes were low for 9 patients, and 10 patients showed some degree of reproductive hormone disruption. Remarkably, ongoing spermatogenesis was demonstrated in 8 patients at a median 12.3 (range 2.3-21.0) years post-treatment.</p><p><strong>Limitations reasons for caution: </strong>This study had a limited sample size, making additional research with a larger study population necessary to verify these preliminary findings.</p><p><strong>Wider implications of the findings: </strong>These findings highlight the need for multicentric research with a larger study population to establish universal inclusion criteria for immature testicular tissue banking.</p><p><strong>Study funding/competing interests: </strong>This study was conducted with financial support from the Research Programme of the Research Foundation-Flanders (G010918N), Kom Op Tegen Kanker, and Scientific Fund Willy Gepts (WFWG19-03). The authors declare no competing interests.</p><p><strong>Trial registration number: </strong>NCT04202094; https://clinicaltrials.gov/ct2/show/NCT04202094?id=NCT04202094&draw=2&rank=1 This study was registered on 6 December 2019, and the first patient was enrolled on 8 September 2020.</p>","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 3","pages":"hoad029"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/14/hoad029.PMC10403430.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9955864","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 impact of small and asymptomatic intramural and subserosal fibroids on female fertility: a case-control study.","authors":"Valentina Bonanni,&nbsp;Marco Reschini,&nbsp;Irene La Vecchia,&nbsp;Marta Castiglioni,&nbsp;Ludovico Muzii,&nbsp;Paolo Vercellini,&nbsp;Edgardo Somigliana","doi":"10.1093/hropen/hoac056","DOIUrl":"https://doi.org/10.1093/hropen/hoac056","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;Do small and asymptomatic intramural and subserosal uterine fibroids affect female fertility?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;Small and asymptomatic fibroids that do not encroach the endometrial cavity appear to not markedly affect female fertility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;The available evidence on uterine fibroids and fertility is limited. Most information has been obtained in IVF settings by comparing the success in women affected and not affected by fibroids. These studies have shown a detrimental effect of submucosal and possibly intramural fibroids. However, this study design provides information only on embryo implantation, not on female fertility in general.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design size duration: &lt;/strong&gt;A retrospective observational case-control study on 200 women whose partner was diagnosed with severe male infertility and 200 women with unexplained infertility was conducted. If the null hypothesis (that fibroids do not affect fertility) is valid, one would expect a similar prevalence of fibroids in the two study groups. Conversely, if fibroids do impact fertility, one would expect a higher prevalence among women with unexplained infertility. The study was carried out at the Infertility Unit of the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico covering a 5-year period between January 2014 and June 2020.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials setting methods: &lt;/strong&gt;We retrospectively recruited women seeking pregnancy whose partner was repeatedly documented to have a sperm concentration below 1 million/ml and matched them by age and study period to a group of women with unexplained infertility. The latter group of women was considered as a case group (infertile subjects), while the former group of women was considered as a control group (reflecting the general female population). Women with fibroids could be included in both study groups; only those with submucosal lesions were excluded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;Fibroids were diagnosed in 31 women (16%) with unexplained infertility and in 32 women (16%) with severe male factor infertility. The adjusted odds ratio of carrying fibroids in women with unexplained infertility was 0.91 (95% CI: 0.52-1.58). Subgroup analyses according to number, dimension and location of fibroids failed to highlight an increased risk of infertility in any group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations reasons for caution: &lt;/strong&gt;This is a retrospective study and some inaccuracies in fibroids detection cannot be ruled out. Moreover, the relatively small sample size hampers robust subgroup analyses. Even though we excluded women with patent causes of infertility, some women with specific causes of infertility could have been included among controls (yet are expected to account for &lt;10% of the group).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Wider implications of the findings: &lt;/strong&gt;This study suggests that small fibroids that do not en","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 1","pages":"hoac056"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/a9/hoac056.PMC9782921.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10800657","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":"Stimulating fertility awareness: the importance of getting the language right.","authors":"H Mertes,&nbsp;J Harper,&nbsp;J Boivin,&nbsp;M Ekstrand Ragnar,&nbsp;B Grace,&nbsp;M Moura-Ramos,&nbsp;S Rautakallio-Hokkanen,&nbsp;M Simopoulou,&nbsp;K Hammarberg,&nbsp;On Behalf Of The International Reproductive Health Education Collaboration Irhec","doi":"10.1093/hropen/hoad009","DOIUrl":"https://doi.org/10.1093/hropen/hoad009","url":null,"abstract":"<p><p>While education about fertility is not intrinsically controversial, finding the right language to communicate the topic can be challenging, as there are several risks of unintended negative effects such as dissonance, anxiety, culpability, and stigma due to social norming. In this article, we share some of our learnings from promoting fertility awareness in the hope that they will inspire further debate and research on this topic. Starting from the ethical principles of respect for reproductive autonomy, avoiding harm (in terms of stigma or anxiety) and inclusivity, we have formulated five recommendations: (i) frame fertility awareness messages with (reproductive) autonomy in mind and aim to be inclusive of those who do not represent the traditional nuclear family; (ii) be empathetic and steer clear of blame; (iii) avoid scaremongering and offer a positive angle; (iv) give due consideration to both women and men in fertility health messaging; and (v) tailor the messages to particular contexts and audiences and develop resources in close collaboration with the target groups.</p>","PeriodicalId":73264,"journal":{"name":"Human reproduction open","volume":"2023 2","pages":"hoad009"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/b7/hoad009.PMC10112336.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442196","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}